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HomeMy WebLinkAbout01-7115COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS JUDICIAL DISTRICT NOTICE OF APPEAL FROM DISTRICT JUSTICE JUDGMENT HOTICE OF APPEAL Notice is given that the appellant has filed in the above Court of Common Pleas an appeal from the judgment rendered by the District Justice on ~the dote and in the case mentioned below. Clifford A. Kieders, Esquire 161 West Third Street Williamspor t PA 17703 11/28/01 Alternatives in Health Care Mgmt. v~sClifford A. Rieders, Esquire CL~JM NQ This block will be signed ONLY when this notation is required underl~'~ R.CPJ.P. 1008B. This Notice of Appeal, when received by the District Justice, will operate as a SUPERSEDEAS fo the ]udgmont for possession in this case CV 19 0000594-01 -~ LTl9 If appellant was CLAIMANT (see Pa. R.C.P.`J.P. No. 1001 ( 6 ) in action before District ,Justice, he MUST Signature of Proth~3o~ar¥ or Deputy FILE A COMPLAINT within twenty (20) days after filing his NOTICE of APPEAL. PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE ('This section of form to be used ONLY when appellant was DEFENDANT (see Pa. R.C.P.J.P. No. 1001(7) in action before District Justice. IF NOT USED, detach from copy of notice of appeal to be sen/ed upon appellee). PRAECIPE: To Prothonotary Alternatives in Health Care Mgmt. Enter rule upon , appellee(s), to file a complaint in this appeal Nan~ of appellee(s) (Common Pleas No. ~J-- ~/~ C,~..31~ L"7--'~-~ within twenty (20)days after serv~e of rule .rJUdg133e~t of nor1 ~. ~// "~ S~ of appellant or his attorney or agent Alternatives in Health Care Mgmt. RULE: To , appellee(s). Ne/ne of appellee(s) (1) You am notified that a rule is hereby entered upon you to fil~ a complaint in this appeal within twenty (20) days after the date of service of this rule upon you by personal sen, ice or by,..certified ~ reg~ '.te~l n~iL (2) If you do not file a complaint within this time, a juDGMENT~OF 'NON PROS WILL BE ENTERED AGAINST YOU. (3) The d~e of .~rvk:e of this rule if s~'vice was by mai~ is the d~ of~rrmiling. COURT FILE TO BE FILED WITH PROTHONOTARY PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT (This proof of service MUSTBE FILED WITHIN TEN (10) DA YS AFTER filing the notice o~PPeal.: Check applicable boxes) COMMONWEALTH OF PENNSYLVANIA COUNTY OF ; ss AFFIDAVIT: ~ hereby sWear 0r affirm'that tserved ~' ,~ ~ [] a copy of the Notice of Appeal, common P. ieas No , upon the District Justice designated therein on (date of service) , i9 [] by personal service [] by (certified) (registered) mail, sender's receipt attached hereto, and upOn the'appellee, (h~m~)i ~' ' ~ <~'~' ~ ~'' CI~ , on ,19 [] bypersonal service ?1 by (certified) (registered)~mail, sender's receipt attached hereto. [] andfurtherthatlservedb~.RuletoFileaCom31aintaccompanyingtheaboveNoticeofAppea upontheappellee(s)towhom the Rule was addressed on mail, sender'~ receipt attached heretO. SWORN (AFFIRMED) AND SUBSCRIBED BEFORE ME THIS DAY OF. ,19 19 . [] by personal service [] by (certified) (registered) Signature of~Rffiant Signature of official before whom affidavit was made Title of official My commission expires on* COMMONWEALTH OF PENNSYLVANIA COUNTY OF: CUMB~]~T,A.ND Mag, Dist. NO.: 09-1-01 Od Name: Horn CHARLES &. CT.I~'N'~, ,J-'E.. '~: 1106 CARL'rSLE ROAD CA~P H'rLL, P~ Telephone: (717) 761-4940 17011 ATTORI~ DEF PRIVATE : ROD~g LEE KN/~r., ESO 161 ~. THIRD ST P.O.BOX 215 ~LLIAMSPORT, PA 17703-0215 CIVIL CASE P~INTIFF: N~E and ADDRESS FALTERNATIVES IN R~LTH CARE MGMT 301 MARKET STtLEET REBECCA J. CHICK NOTICE OF JUDGMENT/TRANSCRIPT ~EW ~u~BEELAND, PA 17070 VS. DEFENDANT: NAME and ADDRESS URIEDE~S, ESQ, CLIFFOP, D 161 WEST THIRD ST RIEDERS AND ABSOCIATES ~fILLI~,,~SPORT, PA 17703 Docket No.: CV-0000594-01 Date Filed: 10/05/01 J THIS IS TO NOTIFY YOU THAT: Judgment: ~-~ Judgment was entered for: (Name) ~ Judgment was entered against: (Name) ~T~'~3;;R.q: in the amount of $ 4: ~RR _ 1313 on: [-~ Defendants are jointly and severally liable. ['-~ Damages will be assessed on: [~ This case dismissed without prejudice. ~ Amount of Judgment Subject to Attachment/Act 5 of 1996 $ ~ Levy is stayed for days or ~'l generally stayed. I~ Objection to levy has been filed and hearing will be held: AT.qrl;~'f4'Aq~T'v"~.q T~' 'IT~AT.qlT-T ~'~.A'R"R M(3 RR~_. ~T,T*IaFO~D (Date of Judgment) (Date & Time) Amount of Judgment $ 4,187.00 Judgment Costs $ 101.00 Interest on Judgment $ o 00 Attorney Fees $ .0O Total $ 4,288.00 Post Judgment Credits Post Judgment Costs Certified Judgment Total Date: Time: Place: ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE ENTRY OF JUDGMENT BY FILING A NOTICE OF APPEAL WITH THE PROTHONOTARY/CLERK OF THE COURT OF COMMON PLEAS, CIVIL DIVISION. YOU ~[~L2~L~,~_] Date . ~.C,,~/u' · , District Justice I atrue judgment.I I certify that this isDate and correct copy of the record of the proceedings cont.a, ining the. D,strict JusticeI My commission expires first Monday of January, AOPC 315-99 2002 SEAL PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT ~ This proof of service MUST BE FILED WITHIN TEN (10) DA YS AFTER filing the notice of- acPeal. CheCk'applicabt~3~x~]~ COMMONWEALTH OF PENNSYLVAI~IA "' ~*"~ COUNTY OF //~"~/~/~0 ~'/~ ~. : ss AFFIDAVIT: ~ hereby swear or affirm'that I served ;" [~ a copy of the Not ce of Appea Common Pleas No ~'/ ~'~ upon the Dmtrlct Justice'desmnateo therein on /date of serv ce) /' Z / z ;' ~ ? o"/ [~] by personal service ~..by (~egistered) mail, sender s receipt~attact~ed hereto', and upon the appellee, (name) ~/'~- ~'~ -u~..~'¢ /,~ ..~'~k~;'''~'~-,~ ,-' '~'~"/~ ~ ""zLe~ , on / Z iJ~ '~ ~ , ~,~",¢ [-~ b~ personal service [~y~eg~stered) mail. s~nder'.s receipt attach, ed ~ereto. .~ and further that I served the Rule to File a Complaint accompanying the above Notice of Appeal upon t he~_a_~ .~,_(s) lowborn the Rule was addressed on ! 7_ ~ ~' ,~'/ [] by personal service [~~(registered) ma;. sender's receipt attached hereto. SWORN [AFF_JLI~IMED) AND SU.B. SCRIBED ~EFORE ME ~f a fluent ru Certified Fee Return Receipt Fee ..D (Endorsement Required) Restricted Delivery Fee Total Postage & Fees (EndorSement Required) 1 '";:.:i..!x.:.,/ ALTERNATIVES IN HEALTH CARE MGMT, Plaintiff(s) RIEDERS, CLIFFORD, Defendant(s) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION - LAW NO. 01-7115 CIVIL TERM JUDGE: JURY TRIAL DEMANDED CERTIFICATE OF SERVICE AND NOW comes Rodney Lee Knier, Esq., Attorney for Plaintiff, and certifies that a copy of the foregoing Notice of Appeal and Praecipe for Rule to File Complaint has, this .