Loading...
HomeMy WebLinkAbout04-3009IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA No.011 - 3OC)9 clot Civil Action - (XX) La ( ) Equity JURY TRIAL DEMANDED PATRICK STRAKA MONROE TOWNSHIP 101 Tuckahoe Road 1220 Boiling Springs Road Dillsburg, PA 17019 Mechanicsburg, PA 17055 RUSSELL STANDARD CORPORATION 2 Prestley Road Bridgeville, PA 15017 STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership 2 Prestley Road Bridgeville, PA 15017 Plaintiff(s) & Defendant(s) & Address(es) Address(es) PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue A Writ of Summons in the above-captioned action. X Writ of Summons Shall be issued and forwarded to ( )Attorney (XX)Sheriff W. Scott Henning, Esquire 1300 Linqlestown Road Harrisburg, PA 17108 (717) 238-2000 Name/Address/Telephone No. of Attorney of AQ Court Date: June WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANT(S): YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFF(S) HAS/HAVE COMMENCED AN ACTION AGAINST YOU. n (J nyv Prothonotary ot/a??ryt Date: JLL?1F- o r ?Qby .by Gam/! nL (Deputy ( ) Check here if reverse is used for additional information 1 ROTHON.•55 ?a o tit CZ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAIN PATRICK STRAKA V. MONROE TOWNSHIP RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAM14AKER EAST, a limited partnership Civil Action JURY TRIAL DEMANDED NO-: 04-3009 PAR MR LONG: Kindly enter the appearance of Wagman Kreider & Wright on behalf of Defendants Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East in the above-captioned matter. All documents in the matter hereafter may be served u on me: P 222 East Orange Street P•O• Box 1522 Lancaster, PA 17608-1522 WAGMAN KREIDER & WRIGHT BY: Jef e TtRussen ht, Attorneys for De nd Standard C po .nd Sterlingwood, c• t/b/d/a Hammaker East 222 E. Orange Street, P.O, Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41495 CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the foregoing Praecipe on the persons indicated below and in the manner indicated: Service by first class mail: W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Monroe Township 1220 Boiling Springs Road Mechanicsburg, PA 17056 WAGMAN KREID13R & WRIGHT Date: U -?- os BY: Clr W Ight, Attorneys for De da is ?tussell Standard Co o and Sterlingwood, c, t/d /a Hammaker East 222 E. Orange Street, P.O. Box 1522 Lancaster, PA 17608-1522 (717) 397-700() S.Ct.ID. No.: 41495 ra ? ?> n-f-: CD )f] i L W L4 w co IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PATRICK STRAKA V. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAM14AKER EAST, a limited partnership Civil Action JURY TRIAL DEMANDED No-: 04•-3009 PRAECIPE FOR RULE TO FILE COMPLAINT MR. LONG: N tr J -9 C G ? Pursuant to Pa.R.C.P. 1037(a), kindly enter a Rule upon Plaintiff to file a Complaint in the above-captioned matter within twenty (20) days, or in default thereof to suffer a judgment of non pros. WAGMAN KREIDER & WRIGHT BJCJe e qato ght, Attorneys for ndussell Standard po and d Sterlingwood, C- t/d/b/a Hammaker East 222 E. Orange Street, P.O• Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41495 RULE n Above requested Rule so entered this ?Nu???°, c?-FL, 2004. day of Prothonotary CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the foregoing Praecipe for Rule to File Complaint on the persons listed below and in the manner indicated: Service by first class mail: W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Monroe Township 1220 Boiling Springs Road Mechanicsburg, PA 17056 Date: 9-09 A BY: WAGMAN KREIDER & WRIGHT Jef =. J&-6ht, Attorneys for D nussell Standard C and Sterlingwood, Inc. t/d/b/a Hammaker East 222 E. Orange Street, P.O. Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41495 ?) ' N r =? i ) ? _ C> ?_ -TE l ??-r I ui G. -;t_, ; _- a X51 ..? t;, l_' , ? IY I BARRY A. KRONTHAL, ESQUIRE Pa. Supreme Court I.D. No. 55672 MARGOLIS EDELSTEIN P. O. Box 932 Harrisburg, PA 17108-0932 Telephone: (717) 975-8114 Facsimile: (717) 975-8124 E-Mail: bkronthal@margolisedelstein.com Attorneys for Defendant, Monroe Township File#38500.4-00069 PATRICK STRAKA Plaintiff COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA VS. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION, and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER NO. 04-3009 CIVIL ACTION-LAW JURY TRIAL DEMANDED EAST, a limited partnership Defendants PRAECIPE TO ENTER APPEARANCE TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Kindly enter my appearance of behalf of Defendant, Monroe Township, with regard to the above-captioned matter. I am authorized to accept service on behalf of said entity. LIS EDELSTEIN DATE: ?(<olb`? -- , 13 Kronthal, Esquire A.ttom No. 55672 3510 Trine Road Camp Hill, PA 17011 717-975-8114 CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing on all counsel of record by placing the same in the Uni States mail at Camp Hill, Pennsylvania, first-class postage prepaid, on the day ofj 2004, and addressed as follows: Scott Henning, Esquire 1300 Linglestown Road Harrisburg, PA 17110 Russell Standard Corporation 2 Prestley Road Bridgeville, PA 15017 Sterlingwood, Inc. t/d/b/a Hammaker East 2 Prestley Road Bridgeville, PA 15017 MARGOLIS EDELSTEIN L'c o . Carol Moose Wmdlr\1 Selec&e tnsurance\38500.4-00069\Plcads\Entry of Appearance.8-10-04.wpd t?J ?.?-n - r. SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2004-03009 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND STRAKA PATRICK VS MONROE TOWNSHIP ET AL R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT to wit: RUSSELL STANDARD CORPORATION but was unable to locate Them in his bailiwick. He therefore deputized the sheriff of ALLEGHENY County, Pennsylvania, to serve the within 4RIT OF SUMMONS On July 26th , 2004 , this office was in receipt of the attached return from ALLEGHENY Sheriff's Costs: So answers: Docketing 6.00 Out of County 9.00 Surcharge 10.00 R. Thomas Kline Dep Allegheny Cc 100.00 Sheriff of Cumberland County Notary 9.00 134.00 07/26/2004 HANDLER HENNING ROSENBERG Sworn and subscribed to before me this d7? day of / / Protonotary J ' SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2004-03009 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND STRAKA PATRICK VS MONROE TOWNSHIP ET AL R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT to wit: STERLINGWOOD INC but was unable to locate Them in his bailiwick. He therefore deputized the sheriff of ALLEGHENY County, Pennsylvania, to serve the within WRIT OF SUMMONS On July 26th , 2004 , this office was in receipt of the attached return from ALLEGHENY Sheriff's Costs: Docketing 6.00 Out of County .00 Surcharge 10.00 .00 .00 16.00 07/26/2004 HANDLER HENNING Sworn and subscribed to before me eo this 27' day of t . d,tv' / A. D. ?i Prothonotary So answers: -f? R. Thomas Kline Sheriff of Cumberland County SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2004-03009 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND STRAKA PATRICK VS MONROE TOWNSHIP ET AL R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT to wit: STERLINGWOOD INC T/D/B/A HAMMAKER EAST but was unable to locate Them in his bailiwick. He therefore deputized the sheriff of ALLEGHENY County, Pennsylvania, to serve the within WRIT OF SUMMONS On July 26th , 2004 , this office was in receipt of the attached return from ALLEGHENY Sheriff's Costs: So answer Docketing 6.00 Out of County .00 Surcharge 10.00 R. Thomas Kline .00 Sheriff of Cumberland County .00 16.00 07/26/2004 HANDLER HENNING ROSENBERG Sworn and subscribeed? to before me this a 7w day of-L Dj o2(k?[ A.D. ?f Prothonotary I SHERIFF'S RETURN - REGULAR CASE NO: 2004-03009 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND STRAKA PATRICK VS MONROE TOWNSHIP ET AL RONALD HOOVER , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within WRIT OF SUMMONS was served upon MONROE TOWNSHIP the DEFENDANT , at 1130:00 HOURS, on the 13th day of July , 2004 at 1220 BOILING SPRINGS ROAD MECHANICSBURG, PA 17055 KAREN LACROIX, SECRETARY, a true and attested copy of WRIT OF SUMMONS by handing to ADULT IN CHARGE together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 5.18 Affidavit .00 Surcharge 10.00 .00 33.18 Sworn and Subscribed to before me this a7? day of .21 vq A.D. AI ? N,. , 4O?a y, P ohonotary So Answers: R. Thomas Kline 07/26/2004 HANDLER HENNING ROSENBERG By; ??,CF?vz? Deputy Sheriff In The Court of Common Pleas of Cumberland County, Pennsylvania 9 o ERVE: w, Patrick Straka vs. Monroe Township et al Russell Standard Corporation aq-P.441 ?-. ?? ?dC?eYi llel a l 5??7 July 1, 2004 hereby deputize the Sheriff of 04-3009 civil No. , T, SHERIFF OF CUMBERLAND COUNTY, PA, do Allegheny County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. MOO Sheriff of Cumberland County, PA Affidavit of Service Now, -7-13-04 , 20_, at Ill o'clock R M. served the within SU m(nox) t upon at by handing to a c,%cer Mom a copy of the original and made known to flE,fren-- the contents thereof. So answers, Sheri of County, PA? Cos Sworn and subscribed bt 1 6 004 SERVICE _ $ me this _ day of 2 MILE?ApG?JEr OMMONWMTH O 'rF?2?INSYAXIrC7 Notarial t Sheila R. O'Brien, Notary Public $ Cof Pi gheny Co uts? MJune 19 , 2008 Mamusr, Panneylvanla Assoeladon of Noted" X5743 In The Court of Common Pleas of Cumberland County, Pennsylvania Patrick Straka vs. Monroe Township et al ' Sterlingwood Inc c9Tres#ie1 l wi , 7 No?July Y, 2004 04-3009 civil No. , I, SHERIFF OF CUMBERLAND COUNTY, PA, do hereby deputize the Sheriff of Allegheny County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. OV Sheriff of Cumberland County, PA Affidavit of Service Now, 7^13-0 Y 20 , at o'clock /7._ M. served the within SU rn rholx$ upon at by handing to CU Lft- r-\,.. ?g- a_ and made known to copy of the original So answers, Sheriff Sworn and subscribed before me this ! day of JUL 16, 4 _? COSTS SERVICE MILEAGE AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA Notarial Seal Sheila R. O'Brien, Notary Public City of Pi Alloghoay County My Commiaaion u= June 19, 2008 Member. Permaylvanla Aaeocialion of Nmarlea the contents thereof f County, ?I P Yn The Court of Common Pleas of Cumberland County, Pennsylvania Patrick Straka r vs. Monroe Township et al Sterlingwood Inc t/d/b/a Hannaker East a2 presl-I if 93ridqevzl nA , I??-J `2t - I - 04-3009 civil No. tow July o I, SHERIFF OF CUMBERLAND COUNTY, PA, do hereby deputize the Sheriff of Allegheny County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. Sheriff of Cumberland County, PA Affidavit of Service Now, within upon at by handing to a 20, at 10-'o'clock su e-",, l.. c,,LA l-n t 110- copy of the original and made known to /9 M. served the rte" the contents thereof. So answers, ?d 19eCF6 ke l? . Sh iff of County, PA COSTS Sworn and subscribed Vorl 6 ? 04 SERVICE $ me this _ day of MILEAGE AFFIDAVIT /A COMbIONWEAUR OF PENNSYLVANIA NotRdai Seel $ Sheila R. O'Brien, Notary Public City of Pit fib rl Allegheny County MY ommisaion N'OreaJunel%2008 Mamtw, PennayNanle Aaaasman ar Naiad" COMMON PLEAS OF CUMBERLAND COUNTYr 7N THE COURT OF CIVIL, ACTION - LAW PATRICK STRAKA v• RUSSELL MONROE TOWNSHIP' STANDARD CORPORATION and STERLINGWOODr INC.r individually and t/d/b/a HAMMAKER EAST, a limited Civil Action PENNSYLVANIA JURY TRIAL DEMANDED NO.* 04-3009 partnership OF SERVICE CERTIFICATE a true and have this day served ersOns listed per certify that I ha Complaint on the I hereby of the Rule to File correct COPY indicated: below and in the manner first class mail: Service by W. Scott Henningr ,Rosen Handler, Henning & berg 1300 LinglestownR101 Harrisburg, PA 1 Monroe Township Road 1220 Boiling Springs 17056 Mechanicsburgr PA WAGMAN KREIDER & WRIGHT v By* Attorneys for fight, Date: jDe Y 'its Russell Standard 4 n and Sterlingwoodr orat, Hammaker East t/d/b aStreetr P.O. Box 1522 Orange 222 E. 17608-1522 Lancasterr PA (717) 397-7000 41495 S.Ct.ID. No.: ?.r i. i C' .l. co PATRICK STRAKA, Plaintiff V. MONROE TOWNSHIP, RUSSEL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 04-3009 CIVIL ACTION -'LAW JURY TRIAL DEMANDED 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 defenses 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 a 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 Telephone 717-249-3166 or 800-990-9108 HANDLER, HENINING & ROSENBERG, LLP W. Scott He ling I.D. #32298 1300 Linglestown Harrisburg, PA 17110 (717) 238-2001) Attorney for Plaintiffs F:\WP Directories\JFL\complaints\mva\road condition\scott\straka.wpd PATRICK STRAKA, Plaintiff v. MONROE TOWNSHIP, RUSSEL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 04-3009 CIVIL ACTION - LAW JURY TRIAL DEMANDED COMPLAINT AND NOW, comes the Plaintiff, Patrick Straka, by and through his attorneys, HANDLER, HENNING & LLP, by W. Scott Henning, Esq., and makes the within Complaint against the Defendants, Monroe Township, Russel Standard Corporation and Sterlingwood, Inc., individually and t/d/b/a Hammaker East, a Limited Partnership, and avers as follows: 1. Plaintiff, Patrick Straka, is an adult individual currently residing at 101 Tuckahoe Road, Dillsburg, York County, Pennsylvania 17019. 2. Defendant, Monroe Township, is a duly existing governmental entity within the Commonwealth of Pennsylvania containing an office at 1220 Boiling Springs Road, Mechanicsburg, Cumberland County, Pennsylvania 17055. 3. Defendant, Russell Standard Corporation, is a corporation with offices and/or a mailing address at 2 Prestley Road, Bridgeville, Allegheny County, Pennsylvania. 15017. 4. Defendant, Sterlingwood, Inc., individually and t/d/b/a Hammaker East (hereinafter referred to as "Sterlingwood, Inc."), is a Limited Partnership with offices and/or a mailing address at 2 Prestley Road, Bridgeville, Allegheny County, Pennsylvania 15017. 5. At all times material hereto, Creek Road in Monroe Township, Pennsylvania, was a township roadway over which Defendant, Monroe Township, had the responsibility for the ownership, design, construction, supervision, inspection, and maintenance of the roadways and all areas within the right-of-way of the roadways. 6. At all times material hereto, Defendant, Monroe Township, owed a duty to Plaintiff and others traveling on Creek Road to provide and maintain a safe roadway, namely, Creek Road. 7. At all times material hereto, Defendant, Russell Standard Corporation, owed a duty to Plaintiff and others traveling on Creek Road to warn of any tarring and/or maintenance they had performed and/or been performing on Creek Road in Monroe Township, Cumberland County, Pennsylvania. 8. At all times material hereto, Defendant, Sterlingwood, Inc., owed a duty to Plaintiff and others traveling on Creek Road to warn of any tarring and/or maintenance they had performed and/or 2 been performing on Creek Road in Monroe Township, Cumberland County, Pennsylvania. 9. At all times material hereto, Plaintiff, Patrick Straka, was the owner and operator of a 1981 Honda motorcycle bearing the Pennsylvania registration number HYV05 (hereinafter "Plaintiff's motorcycle"). 10. At all times material hereto, Plaintiff, Patrick Straka, was insured by Allstate Insurance Company under which motor vehicle insurance policy, Plaintiff was covered by the Full Tort Option. 11. At all times material hereto, there were not adverse weather conditions, but the road surface contained an excessive accumulation of tar and gravel. 12. On July 8, 2002, at approximately 5:30 p.m., Plaintiff's motorcycle was lawfully traveling southwest on Creek Road in Monroe Township, Cumberland County, Pennsylvania. 13. At approximately the same time and place, Plaintiff'S motorcycle spun out of control after encountering and sliding on an excessive accumulation of gravel that had been allowed to remain on the southbound lane of Creek Road, coming to a final rest facing west on the shoulder of Creek Road. 14. As a direct and proximate cause of the aforementioned collision, Plaintiff had to be transported from the scene of the incident via ambulance to Holy Spirit Hospital. 3 15. At all times material hereto, Defendant, Monroe Township, had notice of the dangerous condition of the gravel that was placed upon and accumulated and remained on the southbound lane of Creek Road in Monroe Township, Cumberland County, Pennsylvania. 16. At all times material hereto, Defendant, Russell Standard Corporation, had notice of the dangerous condition of the excess gravel that was placed and remained on the southbound lane of Creek Road in Monroe Township, Cumberland County, Pennsylvania. 17. At all times material hereto, Defendant, Sterlingwood, Inc., had notice of the dangerous condition of the excess gravel that was placed and remained on the southbound lane of Creek Road in Monroe Township, Cumberland County, Pennsylvania. 18. At all times material hereto, there were no warning signs posted on Creek Road warning motorists that an accumulation of gravel remained in the southbound lane of the roadway. 19. Plaintiff is informed and believes, and on the basis of this information and belief alleges, that at all times relevant to this complaint, Defendants were employees, agents, and/or servants of their co-defendants and in doing the things alleged in this Complaint were acting within the course and scope of such agency, employment, direction, and/or commission of Monroe Township. 20. As a direct and proximate result of the negligence of the Defendants, Monroe Township, Russell Standard Corporation and Sterlingwood, Inc., Plaintiff, Patrick Straka, sustained extensive 4 and serious personal injuries, as set forth more specifically below. COUNT I - NEGLIGENCE PATRICK STRAKA v. MONROE TOWNSHIP 21. Paragraphs 1-20 are incorporated herein as if set forth at length below. 22. At all times material hereto, Defendant, Monroe Township, was negligent and careless with respect to the supervision, inspection, and maintenance of Creek Road at, and near, the crash site and such conduct was a substantial factor/factual cause in causing the crash and said injuries and damages suffered by Plaintiff. 23. The occurrence of the aforementioned crash and the resultant injuries to Plaintiff, Patrick Straka, are the direct and proximate result of the negligence, carelessness, and/or recklessness of Defendant, Monroe Township, generally and more specifically as set forth below: (a) In failing to provide adequate signing and warning of the hazards presented by the dangerous condition of the excessive placement and/or accumulation of gravel in the southbound lane of Creek Road; (b) In failing to properly and timely inspect, maintain, and correct the dangerous condition of 5 this roadway presented by the excessive placement and/or accumulation of graved; (c) In failing to properly and timely make repairs to the roadway that would make the roadway safer for vehicular traffic; (d) In failing to properly keep Creek Road reasonably clear of all impediments to easy and convenient street traveling, in violation of 53 P.S. § 57013; (e) In failing to properly alter- or remove any and all refuse or obstructions within the legal width of any public street or highway namely the excessive placement and/or accumulation of gravel in violation of 53 P.S. § 57070; (f) In failing to remove the excessive accumulation of gravel placed on the roadway following the "tarring and chipping" procedure; (g) In failing to properly maintain and repair the roadway, in direct violation of 36 P.S. § 2391.12; (h) In allowing a dangerous condition of its street to exist and in failing to take proper measures to protect against the dangerous condition, in direct violation of 42 P.S. § 8542(b)(6); and 6 (I) In otherwise violating the laws, statutes, and regulations of the Commonwealth of Pennsylvania regarding the maintenance of township roadways. 24. As a direct and proximate result of the Defendant's negligence, Plaintiff, Patrick Straka, sustained severe injuries, including, but not limited to, severe road rash on his left arm, torso, left knee and left thigh, as well as multiple lacerations. Additionally, Mr. Straka has been forced to undergo plastic surgery for the treatment of his scarring. 25. As a direct and proximate result of the negligence of Defendant, Monroe Township, the Plaintiff has been, and will in the future be, hindered from performing and attending to his daily duties and chores, to his great loss, humiliation, and embarrassment. 26. As a further result of Defendant's negligence, the Plaintiff, Patrick Straka, suffered a loss of wages and may continue to suffer the same in the future. 27. As a direct and proximate result of the negligence of the Defendant, the Plaintiff has suffered great physical pain, discomfort, and mental anguish and will continue to endure the same for an indefinite period of time in the future, to his great physical, emotional, and financial detriment and loss. 7 28. As a direct and proximate result of the negligence of the Defendant, the Plaintiff has been compelled, in order to effect a cure for aforesaid injuries, to expend money for medicine and medical attention. Plaintiff continues to incur expenses for his injuries and will most likely continue to do so in the future, to his great detriment and loss. 29. As a direct and proximate result: of the negligence of Defendant, the Plaintiff has suffered a loss of life's pleasures and will continue to suffer the same in the future, to his great detriment and inconvenience. 30. Plaintiff, Patrick Straka, believes and, therefore, avers that his injuries are serious and permanent: in nature.. , Plaintiff, Patrick Straka, seeks damages from the Defendant, Monroe Township, in an amount in excess of the compulsory arbitration limits of Cumberland County, exclusive of interest and costs and demands a trial by jury. COUNT II - NEGLIGENCE PATRICK STRAKA v. RUSSELL STANDARD CORPORATION 31. Paragraphs 1-30 are incorporated herein as if set forth at length below. 8 32. At all times material hereto, Defendant, Russell Standard Corporation, was negligent and careless with respect to the supervision, inspection, and maintenance of Creek Road, namely engaging in the tarring and chipping procedure, at and near, the crash site and such conduct was a substantial factor/factual cause in causing the crash and said injuries and damages suffered by Plaintiff. 33. The occurrence of the aforementioned crash and the resultant injuries to Plaintiff, Patrick Straka, are the direct and proximate result of the negligence, carelessness, and/or recklessness of Defendant, Russell Standard Corporation, generally and more specifically as set forth below: (a) In failing to provide adequate signing and warning of the hazards presented by the dangerous condition of the excessive placement and/or accumulation of gravel in the southbound larre of Creek Road; (b) In failing to properly and timely inspect, maintain, and correct the dangerous condition of this roadway presented by the excessive placement and/or accumulation of gravel; (c) In failing to properly and timely make repairs to the roadway that would make the roadway safer for vehicular traffic; 9 (d) In failing to remove the excessive accumulation of gravel placed on the roadway following the "tarring and chipping" procedure; (e) In otherwise violating the laws, statutes, and regulations of the Commonwealth of Pennsylvania regarding the maintenance of township roadways. 34. As a direct and proximate result of the Defendant's negligence, Plaintiff, Patrick Straka, sustained severe injuries, including, but not limited to, sever road rash on his left arm, torso, left knee and left thigh, as well as multiple lacerations. Additionally, Mr. Straka has been forced to undergo plastic surgery for the treatment of his scarring. 35. As a direct and proximate result. of the negligence of Defendant, Monroe Township, the Plaintiff has been, and will in the future be, hindered from performing and attending to his daily duties and chores, to his great loss, humiliation, and embarrassment. 36. As a further result of Defendant's negligence, the Plaintiff, Patrick Straka, suffered a loss of wages and may continue to suffer the same in the future. 37. As a direct and proximate result of the negligence of the Defendant, the Plaintiff has suffered great physical pain, discomfort, and mental anguish and will continue to endure the same 10 for an indefinite period of time in the future, to his great physical, emotional, and financial detriment and loss. 38. As a direct and proximate result of the negligence of the Defendant, the Plaintiff has been compelled, in order to effect a cure for aforesaid injuries, to expend money for medicine and medical attention. Plaintiff continues to incur expenses for his injuries and will most likely continue to do so in the future, to his great detriment and loss. 39. As a direct and proximate result of the negligence of Defendant, the Plaintiff has suffered a loss of life's pleasures and will continue to suffer the same in the future, to his great detriment and inconvenience. 40. Plaintiff, Patrick Straka, believes and, therefore, avers that his injuries are serious and permanent. in nature. WHEREFORE, Plaintiff, Patrick Straka, seeks damages from the Defendant, Russell Standard Corporation, in an amount in excess of the compulsory arbitration limits of Cumberland County, exclusive of interest and costs and demands a trial by jury. COUNT III - NEGLIGENCE PATRICK STRAKA v. STERLING, INC. 41. Paragraphs 1-40 are incorporated herein as if set forth at length below. 11 42. At all times material hereto, Defendant, Sterling, Inc., was negligent and careless with respect to the supervision, inspection, and maintenance of Creek Road, namely engaging in the tarring and chipping procedure at and near the crash site and such conduct was a substantial factor in causing the crash and said injuries and damages suffered by Plaintiff.. 43. The occurrence of the aforementioned collision and the resultant injuries to Plaintiff, Patrick Straka, are the direct and proximate result of the negligence, carelessness, and/or recklessness of Defendant, Sterling, Inc., generally and more specifically as set forth below: (a) In failing to provide adequate signing and warning of the hazards presented by the dangerous condition of the excessive placement and/or accumulation of gravel in the southbound lane of Creek Road; (b) In failing to properly and timely inspect, maintain, and correct the dangerous condition of this roadway presented by the excessive placement and/or accumulation of gravel; (c) In failing to properly and timely make repairs to the roadway that would make the roadway safer for vehicular traffic; 12 (d) In failing to remove the excessive accumulation of gravel placed on the roadway following the "tarring and chipping" procedure; and (h) In otherwise violating the laws, statutes, and regulations of the Commonwealth of Pennsylvania regarding the maintenance of` township roadways. 44. As a direct and proximate result of the Defendant's negligence, Plaintiff, Patrick Straka, sustained severe injuries, including, but not limited to, severe road. rash on his left arm, torso, left knee and left thigh, as well as multiple lacerations. Additionally, Mr. Straka has been forced to undergo plastic surgery for the treatment of his scarring. 45. As a direct and proximate result of the negligence of Defendant, Sterling, Inc., the Plaintiff has been, and will in the future be, hindered from performing and attending to his daily duties and chores, to his great loss, humiliation, and embarrassment. 46. As a further result of Defendant's negligence, the Plaintiff, Patrick Straka, suffered a loss of wages and may continue to suffer the same in the future. 47. As a direct and proximate result of the negligence of the Defendant, the Plaintiff has suffered great physical pain, discomfort, and mental anguish and will continue to endure the same 13 for an indefinite period of time in the future, to his great physical, emotional, and financial detriment and loss. 48. As a direct and proximate result of the negligence of the Defendant, the Plaintiff has been compelled, in order to effect a cure for aforesaid injuries, to expend money for medicine and medical attention. Plaintiff continues to incur expenses for his injuries and will most likely continue to do so in the future, to his great detriment and loss. 49. As a direct and proximate result: of the negligence of Defendant, the Plaintiff has suffered a loss of life's pleasures and will continue to suffer the same in the future, to his great detriment and inconvenience. 50. Plaintiff, Patrick Straka, believes and, therefore, avers that his injuries are serious and permanent in nature. WHEREFORE, Plaintiff, Patrick Straka, seeks damages from the Defendant, Sterling, Inc., in an amount in excess of the compulsory arbitration limits of Cumberland County, exclusive of interest and costs and demands a trial by jury. Respectfully Submitted, 14 HANDLER, HENN'ING & Date: 5.- ?? By: W. Scott Hennin E I.D. No. 32298 1300 Lin.glestown Harrisburg, PA 17 (717) 238-2000 --' Attorney for Plaintiff 15 VERIFICATION The undersigned hereby verifies that the statements in the foregoing document are based upon information which has been furnished to counsel by me and information which has been gathered by counsel in the preparation of this lawsuit. The language of the document is of counsel and not my own. I have read the document and to the extent that it is based upon information which t have given to counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the contents of the document are that of counsel, I have relied upon my counsel in making this Verification. The undersigned also understands that the statements made therein are made subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. ? \? G?1?Jl.AlCA1 ` Patrick Straka Date: HANDLER, HENNING & ROSENBERG, LLP W. Scott Henning, Esquire ID #32298 1300 Linglestown Road Harrisburg, PA 17110 717-238-2000 PATRICK STRAKA, Plaintiff V. MONROE TOWNSHIP, RUSSEL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 04-3009 CIVIL ACTION - LAW JURY TRIAL DEMANDED CERTIFICATE OF SERVICE On August 23, 2004, 1 hereby certify that a true and correct copy of Plaintiff's Complaint was served upon the following by depositing in first-class imail: Barry A. Kronthal, Esq. Margolis Edelstein P.O. Box 932 Harrisburg, PA 17102 Jeffery D. Wright, Esq. Wagman, Kreider & Wright 222 East Orange Street P.O. Box 1522 Lancaster, PA 17606 Respectfully Submitted, HANDLER, HENNING & ROSENBERG, LLP Date: August 23, 2004 By: W. Scott Henning, -2- IN THE COURT OF COMMON PLEAS OF CUMBERLA;VD COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PATRICK STRAKA V. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Civil Action JURY TRIAL DEMANDED No.: 04-3009 CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the Interrogatories of Defendants Russell Standard Corporation and Sterlingwood, Inc., on the persons listed below and in the manner indicated: Service by first class mail: W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Barry A. Kronthal, Esquire Margolis Edelstein P.O. Box 932 Harrisburg, PA 17108-0932 Dater/0q BY WAGMAN KREIDER & WRIGHT C 1111V X. JW fight, Attorneys for De da s Russell Standard Cor o ti and Sterlingwood, In t/d/b/a Hammaker East 2 2 Orange Street, P.O. Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41495 N [[?? O ?1 C-0 0 1 3C ?m r' L T rY IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PATRICK STRAKA V. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership • Civil Action JURY TRIAL DEMANDED No.: 04-3009 To: W. Scott Henning, Esquire, Handler, Henning & Rosenberg, 1300 Linglestown Road Harrisburg, PA 17101 and Barry A. Kronthal, Esquire, ]Margolis Edelstein P.O. Box 932, Harrisburg, PA 17.108-0932 Date of Notice: September 14, 2004 NOTICE YOU ARE HEREBY NOTIFIED TO FILE A WRITTEN RESPONSE TO THE ENCLOSED NEW MATTER WITHIN TWENTY (20) DAYS FROM SERVICE HEREOF OR A JUDGMENT MAY BE ENTERED AGAINST YOU. WAGMAN KREIDER & WRIGHT ':Lght, Attorneys for Russell Standard and Sterlingwood, 222 E. Orange Street, P.O. Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41495 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PATRICK STRAKA V. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Civil Action JURY TRIAL DEMANDED No.: 04-3009 ANSWER AND NEW MATTER OF DEFENDANTS RUSSELL STANDARD CORPORATION AND STERLINGWOOD, INC., LFTnrrnr.rv AXT" 1. Admitted. 2. Admitted. 3. Admitted. 4. Denied. Sterlingwood, Inc. is a duly registered Pennsylvania corporation and not a limited partnership. The entity which was the party to the contract with Monroe Township for the work on the road in question, which contract is in Plaintiff's possession, was Hammaker East, Ltd., a limited partnership. Hammaker East, Ltd. is located at 4010 McIntosh Road, Harrisburg, Pennsylvania 17106. 5-6. Paragraphs 5 and 6 of Plaintiff's Complaint are directed to Defendants other than Answering Defendants and so no response is required. 7. Denied. Paragraph 7 of Plaintiff's Complaint is denied as a conclusion of law requiring no response. To the extent that any response is required, Defendant Russell Standard Corporation had absolutely no contact or involvement whatsoever with any work that was performed on Creek Road in Monroe Township, Cumberland County, Pennsylvania. To the contrary, the contract for said work, which contract is in Plaintiff's possession, was between Monroe Township and Hammaker East, Ltd.. 8. Denied. Paragraph 8 of Plaintiff's Complaint is denied as a conclusion of law requiring no response. To the extent that any response is required, Defendant Sterlingwood, Inc. had absolutely no contact or involvement whatsoever with any work that was performed on Creek Road in Monroe Township, Cumberland County, Pennsylvania. To the contrary, the, contract for said work, which contract is in Plaintiff's possession, was between Monroe Township and Hammaker East, Ltd.. 9-14. Denied. Paragraphs 9 through 14 of Plaintiff's Complaint are denied in accordance with Rule 1029(e). 15. Paragraph 15 is directed to Defendants other than Answering Defendants and so no response is :required. 16. Denied. Paragraph 16 of Plaintiff's Complaint is denied as a conclusion of law requiring no response. To the 2 extent that any response is required, Defendant Russell Standard Corporation had absolutely no contact or involvement whatsoever with any work that was performed on Creek Road in Monroe Township, Cumberland County, Pennsylvania„ To the contrary, the contract for said work, which contract is in Plaintiff's possession, was between Monroe Township and Hammaker East, Ltd.. 17. Denied. Paragraph 17 of Plaintiff's Complaint is denied as a conclusion of law requiring no response. To the extent that any response is required, Defendant Sterlingwood, Inc. had absolutely no contact or involvement whatsoever with any work that was performed on Creek Road in Monroe Township, Cumberland County, Pennsylvania. To the contrary, the contract for said work, which contract is in Plaintiff's possession, was between Monroe Township and Hammaker East, Ltd.. 18. Denied. Paragraph 18 of Plaintif'f's Complaint is denied in accordance with Rule 1029(e). 19. Denied. At no time were Defendants Russell Standard Corporation or Sterlingwood, Inc. the employees, agents or servants of co-defendant Monroe Township nor did they at any time have any relationship with said entity for the purposes of doing any of the work on Creek Road as alleged in Plaintiff's Complaint. To the contrary, the contract for said work, a copy 3 of which is in Plaintiff's possession, was between Monroe Township and Hammaker East, Ltd.. The relationship between Hammaker East, Ltd. and Defendant Monroe Township is set forth pursuant to said contract. 20. Denied. Paragraph 20 of Plaintiff's Complaint is denied in accordance with Rule 1029(e). COUNT I - Negligence Patrick Straka v Monroe Township 21-30. Count I consisting of paragraphs 21 through 30 are directed to Defendants other than Answering Defendants and so no response is required. WHEREFORE, Defendants Russell Standard Corporation and Sterlingwood, Inc. request that Plaintiff's Complaint be dismissed. COUNT II - Negligence Patrick Straka v. Russell Standard Corporation 31. The Answers contained in paragraphs 1 through 30 above are incorporated herein by reference. 32-33. Denied. Paragraphs 32 and 33 of Plaintiff's Complaint are denied as conclusions of law requiring no response. To the extent that any response is required, Defendant Russell Standard Corporation had absolutely no involvement whatsoever with any of the work or contract referred to in Plaintiff's 4 Complaint. To the contrary, the tar and chipping job was performed by Hammaker East, Ltd. Pursuant to a contract with Monroe Township, which contract is in Plaintiff's possession. 