~ 7 ~ day of~, 2001, been served by Certified Mail, postage pre-paid, upon: District Court 09-1-01 Honorable Charles A. Clement, Jr., 1106 Carlisle Road Camp Hill, PA 17011 Alternatives in Health Care Mgmt. 301 Market Street New Cumberland, PA 17070 RIEDERS, TRAVIS, HUMPHREY, HARRIS, WATERS & WAFFENSCHMIDT I.D. No. 84497 161 West Third Street Williamsport, PA 17703 (570) 323-8711 ALTERNATIVES IN HEALTH CARE MANAGEMENT, INC., PLAINTIFF CLIFFORD RIEDERS, Esq., DEFENDANT IN THE COURT OF COMMON PLEAS OF THE CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION-LAW NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defense or objections to the claims set forth against you. You are warned that if you fail to do So, the case may proceed without you and judgment may be entered against you by the court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 717/249-3166 800/990-9108 ALTERNATIVES IN HEALTH CARE MANAGEMENT, INC., PLAINTIFF V. CLIFFORD RIEDERS, Esq., DEFENDANT IN THE COURT OF COMMON PLEAS OF THE CUMBERLAND COUNTY, PENNSYLVANIA NO: CIVIL ACTION-LAW COMPLAINT TO THE HONORABLE, THE JUDGES OF THE SAID COURT: AND NOW COMES, Alternatives in Health Care Management, Inc., Plaintiff, by and through its attorney, Gregory Barton Abeln, Esquire, who avers as follows: 1. Plaintiffis Alternatives in Health Care Management, Inc. ("Alternatives"), Rebecca J. Chick, R.N., President, PO Box 397, New Cumberland, Cumberland County, Pennsylvania 17070. 2. Defendant is Clifford Rieders, Esquire ("Rieders"), of Rieders, Travis, Humphrey, Harris, Watters & Waffenschmidt, 161 W. Third Street, Williamsport, Pennsylvania 17701. 3. On May 28, 1999, Clifford Rieders, Esquire, signed a fee agreement with Alternatives to have them perform professional services, provide expert reports and submit a Life Care Plan relative to Rieders' client, Ms. Ellen Thurston. Attachment A. 4. Between May 27, 1999 and June 15, 1999, said professional services were provided by Alternatives. 5. Despite numerous attempts to collect fees for Alternatives' professional services, Defendant Rieders has failed to pay the June 15, 1999 invoice amount of $4,187.00. Attachment B. 6. On November 28, 2001, District Justice Charles Clement awarded a default judgment to the Plaintiff in the amount of $4,288.00, including costs. 7. On December 15, 2001, Defendant filed a Notice of Appeal and Praecipe for Rule to File Complaint. WHEREFORE, Plaintiff demands judgment against the Defendant for damages in the amount of $4, 288.00, together with costs of suit, interest and all such additional relief as the Court may deem appropriate. Respectfully submitted, ABELN LAW OFFICES Gregory Barton Abeln, Esquire Attorney for Plaintiff 37 E. Pomfret Street Carlisle, PA 17013 717/245-2851 TeEO. Box 9. C~mp.H~ill, PA 17001.0(~09 iepnone 717) 901-03~ F~ (717) 901-9304 htr: I I v. tw~.ahhcm, cc~rn FEE AGI~ -"-~' ME,NT Referral Source Information: Rc: C. Wal,mun Auomev's N~e: ~, Oiffo~ Riu~. Business F~: (570) 3~4192 Ty~ of Busings: ~ _ ~dividu~, ~pfictors~Ap ~omtion 'rF, I:EvE,i AND CONDITIONS: A retainer i,i th-' amount of F~,~O0.O0 will be f0rwurd~d to Ahcmativcs in Health Care Managcm~a~. Inc., and at:company thc medical records or arnve prior m th~ cliem evaluar~un. Professional time will be billet at a ram of $125.00 tmr hour :md $36 per mile. Final invoice will ~a;ompany ~h¢ report and is payable wit&in 15 business days. If t'~l:mc¢ is unpa'd ~ 90 days from dine ct' invoice, a $15 lam fee per month will b~ ineurrad. ARar 180 days. the ac, count will go into d~fault (See below), File will he updated by ~clcphono interview just prior to tcv, imony il' it l~ax been more t.'~mu six months since ~omplction of thc r~. £xpert Wimess Proux:ols am uutlincd .'~ a. mched and will be strictly adhered to. R~'crral Sourca agrees m pay :md a.s.~umos full responsibility for payment of all billing rclu,-d to the 'shove captiou~ file. If referral source d~faults in p~ymcnt of any amount dtm under this agraement, Al£etuadves in ligalih Cam Managgmant, Inc. shall he entifie, d m tm:over c~un ¢osu, ru.a.sonable agom~y's foes ',md c~ar~ costs -'.,id all~ey's fees oa up1',e, al, if any..~,..~my agdon to gorget the: amount du~ from mt'~n-al source, R~£erral $oun:e agrc~ that venue would I:m proper and appropriate in Cumlx:rl'.,nd County. Pennsylvania. 2 RefeR:ti Source Acceptance: The undersigned acknowlcd~e.~ t~.az h 'd.~he has read t~,,' ~:r/hereby ag'mc~ to lac bouncl by it.~ t~nn~ Thc undersigne, d, I'unt~- rcprcscnt.~ that duly atlthndT.$d to e-t¢ctltc thL~ agre,~e~l! on behazff of the Rcfcrral Nalll¢ of Attomcy/~ferral Some:. Please si~.n and i'e~z~ to: Rebecca }'. Chick. RN, MPA. CCM, CI.NC Altemar,/vca in Health C..at¢ Manage. mcnt. Inc. P.O. Box 9 Camp Hill. PR. 17001-0009 Dec-26-01 12:]7P Alternatives 7179019304 P.02 -- PLEASE REMIT TO: -- ALTERNATIVES IN HEALTH CARE MANAGEMENT, INC. P.O. Box 9 Camp Hill, PA 1700%0009 (717) 901-0366 TAX I{~/25-1676933 Clifford Rleders, Esquire Rieders, Travis, Humphery, Harris, Waters & Waffenschmtdt 161 West Third Street Wflliamsport, PA 17703 #8116 Date: June 15, 1999 Client: Ellen Thurston Re: C. Walt,man Thurston Our File No.: 1077 Coordinator: Rebecca Chick 5/27/99 5/28/99 5/28/99 5/28/99 5/28/99 5/28/99 6/2/99 6/2/99 6/3/99 613/99 614199 6/6/9~ 6/6/99 6/7/99 6/7/99 6/7/99 617199 6/7/99 6/7/99 6/8/99 618/99 6/9/99 6/9/99 6/10/99 6/10/99 6/10/99 6/12/99 6/12/99 6/13/99 6/14/99 6/14/99 Invoice and Itemization of Services R~ndered -File review and set up -Telephone call to Attorney Rleders -Telephone call to Attorney Rleders -Telephone call to Attorney Rleders -Fax to Attorney Pdeders -File review -Telephone call to Attorney Rieders -File review -Telephone call to Attorney Rleders -File collation and write reports -Teleconference -Fax to Attorney R/eders -Report dictation -Telephone call to Dr. Voogt -Telephone call to Dr. Voogt -Telephone call to client -Fax to Dr. Voaght -Fax to Attorney Rieders -Proof prior to fax -Visit client's home -Travel -Telephone call to Attorney Rleders -Telephone call to Dr. Voagt -Telephone call to Dr. Burke -Telephone call to Dr. Burke -Telephone call to Dr. Dahl -Telephone call to Attorney Rleders -Write report -Review add expert reports -Write report -Telephone call to Attorney Rieders -Fax report draft to Attorney Rieders 6,00 0.10 0.10 0.30 0.10 1.00 0.30 1.00 0.30 5.00 0.60 0,10 1.50 0.20 0.20 0.30 0,10 0.10 0.S0 1.50 7.50 0.30 0.50 O.lO 0.40 0.40 0.30 5.00 1 .O0 3.30 0.30 0.60 750.00 12.50 12.50 37.50 12.50 125.00 37.50 125.00 37.50 625.00 75.00 12.50 187.50 25.00 25.00 37,50 12.50 12.50 62.50 187.50 487.50 37.50 62.50 12.50 50.00 50.OO 37,50 625.00 125.00 412,50 37.50 75,0O Dec-26-o1 12:18P Alternatives 7179019304 P.03 PLEASE REMIT TO: B ALTERNATIVES IN HliALTH CARE MANAGEMENT, INC. FO.~x9 CampHiU, PA17~I-0009 (71~ Ellen Thurston June 15. 1999 Page 2 6/8/99 6/t5/99 Invoice and Itemization of Services l~ndered For professional services rendered Additional charges -Mileage {450) Total additional charges Total time and expense charges -Retainer received - thank you Balance due Payment Due Upon Receipt Hours 39.00 /~4,¢25.00 162.00 $162.00 $4,567.00 { oo.oo) S4,x87.oo 12/28/2001 I2:49 ?I72459622 ABELN LAN OFFICES PAGE 89 VERIFICATION I v~i~ tha~ O~e ~tatements made in the foregoing document are true and correc~ to the best of my knowledge, information and belief. I understand that false statements are made ~ubject to the penalties of 18 Pa.C.S.A. §4904, relating to Unswom Falsific, ation~ to Authorities, R~be~a $. Chi~k, R.N. ALTERNATIVES IN HEALTH CARE MANAGEMENT, INC., PLAINTIFF CLIFFORD RIEDERS, Esq., DEFENDANT IN THE COURT OF COMMON PLEAS OF THE CUMBERLAND COUNTY, PENNSYLVANIA NO: CIVIL ACTION-LAW CERTIFICATE OF SERVICE I hereby certify that I have this day served the foregoing COMPLAINT by mailing a true and exact copy addressed to the following: Rodney Lee Knier, Esquire PO Box 215 Williamsport, PA 17703-0215 Date /',,~ Respectfully submitted, ABELN LAW OFFICES Legal Assistant 37 East Pomfret Street Carlisle, PA 17013-3313 717/245-2851 ALTERNATIVES IN HEALTH CARE MGMT, Plaintiff(s) RIEDERS, CLIFFORD, Defendant(s) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION - LAW NO. 2001-7115 NOTICE TO PLEAD YOU ARE HEREBY NOTIFIED to file a written response to the enclosed New Matter within twenty (20) days or a judgment may be entered against you. RIEDERS, TRAVIS, HUMPHREY, HARRIS, WATERS & WAFFENSCHMIDT I.D.# 84497 161 West Third Street Williarnsport, PA 17701 (570) 323-8711 ALTERNATIVES IN HEALTH CARE MANAGEMENT, INC. Plaintiff CLIFFORD RIEDERS, ESQ. Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION - LAW iNO. 2001-7115 ANSWER / NEW MATTER / COUNTERCLAIM COMES NOW, Clifford A. Rieders, Esquire (hereinafter Rieders), by and through his attorney, Rodney Lee Knier, Esquire, of Rieders, Travis, Humphrey, Harris, Waters & Waffenschmidt, and answers the Complaint of Plaintiff Alternatives in Health Care Management, Inc. (hereinafter Alternatives) as follows: 1. Admitted that Alternatives is the listed Plaintiff. 2. Admitted that Rieders is the listed Defendant. 3. Admitted. 4. After reasonable investigation Plaintiff is without knowledge sufficient to form an opinion as to the truth of the averment that Alternatives actually performed any services in regard to this matter on any specific dates and accordingly the averment is denied. 5. Admitted that there has been communication regarding this disputed debt, specifically denied that said communication/s constitute numerous attempts. Admitted that Defendant chose not to litigate this matter before the Magistrates Court and permitted the entry of a Default Judgment in that Court. Admitted that pursuant to the Pennsylvania Rules Defendant appeals de-novo to the Court of Common Pleas of Cumberland County. NEW MATTER 8. At that time of contracting for services Alternatives, through their agent Rebecca Chick, was advised that the matter was pending in Federal Court and that the report was due to the Court on June 15, 1999, which would require its being shipped from Rieders' office on, or before June 14, 1999. Copies of two letters from Rieders' office to Ms. Chick attached as Exhibit "A." 9. At that time of contracting for services Alternatives, through their agent Rebecca Chick, was advised that time was of the essence. See Exhibit "A." 10. At that time of contracting for services Alternatives, through their agent Rebecca Chick, was advised of the requirement that Rieders had to have the Report and Life Care Plan sufficiently prior to the due date to permit Rieders and his staff to fully check and proofread the Report and Life Care Plan for errors, omissions and improper materials; to discuss any needed changes to the report with Ms. Chick and to permit Ms. Chick time to make any needed corrections and/or changes and then to prepare and provide a final Report and Life Care Plan. See Exhibit "A." 11. At the time of contracting with Alternatives for the preparation of a Report and Life Care Plan Rieders paid Alternatives a retainer of $400.00. See Agreement and invoice, both attached to Plaintiffs Complaint. 12. A faxed draft copy of Ms. Chick's Report and Life Care Plan was not received in Rieder's office until approximately 3:00 p.m. on June 14, 1999. Draft copy of Report and Life Care Plan attached as Exhibit "B." 13. The Report and Life Care Plan faxed at 3:00 p.m. June 14, 1999, contained significant and material errors. 14. The Report and Life Care Plan faxed at 3:00 p.m. June 14, 1999, contained information and materials that were inappropriate and/or immaterial and/or irrelevant and which had to be removed from the Report and Life Care Plan before it could be filed with the Court. 15. The Report and Life Care Plan as provided on the afternoon of June 14, 1999, was unusable to Rieders due to its significant and material errors and the inclusion of inappropriate and/or improper materials. 16. Rieders and his staff proofed and reviewed the faxed Report and Life Care Plan and, at approximately 3:45 p.m., Rieders attempted to contact Ms. Chick with the required corrections and changes to the Report and Life Care Plan. 17. Ms. Chick was not in her office at the time and Rieders discussed the needed changes with Ms. Chick's secretary. 18. The requirement to proofread and fully review the Report and Life Care Plan is exactly the reason Ms. Chick was notified that time was of the essence and that the Report and Life Care Plan had to be provided to Rieders early enough before the due date to permit the proofreading and full review of the Report and Life Care Plan and to permit Ms. Chick to make any needed corrections, additions and/or deletions to the Report and Life Care Plan. 19. A corrected Report and Life Care Plan, with a significant amount of material that Rieders had required to be removed still in the report and containing material errors in the Life Care Plan computations, was not faxed to Rieders until approximately 5:30 p.m. on June 14, 1997. 20. The necessities of filing had required that all expert reports be sent out by Federal Express overnight delivery at 5:00 p.m. 21. The corrected Report and Life Care Plan was not received until approximately 30 minutes after it had to be shipped to the Court. 22. The corrected Report and Life Care Plan was received far too late on the afternoon of June 14, 1999 to permit Rieders and his staffto proofread, copy and prepare the Report and Life Care Plan for filing. 23. The corrected Report and Life Care Plan was unusable to Rieders as it was provided too late to permit its filing with the court prior to the due date. 24. The Report and Life Care Plan was not used at the trial of this matter. 25. Defendant Rieders asserts that the failure of Alternatives to provide a usable Report and Life Care Plan within the Court mandated timelines constitutes a significant and material breach of the agreement by Alternatives. 26. Defendant Rieders asserts that Plaintiff is not entitled to any recovery or payment under the contract as the contracted for Report and Life Care Plan was not provided in a usable format until after the passing of the Federal Court mandated deadline. 27. Rieders further asserts that PlaintiWs breach mandates their return to him of the four hundred dollar ($400.00) retainer he has paid to Alternatives. COUNTERCLAIM 28. At the time of contracting for the preparation of the Expert Report and Life Care Plan Rieders paid Alternatives a retainer in the amount of four hundred dollars ($400.00). See agreement and invoice attached to Plaintiff's Complaint. 