33-40. Denied. Paragraphs 33 through 40 of Plaintiff's Complaint are denied in accordance with Rule 1029(e). WHEREFORE, Defendant Russell Standard Corporation requests that Plaintiff's Complaint be dismissed. COUNT III - Negligence Patrick Straka v Sterling. Inc. 41. The Answers contained in paragraphs 1 through 40 above are incorporated herein by reference. 42-43. Denied. Paragraphs 42 and 43 of Plaintiff's Complaint are denied as conclusions of law requiring no response. To the extent that any response is required, Defendant Sterling [sic.], Inc. had absolutely no involvement whatsoever with the work or contract referred to in Plaintiff's Complaint. To the contrary, the tar and chipping job was performed by Hammaker East, Ltd, pursuant to a contract with Monroe Township, which contract is in Plaintiff's possession. 43-50. Denied. Paragraphs 33 through 40 of Plaintiff's Complaint are denied in accordance with Rule 1029(e). WHEREFORE, Defendant Sterlingwood, Inc,. requests that Plaintiff's Complaint be dismissed. 5 NEW MATTER 51. The contract for the performance of the work on creek Road referenced in Plaintiff's Complaint was between Monroe Township and Hammaker East, Ltd (hereinafter referred to as the "Contract"). 52. A true and correct copy of the Contract is attached hereto as Exhibit "A" 53. A copy of the Contract was in Plaintiff's possession at the time that he initiated the within cause of action. 54. Plaintiff's cause of action is barred by the applicable statute of limitations. 55. Plaintiff failed to join an indispensable party. 56. Plaintiff's damages in are limited in whole or in part by the applicable provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law. 6 WHEREFORE, Defendants Russell Standard Corporation and Sterlingwood, Inc. request that Plaintiff's Complaint be dismissed. WAGMAN KREIDER & WRIGHT Date: W v BY: ,exr D. ight, Attorneys for De an s Russell Standard Co porati and Sterlingwood, I . 222 E. Orange Street, P.O. Box 1522 Lancaster, Pik 17608-1522 (717) 397-7000 S.Ct.ID. No.:: 41495 7 VERIFICATION I verify that the statements made in the foregoing Answer with New Matter of Defendants Russell Standard Corporation and Sterlingwood, Inc., Individually and t/d/b/a Hammaker East, a Limited Partnership which are within the personal knowledge of the undersigned, are true and correct, and as to facts based on the information of others, the undersigned, after diligent inquiry, believes them to be true. And further, as to language and averments which may constitute legal conclusions, I sign this verification on the recommendation of my attorneys who advise that the allegations and language in the Defendant's Answer with New Matter constituting legal conclusions are required legally to raise issues for resolution at trial, by the Court, or by continuing investigation and preparation for trial. I understand that some of these allegations may prove inappropriate after investigation and trial preparation are complete and I leave determination of these matters to my attorneys on their advice. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. § 4904 relating to unsworn falsification to authorities. Matthew W. Johns Russell Standard Corporation CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the foregoing Praecipe for Rule to File Complaint on the persons listed below and in the manner indicated: Service by first class mail: W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Barry A. Kronthal, Esquire Margolis Edelstein P.O. Box 932 Harrisburg, PA 17108-0932 WAGMAN KREIDER & WRIGHT Date: 91H IoL4 BY r ht, Attorneys for n us sell Standard and Sterlingwood, 22'2--t. Orange Street, P.O. Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41495 ra i 1 C, I - CD - IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PATRICK STRAKA V. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Civil Action JURY TRIAL DEMANDED No.: 04-3009 PRAECIPE TO ATTACH EXHIBIT A MR. LONG: Please attach Exhibit A to Answer and New Matter of Defendants Russell Standard Corporation and Sterlingwood, Inc., Individually and t/d/b/a Hammaker East, A Limited Partnership which was filed in Cumberland County on September 15, 2004. WAGMAN KREIDER & WRIGHT BY: fight, Attorneys for Russell Standard and Sterlingwood, 222 E. Orange ;Street, P.O. Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41495 Nov 05 02 08:16a RLaSELL BRI 141-"213811 flow 05 02 08:08& Hammaker East Office 717-284-8825 6J.L Wt?a-e aA.uaeCl.44 44t c moor. m" PRDPOBAL AND CONTRACT (I NIIN EMUTID) THMPROPML N00E 0 1 I p$TRUCI OM To am= walaVeTlalla ON PAOa4 A. DEPOSIT OF PrAHKM 4LS. All amabpes aardalaing did propoaaM shall Monroe Township be candy madosd'7Id Proposal tar letting d ---MU ALITY (NAME 8 -BEY. --- Marjorie E. ;lletsx&t ECRUARY seemed Propose&will berwhadonorbabro 1220 Eoiliog Springs Road 9 :00 AM on to above Leednet DsM win c es uz,g, A - ADDRESS Shea will be opened and same at spitmintaeNy 9'00 AN_, oneha above LddngJ11011m. PROPOSALS MUST HE MAILED OR OTHERWISE TIME DELIVERED TO THE ABOVE ADDRESS. 1 The conesolm prapoaae In a:mish and ddm all nrleeialt (including Form TRAM Daly Mkdtea CwMN m) and b do sad perb:m ag work On Brebgowirp po)eN as more apaedragy ad brih in No Schedule of Prioaa oftehmemA in acoordome vNh dmwkW and spec"lbne on de at u wean the w:pplrnenlo and special ragdram mints convened heron and! or sllxhad twain red anent PannOOT Spaelkallons (PublPoagon 405), mopf (a) bW&m need net be qmp aSlad by PONCOT (3aa102.01). and (b) Ma kA Wong of Wianinaue paving mateill" le not required (boa 401). 2 It datyraYdso I* arnomaN bkidr, to cm*sdor will begin work art to da* wedged in Ow no:lm to pmo@W. or as auummim provided in the special "ka mos. and will complete all work wkhn working days. 3 Aodompan+ing this plaPoaa' is It o0lied cook or bW bond In gw amoralt at 105 of Bid maundwalood, will de payable to ale munkipagy we a proposal grannfee which, It Is extended In am gw coil aaor We b comply with go n**wr cue of the propwd. 8. PROPOSAL OF: dA10(AEEH EAST LZD. - 4010 e a osb oad -P. 0. got Barriebar=. A. 7 6 NAMEI CONTRACTORS CERTIFICATION It is oreby aardeled as follows: 1 Ttw only pmm nlereded in to pmpomd as p irocipal (a) Is (aWy BAMNALEd EAST LTD. 2 Nona at au above pwwm am employees of M munWelity. 3 This pmpoml It made wili mgusion vrAh any alter person. Wm or oorpombon. AN plena and apeni ieellons mattered to above and !ha aft of the won: hew hear saardrrad by the amt:actor. Thor conbaebr undwounds *W the quentltlas indialed hersk are approdmsM NW are su*d to charge as may be ngterod; and gral all work it payade on ate beak or the urd price etted on aw Sdwdule of Prkve (Abaehrrrent 1). .1. P.2 P.2 Nov 05 02 08:16a RL._SELL BRI 141 .213811 P.3 Nov 05 0E 08:08a Haaaaker East Office 717-264-8826 P.3 County- ?,yeryaad MunidpaBly; Monroe Tovoahip L'OCA TIOFI OF WORN: List attached for 1])--2 Binder and Wearing DESCRIPTION OF WORK: o See attached specifications and notes for $eal Coat See attached specifications and notes for ID-2 Binder and Wearing n R m Z O ? al ESCALATOR CLAUSR(If adopted* MLINdPSW 4 x r ATFACHVAW f iL31i8-014'(PRIO lC6ALIdgD CONTRACT M8 -54t•) PTDJect Nlarlbar•_ Liet attached for Seal Coat O W Attached ' Item t Apprmllmsd • Unk n 'DseadPtioR a Untt ¢ TaLSF n b ng ce - CMEP n r Un -puce n wearlus tin ace- Lt O C Y R 1% Is. -F •OSSddPTWlk . Mur11nalmds ADTan asnr ftowleees. UM OF CUTBACKASPHALTIS PROD BETWEEN MY lalANDOCTOBER31ae,EXCEPT / rMEM61 OFrKM TOR AL AS NOTED IN BULLETIN NO.25. FOR OPTION OR PHASE BENI THE TOTALS MR 2 BID TOTAL OR PHASE EAM MBSTBE 9 CWDEO OPTION 3 OR PHASE 3 Bib TOTAL 3 "bd Y/i4 Nov 05 02 08:16a RU, SELL BRI 141- 213811 Nov 05 02 09:108 Hammaker East Office 717-284-5885 le m> ' SPECIAL PRO VISIDNS TO CONTRACT M84M4 (AMedumd'I,A l COwma m KWAMT INPORMATM FOR THE CONTRACTIWt TMPrkmCammdwmdsr6amk4domMatoaaplyMmidtlb?o Mprsybbas aatmaatarkadmalam W. Traac Core d and Sdsy Oakes b be prwWW by as Ca *scw. (PA. O ART. Of TRANS. Pliamlm 2a WORK WOTROM CONTROL CURRENT VOMON.) OmMary Idmm oral maker s. 084171 Cmacsb dCa*PMnce ragired For allmaMdela X NmymaMwicoft S w0rW2d2ya PlbrbaOKQ1F4 oL Wmkbbacatpbbdmarbsbm .Abe I.kdddddrnaYeomV*d dmmmd6 paraalmtdel X Roahaybbapkmr- w, 'by (miaow X mmigpMly )pdm AD am d PMMIC. X EMM Mail b be mammal by (aamlmdor X nwgkbdtr .1 X Mmbydybkmpedpgioa Wall 04 of badh8 braoh ahprmrb : d tMYbim nWNM PerSadbrr TOLI(C) d SpedbemWm aOl. X Tack Cadmgdmdpar8agkn 4OLor400fsraupar m cilpM(bablu4aandiobmbrrWb imal Ram mrlsea hall Mm ulaa. Prime CodmgdraparSal491dSpe m40L X SlWlkmmsedindadma pamantmdardmabsmgrira. X SmarataMNad Pma NdekmgiadadkwMmMWparkgENkunbanobdcdmnNr, OmMdikmrdkq Ooaambboplmadat Um' i Isn dgpabmdkapaelmle). fob wddm pararmnl wst arm pans taquimd. kidcipfgr raaaws ae" 12 INS work cowpha . Tape pamaraam ar lad ? hN b wPb. far ROB Swu bill Mail tbmartm WE damtbb8b asbcgm d Id ward. Mw*#oly tawrwm dm Aw to POWs mMMM which beg aft Smtragidrattaes Ow d 100 and bam am mwwmd. Campldm d NON•CMWWON AFROAVRTmaMad X bdblalI Pmpmadm anddmnup Taaamd (Prgad Caft bon Mabbb) The ma*kmk mama On rip" to amp m a.wd an tha baba of On aparosaIs all far 91 04 Sams on lilt ambbam we mahad. PabYM. drgt, whkh I BprMadmw F•ae 408 b da mtnbya1% 6dappbrbaadadwork X Ow&oo Trmpambla for dabcb dmaDaurw" am vow d gmkdorm. Cosuibrm" bmaiwrpmp, pra)wtaimmin"a NshpaaanWM pbrb adtlbp. Okasmpba mgdmd tam al dbtsular tai byaadrada (1) om gtmrl: A.M. & PAL and wbkraaad by mhidpdyand rddrmd by WAMk4 ft.(Ob amnpbs mudbepmmdam appmelit"carow andbtwmpabb wRtd sarrpla) AlwearIaaamgmtiaramrrbymbbaManbypwa anpa)ataftwimaadby meidpa0yand mtdmd W naeidpdq. Cwr*Wb M bdng m aodeManm all Spwnowjmb Pam 406 Sal 401 al Mamhd T'adnp m AwmrpapwaSel406swepbiarsupel ewvolmmlrpbin/. Ndaa b Pmo.ad ad bea. dob01 Oaerm ucepip m. Igml CampM W CadMab A Nobsa dcwfkftn mgabad. X WtmmuddCammdwilbdbwdmtpolydwmkmddsmdmdbydmmunkslaW!. 01 *11100". ODW 80 Oddil a dparrdbs Walk b be pmtrmad. A iWOU *0 1 amad aM pmvkWw bV? aatbmt, and by bases subo bs.d bw tbb aap ny to ad an Oak mdhmiud ngmaaabtkm, and mV1w dtdfk. ai ?dkwabary as an dlb. PWAGW. Paldeblto still aataeR. ,ti a.w.ram+ sew. acamaaal, annawaanr Mb KEA EAST LTD. aa,gra' arayar p.4 p. 4 Nov 05 02 08:17a RL. SELL HRI 141_e213811 Nov as 02 08:10a Haaaaker Ease Office '117-264-8925 BMMMMIISRRALC (DESCRWrION OF WORN Clem Vdattag mu ttcs ofloom and braille. maWilb. When spa, air and sttrhm me at lam 60 dgpu or higher and rain is not iaunobnt, apply bituminous matanl (83-M as dotambW by proper tesoug) unNa" ly at the rata of.35 to .50 gtllon per opmeyerd. Unifoamly spread 20 to 2S b. par KpMl yard No. 8 a wgpts (dean washed) haven less than 2% passing 200 Slave with a calibrated matoriaed chip spreader Rolft to be with auffident number of paaanntic tiro rollers to cover the width of agpollass spud in one past. No less then two ro9ems. Valtimler traffic to be controlled mad newly completed su shoe has stunted adequate stability and adM=k to prevent dhsortion and loss of agragsta Wofk to be completed by August 30, 2002. Approdmsteb' 101,645 equate yards total for the 16 roads or secdon of roads. 1. B" Road pmam pt. to Speedway) 9,034 Sq. Yd. 2. Crack Road (asst ftam WOW Part) 1,173 Sq. Yd. 3. Ctsdr Road QAd'tgh Dr. to Kuhn Rd.) 3,464 Sq. Yd. 4. Creak Road (section At RR Wowing) 1,877 Sq. Yd. 5. Heiaey Road 19.946 Sq. Yd. 6. Mna.8wlavatd 3,754 Sq. Yd. 7. Kuhn Road (fitst Lyon) 7,708 Sq. Yd. 8. Kula Road (fla rert of Ruhr to dead aid) 22,997 Sq. Yd. 9. UK== Road (motions and each and not paved) 2,200 Sq. Yd. 10. Martin Road (RI 74 to Baken) 7,816 Sq. Yd. 11. Millar Boulevard 2,217 Sq. Yd. 12 .Miller's Road 2,640 Sq. Yd. 13. Myers Road 12,672 Sq. Yd 14. RhodaBoukvard 1,160 Sq. Yd. 15. Ryapm Road 4,ss1 Sq. Yd. 16. Stoner Road - 4106 Sa Yd. P.5 p.5 TomA 101,645 Sq. Yd. Nov 05 02 08:17a R6oSELL BRI 1.41-e213811 P.6 Nov 05 0e 08:10a Haaaaker East Office 717-284-8825 P.e b The wolmcbr will comply wlh all taqu6antaras of the laws Old impleteW t9 rapuWi" of M CWWWWA t of pennsyivm* wtd llta Utibd thetas vela ft to hwtmn releft s, equal oppWWRy artd 104!Wi I I MO n in agploymanR and wH pry 10 wmkmert empWW M do parfonner08 oflhe comes the wapee m which dray may be entilled. 8 The =iomclorwill povtda the munMpWy with a perfomwnas bond, carddioned upon the faIM performanos of dts conlrat in eoootdarhoe with dte plwu, speakmtme and mminum moan ,, am a plc omd bond. COMM" on dta prompt peymaa of sic ffm*W fitmW*d end laborsuppWd or pa Wm9d in Itro proseeudm of Me work, in aeeordatho, WM tlw Puth90 iMa1n Caetradota' Bad Law *F 1987: and an adidavR ao , - 9 thaprovolone a Fthe Woriuvan's Compense9on Act df 1915, as ammiad. BAMMAEER EAST LTD. _ w1I11eefaD01lATifetE9111/: r ?11? ideut & aaa ecsetasq IYGCS7m0a- SAW- ATTOYMSY: _ RTM 9fiAL -2- Nov 05 02 08:17a RL_JELL HRI 141 213811 p.7 Nov OS 02 09:10a Hammakar East Office 717-284-8925 p.7 PROPOSAL AND CONTRACT INISTRUCTIM18- FORM 9" 1 7110 Propose! mt+d be typsalbn or; , 2 if mote two" Map" on 0^y pmpd in saretsad by an trrOvl" Nm or pwowdkk% corpormbn or sesoaalbn wMS aw romm a Mast rwnsc, a ly ons lowest pray, d w0 6e co ddead. 3 0@80"Morwak--- A. Kaddl9aWapaoabnwded.tmadq*mPlO mxnbaedsosdwrarswdno*Voriftmalan al, , l wow deals. 4 Pot A d Pape 1 to be oompbbd by mwidp k. Pad 8 of Pap t to be wOWaeed by mntmda. Module of Ptloes - Collmn 01(Aan? a2 OppmxhM gwd>bs? a8 (L494 1,e., wn, squaw w4 Wow fast elm) Ard 60 puapBon, Le., bfWnNwus mrerlals -107. FJ1. FBA. OCBC. aloe) Mat be 81ed in by the nuk%m ly to' - es equks6b' * I - 00AM 45 (Unit Ploe? iM (Taal) and aal mmKw of bid. mat bus 9taa lo by ere oorsmCbr. If MOM spaoa b nM&d, Sad now d Me' I laa tithe peps: •Ca lim and on Aaedarwnt No. Wow sdd wWftrsl drad dedprabd • ABadalwK Ho, 1A 1-% de.. rupestbr each 6:10011 ~ mgried 5 B Igr/dabd demapssambbea0eaaeW addlMiWOMrgaatMSrwetoPatANLYalwaklanommpbbd on am Oarapaswll be ereasd at On nde of 9MXV per addikow wal" dry. (OR'... as am brf In ft altadw I edwdrls.17 8 PaymMt Kid PeRaarnas barrde are Proddb any by WHO srexeedld "M Cmmaola and8S5A00- bords matbein59%oflhacanthk SMWAa.ConleobbWeanofMOM-bnumatDaM100%offs emmot of wowed 6md Forth M6444 Aaadmanw tad 9 and VMloeede Comm#wumbon AM** AHKbMM%4muwtwUOTMdby91aslano6/bidderWdn=daysofto=* atawwdF10Iaeb srrbrrrkdwirads dakoawBTubpaedabewlat6waonaacL TAnsbtown -2 aa.whw00weWnptedaMtdfsbblprafettsmeeda1016AMwewbledb" PraisionsofeNPGRIVIA 11bPeaeOMWa9PAct 442.9 6 1110wePbabayof010 MW*kft ytoobtab dw P1eaOnp weps Saw Puff area arrd sus sale k In ft pra)osel. B ft PraraOa VdaOAdapWbs, Mb bdshal be nabd In twadraWanad. an ygede uMdnp Federal Ravsaw She" Funds, if 6w Prokd cod aeoaerb RA98 am Is 0nOMM wsh 25%orwae Fedewl Revw w BIIMI Fur4t ew Oevb Bacon Aotapplea. Ppab b b fe raspMtft d tlw menanldpmfy tomsir wo OWm 8som Wepe Ran. k4M fan In fe poposel and rrdefe NO In adar8eaalad. K bo8r aeb are ePpllo?b, TM oavb SWMACt has prdawrce om tM Pamwylanb Pr4vMM wow Ad. M ESCALATOR CLAUSE Is opbwa; C used, k mum ba Wiuded In ft Pmmid WePared by Me maidoely. An a modabr lone meynot be Mewled bykw o, fear. •(1961, Aup.15, P.C. 887:43 P.S. 196) 4- Nov 05 02 08:180 R? SELL BRI 141 213811 P.8 Nov 06 02 08:118 Hammaker East Office 717-254-8825 P.8 o-ttat Iwi) F-1 ANTI-COLLUSION AFFIDAVIT Stow Of paumsylvaula County of ' Dauphin County Covbarland. Munk*aBy Monroe Project Number Fed. Project No. ([f Appica s The undersigned deponent deposes and says dw he b the President of the 8 a0sake r East Ltd. Company,. that he Is authorized to make this aMdavt on behalf of said company in compliance with section 10206 (e) of Depattmsnt Spscftatk m% Publication 466, as amended and Not the said company has not. either directly or indirectly, entered into any agreement, pattlcipated in any colusion, dr othe wies taken any action in reft nd ofitae competltlw biddiV In connection with such contract. HAKMAKEE EAST LTD. (Contractor) By Sworn to and the undersigned notary public this 16th day of way , 2002 . &A4. lub IhlWery Pubic My Commission expires is iDt Mow 05 02 08:18a R. SELL HRI 114. 213811 Now 05 02 Mile Haaeaker East Office 717-264-8825 2002 1. Creek Road (flan Route 74 to Leiraweaver P UP00Y) 2 %w Biada - 20' wide x 3,960' long I W Wearing - 20' Wide x 3,960' long 2. TOWN* Caen (1220 Boiling 9PdeP Road) 4-5• BWW - vado (n rapamed by WwaddP) I W Wearing parking amm ad drive wr p.8 P.9 NOTE: ALL above narking to be tapered and joined to all mdating paved driveways. Nov 05 02 08:18a R. SELL BRI 114. 213811 P.10 Nov 05 02 09:118 Hommaker East Office '717-264-8925 P.10 KEMPER L1Md8ERMENSMUTUALCASUAL TY COMPANY INSURANIa COMPANIES AMERICAN MOTORIS751NSURANCECOMPANY AMERICAN MANUFACTURERS MUTUAL MSURANCE COMPANY Hid Hand A-LA. Doer mwSI(o. Aidb (Fdnety 1dM EtL) Oft ALL= ByTp?eRElBlls.tlmtvt. Hawker But Ltd P. 0. Box 60397 4010 mantosb now Harrisburg. PA 17106 m PdeaW. ImmWRa coed a*PtakymL so Luobormens Mutual Caeeslty Compm CNO Tore'. 625 Liberty Avenue Pittsburgh, PA 15222 +taeeerMft00p11111MrrreeIMdI IS*d Illinois wSwIt%bwdo wKWOnSw .neeeNxW4wb6oundwm% MONROE TOWNSHIP - CUMBERLAND COUNTY a Obspe. katdadbreww as oft% N them d Tan Porcout (109) of Total Bid-e--+--D/Uaa(d10x of Bid) artkatra"MMtdwNdw em amp andit* mbe made. OeeYd PM*d aadtWUW Swft bind tam d"k oaeekc, awsom sdadasaamm aa[eransadmist6iobtb'ttadametlbt thtttbby lYaaprrwm. W8o16.tS.00PMdpNematbmlmedabMIs Seal Cost NOW'B 111111 8.0 dte MUM dub=spoke bW Ofd* P**d=d toe Pliwbd 1W esmr lam amanawltk dMMUM a ttewdenterlm Wa lose dnokYid,aA*0"bool rbmdtaMWbe%wdsadIs umbtddksorWorm doommnwkhpodawdadndmtaaafartkeakkal ietlmtaaMe of sob masaet aN law dwprmetpVmtdbbwaadadmal broMW IS tlmpmmsdm Semi, a fa an war of the abn of tke Pmatpdtoetaareetbmantaadpleemxkboadwbomb,ifdw?dii*d 0e4mdmWNWdwdffamtaPatto umdtlapmutekwedbmw m teeasmutarasa8adb WdDWmdwdwkaprswatirrhlmehaOWtpeatgtapedaukmmaawseaaadarb+r4mperdbratkewarkawa?dbf wddbld, tkm tb4 orWaosdaU be adl tadmY, atkrtwiw mtmadabw aN sea and OOmt. SlpmdmdaWedtek 16th dwor May A.D. 20 n2 eessakar Bast Ltd. 0"W11" PRO Soc tart' Mme) r ! nt U Lua is Hutnal Casualty Co.eaer tdrwwgl owl !