29. Alternatives failed to provide Rieders with a usable Report and Life Care Plan within the mandated time frame. 4 30. Alternatives knew of the strict time limitations at the time of contracting to perform these services and that time was of the essence. 31. The failure of Alternatives to provide the Report and Life Care Plan in a usable form within the mandated time frame constitutes a significant and material breach of the contract. WHEREFORE, Rieders demands judgment against Alternatives in the amount of four hundred dollars ($400.00) together with costs of suit, interest and all such additional relief as the Court may deem appropriate. RIEDERS, TRAVIS, HUMPHREY, HARRIS, WATERS & WAFFENSCHMIDT Attorney for Defendant I.D. No. 84497 161 West Third Street Williamsport, PA 17701 (570) 323-8711 Exhibit A (570) 323-4192 JEFFREY C. DOHRMANN GA~¥ T. I-IA~a$ JOHN M. HUt4PHP. m' CUFFO~D A. ~ED~ ~ Memb~ N.Y e D.C. Ba. RON~ C. T~S THO~ W~FENSC~IDT C. S~ WA~S A PARTNERSHIP 161 '~ESl TI-III~ $'rI~ET P.O. BOX 215 W[LLIAMSPORT, PENNSYLVANIA 17703-0215 (570) 323-8711 May 21, 1999 ~hh@mail.csrh~k.net Ros~ffr H. VESELY Also Memk-r Mai~ ~ Mu,. Ba,, VAnff~m G. Zu4 KlbtBEI~y A. PALTHM4US Rebecca J. Chick, MPA, RN, CCM, CLNC 301 Market Street New Cumberland, PA 17070 Re: Ellen Thurston Dear Rebecca: It was a pleasure speaking with you on the above date. We certainly appreciate you making yourself available on such short notice to review this matter and prepare a life care plan on behalf of Ellen Thurston. As discussed, I am enclosing a retainer in the amount of $400.00 along with the below listed items for your review. 1. A summary of medical events; 2. Medical records from Robert Packer Hospital for the date August 26, 1996 to December 11, 1996; 3. Medical records from Cortland Hospital; 4. Medical records of Dr. Burke, Ellen's current treating physician; 5. Medical records from Dr. Lee; 6. Medical records from Dr. Gauss; 7. Notes/Diary prepared by Ellen Thurston; 8. Video tape depicting a day in the life of Ellen Thurston; 9. Video taped interview of Ellen and Bud Fleming (Ellen's fiance'); 10. Deposition transcript of Ellen Thurston; 11. Medical Bill summary as provided through the insurance company; 12. Medial receipts for supplies; As indicated, all'expert reports are due by June 15, 1999. Upon reviewing this file, I would ask that you contact either Mr. Rieders or myself to arrange a convenient time for you to meet with Ms. Thurston. In the interim, should you have any questions or concerns, please do not hesitate to call. Rebecca J. Chick May 21, 1999 Page 2 Again, thank you for your time in this matter. Very truly yours, RIEDERS, TRAVIS, HUMPHREY HARRIS, ,~S &~SCHMIDT Pamela L. Hiqks, Paralegal to Clifford A. Rieders, Esquire CAPJplh PENDING: June 10, 1999 (570) 323-4192 JEFFRJEY C. DOHRMANN GARY T, HARRIS ~OHN M. HUMPHI~Y CLIFFORD A. ~DE~ M.~ N.Y. ~ D.~. B~ RO~ ~. ~S THO~ ~NS~I~ C. S~ WA~ A PARTNERSHIP 161 ~r'EST THIRD STREET P.O. Box 215 '~71LLIAiviSPORT. PENNSYLVANIA 17703-0215 (5'70) 323-8'711 June 3,1999 rtmhh@mail.csrh~k.net ROBERT H. VESI~,¥ Aho iViem{n~ lvi,.h~e 6' Ms,,,. B~,, VALI~PJE G. Zmi KIbIBE P, Ly A. PAULHAMUS VIA FAX (717) 901-9304 and FIRST CLASS MAIL Rebecca Chick, MPA, RN, CCM, CLNC 301 Market Street New Cumberland, PA 17070 Re: Thumton Dear Rebecca: We have been trying to reach you, because our expert report is due no later than June 15, 1999. Since we are in federal court, judges do not easily grant extensions and there will not be an extension, granted here. Obviously, we would want to be able to review whatever you put in writing, or ideally, speak to you ahead of time. When you call the office, have me interrupted. If you would rather use the 800 number, it is 1-800-326-9259. You may feel free to call me at home. My home phone number is (570) 326-7180. CAR/]ss It is very urgent that we get to speak. I thank you in advance. Exhibit B Jun-14-g9 02:53P Alternatives 717 901 9304 P.O1 FAl~ 717-901.~1366 Pax 717-901-9304 TOTAL NUMBI~R. OF PAOF. S INCLUDING COV]~ S]4~*- F: Obn-14-g9 02:54P Alternatives 717 901 9304 P.02 L~ HEALT'rI C. ARE MANAG]~.tENT, ~C. l~b~cc~ I. ~ ~, 3~A, CCM, CLNC Tel - P.O. Box_9., C~mp Hill, PA 17001-0009 epnone (717) 901 .-4~366'. Fax (717) 901-9304 ht'tp://www.althCm.com LIFE CARE PLAN FOR ELLEN THURSTON Prepared by Rebecca J. Chick, CLNC June 14, 1999 ~n-14-99 02:54P Al[e~na%~ve$ 717 901 9304 P.03 Introduction Medical Records Reviewed Table of Contents Medical Summary 2 Past Medical History Social History Chief Complaints Activities Current Medical Care Medication and Supplies Recommendations M~ical Care Home Management I~)urable Medical Equipment Medications Wound Managcmcnt llome Care Diagnostic Studies C~e Management Multiple Hospitalizations Personal Care and Companion Cate Comments Regarding the Interview Conclusion Bibliography 4 5 6 7 g 8 8 8 9 9 9 9 9 9 9 10 10 1! Summary of Costs Life Care Plan Appendix Appendix J~n-14-99 02:S4P Alt;rnativ~s 717 901 9304 P.04 NAME: DATE OF BIRTH: DATE OF EVENT: DATE OF EVALUATION: DATE OF REPORT: Ellen Thurston 4-24-46 8-26-96 6-8-99 6-14-99 INTRODUCTION Ellen Thurston is a 53-year-old woman rcf,~rred by Attorney Clifford Rieders for a rehabilitation evaluation. '['he purpose of this referral is to assess the extent to which Ms. Thurston has incurred handicapping conditions ~condary to an August 26. 1996, incident and onset of di~bility. We will explore the specific manner in which this situation evolved and to what extent the sequelae of the incident impedes her ability to demonstrate independent living skills. In addition to an interview in the home of Ms. Thurston on June 8, 1999, extensive medical records have been reviewed. The purpose of the evaluation is to determine Ms. Thurston's lifelong needs as they relate to her injuries and secondary disability. This report will outline her history, her current status, and propose her lifetime ne. ads and their associated costs ill thc attached Life Care Plan. The basis for recommendations outlined in this report are the pertinent medical records, thc interview with the patient, re,arch into the current medical care, and the education and experience of this medical consultant. Ms. Thurston was born April 24, 1946. She has just turned 53 years of age. She is a white t~,ma, le..B~.~ed on the. 1990 Life .T~ables she has a life expectancy of 29 years, or until age 82 years. ~ ne Vital Statistics of the United 5tares, 1990 Life Tables, is a government document designed to provide life expectancy information. It is ba~sed on averages (i.e. deaths by all cauls), and addresses life expectancies based on gender, age, and race. MEDICAL RECORDS REVIEWED Robert Packer Hospital Courtland Care Center Courtland Memorial Hospital Robert Packer ltospital Michael J. Oeorgetson, admission for PEG tube insertion, Guthrie Clinic Counland Memorial Hospital Robert Packer Hospital Courtland Memorial HosT~ital Crouse Hospital 8-26-96 to 12-2-96 12-2-96 to 12-4-96 12-14-96 to 12-17-96 12-14-96 to 12-17-96 3-17-97 4-6-97 to 4- I i-97 4.-12-97 to 5-2-97 5-2-97 to 5-6-97 6-30-97 to 7-4-97 6-13-98 to 6-16-98 J~n-14-99 02:54P Alternatives 717 901 9304 P.05 Thurston, Ellen William A. Burke, M.D., office notes William A. Burke, M.D., report P. Gauss, M.D., office notes P. Gauss, M.D., report Letter from H. Woon Lee Letter from Lawrence H. Repsher, M.D. Report from James Bass, Jr., M.D. Depositions 6-16-97 to 9-15-98 2-17-94 to 1-20-98 8-8-96 5-6-99 Ellen Thurston Paul Fiemming Robert J. Lennox Michael W. Chisdak Tammy S. Schrick Lisa C. Jordan 2-25-99 2-25-99 1-19-99 1-26-99 4-28-99 12-21-98 MEDICAL SUMMARY On August 20, 1996, Ms. Thurston presented to Pulmonary Medicine Clinic because of an abnormal chest x-ray. She was Men by Robert J. Lennox, M.D., who recommended a surgical approach to the small nodule in the left lower lobe of her lung. He also recommended pulmonary function studies and blood work. Ms, Thurston was seen by Dr. Robert Quigley that same day. He recommended and scheduled admission for a bronchoscopy and left lower Iobecu~my. Ms. Thurston was admitted to the Robert Packer Hospital on August 26, 1996, by Robert Quigley, M.D. On August 27, 1996, Dr. Quigley performed a bronchoscopy and left lower lobectomy under general anesthesia. The specimen (nodule) was removed and sent to thc lab. Dr. Quigley's operative notes indicate he dissected multiple adhesions of the left lower chest area and wall and noted .several air leaks in the upper lobe, which were oversewn. The lower lobe was removed, a chest tube was inserted, thc ribs were closed, lung reinflation was accomplished, and the skin was closed. Post-operatively, Ms. Thurston began complaining of severe abdominal pain. A CT scan on August 31, 1996, showed plcural effusion and ateleetasis post reinsertion of the chest tube. I Ier chest tube was draining large amounts of dark coffee-ground-colored drainage. She was returned to ICU on September 1, 1996, and hyporalimentation wa.s started and a central line wa.s surgically plaeod by Dr. Quigley. On September 4, 1996, another CT scan showed collection of gas and/or fluid in the left chest area. A portable chest x-ray on September 5, 1996, showed continued large plcural effusion on thc left. J~n-14-99 02:54P Altarnativas 717 90! 9304 P.06 Thurston, Ellen 3 Finally on September 6, 1996. Felice Rcitknecht, M.D., performed an exploratory thoracotomy with dcbridement of the left pleural cavity and repair of a diaphragmatic hernia. She called in Dr. Carlton to perform an explor'atory laparotomy with debridement and repair of stoanach, which had necrosed and pcrforuted into the plcurai cavity. The wound was thoroughly irrigated and debrided. Because of the massive infection, the wound was left open and packed with Kerlix dipped in normal saline. The endotracbeal tube was rcplaced with a tracheal tube and Dr. Carlton, General Surgeon, inserted a gastrostomy tube prior to completion of his surgery. Tube feedings werc started. Ms. Thurston was transferred to the recovery room and placed on a ventilator because of breathing difficulties. On September 9, 1996, Ms. Thurston was extubated but, due to difficulty, she was reintubated on September 10, 1996, ix)st pneumonia. Ms. Thurston began having problems with atrial fibrillation and was treated with digitalis and magnesium sulfate; however, her temperature continucd to remain elevated. Infectious Disease was consulted for assistance. Blood transfusions were given and regular dressing changes continued. A mucous plug was discovered by Pulmonary on September 19. 1996. This again compromised her breathing, leading to hypoxia, and the plug was removed. Multiple attempts were made to wean Ms. Thurston from the ventilator; however, there w~s difficulty in doing so partly due to a pneumothorax on thc left. A tracheotomy was inserted on September 25, 1996, and the thoracotomy wound was examined under anesthesia. Air leaks were sutured and stapled on thc left upper lobe. On September 27 1996, an angiogram was performed to a~sess the blood supply to her chest in anticipation of a flap to aid in closure of the chest wound. By September 30, 1996, Ms. Thurston was again taken to surgery for evaluation of her left chest under anesthesia. Two air leaks were tbund, and a purulent cxudate found on the remaining portion of her lung. A pneumonectomy was then performed with a pectoralis flap for coverage of thc left hilum. Ms. Thurston progressed with treatment and on October 5, 1996, her trach¢otomy was capped. She was also initiated on a regular diet plus tube feedings, and on October 11, 1996, she was returned to ICU with a diagnosis of aspiration pneumonia. This caused her to require intubation fo, r.b,reathing difficu, lties. She again progressed and was ultimately weaned from thc tracheotomy, wmcn was removed on Octobcr 28, 1996. Again on October 31, 1996, Ms. Thurston wa.~ felt to have aspirated, which again led to pneumonia. She returned to ICU and required mechanical ventilation for hypoxia. She gradually stabilized and started to improve, and she was weaned from the ventilator. Ms. Thurston continued to have p~riodic probleras with expiration. However, with the aid of numerous broad- spectrum antibiotics she stabilized, and on November 5, 1996, her antibiotics were stopped and her by-mouth diet was advanced. Occupational therapy and physical therapy wcrc aggressively pursued and a swallowing evaluation was performed, Dressing changes continued regularly with wound packing inu.~ the open cavity. Occupational therapy worked on her lef~ shoulder with attempts to increa.~e the range of motion due to lo.~ of t~nclion. Ms. Thurston was discharged from the Robert Packer Hospital on December 2, 1996. with an open cavity requiring skilled nursing care. She was transferred ~o the Courtland Care Center and from then discharged t...o hem? on, ,E .)e~.'....'...m. bet..4, 19..96. She wa~ then admitted to th,e Courtland Memorial Hospital-on l..w. ccmoer ~,~, lyre, w~tn a diagnosis of bronchitis or pncurnoma. She was treated there and immediately transferred to the Robert Packer Hospital for follow-up care. At Jbn-14-99 02:$~P Alternatives 717 go1 9304 P.07 Thurston, Ellen Robert Packer she was found to have an infbction of her intcrnal jugular vein catheter, which was changed and she was discharged on the following medications: Atarax 25 rog. Reglan 10 rog. Estrace 0.5 rog, ~overa 2.5 rog. Myco~tatin 2% Tylenol 650 lng, Restoril 15 rog. daily daily daily by mouth daily as needed local application by mouth every four hours a.s needed by mouth every four hours as needed She was discharged from thc Robert Packer Hospi~d on December 17, 1996, and remained at home until March 17, 1997, when she wa.~ seen at the Rolx:rt Packer Hospital Guthrie Clinic for PEG tube insertion due to weight loss and anorexia. She was di~harged from there on March 18, 1997, in satisfactory condition. She was again admitted to Courtland Memorial Hospital on April 6, 1997, discharged on April I 1, 1997, and transferred to Robert Packer Hospital for a continued elevated temperamrc of 100 degrees. By April 21, 1997. Ms. Thurston had developed pucumonia again requiring care. A thoroccnte.