/ Nov O5 02 08:18a R. SELL BRI 14: 213811 P.11 Nov 05 02 08:L2a Haseaker East Offlos 717-264-8826 P.11 POWER OF ATTORNEY • Know At Men By Thee Presents: That trio Lumbom ws Mutual Casually Pomp". the American Motoffaba Insurance Comp", end the American ManWacmrers Mutual Msuwm Campary, colporatorrs orgaehmad and exisPrhp under the laws of to State at ANnois, hating 0* prihtgel oft* in Long Grove. IN* (hordna?INr cdkdvay rdsrred to as the 'Company') do hereby eppWnt ADobbeert Mayer and Datudd odds Kerr of 6 EGIE (EA Ned W. Smith. ............. tfa k.true and Iswlul aQ n s) .and Atiomsy(aNn-,Ftlrek to make, execute, seal, and deliver from the dab of Issuance of this power for and on ns tense as surely, and as so and dssd: Any and as bonds and unft%Wngs EXCEPTION: NO AUTHORrry to granted to nWte; execute, sad and d*M any 00 of undedekkg W*h guarantees the payment or adlecuon d any palmissory note. deck draft or loser of credit. This authofdy does not permit the same oblipation to be split khts two or more bands in order to bring each such bond wWCn rho dollar Unfit of auttarky es set WM herein, This appoinbnant may be revoked st any time by the Canpary- The ezeaalcn of such bonds and undertakings in pursuance of to these a had been sduly hall bed end Upon the a d Company as ft* and amply to all Intenu and purposes by their regularly elected ol6oas at their principal oFm In Long Grove, Pinola. This Power of Attomoy is executed by authority of resakrtore adopted ty the Executive Canenittees of the Boards which are hereinafter set With and we babon Februiuy 23, 1MB at y carolled to by the undersigned Secretary as bein0 in full force and "VOTED. That the Chdraw or the Board. the President. or any Vice President, or their appointees designated in writing and fled with the Secretary, or the Secretary shad have the power and authority to appoint agents and atomeys in-fw1, and to authorize them to execute on behalf of the Company, and attach the zeal of the Company theasao, bonds and undertakings, recognicanaa, contracts of Indemnity and other writings, obligatory In to nature thereol, and any such o8bers of the Company may appoint agents for acceptance of process.' This Power of Attorn is signed. eased and cediPed by facsimile under and by authority of the following ? hi on d adopted the of ? 1miftes of No Boards of Directors of the Company at a meeting duly oollod "VOTED. That the signature of the Chairman of the Board, the President ary Vloe Praidenk or their appointees designated In writing and ifbd will the Secretary, and the dgnoWre of the Secretary, the seal of tit Cornpany, and cedlics0ons by to Secretary, may be allsnd by faceirarPS an any power of attorney or bond executed pursuant to resolution adopted by the Executive Commtlae of go Board of Directors on February 29. 1986 and any such power so executed, sealed and addled with respect to any bond or undeAaldog to which it is ateche4 shah continue to be valid and binding upon the Company- FK 08 76 (Ed. 00 01) Page 1 of 2 Printed in U.SA. CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the foregoing Praecipe to Attach Exhibit A on the persons listed below and in the manner indicated: Service by first class mail: W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Barry A. Kronthal, Esquire Margolis Edelstein P.O. Box 932 Harrisburg, PA 17108-0932 Date: q-1-1-014 BY: WAGMAN KREIDER & WRIGHT Jef y D. tight, Attorneys to De nd n j Standard C o ati n and Sterlingwood, 2 2 E. Orange Street, P.O. Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41495 ??) ?? rn s T1 ?.7 -? ...? YI r? „ ?_! ° ? _, ?? --, ..x. =<i m :i BARRY A. KRONTHAL, ESQUIRE Pa. Supreme Court I.D. No. 55672 MARGOLIS EDELSTEIN P. O. Box 932 Harrisburg, PA 17108-0932 Telephone: (717) 975-8114 Facsimile: (717) 975-8124 E-Mail: bkronthal@margolisedelstein.com Attorneys for Defendant, Monroe Township File#38500.4-00069 PATRICK STRAKA Plaintiff COURT OF COMMON PLEAS CUMBERLAND COUNTY, I' E N L'SYLVANIA VS. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION, and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Defendants NO. 04-3009 CIVIL ACTION-LAW JURY TRIAL DEMANDED STIPULATION 301A OAA&AIL AND NOW, this day of I r 2004, IT IS HEREBY AGREED upon among the parties hereto, Plaintiff, Patrick Straka, and Defendant, Monroe Township, by and through their respective counsel, that Paragraph 23(I) is hereby removed from Plaintiff's Complaint in its entirety. This Stipulation is effective upon the approval of the Court of Common Pleas of Cumberland County, Pennsylvania. HANDLER, HE G ROSENBERG By: W. Sco He ngj(jEs? Attorney o.32299./ 1300 Linglestown Roa Harrisburg, PA 17110 717-238-2000 Attorneys for Plaintiff By: JUDGE MARGOLIUMLSTEIN Barry APIZWnthal, Esquire Attorney No. 55672 3510 Trindle Road Camp Hill, PA 17011 717-975-8114 Attorneys for Defendant, Monroe M:UWir\l Selective Insurance\38500.4-00069\Pleads\Stipulation.9-1-04.wpd ° ? ?' r?a x- .-? T„?. .? , ? ? .:: '?, r-R ? p n ?? ; ? ??r Q ?} \v BARRY A. KRONTHAL, ESQUIRE Pa. Supreme Court I.D. No. 55672 MARGOLIS EDELSTEIN P. O. Box 932 Harrisburg, PA 17108-0932 Telephone: (717) 975-8114 Facsimile: (717) 975-8124 E-Mail: bkronthal@margolisedelstein.com PATRICK STRAKA Plaintiff vs. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION, and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Defendants s NAU 2 2004 r' Attorneys for Defendant, Monroe Township File#38500.4-00069 COURT OF COMMON PLEAS CUMBERLAND COUNTY, Tyr- i ni- *TSYLVAl`V'1A NO. 04-3009 CIVIL ACTION-LAW JURY TRIAL DEMANDED STIPULATION AND NOW, this 30 'A day of; 5 2004, IT IS HEREBY AGREED upon among the parties hereto, Plaintiff, Patrick Straka, and Defendant, Monroe Township, by and through their respective counsel, that Paragraph 23(I) is hereby removed from Plaintiff's Complaint in its entirety. This Stipulation is effective upon the approval of the Court of Common Pleas of Cumberland County, Pennsylvania. HANDLER, By: W. Scott Hemjing? Esc Attorney o.322 1300 Linglestown Roa Harrisburg, PA 17110 717-238-2000 Attorneys for Plaintiff ROSENBERG MARGOLIS By:. . Barry A 4thal, Esquire Attorney No. 55672 3510 Trindle Road Camp Hill, PA 17011 717-975-8114 Attorneys for Defendant, Monroe Ivey • y, Loa y JUDGE M:\mdir\t Selective Insurance\38500.4-00069\Pleads\Stipulation.9-1-04.wpd rr s 1 Q s J C I : 'ri a' ? IU Z 0 Lw '`ar-a ? ' Lam}' 71 Oj c -rt PATRICK STRAKA, Plaintiff v. MONROE TOWNSHIP, RUSSEL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 04-3009 CIVIL ACTION - LAW JURY TRIAL DEMANDED PLAINTIFF'S REPLY TO NEW MATTER AS PROPOUNDED BY DEFENDANTS RUSSEL STANDARD CORPORATION AND STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, A LIMITED PARTNERSHIP AND NOW, comes the Plaintiff, Patrick Straka, by and through his attorneys, HANDLER, HENNING & ROSENBERG, LLP, by W. Scott Henning, Esq., and replies as follows: 51. Denied. The allegation set forth in paragraph 51 refers to a writing, namely the document identified as the "Contract", and to that extent, the Plaintiff asserts that the document being a writing speaks for itself. Moreover, as indicated in response to Paragraph 52, the Answering Defendants assert that a copy of the Contract was attached to their Answer to New Matter as Exhibit A, however, said document was not attached to the copy of the Answer with New Matter that was directed to the Plaintiff. 52. Denied. The copy of the Answer with New Matter received by the Plaintiff did not contain a copy of the Contract. 53. Denied. It is denied that a copy of the Contract was in Plaintiff's possession at the time that he initiated the within cause of action Indeed, to this point in time the Plaintiff is still not in possession of a copy of the Contact 54. Denied. The allegation set forth in paragraph 54 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, it is denied that the Plaintiff's cause of action is barred by the applicable Statute of Limitations and proof to the contrary is demanded at the trial in this matter. 55. Denied. The allegation set forth in paragraph 55 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, it is denied that the Plaintiff has failed to join an indispensable party, and proof to the contrary is demanded at the trial in this matter. 56. Denied. The allegation set forth in paragraph 56 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, the Plaintiff acknowledges that he will be bound by any provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law that the Honorable Court deems properly applicable to the subject cause of action. WHEREFORE, Plaintiff demands judgment against Defendants, Russel Standard Corporation and Sterlingwood, Inc., Individually and t/d/b/a Hammaker East, a Limited Partnership, for the relief set forth in his Complaint. Respectfully submitted, //- HANDLER., G & ROSENBERG, LLP DATE n (?n /11 W. Scott Hehffitng' I.D. #32298 1300 Linglestown Ro Harrisburg, PA 1711( 717-238-2000 Attorney for Plaintiff VERIFICATION PURSUANT TO PA R.C.P. NO. 1024 c W. SCOTT HENNING, ESQUIRE, states that he is the attorney for the party filing the foregoing document; that he makes this affidavit as an attorney, because the party he represents lacks sufficient knowledge or information upon which to make a verification and/or because he has greater personal knowledge of the information and belief than that of the party for whom he makes this affidavit; and that he has sufficient knowledge or information and belief, based upon his investigation of the matters averred or denied in the foregoing document; and that this statement is made subject to the penalties of 18 Pa C.S. §4904 relating to unsworn falsification to authorities. Date: IL 2w- PATRICK STRAKA, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. MONROE TOWNSHIP, RUSSEL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, Defendants No. 04-3009 CIVIL ACTION -LAW JURY TRIAL DEMANDED CERTIFICATE OF SERVICE On the 30th day of November, 2004, 1 hereby certify that a true and correct copy of Plaintiff's Reply To New Matter was served upon the following by depositing in U.S. Mail; Jeffery D. Wright, Esq. Wagman, Kreider & Wright 222 East Orange Street P.O. Box 1522 Lancaster, PA 17608-1522 Barry A. Kronthal, Esq. Margolis Edelstein P.O. Box 9,32 Harrisburg, PA 17102-0932 Respectfully submitted, DATE HANDLER, HMNIN" ROSENBERG, LLP W. Scott Henning, Es? I.D. #32298 1300 Linglestown Road Harrisburg, PA 17110 717-238-2000 Attorney for Plaintiff r T r7 't t 1 0 FTi -f ?` C..7 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: STRAKA COURT OF COMMON PLEAS TERM, -VS- MONROE TOWNSHIP, ET AL CASE NO: 04-3009 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of BARRY A. KRONTHAL, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 12/08/2004 i MAYAJAIRONHAL, Son behalf of d ESQ. Attorney for DEFENDANT DE11-532539 7 1- 6 7 5- L 0 1 C O M M O N W E A I.,T H OF, P E WW S Y L VAN 2 A COUNTY O V CUMBER LAN D IN THE MATTER OF: COURT OF COMMON PLEAS STRAKA -VS- MONROE TOWNSHIP, ET AL TERM, CASE NO: 04-3009 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 HOLY SPIRIT HOSPITAL MEDICAL RECORDS HOLY SPIRIT HOSPITAL X-RAY ONLY JOHN STRATIS, M.D. MEDICAL RECORDS & XRAYS TO: JEFFREY D. WRIGHT, ESQUIRE W. SCOTT HENNING, ESQ., PLAINTIFF COUNSEL MCS on behalf of BARRY A. KRONTHAL, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 11/18/2004 CC: BARRY A. KRONTHAL, ESQ. - 38500.4-00069 Any questions regarding this matter, contact NICS on behalf of BARRY A. KRONTHAL, ESQ. Attorney for DEFENDANT THE MCS GROUP INC. 1601 MARKET STREET #1100 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-284724 7 1 6 7 5- C O 2 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND STRAKA vs. MONROE TOWNSHIP, ET AL File No. 04-3009 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for HOLY SPIRIT HOSPITAL (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: * * * * SEE ATTACHED RIDER * * * * at The MCS Group. Inc.. 1601 Market Street. Suite 800. Philadelphia. PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the adch•ess listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to cornply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: BARRY A. KRONTHAL. ESO. ADDRESS: 3510 TRINDLE ROAD CAMP HILL. PA 17011 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant DEC 0 8 2004 Date: Jlxj. Is _ Q no l Seal of the Court BY HE COURT: L• Prothonotary/Clerk, Civil Division Deputy 71675-01 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: HOLY SPIRIT HOSPITAL 503 NORTH 21 ST STREET CAMP HILL, PA 17011 RE: 71675 PATRICK STRAKA Please call for prior approval for fees in excess of $100.00 for hospitals, $50.00 for all other providers. Entire hospital medical file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physician, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, nurse's notes, doctor's comments, dietary restrictions, and all patient consent or refusal of treatment, procedures, test, and/or medication, lab and diagnostic test results, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care, treatment, admission, discharge, or emergency care pertaining to: Dates Requested: up to and including the present. Subject : PATRICK STRAKA 101 TUCKAHOE ROAD, DILLSBURG, PA 17019 SU10-534520 7 1 6 7 5- 11 0 1 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: STRAKA -VS - COURT OF COMMON PLEAS TERM, CASE NO: 04-3009 MONROE TOWNSHIP, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of BARRY A. KRONTHAL, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received., and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 12/08/2004 BARRY A. KRONTHAL, ESQ. Attorney for DEFENDANT DE11-532540 7 1 6 7 5- L 0 2 C O M M O N W E A L T H OP P E N N S Y L VAN TA COUNTY OP C U M 13E R L AN D IN THE MATTER OF: COURT OF COMMON PLEAS STRAKA -VS- MONROE TOWNSHIP, ET AL TERM, CASE NO: 04-3009 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 HOLY SPIRIT HOSPITAL MEDICAL RECORDS HOLY SPIRIT HOSPITAL X-RAY ONLY JOHN STRATIS, M.D. MEDICAL RECORDS & XRAYS TO: W. SCOTT HENNING, ESQ., PLAINTIFF COUNSEL JEFFREY D. WRIGHT, ESQUIRE MCS on behalf of BARRY A. KRONTHAL, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 11/18/2004 CC: BARRY A. KRONTHAL, ESQ. - 38500.4-00069 Any questions regarding this matter, contact NICS on behalf of BARRY A. KRONTHAL, ESQ. Attorney for DEFENDANT TIRE MCS GROUP INC. 1601 MARKET STREET 1800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-•284723 7 1 6 7 5- C O M COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND STRAKA vs. MONROE TOWNSHIP, ET AL File No. 04-3009 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for HOLY SPIRIT HOSPITAL (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: **** SEE ATTACHED RIDER **** at The MCS Group, Inc., 1601 Market Street, Suite 800. Philadelphia. PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: BARRY A. KRONTHAL. ESQ. ADDRESS: 3510 TRINDLE ROAD CAMP HILL. PA 17011 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant DEC 0 8 2004 Date: Ca Seal of the Court BY HE COtTRT: Prothonotary/Clerk, Civil Division 01 eputy 71675-02 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: HOLY SPIRIT HOSPITAL 503 NORTH 21ST STREET CAMP HILL, PA 17011 RE: 71675 PATRICK STRAKA Please call for prior approval for fees in excess of $100.00 for hospitals, $50.00 for all other providers. Any and all x-ray films and reports, including any and all such iterris as may be stored in a computer database or otherwise in electronic form, pertaining to: Dates Requested: up to and including the present. Subject : PATRICK STRAKA 101 TUCKAHOE ROAD, DILLSBURG, PA 17019 SU10-534522 7 1 6 7 5- L 02 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS STRAKA TERM, -vs- CASE NO: 04-3009 MONROE TOWNSHIP, ET AL As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of BARRY A. KRONTHAL, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 12/08/2004 BARRY A. KRONTHAL, ESQ. Attorney for DEFENDANT DE11-532541 7 1 6 7 5- L 0 3 C O M M O N W E A L T H OF P E N N S"Y L VA N T A COUNTY OF C U M B E RIB -A-ND IN THE MATTER OF: COURT OF COMMON PLEAS STRAKA -VS- MONROE TOWNSHIP, ET AL TERM, CASE NO: 04-3009 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 HOLY SPIRIT HOSPITAL MEDICAL RECORDS HOLY SPIRIT HOSPITAL X-RAY ONLY JOHN STRATIS, M.D. MEDICAL RECORDS & XRAYS TO: W. SCOTT HENNING, ESQ., PLAINTIFF COUNSEL JEFFREY D. WRIGHT, ESQUIRE MCS on behalf of BARRY A. KRONTHAL, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 11/18/2004 CC: BARRY A. KRONTHAL, ESQ. - 38500.4-00069 MCS on behalf of BARRY A. KRONTHAL, ESQ. Attorney for DEFENDANT Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-284723 7 1 6 7 S- C 0 1. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND STRAKA vs. MONROE TOWNSHIP, ET AL File No. 04-3009 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for JOHN STRATIS. M.D. (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: **** SEE ATTACHED RIDER **** at The MCS Group_ Inc., 1601 Market Street, Suite 800. Philadelphia. PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: BARRY A. KRONTHAL. ESQ. ADDRESS: 3510 TRINDLE ROAD CAMP HILL. PA 17011 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant DEC 0 8 2004 Date: / Uy Seal of the Court 71675-03 BY T E COURT: --? Prothonotary/Clerk, Civil Division 7?r- EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: JOHN STRATIS, M.D. 816 BELVEDERE STREET CARLISLE, PA 17013 RE: 71675 PATRICK STRAKA Entire medical, billing, and diagnostic file, including but not limited. to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care or treatment pertaining to: Dates Requested: up to and including the present. Subject : PATRICK STRAKA 101 TUCKAHOE ROAD, DILLSBURG, PA 17019 SU10-534524 7 1 6 7 5- L 0 3 r C-7 (77 ? r CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: STRAKA COURT OF COMMONIFLEAS TERM, -VS- MONROE TOWNSHIP, ET AL CASE NO: 04-300 As a prerequisite to service of a subpoena for documents and things pu to Rule 4009.22 MCS on behalf of BARRY A. KRONTHAL, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the sub attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought t served, (2) A copy of the notice of intent, including the proposed subpoena, attached to this certificate, (3) No objection to the subpoena has been received, and be 1 is (4) The subpoena which will be served is identical to the subpoena w{}ich is attached to the notice of intent to serve the subpoena. Il on be DATE: 03/22/2005 or DE11-550028 7 1 6 7 Ell- L 0 4 C O M M O N W E A L T H or P E N N S Y L VANS A COUNTY OF' C UMBER LAN D IN THE MATTER OF: STRAKA -VS- MONROE TOWNSHIP, ET AL COURT OF COMMONIPLEAS TERM, CASE NO: 04-30 TO PRODUCE DOCUME TTS . TO RULE 4009.21 ROBERT It. DAVIS,MD MEDICAL RECORDS 6 XRAYS TO: W_ SCOTT HENNING, ESQ., PLAINTIFF COUNSEL JEFFREY D. WRIGHT, ESQUIRE MCS on behalf of BARRY A. KRONTHAL, ESQ. intends to serve a subpo na identical to the one that is attached to this notice. You have twenty (2 ) days from the date listed below in which to file of record and serve upo the undersigned an objection to the subpoena. If the twenty day notice perio is waived or if no objection is made, then the subpoena may be served. Comp ete copies of any reproduced records may be ordered at your expense by compl ting the attached counsel card and returning same to MCS or by contacting our loca MCS office. DATE: 03/02/2005 CC: BARRY A. KRONTHAL, ESQ. - 38500.4-00069 MCS on behalf of Attorney Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 1 103 (215) 246-0900 DE02-293745 7 1 6 7 51- C 0 1 COMMONWEALT14 OF PENNSYLVANIA COUNTY OF CUMBERLAND STRAKA vs. MONROE TOWNSHIP, ET AL File No. SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the documents or things: **** SEE ATTACHED RIDER **** at You may deliver or mail legible copies of the documents or produce things requested by this subp with the certificate of compliance, to the party making this request at the address listed above. You to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: BARRY A. KRONTHAL. ESQ. ADDRESS: 3510 TRINDLE ROAD CAMP HILL. PA 17011 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant M"'R 2 2 2C0 Date: ?? -?_ Seal of the Court BY THE COURT: Prothonotary/Clerk, together the right its service, 71675-04 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: ROBERT H. DAVIS,MD MECHANICSBURG, PA 17055 RE: 71675 PATRICK STRAKA Prior approval is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. Entire medical, billing, and diagnostic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care or treatment pertaining to: Dates Requested: up to and including the present. Subject : PATRICK STRAKA 101 TUCKAHOE ROAD, DILLSBURG, PA 17019 SU10-550524 7 1 6 7 $- 1, 0 4 r} < ? ?: ?. ? R n _8. ? i} _ J ?^) Tom- a T i'? (? C7 l1 •? L? BARRY A. KRONTHAL, ESQUIRE Pa. Supreme Court I.D. No. 55672 MARGOLIS EDELSTEIN P. O. Box 932 Harrisburg, PA 17108-0932 Telephone: (717) 975-8114 Facsimile: (717) 975-8124 E-Mail: bkronthal?t)margolisedelstein.com PATRICK STRAKA Plaintiff Attorneys for Defendant, Monroe Township File#38500.4-00069 COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION, and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Defendants NO. 04-3009 CIVIL ACTION-LAW JURY TRIAL, DEMANDED NOTICE TO PLEAD To: Patrick Straka c/o Scott Henning, Esquire 1300 Linglestown Road Harrisburg, PA 17110 Russell Standard Corporation and Sterlingwood, Inc. c/o Jeffery Wright, Esquire 222 E. Orange Street P.O. Box 1522 Lancaster, PA 17608-1522 YOU ARE HEREBY NOTIFIED to plead to the enclosed ANSWER WITH NEW MATTER AND CROSSCLAIM OF DEFENDANT. MONROE TOWNSHIP, within twenty (20) days from service hereof, or a default judgment may be entered against you. Respectfully submitted, Date: to to !r By: / Barry -WI ID No. 5 2 P.O. Box 932 Harrisburg, PA 17108-0932 717-975-8114 Attorney for Defendant Monroe Township BARRY A. KRONTHAL, ESQUIRE Pa. Supreme Court I.D. No. 55672 MARGOLIS EDELSTEIN P. O. Box 932 Harrisburg, PA 17108-0932 Telephone: (717) 975-8114 Facsimile: (717) 975-8124 E-Mail: bkronthal@margolisedelstein.com Attorneys for Defendant, Monroe Township File#38500.4-00069 PATRICK STRAKA Plaintiff COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA VS. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION, and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Defendants NO. 04-3009 CIVIL ACTION-LAW JURY TRIAL, DEMANDED ANSWER WITH NEW MATTER AND CROSSCLAIM OF DEFENDANT, MONROE TOWNSHIP, TO THE COMPLAINT OF PLAINTIFF, PATRICK STRAKA AND NOW, comes Defendant, Monroe Township ("Monroe Township"), by and through its counsel, Margolis Edelstein, and files this Answer with New Matter and Crossclaim to the Complaint of Plaintiff, Patrick Straka ("Plaintiff'), averring the following in support thereof. ANSWER 1. Denied. After reasonable investigation, Monroe Township is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 2. Admitted. 3. Denied. After reasonable investigation, Monroe Township is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 4. Denied. After reasonable investigation, Monroe Township is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 5. Admitted in part and denied in part. It is admitted that Creek Road is in Monroe Township, Pennsylvania, and is a Township roadway. The remaining averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, the remaining averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 6. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, the remaining averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 7. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, the remaining averments of this Paragraph are generally denied, pursuant to Pa. F.C.P. No. 1029(e). 8. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, the remaining averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 9. Denied. After reasonable investigation, Monroe Township is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 10. Denied. After reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 11. Denied. After reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 12. Denied. After reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. By way of further answer, the averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. 13. Denied. After reasonable investigation, Monroe Township is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 14. Denied. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 15. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 16. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of furl:her answer, after reasonable investigation, Monroe Township is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 17. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, after reasonable investigation, Monroe Township is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph and they are, therefore, denied. 18. Admitted in part and denied in part. It is admitted that there was no warning sign on the subject road. This is because it is specifically denied that there was any dangerous accumulation of gravel on the southbound lane of the roadway. 19. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. It is specifically denied that, at any time relevant hereto, Defendants, Russel Standard Corporation, and Steirlingwood, Inc., individually and t/d/b/a Hammaker East, a limited partnership, were employees, agents and/or servants of Monroe Township, and/or were acting within the course and scope of any agency, employment direction, and/or commission, with the existence of any such relationship being specifically denied. 20. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, after reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph regarding Plaintiff's alleged personal injury and they are, therefore, denied. Also, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). WHEREFORE, Defendant, Monroe Township, demands judgment in its favor and againt Plaintiff, Patrick Straka, with costs assessed to Plaintiff. COUNT I- NEGLIGENCE PATRICK STRAKA V. MONROE TOWNSHIP 21. The answers contained in Paragraphs 1 through 20 inclusive hereof, are incorporated by reference herein as if set forth in their entirety. 22. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 23. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). Also, pursuant to a Stipulation between Plaintiff and Monroe Township, and approved. by the Court on or about November 4, 2004, Paragraph 23(1) is dismissed from the Complaint. A copy of the Stipulation is attached hereto, made a part hereof, and marked as Exhibit "A." 24. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, after reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph regarding Plaintiff s alleged injuries and they are, therefore, denied. Also, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 25. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, after reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph regarding Plaintiff s alleged inability to attend to his daily duties and chores, and they are, therefore, denied. Also, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 26. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, after reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph regarding Plaintiffs alleged loss of wages and they are, therefore, denied. Also, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 27. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, after reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph regarding Plaintiff s alleged pain, discomfort and anguish and they are, therefore, denied. Also, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 28. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, after reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph regarding Plaintiff's alleged medical expenses and they are, therefore, denied. Also, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 29. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, after reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph regarding Plaintiff s alleged loss of life's pleasures and they are, therefore, denied. Also, the averments of this Paragraph .are generally denied, pursuant to Pa. R.C.P. No. 1029(e). 30. Denied. The averments of this Paragraph state a conclusion of law to which no response is required and they are, therefore, denied. By way of further answer, after reasonable investigation, Monroe is without knowledge or information sufficient to form a belief as to the truth of the averments of this Paragraph regarding Plaintiff s alleged injuries and they are, therefore, denied. Also, the averments of this Paragraph are generally denied, pursuant to Pa. R.C.P. No. 1029(e). WHEREFORE, Defendant, Monroe Township, demands judgment in its favor and againt Plaintiff, Patrick Straka, with costs assessed to Plaintiff. COUNT II- NEGLIGENCE PATRICK STRAKA V. RUSSELL STANDARD CORPORATION 31. The answers contained in Paragraphs 1 through 30 inclusive hereof, are incorporated by reference herein, as if set forth in their entirety. 32-40. Denied. The averments of these Paragraphs are directed to a Defendant other than Monroe Township and, therefore, there is no need to answer same. However, to the extent that said Paragraphs aver and/or imply any negligence and/or wrongdoing on the part of Monroe Township, then same are specifically denied. WHEREFORE, Defendant, Monroe Township, demands judgment in its favor and againt Plaintiff, Patrick Straka, with costs assessed to Plaintiff. COUNT III- NEGLIGNECE PATRICK STRAKA V. STERLING, INC. 41. The answers contained in Paragraphs 1 through 41 inclusive hereof, are incorporated by reference herein as if set forth in their entirety. 42-50. Denied. The averments of these Paragraphs are directed to a Defendant other than Monroe Township and, therefore, there is no need to answer same. However, to the extent that said Paragraphs aver and/or imply any negligence and/or wrongdoing on the part of Monroe Township, then same are specifically denied. WHEREFORE, Defendant, Monroe Township, demands judgment in its favor and againt Plaintiff, Patrick Straka, with costs assessed to Plaintiff. NEW MATTER 51. The answers contained in Paragraphs 1 through 50 inclusive hereof, are incorporated by reference herein as if set forth in their entirety. 52. Plaintiffs injuries and/or damages, if any, were solely, proximately and directly caused by negligent, careless, and/or reckless actions of person(s) over whom Monroe Township had no control and for whom it is not legally or otherwise responsible. 53. Plaintiffs claim, if any, for non-economic damages is ]limited by his tort selection under the Motor Vehicle Financial Responsibility Law, Act 6 of 1990. 54. Plaintiff s proof and recovery of damages, if any, is limited to and controlled by the provisions of the Pennsylvania Motor Vehicle Financial Responsibility Act, 75 Pa. Cons. Stat. § 1701,etseq. 55. Plaintiff s claim, if any, is limited by the applicable statute of limitations. 56. Monroe Township is a local agency entitled to governmental immunity pursuant to the Political Subdivision Tort Claims Act, 42 Pa. Cons. Stat. Ann. §8501 et seq. 57. Plaintiffs proof and recovery of damages, if any, is limited to and controlled by Chapter 85, 42 Pa. Cons. Stat. § 8501 et seq. 58. Plaintiffs claims may be barred by the Political Subdivision Tort Claims Act, 42 Pa. Cons. Stat. Ann. §8541 et seq. 59. Plaintiffs recoverable damages, if any, are subject to the limitations provided by the Political Subdivision Tort Claims Act, 42 Pa. Cons. Star. Ann. §8553. 60. Plaintiff's claims maybe barred or limited by provisions of the Motor Vehicle Financial Responsibility Law 75 Pa. Con. Star. Ann. § 1701 et seq. 61. Monroe Township did not have notice, written or otherwise, of the allegedly dangerous condition, or in the alternative, if said notice was received, it was not received in sufficient time prior to the alleged accident for Monroe Township to have corrected or to have warned the traveling public of the allegedly dangerous condition. 62. Monroe Township is immune from claims alleging conditions on rather than of the highway. 63. Monroe Township avers that recovery may not be had against it for alleged failures to redesign, change or update designs of state-designated highways, rights-of-ways or fixtures or structures affixed thereto or located thereon. 64. The location of the alleged accident is not under the jurisdiction or control of Monroe Township, and as such, Monroe Township is not responsible for the alleged dangerous conditions. 65. Monroe Township has no duty to erect traffic signs or signals. 66. The accident as pleaded, if true, was caused by the negligence of Defendants, Russel Standard Corporation and Sterlingwood, Inc., individually and t/dAb/a Hammaker East, a limited partnership, as more fully set forth within Plaintiffs Complaint, which is incorporated herein by reference without admission or adoption. 67. Plaintiff s claims, if any, are barred or limited by the doctrines of contributory and/or comparative negligence. 68. Plaintiff may have voluntarily assumed the risk of his injuries and damages. 69. Some of the Plaintiff's injuries may be the result of pre-existing conditions. 70. Plaintiff may have failed to mitigate his damages. 71. Plaintiff's Complaint fails to set forth a cause of action against Monroe Township upon which relief may be granted. 72. Plaintiffs claims, if any, are barred by the applicable statute of limitations. 73. At all times relevant hereto, Defendants, Russel Standard Corporation, and Sterlingwood, Inc., individually and t/d/b/a Hammaker East, a limited partnership, were independent contractors. WHEREFORE, Defendant, Monroe Township, demands judgment in its favor and againt Plaintiff, Patrick Straka, with costs assessed to Plaintiff. CROSSCLAIM PURSUANT TO PA. R.C.P. NO. 2252(d) MONROE TOWNSHIP V. RUSSEL STANDARD CORPORATION AND STERLINGWOOD INC., INDIVIDUALLY AND T/DB/A HAMMAKER EAST, A LIMITED PARTNERSHIP 74. The answers contained in Paragraphs I through 73 inclusive hereof, are incorporated by reference herein as if set forth in their entirety. 75. Monroe Township incorporates herein by reference the averments of Plaintiff s Complaint, without admission or adoption. 76. The negligence, recklessness, and/or carelessness of Defendants, Russel Standard Corporation and Sterlingwood, Inc., individually and t/d/b/a Hammaker East, a limited partnership, exceeds any negligence on the part of Monroe Township, with the existence of any negligence on the part of Monroe Township being expressly denied. 77. If it is determined that Plaintiff is entitled to recover damages, which is denied, then Monroe Township avers that Defendants, Russel Standard Corporation and Sterlingwood, Inc., individually and t/d/b/a Hammaker East, a limited partnership, are solely liable to Plaintiff. 78. In the alternative, if it is determined that Monroe Township is liable to Plaintiff, with said liability being expressly denied, then Monroe Township demands that Defendants, Russel Standard Corporation and Sterlingwood, Inc., individually and t/d/b/a Hammaker East, a limited partnership, be held jointly and severally liable with it and/or that said Defendants be held liable over to Monroe Township for contribution. WHEREFORE, to the extent that Plaintiff, Patrick Straka, its entitled to recover on his Complaint, Defendant, Monroe Township, demands judgment against Russel Standard Corporation and Sterlingwood, Inc., individually and t/d/b/a Hammaker East, a limited partnership, on the basis that they are solely liable to Plaintiff on Plaintiff s cause of action, liable over to Monroe Township by way of contribution and/or jointly and severally liable with Monroe Township on Plaintiff's cause of action, with any liability on the part of Monroe Township being expressly denied. DATE: 1z11(.10r MARGOLIS EDELSTEIN Barry A. Kronthal, Esquire Attorney No. 55672 3510 Trindle Road Camp Hill, PA 17011 717-975-8114 VERIFICATION I, Barry Kronthal, have read the foregoing Answer with New Matter and Crossclaim. The factual statements contained therein are true and correct to the best of my knowledge, information and belief. I am authorized to make this Verification on behalf of my client. This Verification is made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unswom falsification to authorities, which provides that if I knowingly make false averments, I may be subject to criminal penalties. Date:/ 0 /0-5 5 CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing on all counsel of record by placing the the Unit States ail at Camp Hill, Pennsylvania, first-class postage prepaid, on the s e in ? day of ,-- , 2005, and addressed as follows: Scott Henning, Esquire 1300 Linglestown Road Harrisburg, PA 17110 Jeffery Wright, Esquire 222 E. Orange Street P.O. Box 1522 Lancaster, PA 17608-1522 MARGOLIS EDELSTEIN By: Carol Moose M'.