~is completed on April 29, 1997, was performed due to continued elevated temperature. A Heparin drip was initiated for t~ar of puhnonary embolism. The right pleural effusion and atelecta.sis were treated with Rocephin and Gcntomycin. Her wound was clean and she was ultimately transferred to Robe~ Packer Hospital on May 2, 1997, under the care of Dr. Reitknecht. She stopped antibiotics and cultured the wounds, and the cultures were negative. The x-rays were clear, so she was di~harged home in stable condition on May 6 1997 .Accor..~in.g~t_o_the records from Mr. Reidcrs' office, Ms. Thurston was readmittcd to June 3u, 1 ~J'l, to July 4. [ 997; however, I do not have benefit of those records. F.romxmy rev_iew, tof~;[e,se records, i~appcars that m~tiiple errors occugred in tt~c treatn~erlt of Ms. lnurs~n. ?n//num¢.l~s_occasig'hs Ms. Thurston "~s hypoxic~hich rc~ulred cmerltencv measutgts, l,~grcc wit~[;~r. Rel/sber that Dm. Lenno~kand C,R~dak failed '~ reco~niz~l~l.~. Thurst.on~. suffering fr~ e4pyema of uncertain caus .'~q~lChii ~ld have-b~n thr~o_u, gh re~ng the nurses nol~ ~v'hich thoroughly explai[ltt~e unusual left cbe.~'t~j;~rainage and througfi ~q~amination of thgtc'h~st x-rays or repons. ~ rcle-~less complaints orbit'n, her high tcmpe.ratjtre, th~ color of hectchcstNlrainage, and th~leural ef~ion shown hyp~c~should alii{nyc be. enNalues that r~g,,(xploration of fi~l~ chest are~hould PAST MEDICAL HISTORY Ms. Thurstoll was a customer service manager for Wal Mart in her town in New York. She had history of a cough, which started approximately one month prior to her .seeking medical carc. She noted productive purulent sputum ass.ociated with some blood-streaked sputum. Sh w her doctor, who ~,tcd her wi* antibiotics and ordered a chest x-my. Thc cbe.~t x-rea~ nodule in thc left lower lobe. She saw Dr. Quig]ey for a second opinion about the removal of the lesion. She was suffering from some dyspnea upon climbing steps. She w[~ sleeping on two pillows; however, there w~q no allkJc edoma. M.~. Thurston suffered from chronic urticaria and was taking thc following medications prior ~o her admission to thc hospital on Ausmst 26, 1996: J~n-14-99 02:5~P Altarnativas 717 901 9304 P.08 Thurston, Ellen 5 Cladtin 30 mg. per day Cyrin :2.5 m§. daily Estrace 0.5 rog. daily Hydmxyzinc 25 rog. two tablets three times a day She claimed to be allergic to Ceclor, which had caused welts, and aspirin, which has caused hives. She al~ has food allergies and avoick~ products such as ~',ffood, acidic foods, spices, nut.~, and potatoes. at ~34.-~i/~,,~lw~. There were six children in all, five of whom arc living and well. One sister died at age 5 of rheumatic fever. SOCIAL HISTORY Ms. Thurston is the mother of one 30-year-old son, who lives in thc Counland, NY, area. Shc also has several nieces and nephews with whom she enJOyS spending time. I~'~Pfmm'~mmm-is div ' ' ' . Paul Flemming is Ellen Thurston's fianc6. They met over 2.5 years ago and have maintained a relationship ever since. They reside together in a medium-sized, well-kept home where Ellen used to enjoy doing all the yard work. housekeeping, and cooking. Presently Ms. Thurston, because of her disability, can barely complete the laundry, do light housekeeping, and minimal meal preparation. She is totally unable to do any yard work and must rely upon hired help or Mr. Flemm/ng to complete the~ chores. Ms. Thurston is mostly confined to thc hott~ because she must rely upon visiting nurses to oack her chest wound and apply her dressings on a daily basis. She is at the beck and call of [l~eir schedule. Ms. Thurston is unable to eat prior to the nurses' visit, because when they remove the packing from and repack the chest cavity it cauls her to gag and cough, sometimes causing her to vomit. This reaction to the dressing change prevents her from taking breakfast until after the nur~s' visits. Food preparation is an activity she used to cnjoy that is now limited not only due to her lack of endurance and the left shoulder stiffness, but because of the difficulty with her short-term memoi'y. Safety is an issue whcn it comes to operating thc stove, because many times the stovc is forgotten due to the short-term memory loss. CHIEF COMPLAINTS In view of Ms. Thurston's serious and debilitating ~)st-operative problems, it is only because of her determination and persistence that she is living independently at all She is fearful of be,n alone when Mr. Flemming is out et' town, and in lieu .-~ '-:--: ....... ' . 7 ! g sister, who lives in the Courtland area. ,,, ,,.,.~ a companmn, she stays with ncr Lifting is a major problem for Ms. Thurston. because it pulls against the opening in her ches! cavity and hurts her shoul .der. She accomplishes small tasks such as bringing the laundry ba.~ket o.u.t of the b.escman, t by res~ng, at frequent !ntervals unti) she regains her strength and breath and is ~reIZt~ continue. AS yOU can imagine, stalls arc very difficult to negotiate due to her shortness of ~n-14-99 02:55P Alternatives 717 90! 9304 P.09 Thurston, ]Ellen Memory problems have plagued Ms. Thurston since her discharge from the hospital Followin di.scharge ~he began keeping a written log of events in an effort to keen tr~,-t- ~,¢ ~.~..~,~..~-. · g. otlaer issues, r ......... ,-,,,, ,,.,arco aha Bathing presents a problem because of the need to kccp water out of the chc,~t cavity. Thus, bathing must be limited to thc tub with a.ssistancc and very careful management of the open wound arcs. She is unable to lift the left arm high enough to use both hands for hair washing slid care. Sleeping for Ms. Thurston is literally a nightmare. She must always be watchful not to sleep on her right side, as fluid from the affected left side can drain through the opening in thc stump of her left lung into the right (good) lung and cause aspiration pneumonia. This has happened on numerous occasions and is one of Ms. Thurston's gr~ate~st fears. She then is required to sleep on her painful open wound by lying on her left side. or must sleep with her head elevated at a 30- degree angle on her back to prevent aspiration. When Ms. Thurston is walking outside thc home she uses a cane duc to her feeling of imbalance, especially on uneven ground. This imbalance is attributable to the brain damage caused by the hypoxia, a.s is her memory loss and inability to orchestrate her dally aspects of living. She ~s not safe to function indenendentlv ..... ~. . . . ~ --..,, ,,,- ,a =a~ .uny ~onger capanle of managing her own arrmrs. /nese are prc~nuy oemg managed by her fiance, Mr. Flemmmg. Lifting: Walking: Standing: Sitting: Climbing: Balancing: Stooping: Kneeling: Crawling: Crouching: Reaching: Handling: ACTIVITIES Obviously thc client's strength in her upper body is compromised primarily on the left side. Restricted duc to imbalance and shortness of breath. Restricted duc to endurance and shortness of breath. No major restrictions. Totally restricted due to sho~ncs.