\mdidl Selective Insurance\38500.4-00069\Pleads\Answer with New Maltecl0-21-04.wpd !`? r^. -:? ::? C? T r ' --1 C'! ?1 -T} t'? ?i1 t' C? r? ?':} '^?f? ^U %'_? -! .'rl ''J __- K (? a PATRICK STRAKA, Plaintiff V. MONROE TOWNSHIP, RUSSEL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/dlb/a HAMMAKER EAST, a Limited Partnership, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 04-3009 CIVIL ACTION - LAW Defendants : JURY TRIAL DEMANDED PLAINTIFF'S REPLY TO NEW MATTER OF DEFENDANT MONROE TOWNSHIP AND NOW, comes the Plaintiff, Patrick Straka, by and through his attorneys, HANDLER, HENNING & ROSENBERG, LLP, by W. Scott Henning, Esq., and replies as follows: 51. Paragraph 51 is an incorporation Paragraph to which no responsive pleading is required. 52. Denied. It is denied that the Plaintiffs injuries and/or damages are solely, proximately and directly caused by negligent, careless, and/or reckless actions of persons over whom Monroe Township had no control or for whom it was not legally or otherwise responsible, and proof to the contrary is demanded at the trial in this matter. 53. Denied. The allegation set forth in Paragraph 53 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, the Plaintiff asserts that he is covered by the Full Tort option. By way of further answer, to the extent that it would be determined that the Plaintiff is governed by the Limited Tort provisions of the Motor -t- Vehicle Financial Responsibility Law, then the Plaintiff asserts that the nature and extent of his injury and damages are such as to be categorized as a serious and permanent impairment of a bodily function and serious and permanent disfigurement so as to enable him to seek non-economic damages pursuant to Section 1705 of the Pennsylvania Motor Vehicle Financial Responsibility Law. 54. Denied. The allegation set forth in Paragraph 54 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, the Plaintiff acknowledges that he will be bound by any provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law that the Honorable Court deems properly applicable to the subject cause of action. 55. Denied. The allegation set forth in Paragraph 55 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, it is denied that the Plaintiffs claim is limited or barred by the applicable Statute of Limitations, and proof to the contrary is demanded at the trial in this matter. 56. Denied. The allegation set forth in Paragraph 56 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, the Plaintiff acknowledges that Monroe Township is a local agency that falls within the provisions of the political subdivision Tort Claims Act, however, the Plaintiff asserts that Defendant Monroe Township is not entitled to Tort immunity in circumstances of the subject cause of the action, and proof to the contrary is demanded at the trial in this matter. 57. Denied. The allegation set forth in Paragraph 57 is a conclusion of -2- law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, the Plaintiff acknowledges that he will be bound by any provisions of the Political Subdivision Tort Claims Act that the Honorable Court deems properly applicable to the subject cause of action. 58. Denied. The allegation set forth in Paragraph 58 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, the Plaintiff denies that his claim is barred by the Political Subdivision Tort Claims Act, and proof to the contrary is demanded at the trial in this matter. 59. Denied. Plaintiff incorporates his reply to Paragraph 57 as though fully set forth herein. 60. Denied. Plaintiff incorporates his reply to Paragraph 54 as though fully set forth herein. 61. Denied. The allegation set forth in Paragraph 61 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, it is denied that Monroe Township did not have notice of the dangerous condition. By way of further answer, the Plaintiff asserts that Monroe Township, by and through its agents, servants, employees, created the dangerous condition, and hence, they would be deemed to be on notice of the dangerous condition that they created through their negligent acts. By way of further answer, the Plaintiff asserts that if Defendant Monroe Township did not have actual notice of the hazardous/dangerous condition, through the exercise of reasonable care and inspections of their premises, they should have been aware of the -3- dangerous/hazardous condition so as to be deemed to have constructive notice of the dangerous and hazardous condition. 62. Denied. The allegation set forth in Paragraph 62 is a legal conclusion to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, the Plaintiff asserts that Defendant Monroe Township is not immune from the claim being asserted by the Plaintiff. The Plaintiff further asserts that the "on" versus "of' distinction is not applicable to the subject cause of action. 63. Denied. The allegation set forth in Paragraph 63 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, the Plaintiff asserts that the allegations set forth in Paragraph 63 are not applicable to the subject cause of action, and proof to the contrary is demanded at the trial in this matter. 64. Denied. The allegation set forth in Paragraph 64 is contradictory to the admission set forth in Paragraph 5 of Defendant Monroe Township's Answer to Complaint. The Plaintiff asserts that the location of his injury causing incident was on Creek Road and is a road within the ownership, jurisdiction and/or control of Monroe Township. 65. Denied. The allegation set forth in Paragraph 65 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, the Plaintiff asserts that under the circumstances giving rise to the dangerous/hazardous condition that resulted in his injuries, that Monroe Township did have a duty to construct a warning sign. Said -4- warning sign would be separate and distinct from the erection of traffic signs or signals, such as stop signs, speed limit signs or traffic light signals. 66. Denied. It is denied that the incident and injuries sustained by the Plaintiff were caused solely by the negligence of Defendants Russel Standard Corporation and Sterlingwood, Inc., individually and t/b/a Hammaker East, Limited Partnership, but rather, Plaintiff asserts that these other entities were acting as the agent, employee or servant of Defendant Monroe Township and therefore Defendant Monroe Township is vicariously responsible for the Co-Defendants' actions and/or inactions, and proof to the contrary is demanded at the trial in this matter. 67. Denied. The allegation set forth in Paragraph 67 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, it is denied that the Plaintiffs claims are barred and/or limited by the Doctrines of Contributory and/or Comparative Negligence. By way of further answer, the Plaintiff asserts that he was in no way comparatively or contributorily negligent, and proof to the contrary is demanded at the trial in this matter. 68. Denied. The allegation set forth in Paragraph 68 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, it is denied that the Plaintiff knowingly and voluntarily assumed the risk of the injury causing incident and resulting injuries and damages, and proof to the contrary is demanded at the trial in this matter. 69. Denied. It is denied that the Plaintiffs injuries are solely the result of pre-existing conditions, and proof to the contrary is demanded at the trial in this matter. -5- 70. Denied. It is denied that the Plaintiff has failed to mitigate his damages, and proof to the contrary is demanded at the trial in this matter. 71. Denied. The allegation set forth in Paragraph 71 is a conclusion of law to which no responsive pleading is required, however, to the extent that the Honorable Court deems a response necessary, it is denied that the Plaintiffs Complaint fails to set forth a cause of action against Monroe Township upon which relief may be granted, and proof to the contrary is demanded at the trial in this matter. 72. Denied. Paragraph 72 is a reiteration of Paragraph 55, and therefore, Plaintiff incorporates his response to Paragraph 55 as though fully set forth herein. 73. Denied. The allegation set forth in Paragraph 73 is a conclusion of law to which no responsive pleading is required. To the extent that Defendant Monroe Township is endeavoring to assert that the Co-Defendants are independent contractors, so as to absolve themselves of liability for the actions or inactions of the Co- Defendants, the Plaintiff specifically denies that independent contractor status would completely shield Defendant Monroe Township from liability for the Co-Defendants' actions and inactions. The Plaintiff believes, and therefore asserts, that the manner in which the highway was tarred and chipped was done within the specifications and control of Defendant Monroe Township and that until Discovery is completed, the Plaintiff asserts and therefore believes that there may have been employees of Defendant Monroe Township present at the work site directing and supervising the work of the Co-Defendants. -6- WHEREFORE, Plaintiff demands judgement against Defendant Monroe Township for the relief set forth in his Complaint. Respectfully submitted, DATE HANDLE, HEN" ROSENBERG, LLP W. Scott Henning I.D. #32298 1300 Linglestown R a Harrisburg, PA 17110 717-238-2000 Attorney for Plaintiffs -7- PATRICK STRAKA, Plaintiff V. MONROE TOWNSHIP, RUSSEL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/dlb/a HAMMAKER EAST, a Limited Partnership, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 04-3009 CIVIL ACTION - LAW Defendants JURY TRIAL DEMANDED CERTIFICATE OF SERVICE On the 27t' day of December, 2005, 1 hereby certify that a true and correct copy of Plaintiffs Reply To New Matter was served upon the following by depositing in U.S. Mail; Jeffery D. Wright, Esq. Wagman, Kreider & Wright 222 East Orange Street P,O. Box 1522 Lancaster, PA 17608-1522 DATE Barry A. Kronthal, Esq. Margolis Edelstein P.O. Box 932 Harrisburg, PA 17102-0932 Respectfully submitted, HANDLER, & ROSENBERG, LLP W. Scott hens ing, Etc I.D. #32298 1300 Linglestown RoE Harrisburg, PA 17110 717-238-2000 Attorney for Plaintiff VERIFICATION PURSUANT TO PA R.C.P. NO. 1024 (c) W. SCOTT HENNING, ESQUIRE, states that he is the attorney for the party filing the foregoing document; that he makes this affidavit as an attorney, because the party he represents lacks sufficient knowledge or information upon which to make a verification and/or because he has greater personal knowledge of the information and belief than that of the party for whom he makes this affidavit; and that he has sufficient knowledge or information and belief, based upon his investigation of the matters averred or denied in the foregoing document; and that this statement is made subject to the penalties of 18 Pa C.S. §4904 relating to unsworn falsification to authorities IQ- Date: ??j? ' C) <° C- c_? .3 ?7 .-.-} :: --1 ` ? .;. T ?'.? i_? t?;J `a _. - r? ?. ',rr v __ r , -fj c, -< ORIGINAL 04-3009 BENNETT, BRICKLIN & SALTZBURG LLP BY: Jeffery D. Wright, Esquire I.D. No. 41495 222 EAST ORANGE STREET LANCASTER, PA 17602 (717) 397-7000 ATTORNEY FOR DEFENDANTS Russell Standard Corporation and Sterlingwood, Inc. PATRICK STRAKA vs. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership COURT OF COMMON PLEAS CUMBERLAND COUNTY CIVIL ACTION - LAW JURY TRIAL DEMANDED DOCKET NO.: 04-3009 DEFENDANT RUSSELL STANDARD CORPORATION AND STERLINGWOOD, INC., INDIVIDUALLY AND T/DB/A HAMMAKER EAST, A LIMITED PARTNERSHIP'S ANSWER TO DEFENDANT MONROE TOWNSHIP'S CROSSCLAIM PURSUANT TO RULE U52(Dl 74.-75. Answering Defendants repeat and incorporate by reference their Answer and New Matter as though the same were set forth more fully at length herein. 76.-77. Denied. Paragraphs 76-77 of Defendant Monroe Township's Crossclaim are denied as conclusions of law requiring no response. To the extent any response is required, neither Answering Defendant had any relationship, contractual or otherwise, with Defendant Monroe Township at any time relevant to the within claim. To the contrary, the entity which was the party to the contract with Monroe Township for the work on the road in question was Hammaker East, Ltd., a limited partnership, an entity which is not a party to the within lawsuit. WHEREFORE, Defendants Russell Standard Corporation and Sterlingwood, Inc. request that Defendant Monroe Township's Crossclaim be dismissed. 04-3009 BENNETT, BRICK.LIN & SALTZBURG, LLP BY: D. Russell Standard Corp ra on and Sterlingwood, Inc. S.Ct.ID No. 41495. 04-3009 CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the foregoing Defendant Russell Standard Corporation and Sterlingwood, Inc., Individually and t/d/b/a Hammaker East, a Limited Partnership's Answer to Defendant Monroe Township's Crossclaim Pursuant to Rule 2252(d) on the persons listed below and in the manner indicated: Service by first class mail: W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Barry A. Kronthal, Esquire Margolis Edelstein 3510 Trindle Road Camp Hill, PA 17011 TT, BRICKLIN & SALTZBURG, LLP Date: / - J-66 BY: , Attorneys for Defendants Corporation and Sterlingwood, Inc. (7 ?`'? it ?.. TI ?, ? _ " ? __ ` pl _..7 -. f 1 ll( ?`. ? __ t ORIGINAL BENNETT, BRICKLIN & SALTZBURG LLP BY: Jeffery D. Wright, Esquire I.D. No. 41495 222 EAST ORANGE STREET LANCASTER, PA 17602 (717) 397-7000 ATTORNEY FOR DEFENDANTS Russell Standard Corporation and Sterlingwood, Inc. PATRICK STRAKA vs. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership COURT OF COMMON PLEAS CUMBERLAND COUNTY CIVIL ACTION - LAW JURY TRIAL DEMANDED DOCKET NO.: 04-3009 ORDER AND NOW, this day of 2006 upon Defendants Russell Standard Corporation and Sterlingwood, Inc.'s Motion to Compel: IT IS HEREBY ORDERED that Plaintiff is directed to serve full, complete and verified answers to said Defendants' Interrogatories and a full, complete and verified response to said Defendants' Request for Production of Documents within twenty (20) days from the date of this Order or suffer such sanctions as may be appropriate. BY THE COURT: J. ORIGINAL 04-3009 BENNETT, BRICKLIN & SALTZBURG LLP BY: Jeffery D. Wright, Esquire I.D. No. 41495 222 EAST ORANGE STREET LANCASTER, PA 17602 (717) 397-7000 PATRICK STRAKA ATTORNEY FOR DEFENDANTS Russell Standard Corporation and Sterlingwood, Inc. COURT OF COMMON PLEAS CUMBERLAND COUNTY VS. CIVIL ACTION - LAW MONROE TOWNSHIP, RUSSELL STANDARD JURY TRIAL DEMANDED CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership DOCKET NO.: 04-3009 DEFENDANTS RUSSELL STANDARD CORPORATION AND STERLINGWOOD, INC.'S MOTION TO COMPEL This is a civil action arising out of a motorcycle accident which occurred on July 8, 2002. 2. On August 27, 2004, Defendants Russell Standard Corporation and Sterlingwood, Inc. (hereinafter Defendant Russell) served Plaintiff with Interrogatories and a Request for Production of Documents. (A true and correct copy of the Interrogatories are attached hereto as Exhibit A, the Request for Production of Documents as Exhibit B and the cover letter serving the same as Exhibit C). 3. When, the time in which to respond to these discovery requests passed and no answers were received, by letter dated October 5, 2004, counsel for Defendant Russell requested responses to the same. (A true and correct copy of Defendants' counsel's letter is attached hereto as Exhibit D). 1 04-3009 By letter dated October 18, 2004, counsel for Defendant Russell again requested that the overdue responses be provided. (A true and correct copy of Defendants' counsel's letter of October 18, 2004, is attached hereto as Exhibit E). 5. When Plaintiff still failed to answer the discovery or even respond to the earlier letters, by letter dated November 3, 2004, counsel for Defendant Russell again requested the overdue discovery responses and gave Plaintiff ten days to provide the same. (A true and correct copy of Defendants' counsel's letter of November 3, 2004, is attached hereto as Exhibit F). 6. In response, by letter dated November 9, 2004, counsel for Plaintiff indicated that Plaintiff was being activated in the military to be deployed to Kuwait for 1 '/2 years but that he would be forwarding verified discovery answers prior to his deployment on November 10, 2004. (A true and correct copy of Plaintiffs counsel's letter of November 9, 2004, is attached hereto as Exhibit G). Unfortunately, despite those representations, the discovery answers still were not provided. 8. Accordingly, by letter dated November 29, 2004, counsel for Defendant Russell again requested that discovery responses. (A true and correct copy of Defendants' counsel's letter of November 29, 2004, is attached hereto as Exhibit H). 9. Finally, on January 4, 2005, counsel for Plaintiff forwarded Plaintiff s Response to Defendant Russell's Interrogatories and Request for Production of Documents and requested that the matter be kept in abeyance until Mr. Straka's return from overseas. (A true and correct copy of Plaintiffs counsel's letter of January 4, 2005, is attached hereto as Exhibit 1). 04-3009 10. The answers to the Interrogatories and Request for Production of Documents forwarded were incomplete and unverified by Plaintiff. (A true and correct copy of Plaintiff s Answers to Defendant Russell's Interrogatories are attached hereto as Exhibit J and a copy of the Response to Request for Production is attached hereto as Exhibit K). 11. Nonetheless, at Plaintiff s counsel's request, counsel for Defendant Russell allowed the matter to be in abeyance until such time as Plaintiff returned to the United States from active duty. 12. By letter dated October 14, 2005, counsel for Defendant Russell were informed that Plaintiff was returning to the United States in December, 2005. (A true and correct copy of the October 14, 2005, letter is attached hereto as Exhibit L). 13. Following receipt of that letter, on October 28, 2005, counsel for Defendant Russell requested that Plaintiff supplement the incomplete and unverified discovery answers previously forwarded. (A true and correct copy of Defendants' counsel's letter of October 28, 2005, is attached hereto as Exhibit M). 