~ of breath. Difficulty with balaa~ce because of the traumatic brain injury. Restricted duc to balance problems and shortness of breath. Restricted, again due to balance problems. Able to crawl for short distances. Sits in a crouch position due to poor postur~ as.c, ociated with her chest wound. Thc client's right arm is unrestricted; however, thc left arm is restricted duc to the shoulder immobilization. She enjoys crafts and crocheting. J~n-14-gg 02:55P Alternatives 717 901 9304 P.10 Thurston, Ellen Fingering: Feeling/Sensation: Talking: She enjoys crafts and crocheting. Upper extremity se, cms unaffected. Difficulty due to shortness of breath. Heating: Within normal limits. Smell/Taste/Vision: Within normal limits. Exposure to heat, cold, and weather: Noise Intensity: Vibration: Restrictions due to potential for frequent upper respiratory infections, which are a major threat to her life. Startles easily. No limitation noticed. Atmospheric Conditions: Sleeping: Stamina: Driving: Ms. Thurston hax reduced lung capacity and should not be in areas that may contribute to further dysfunction. This client states she is tearful of aspiration should she roll on the right side while sleeping. She is confined to 30-degree elevation on her back or sleeping on her left side. Ms. Thurston's stamina is low due to prolonged confinement to bed and inactivity, plus the dramatically decrea.~ed lung capacity, Shc would like to drive but is fearful of endangering other people because of short attention span and inability to problem solve. CURRENT MEDICAl. CARE Ms. Thurston is being followed by her family doctor, Paula Gauss, M.D., who moniwrs her lung infection and offers prompt care fi~r early treatment of sinus and lung infections. She has educated Ms. Thurston in self-monitoring of her care through daily body temperature monitoring, self: physical therapy and wound care management. Dr. Gauss r~ferrcd Ms. ThursWn w pulmonary assist ~ chest who is monitoring her from a of thc 2. Try is an attempt would which x dd J~n-14-gg 02:56P Alt~rnativos 717 901 g304 P-ll Thurston, Ellen 8 4' Th°r'~l' ' ern~nt o' eft ch~. il to The greatest decision faced by Ms. Thurston is whether she wants to undergo closure procedure' or remain in her pre~nt condition. MEDICATION AND SUPPLIES Ms. Thurstou takes Tylenol lli with Codcine, 300 mg., for pain as needed. She also uses Atarax, 2.5 rog., to be taken as needed for urticaria. Antibiotics, which she has available to take at the first sign of infection, are Augmentin, 500 rog., for sinus infection and Cipro. 500 rog., to self-start for temperatures 'dbovc 100 degrees. ' RECOMMENDATIONS Continue with her family &x:tor, Paula Gauss, M.D., to care for her ongoing medical concerns if needed, at least every three months. Quarterly visits to Dr. Burke, Thoracic Surgeon, for regular monitoring of the chest wound and bronchoplcura] fistula (open chest wound). Annual visits to an orthopedic surgeon after an initial evaluation for treatment of the painful frozen left shoulder. A neuropsychologieal evaluation. An initial evaluation with regular subsequent evaluations starting annually, then tapering to every five years. Speceh therapy is a Service that can be utilized to help Ms. Thurston with cognitive cueing and assist with increasing the rate of her cognitive, auditory, and motor processing. 1 would recommend speech therapy with an initial evaluation and monthly visits for six months, then annually for eight years. · Due to lifestyle changes being experienced by Ms. Thurston and her fiancd, I recommend a serics of counseling sessions especially aimed at helping Ms. Thurston and Mr. Flemming regain a part of their intimate rel.,a, tionship. It !s my opinion that they would benefit fron,~ some help regarding positioning and new techniques for Iovcmaking in view of' Ms. Thurston s chest wound limitations. I noticed Mr. Flemraing treats Ms. Thurston in a child-like fashion. They would benefit from help with communication and .,zlf-cstccm building. · Ms. Thurston would bcnefit from physical therapy to thc visit to her orthopedic surgeon, correct her frozen right shoulder pending · Life Skills Coach~Request an evaluation be performcd by Community Skills, an agency offering a plcthora of services pending the needs of the client. This would he requested in an effort to provide Ms. Thurston with techniques for making her everyday living safer and less stressful. · Biweekly house cleaning to help with heavier chores and regular lawn maintenance, including lawn care, snow removal services, and biannual cleanup. Durable Medical Eouit~mcnt- · Ms. Thurston ~il}' require a hand-held shower replacement every five years with grab bars for the tub replaced every ten years. · A cam: will be required and need to be replaced every three years, depending uIx)n use. · A raised toilet ~ to be replaced every five years. J~n-14-g9 02:56P Alttrnativos 717 901 9304 P.12 Thurston, Ellen 9 Me. dication~ Tylenol Ill with Codeine, 300 rog., pm Atarax, 25 rog., pm, for urticaria Antibiotics include Augmentin, 500 rog., for sinus infections and Cipro, 500 rog., for temperature over 100 degrees. * Daily visits from the VNA will be required fi)r her lifetime, pending her decision regarding the drastic and risky surgery options. This will also require purchase of appropriate supplies for wound care. · Surgical intervention to close the chest cavity: · The one with thc most likelihood of success is the resection of the left main bronchus via a midline sternotomy at Massachusetts General in Boston, MA. · The muscle flap placement over the bronchopleurai cavity. · The thoraeopla.sty with massive rearrangement of the leR chest wall. again at Mass General in Boston. ' Home Care,: Regardless of the surgical decision made by Ms. Thurston about her brenchopleural fistula, she &ms now and will continue throughout her life to require some type of supervised care. Due to the hypoxic damage caused to her frontal lobe, documented by neuropsychological testing, which is responsible for orchestrating her thoughc~, she will require some type of companion or supervised person',d care throughout her life. Multiple diagnostic studies will be required to sustain Ms. Thurston's health management. This will require multiple and regular x-rays of her shoulder mid chest, MRI smdles of the shoulder, and lab studies for pulmonary function and oxygen saturation. This service will assist Ms. Thurston in obtaining appropriate care throughout the remainder of her life. Should something happen to Mr. Flemming, her fian¢6, Ms. Thurston would be at a loss for management of her 'affaim. A case manager would obtain the services of a companion, assist in transfer to a personal care boarding home, and assist her in obtaining a bank offering fiduciary services to safeguard her resources. A cam manager would be available to guide Ms. Thurston with decisions and care throughout dm remainder of her life. Mulfinl¢ Hospitalizations: Considering the present status of Ms. Thurston, I expect she will require at least one hospitalization, perhaps two, per year for the remainder of her life. Because of the susceptibility for her to acquire aspiration pneumonia and develop infections in her pleural cavity, I will build in at l~ast one to two hospitalizations per year for Ms. Thurston for the remainder of her life. Personal Care and Comoanion Care; For approximately the next ten years, Ms. Thurston should be able to function aided by her fianc6 with approximately 48 hours per week of companion care, a.~ her fianc6 is out of town frequently. Ms. Thurston is fearful of staying alone, and should not be left alone due to safety factors uncovered by her neuropsychological testing. However, her fianc6 cannot be considered immortal, as he comes with his own ~t of bealth problems that will tend to escalate over the next ten yea~s.,. Th,erefo.r?. l.am pl.acin.,g Ms. T_h__urston under the 24-hour care of a companion or into a personat care ooarmng nome ~y m~ year 2009, as I do not feel Mr Flemming will be capable, nor should he be expected t.o continue in her Care beyond that date. I have offered Option I and Option 11 as two viable altemattves for Ms. Thurston's care into the future. J~n-14-gg 02:56P Alternatives 717 go1 g304 P.13 Thurston, Ellen I 0 COMMENTS REGARDING THE INTERVIEW Thc interview was held at Ms. Thurston's apartment, which she shares with her landlord and fianc6, Paul Flemming. The apartment was neat, clean, and ordcrly and had two bedrooms, one of which was obviously exclusively Ms. Thurston's. There wa.s a living room, dining room, kitchen, and bath, which she shares with her fianc6. The kitchen was recently remodeled by Mr. Flemming in an effort to make it more accessible for Ms, Thurston. The bathroom seemed adequate but would be more convenient with a raised potty ~'at and grab bars; a hand-held shower and grab bars would be beneficial. The interview was attended by Ellen Thurston, her fiancfi Mr. Flemming, and initially by Brenda Twomey, RN, the visiting nurse who changed thc packing and dressing during my visit. All persons were friendly and helpful. CONCLUSION Careful consideration has been given to all medical, psychological, and rehabilitation data contained within thc file and providcd in my report. There is no question Ms. Thurston is cxpericncing adju~tmcnt issues and also physical and cognitlvc conditions s~condary to hcr August 27, 1996, surgery. Thc~ conditions havc impaired her pre~nt and future life, all duc to hlatant systcmic ncglcct. Thc impact of thc damage caused by thc surgery has altered her physical, psychological, economic, and cognitive capabilities severely cnough to warrant thc nccd for my recommendations. Ms. Thurston will never regain thc ability to function independently. Realistically, there is going to come a time for Ms. Thurston when her fianc~ cat no longer b~ at her side. She dl require outside, round-the-c ock help in thc form of a companion or a personal care home. It is my opinion Ms. Thurston will require help through counseling and must soon face a major, potentially life-threatening decision 'about her options for surgical trcatmcnt of her bronchopleural fistula. All of the nccds dictated by the onset of this disability through life expectancy are outlined in the 'at '~hed Life Care Plan. Rcspccffully submitted, Rebecca J. Chick. RN, MPA, CCM, CLNC Rehabililation Consultant RJCffnjd JQn-14-g9 02:~7P Altarnativ~$ 717 901 9304 P.14 Thurston, Ellcn 11 BIBLIOGRAPHY Dorland's pocket Medical Dictionary. 24th Edition. W.B. Saundcrs Co. Philadelphia, PA. 1982. "Hiring Personal Attendants: Reducing the Risk." New Mobility. November 1996, page 45. Inside Life Care Planning_ A Bimonthly Newsletter for Life Care Planners and Case Manaecr.~. Volume 1, Number 3, Livoencott Manual of Nursin~ Practigg:. 6th edition. Lippcncott Raven Publishers. Philadelphia, PA. 1996. Neurorehabilitation Life Care Planning. October 1996. St. Thomas.G.uide. Ameri. can ,N. urses Association. Reprinted with Permission from Code Fgt' Nurses w~th Interp_ret~ve StatemenTs. American Nurses Association. Washington, D.C. 1995. J6n-14-gg 02:57P Alternatives 717 901 9304 P.15 NAME: LIFE EXPECTANCY: DAT..; OF BIRTH: D ATE OF EVENT: DATE PREPARED: PREPARED BY: Description Life Care Plan Summary of Costs Ellen Thurston 29 years (to age 82) 4-24-46 8-26-96 June 15, 1999 Rebecca J. Chick, R.N, MPA, CCM, CLNC Rehabilitation Consultant Medical Care Home Management (~pttion 1 ion II Durable Medical Equipment Option 1 Opt/on LI Medications Wound Management Diagnostics Case Management Hospitalizations Therapy Option 1: In-Home Companion Care Option 11: Personal Care Home Total Cost Total, Option ! Life with companion cam for 24 hour~ starring in 10 years Total, Option I1 10 years with a move to a Personal Care Home in 2009 $78,340.00 $87,413.20 $32,963.00 $907.65 $325.85 $24,053.76 $342,220.30 $20860.00 $22742.$0 $432912.00 $5 000.00 $1,000800.00 $517 92O.00 $2,015,249.41 $1,477,377.41 J~n-14-99 02:57P Altarnativas 717 901 9304 P.16 ~n-14-gg 02:S8P Altarnattvas 717 go1 g304 P.17 ~n-14-99 02:58P A~e~na[~ves 717 901 9304 P.18 J~n-14-g9 02:58P Alternatives 717 901 9304 P.19 z~ J~n-14-gg 02:58P Alternatives 717 901 9304 P.20 Jun-14-99 02=58P A]~rna~vm$ 717 901 9304 P.21 J~n-14-99 02:59P Alternatives 717 901 9304 P.Z3 ~un-14-99 02:59P A~ta~nat~ves 717 901 9304 P.22 r,~ J~n-14-99 02:59P Alternatives 717 901 9304 P.24 ALTERNATIVES IN HEALTH CARE MANAGEMENT, INC. Plaintiff CLIFFORD RIEDERS, ESQ. Defendant 1N THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION - LAW NO. 2001-7115 CERTIFICATE OF SERVICE AND NOW comes Rodney Lee Knier, Esq., Attomey for Defendant, and certifies that a copy of the foregoing Answer / New matter / Counterclaim has been served upon Gregory B. Ablen, Esq., 37 East Pomfret St.; Carlisle, PA 17013-3313, this~13~ day January, 2002, by first- class mail, postage pre-paid. RIEDERS, TRAVIS, HUMPHREY, HARRIS, WATERS & WAFFENSCHMIDT Attorney for Defendant I.D. No. 84497 161 West Third Street Williamsport, PA 17701 (570) 323-8711 ALTERNATIVES IN HEALTH CARE MANAGEMENT, INC., PLAINTIFF Vo CLIFFORD REIDERS, ESQ., DEFENDANT IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNA CIVIL ACTION - LAW NO. 2001-7115 PRAECIPE TO WITHDRAW TO: PROTHONOTARY Please mark the above captioned matter as settled and withdrawn with prejudice. Respectfully submitted, ~rregory Barton Abeln, Esquire Attorney for the Plaintiff 37 E. Pomfret Street Carlisle, PA 17013 717/245-2851 ALTERNATIVES IN HEALTH CARE MANAGEMENT, INC., PLAINTIFF CLIFFORD REIDERS, ESQ., DEFENDANT IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNA CIVIL ACTION - LAW NO. 2001-7115 CERTIFICATE OF SERVICE I hereby certify that I have this day served the foregoing PRAECIPE TO WITHDRAW by mailing a tree and exact copy addressed to the following: Rodney Lee Knier, Esquire PO Box 215 Williamsport, PA 17703-0215 Respectfully submitted, ABELN LAW OFFICES Legal Assistant 37 East Pomfret Street Carlisle, PA 17013-3313 717/245-2851