14. Plaintiff neither answered the discovery nor contacted Defendant Russell's counsel regarding the same. 15. Accordingly, by letter dated December 8, 2005, counsel for Defendant Russell once again requested full, complete and verified answers to the discovery requests. (A true and correct copy of Defendant's counsel's letter of December 8, 2005, is attached hereto as Exhibit N). IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PATRICK STRAKA V. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Civil Action JURY TRIAL DEMANDED No.: 04-3009 INTERROGATORIES OF DEFENDANTS RUSSELL STANDARD CORPORATION AND STERLINGWOOD INC.. ADDRESSED TO PLAINTIFF - SET NO. 1 Pursuant to Rule No. 4005 of the Pennsylvania Rules of Civil Procedure, Russell Standard Corporation and Sterlingwood, Inc., Defendants in this action, serve the within interrogatories on Plaintiff and make demand on Plaintiff to answer same under oath within thirty (30) days of the date of service hereof. A. INSTRUCTIONS 1. These Interrogatories are considered to be continuing and, therefore, should be modified or supplemented as you obtain further or additional information up to the time of the trial of this case. 2. The answers to these Interrogatories shall reflect the cumulative knowledge of all representatives, agents, and employees of the party to whom they are addressed. 3. Where exact information cannot be furnished, estimated information is to be supplied. When an estimate is to be used, it should be identified as such and accompanied by an explanations to the basis on which the estimate is made and the reason the exact information cannot be furnished. 4. Where knowledge, information or documents in the possession of a party are requested, such request includes knowledge, information or documents in the possession of the party's agents, representatives and attorneys. 5. If any document was, but no longer is in your possession or subject to your control, state what disposition has been made of it. FXHIBIT A B. DEFINITIONS 1. "Document" or "documents" includes, without limitation, writings and printed matter of every kind and description, photographs (including any and all discs, cards or other media utilized to store images and photos taken by any digital camera), drawings, notes and records of oral communication, and recordings (tapes, discs or other) of oral communication. In all cases where originals are not available, "document" also means copies of original documents and copies of non-identical copies. Further, "document" also means all internal or external e-mails, data, material and information stored on disc, CD or tape, or stored in any other way and which is capable of being reproduced into document form electronically or mechanically. 2. "Identify" as applied to a person means to state the following: (a) full name; (b) title, if any; and (c) present home or business address. 3. "Identify" as applied to any writing means to state the following: (a) its date; (b) identity of its author(s); (c) identity of its sender(s); (d) identity of person(s) to whom it is addressed; (e) identity of recipient; (f) format; (g) title; (h) number of pages; (i) complete summary of contents; and (j) identity of person(s) known or believed to have possession, custody or access to the writing. 4. "Identify" as applied to an oral statement, conversation or conference means to: (a) identify the person making each statement, the person whom each statement was made, and all other persons present at the time of each statement; (b) state the date of such statement, conversation or conference; (c) state the place where such statement, conversation or conference was held; (d) if by telephone, identify the person receiving the telephone call, the person making the call, and the places where the persons participating in the call were located; and (e) state in detail the substance of each statement, conversation or conference. 5. "Person" means any individual, firm, association, partnership, corporation, or trustee and also, where relevant, the person representing or acting for such "person". 2 6. As used herein, the terms "you" or "your" means the party responding to these Interrogatories, together with his/her/their agents, servants, employees, officers, directors, and all other persons acting or purporting to act on his/her/their behalf. 7. "Explain" or "state" means to set forth every fact relevant to the answer to the Interrogatory and to set forth each such fact fully and unambiguously. 8. "Health care provider" means physician, dentist, nurse, physical therapist, chiropractor, psychiatrist, or other person licensed to provide health care services. 9. "Health care facility" means any institution which provides health care services. 10. "Insurance policies" means any motor vehicle insurance, workers' compensation or any program, group contract or other arrangement for payment of benefits, pursuant to which Plaintiff has received or will in the future be eligible to receive payment of medical expenses, and/or reimbursement for past or future wage loss as a consequence of the incident described in the Complaint. 11. "Incident" or "accident" refers herein to the set of circumstances described in the Complaint in this action, upon which your claim for relief is based. C. INTERROGATORIES I_ PERSONAL BACKGROUND: Please state the following: (a) Date of birth; (b) Place of birth; 3 (c) Social security number; (d) Service and inclusive dates of military service and type of discharge; (e) Date, place and spouse's name of each marriage; (f) Present home address and length of time at said address; (g) Type, policy limits, policy number, and name of insurance carrier for all medical or hospitalization insurance in effect both at the time mentioned in the Complaint and at present; (h) Any other names by which you are or have been known. 4 2. At the time of the accident, were you the possessor of a current and valid motor vehicle operator's license? 3. If your answer to the preceding Interrogatory is in the affirmative, please identify the state issuing the license, the license number, and the date of expiration of the license. 4. At the time of the accident, did you possess a valid motor vehicle operator's license? 5. If your answer to the preceding Interrogatory is in the affirmative, please identify the state issuing the license, the license number, the date you first obtained the license, and the date of expiration of the license. 5 6. At the time of the accident, did you possess a valid motorcycle operator's license? 7. If your answer to the preceding Interrogatory is in the affirmative, please identify the state issuing the license, the license number, the date you first obtained the license, and the date of expiration of the license. 8. Have you ever had your motor vehicle operator's license suspended or revoked? 9. If the answer to the preceding Interrogatory is in the affirmative, please state: (a) the dates of the revocation or suspension; and, (b) the reasons for the revocation or suspension. 6 10. Have you ever had your motorcycle operator's license suspended or revoked? 11. If the answer to the preceding Interrogatory is in the affirmative, please state: (a) the dates of the revocation or suspension; and, (b) the reasons for the revocation or suspension. 12. Describe your driving experience, including how many years you had been driving prior to the date of the accident. 7 13. MOTORCYCLES Describe your experience operating a motorcycle, including: (a) how many years you had operated motorcycles prior to this incident; (b) how many times you operated the motorcycle involved in this incident; (c) how many motorcycle accidents involving either property damage and/or personal injury you have had prior to this incident; (d) how many motorcycle accidents involving either property damage and/or personal injury you have had after this incident; and, 8 (e) what motorcycle safety course you have taken including the dates and locations. 14. CURRENT EMPLOYMENT: Please state or describe: (a) Current place of employment and position; (b) Length of current employment; (c) The place of employment and position at the time of the incident, if different; 9 (d) Educational background (include high school, college, postgraduate, special training); (e) Qualifications required for person holding your current employment position and your employment position at the time of the incident, if different. 15. SUMMARY OF SPECIAL DAMAGES: State the total and types of expenses (special damages) which you claim resulted from the incident (answer, even if these were paid or reimbursed, such as through an insurance policy). (a) Medical; 10 (b) Physical Therapy; (c) Wage Loss; (d) Vocational Therapy; (e) Property Damage; (f) Household Help; (g) Other (describe): 11 16. INJURIES: (a) Describe separately each injury you sustained in the incident and the approximate date on which you recovered from each such injury; (b) If you believe you have not fully any of the injuries, state in what have not fully recovered from each injury. recovered from respect you such separate 12 17. HEALTH CARE FACILITIES: Identify each health care facility in which you have been confined, examined or provided out-patient treatment because of the incident, with dates of confinement and out-patient treatment received, the charges for same, and the amount of each such charge that has been paid and by whom paid. 18. HEALTH CARE PROVIDERS: Identify each health care provider who has examined, treated or rendered services to you because of this incident, the inclusive dates of such services, the dates of all visits, the charges for same, and the amount of each such charge that has been paid and by whom paid. 13 19. X-RAYS: If x-rays were taken at any time because of this incident, identify the health care providers taking same, the dates taken, the persons who have interpreted the x-rays, and the parts of the body x-rayed. 20. TERMINATION OF MEDICAL SERVICES: When and by whom were you last examined or given medical attention for the injuries received in this incident? 14 21. CONTINUATION OF MEDICAL SERVICES: If you are still being treated for the injuries received in this incident, identify by whom and state how frequently such treatments are being given now, the nature of the treatment being administered, and the extent to which treatment will be required in the future. 22. CONFINEMENT: If you were confined to a bed or confined to the house as a result of the injuries sustained in this incident, either in lieu of hospitalization or after such hospitalization was over, state the time period and location of any such confinement. 15 23. PRIOR CONDITION: (a) Explain all prior health problems or injuries involving any portions of your body which you claim to have injuries in this incident; (b) Describe the treatment received for prior health problems or injuries; (c) Identify all health care providers who treated you for prior health problems or injuries; 16 (d) State the dates of treatment for prior health problems or injuries; (e) State whether you had recovered from said condition at the time of the incident here involved and the approximate date of your recovery; (f) State the name and address of your family physician(s) for the last ten (10) years. 17 24. PRIOR OR SUBSEQUENT INCIDENTS: If before or after the incident you were involved in any other incidents involving injuries to any part or parts of the body: (a) State the place(s) and date(s) of such incident(s); (b) Describe the injuries sustained, if any; (c) Identify ail other parties involved and witnesses to such incidents; 18 (d) State whether you made claims for such injuries; (e) Provide the court, attorneys and docket number of all litigation arising therefrom; and, (f) Identify all medical reports and records which concern such injuries, or provide a copy of each. 19 25. DISABILITIES: Do you contend you have been permanently injured as a result of this incident? If so, please describe the exact nature of the alleged permanent injury, whether such injury is totally or partially disabling, whether the conclusion that such injury is permanent is based on competent medical advice or opinion, and the identity of all health care providers who have informed you that the injury is permanent. 26. EMPLOYMENT HISTORY: Describe your employment years, including each employer, job inclusive dates of employment, and pay. history for the last ten (10) title, description of duties, starting and ending rates of 20 27. LOSS OF EARNINGS: If you are making any claim for loss of earnings or impairment of earning power because of this incident, provide the following information: (a) Each employer, job title, description of duties, and monthly or weekly rate of pay at the time of this incident; (b) Your adjusted gross income and net income after taxes as shown on federal income tax returns for each of the three (3) years preceding the incident, the year of the incident, and each year since the incident; (c) The inclusive dates during which you allege you were unable to work as a result of this incident and the total amount of earnings you lost because of this absence; 21 (d) The source and amount of any wages or salary received since the incident; (e) The source and unearned income incident; amount of any other earned or or property received since the (f) The date on which you first returned to work following the incident and each employer for whom you have worked since the incident, with inclusive dates of employment, each job title you have held and each monthly or weekly rate of pay which you received from the date of starting work again after the incident until the present time; 22 (g) Whether you have suffered any disability as a result of the incident, since returning to work; (h) If you have not yet returned to work since the incident, explain why, identify all health care providers consulted with respect to returning to work, and describe each job for which application has been made since the incident and when such application was made; (i) If you are self-employed, provide the address of the usual place of business, the name under which it is operated, the nature of the business, the nature and extent of interest in the business, the amount claimed to have been lost as a result of the incident and how same was calculated; and, 23 (j) If self-employed, identify such employee hired as a result of your disability, if any, the dates of such employment, and the amount of money paid to each employee. 28. HOUSEHOLD HELP: Is a claim being made for household help? If so: (a) State whether or not you had any household help prior to the incident; (b) Provide the name, address and period of employment of each person employed since this incident and before the incident, if applicable; and, 24 (c) State the increase in cost of household help which resulted from the incident and how that amount was calculated. 29. STATEMENTS: (a) Have you or anyone acting on your behalf obtained statements, reports, memoranda or testimony in any form from any person(s) in any way relating to or concerning the incident? (b) If the answer to (a) above is affirmative, either attach copies or state: (1) The identity of each person making such statement(s) or report(s); 25 (2) The identity of each person in whose presence such statement(s) or report(s) were made; (3) The date and place each such statement or report was made; (4) The form of each such statement or report, whether written, oral, or recorded, by a recording device or a stenographer; (5) Whether each such statement or report, if written, was signed and the number of pages thereof; and (6) The identity of each person presently having custody of each such statement or report or any notes or writings pertaining thereto. 26 30. WITNESSES: Please identify the following persons: (a) Those who you believe may have knowledge of or information as to the facts pertaining to the incident; (b) Those who have been interviewed concerning this lawsuit, whether or not a statement was taken; (c) Those who you or your representative have tried to interview or expect to do so in the future; 27 (d) Those who actually saw the incident; (e) Those who did present at or incident; and, not see the incident but were near the scene at the time of the (f) Those who you expect to call at trial, providing a summary of each witness' testimony and the identity of the documents each witness intends to use at trial. 28 31. EXPERT WITNESSES: (a) Have you or anyone acting on your behalf retained any expert who is expected to testify at the trial of this matter? (b) If the answer to (a) above is affirmative, state: (1) The name, residence, business address, occupation or profession, and the area of expertise and/or discipline of each such expert; (2) The substance of the facts to which each such expert is expected to testify; 29 (3) The opinion with respect to which the expert will testify; (4) The grounds of each opinion to which each such expert will testify; and, (5) In detail, the factual information supplied to each such expert which was used as a basis for the expert opinion, including all objects examined, the type, place and date of examination, as well as a description of all photographs and plans reviewed; 30 (c) Attach a current curriculum vitae of each expert identified. (d) In place of answering Interrogatory No. 26(a) and (b), you may file as your answer, each expert's report or you may have the Interrogatory answered by the expert. 32. PHOTOGRAPHS, DOCUMENTS AND THINGS: (a) Do you or anyone on your behalf have or know of any photographs, motion pictures, maps, drawings, diagrams, measurements, surveys or other descriptions regarding or in any way relating to or concerning the incident? (b) If the answer to (a) above is affirmative, either attach copies thereof or state for each: (1) The nature of same; 31 (2) Its specific subject matter; (3) The date it was made or taken; (4) The identity of the person making or taking same; (5) What it purports to show, illustrate or represent; and, (6) The name and address of each person presently having custody of same. 32 33. DOCUMENTARY EVIDENCE: (a) Do you intend to use any book, magazine, or other writing at the trial of this case? (b) If so, describe the writing in detail as to author, publisher, and copyright date, and give the name and address of the present custodian of said writing. 34. INSURANCE: (a) Describe each insurance policy including automobile/motor vehicle insurance, first party coverage, workers compensation, program, group contact, such as professional health services corporation, a hospital plan corporation or any other arrangement for payment of benefits, for which you are eligible to receive benefits. 33 (b) State the group, contract and policy number for each, and whether the policy is full tort or limited tort. (c) State the amount of coverage available for each policy identified. (d) List all payments made, the dates of payments, the payer and the payee. (e) Identify all registered motor vehicles owned by Plaintiff(s), individually or jointly, at the time of the accident. 34 (f) Identify the name and policy number of the insurance company providing financial responsibility for the motor vehicle(s) at the time of the accident. (g) Do you contend you have incurred any economic detriment which has not been compensated? If so: (1) Describe the economic detriment; (2) State the amount of economic detriment and how that was calculated; (3) State the amount compensated and the balance that remains uncompensated; (4) State when and identify by whom compensation was made. 35 (h) With regard to any other non-economic detriment for which you seek compensation (such as pain and suffering due to any injury), describe with specificity the detriment for which you are seeking compensation. 35. SETTLEMENTS: State whether you have received or agreed to receive, from any person, any sum or thing of value for any injuries or damages resulting from the incident; and if so, provide the amount(s) received or to be received and date(s) of payment. 36 (e) List the chronological order of routes you traveled and stops you made in traveling to the destination listed above. 37. Please describe as specifically as possible, the following: (a) The weather conditions at the time of the incident including lighting, cloud cover, temperature, and precipitation; (b) The condition of the road surface on which you were traveling; 38 (c) The extent to which there was other traffic on the road at the time and at the place of the incident; (d) The speed at which your vehicle was traveling at the time of the incident. 38. Do you contend any Defendant was negligent and therefore liable for injuries Plaintiff sustained? If so: (a) Identify any act or failure to act by Defendant which constitutes negligence; and, (b) State the action you contend Defendant could or should have taken which would have prevented Plaintiff's injuries. 39 39. Describe any actions taken by you to avoid the accident. 40. Did you attempt to slow down or stop prior to the accident? If so, state what action was taken and what was the effect? 41. State whether you had taken any drugs, alcoholic beverages, medication, or stimulants within twenty-four (24) hours preceding the incident. If your answer is in the affirmative, identify such substance, the amount taken, where, when and with whom taken, why taken, and from whom received. 40 42. Were there any drugs, alcoholic beverages, medication, or stimulants in your possession at the time of the incident? 43. If the answer to the preceding Interrogatory is in the affirmative, please identify how much, what kind, and when and where each was obtained. 44. Please describe the vehicle you were operating at the time of the incident, including the make, model, year and mileage and person(s) with ownership interest in said vehicle. 41 45.(a) If Plaintiff was not the owner of the vehicle, please identify the owner, and who gave the Plaintiff permission to drive. (b) How long did the Plaintiff have the vehicle in his/her possession (whether or not you owned the vehicle)? (c) Identify the owner(s) of the said vehicle now, and at the time of the incident. (d) Were any parts (i.e. brakes, lights, and steering mechanisms) of the vehicle operating improperly at the time of the incident? If so, did you know that at the time of the incident? 42 (e) Who normally did repair work and state inspections of the vehicle? (f) What was the last work done on the vehicle before the incident? When and by whom? (g) Where is the vehicle located at present? 46. At the time of the accident, were you diagnosed as needing corrective eyeglasses or lenses? 43 47. Subsequent to the accident, have you been diagnosed as needing corrective eyeglasses or lenses? 48. At the time of the accident, were you wearing eyeglasses or lenses? If not, please explain. 49. Describe your version of the events subsequent to the incident, including: (a) Your position in the vehicle just before and following the incident; 44 (b) Did you lose consciousness at any time; (c) Whether you were able to walk from the scene of the incident unaided; (e) A description of assistance rendered; (f) Whether you notified any parties of your injuries and, if so, who was notified and when were they notified; (g) Whether anyone called for medical assistance to help you following the incident and, if so, who called for medical help; 45 (h) Where were you found by those first rendering medical assistance; and, (i) Whether anyone called for police assistance, and if so, who called, who was called, and who arrived. 50. Please describe: (a) Any and all immediate medical treatment received by you subsequent to the incident; (b) The identity of those giving such treatment; 46 (c) Whether or not you were taken to a health care facility immediately after the incident and, if so, how you were taken; and (d) The identity of the person or organization who transported you to the hospital and the identity of the hospital. 51. Approximately how often had you driven on the road where the incident occurred: (a) In the year prior to the incident? (b) In the month prior to the incident? 47 (c) In the week prior to the incident? 52. If you allege that a dangerous condition existed on the roadway location in question, please state: (a) the exact dangerous condition that existed; (b) when you became aware of the dangerous condition; 48 (c) what person or persons were responsible for causing the dangerous condition. 53. Does Plaintiff contend that there was excessive chip or gravel on the roadway at the location of the accident in question? If so, please state: (a) How much gravel or chip was on the roadway at the location of the accident in question; (b) How the quantity of gravel or chip was determined and by whom; (c) Whether the amount identified in your answer to subpart (b) exceeds the quantity specified in the contract between Monroe Township and Hammaker East, Ltd.; 49 (d) Whether the amount identified in your answer to subpart (b) is in violation of any federal, state, and/or local statute, regulation, or ordinance, and if so, identify said statute, regulation or ordinance; and, (e) Whether the amount identified in your answer to subpart (b) is in violation of any established industry standard and, if so, identify the source of that standard. 54. Does Plaintiff contend that the portion of the roadway where the accident occurred was still under construction? If so, state all facts supporting said contention. 50 55. Does Plaintiff contend that Defendants failed to erect warning signs? If so, please state: (a) Whether Plaintiff contends Defendants were required to erect said signs pursuant to the contract between Monroe Township and Hammaker East, Ltd. (b) If your answer to subpart (a) is yes, specify where in said contract. (c) Whether Plaintiff contends Defendant was required to erect said signs pursuant to any federal, state and/or local statute, regulation or ordinance and/or established industry standard. (d) If your answer to subpart (c) is yes, identify said statute, regulation or ordinance and/or industry standard. 51 56. In feet, yards or miles, how far had Plaintiff traveled on the newly "tar and chipped" roadway prior to the incident in question? 57. In seconds, minutes or hours, how long had Plaintiff traveled on the newly "tar and chipped" roadway prior to the incident in question? 58. Had Plaintiff traveled on the roadway either that day or any other time while it was being "tar and chipped?" If so, please state: (a) How many times; (b) When; (c) The distance traveled each time. 52 59. Please identify the specific laws, statutes, and/or regulations of the Commonwealth of Pennsylvania regarding the maintenance of township roadways Plaintiff contends Defendants violated in Paragraph 33 (e) and 43 (e) of the Complaint. 60. For each said law, statute, and/or regulation identified in your answer to the preceding Interrogatory, please identify every fact supporting Plaintiff's contention that Defendants violated said laws, statutes, and/or regulations. 61. OTHER: (a) Identify or attach copies of any and all writings, notes, records or other documents in the nature of any communication between you and any insurance carrier or attorney, not otherwise privileged, which are related to the incident. 53 (b) State the nature, time and conclusions of all investigations made by you or on your behalf into the incident or the circumstances surrounding it. (c) State whether you have ever been prosecuted, convicted, or pleaded guilty to a criminal offense, and, if so, for each offense, the court term and number of the proceeding, the charge, and the disposition. (d) State whether you have made any other claim or demand to any other person/party or filed any other lawsuit for any injuries sustained in this accident. If so, identify the person/party to whom claim or demand was made, the date of claim, demand or lawsuit filed, the reasons for and damages claimed, and the resolution, if any. 54 (e) Identify by caption, number and lawsuit in which you are or have either a plaintiff or defendant, attorney; and court, any other been involved, as and identify your (f) Identify ail individuals who prepared or supplied information in the preparation of these Interrogatories, including such individuals' relationship to you, title, job and address. WAGMAN KREIDER & WRIGHT BY: \_ I De n s u sell Standard Jef )Orange FY. h Attorneys for Co t o and Sterlingwood, In d /a Hammaker East 2 EStreet, P.O. Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41.495 55 CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the foregoing Interrogatories of Defendants Russell Standard Corporation and Sterlingwood, Inc., Addressed to Plaintiff - Set No. 1 on the persons listed below and in the manner indicated: Service by first class mail: W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Barry A. Kronthal, Esquire Margolis Edelstein P.O. Box 932 Harrisburg, PA 17108-0932 WAGMAN KREIDER & WRIGHT Date: 0 p0? BY: J S,?nsian s H rat c. t/d a E. Orange J1C Lancaster, PA (717) 397-7000 S.Ct.ID. No.: ght, Attorneys for ussell Standard and Sterlingwood, Hammaker East Street, P.O. Box 1522 17608-1522 91495 j ? ? ?-, ? ? ni IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PATRICK STRAKA v. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Civil Action JURY TRIAL DEMANDED No.: 04-3009 DEFENDANTS RUSSELL STANDARD CORPORATION AND STERLINGWOOD, INC. REQUEST FOR PRODUCTION AND COPYING OF DOCUMENTS DIRECTED TO PLAINTIFF - SET NO. 1 Pursuant to Rule 4009 of the Pennsylvania Rules of Civil Procedure, Defendants Russell Standard Corporation and Sterlingwood, Inc., request that Plaintiff produce the documents hereinafter described and permit Defendants, through his/her/their attorneys, to inspect them and copy such of them as they may desire. Defendants request that the documents be made available for this inspection at the offices of Defendants' attorneys located at 222 East Orange Street, Lancaster, Pennsylvania, within thirty (30) days of the date of service hereof. This request is intended to cover all documents in the possession, custody and control of Plaintiff, his agents, employees, insurance carriers and attorneys. The documents specifically covered by this request are: 1 EXHIBIT B 1. All investigations, reports, test results, photographs, drawings, sketches, summaries or records of or which relate to the accident, Plaintiff's injuries, and the treatment received. 2. All statements of any person interviewed or contacted, expert or otherwise, who will be called as a witness at trial. 3. All statements of any eye witnesses to the accident. 4. All statements of any party, his/her/their agents or employees concerning the accident and events surrounding it. 5. A current curriculum vitae for each expert who will be called at trial. 6. All documents prepared by each expert identified together with all correspondence between expert and Plaintiff or anyone acting on his/her/their behalf. 7. All documents, exhibits, or other demonstrative evidence which will be introduced or used at trial. 8. The entire contents of any investigation file or files and other documentary material in your possession which relate in whole or in part to the matter at issue, excluding references to mental impressions, conclusions or opinions respecting the value or merit of a claim or defense or respecting strategy or tactics and privileged communication from or to counsel. 9. All medical records, hospital records, x-ray records, emergency room records, physician reports, billing statements, and non-privileged correspondence concerning Plaintiff's injuries 2 and treatment. 10. All documents which you believe support or verify Plaintiff's claim for lost wages and loss of earning capacity, including federal, state and local income tax returns for the last five (5) years. 11. All documents which refer to or verify insurance policy coverage (including first party coverage, workers compensation or group contract) and payment of benefits for medical treatment, wage loss and/or loss of earnings. 12. The declaration page of any and all motor vehicle/automobile insurance policies on which Plaintiff was a named insured, an insured or a covered person at the time of this accident. 13. All documents identified, referenced or used in answering Defendant Russell Standard Corporation's Interrogatories to Plaintiff - Set No. 1. WAGMAN KREIDER & WRIGHT BY: Jef D. ht, Attorneys for De ant ssell Standard C rporation and Sterlingwood, \ Inc. t/d/ a Hammaker East ? E. Orange Street, P.O. Box 1522 Lancaster, PA 17608-1522 (717) 397-7000 S.Ct.ID. No.: 41495 3 CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the foregoing Defendants Russell Standard Corporation and Sterlingwood, Inc.'s Request for Production of Documents Directed to Plaintiff - Set No. 1 on the persons listed below and in the manner indicated: Service by first class mail: W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Barry A. Kronthal, Esquire Margolis Edelstein P.O. Box 932 Harrisburg, PA 17108-0932 Date: BY: WAGMAN KREIDER & WRIGHT Yeffe • I D 04 Defe da is Corp ra io Lancaster, PA (717) 397-7000 S.Ct.ID. No.: Inc. t d/b/? 22"zLF,. O range g'V, Attorneys for u sell Standard a d Sterlingwood, ammaker East treet, P.O. Box 1522 17608-1522 41495 WAGMAN KREIDER & WRIGH' MICHAEL W. WAGMAN JEFFERY D. WRIGHT JEFFREY P. OUELLET ATTORNEYS AT LAW 222 East Orange Street Post O{{ice Box 1522 Lancaster, Pennsylvania 17608-1522 (717) 397-7000 FAX (717) 394-0645 August 27, 2004 W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Re: Straka v. Monroe Twp., Russell Standard, et al. Civil Action No.: 04-3009 (Cumberland Countv) Dear Mr. Henning: OF COUNSEL: DAVID A. KREIDER Enclosed herewith for service upon you as counsel for the Plaintiff are true and correct copies of the following: 1. Interrogatories of Defendants Russell Standard Corporation and Sterlingwood, Inc., Addressed to Plaintiff - Set No. l; and, 2. Defendants Russell Standard Corporation and Sterlingwood, Inc. Request for Production of Documents Directed to Plaintiff - Set No. 1. Please respond according to the Rules of Civil Procedure. Sincerely, 91, Elaine ,J. Jones Paralegal ejj Enclosures cc: Barry A. Kronthal, Esquire (w/ encls.) EXHIBIT C WAGMAN KREIDER & WRIGHT ATTORNEYS AT LAW 222 East Orange Street Post Office Box 1522 Lancasteq Pen nsy(va nia 17608-1522 MICHAEL W. WAGNIAN (717) 397-7000 JEFFERY 1). WRIGHT FAX (717) 394-0645 JEFFREY P. OUELLET October 5, 2004 W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 OFCOUNSEL: DAVID A. KREIDER Re: Straka v. Monroe Township, Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East Civil Action No.: 04-3009 (Cumberland Countyl Dear Mr. Henning: As you may recall, by letter dated August 27, 2004, we served your client with Interrogatories and a Request for Production of Documents in the above-captioned matter. The time in which to respond to these discovery requests is past and, unfortunately, no such responses have been received. I would appreciate it if you would see to it that your client responds to these discovery requests at his earliest convenience. Naturally, I remain at your disposal if you would like to discuss this case at greater length. Very truly yours, Jeffery D. Wright JDW/cam cc: Barry A. Kronthal, Esquire bcc: David Woodruff, Sr. Acct. Rep. Claim No.: P040299027 EXHIBIT D ?' ?-- ? ????? ? _ x l?, WAGMAN KREIDER & WRIGHT ATTORNEYS AT LAW 222 Fast Orange Sereet Post Office Hox 1622 Lancaster, Pen nsywania 17608-1522 MICHAEL W. WNGMAN (717) 397-7000 JEFFERY D. WRIGHT FAX (717) 394-0645 JUPREY P OUELLET October 18, 2004 W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 OF COUNSEL: DAVID A. KRODER Re: Straka v. Monroe Township, Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East Civil Action No.: 04-3009 (Cumberland County) Dear Mr. Henning: As you may recall from my letter of October 5, 2004, your client's response to our Interrogatories and Request for Production of Documents served on August 27, 2004, were overdue. Unfortunately, more time has passed and we have yet to receive these discovery responses. I would appreciate it if you would see to it that your client responds to these discovery requests as soon as possible. Naturally, I remain at your disposal if you want to discuss this case at greater length. Very truly yours, Jeffery D. Wright JDW/cam cc: Barry A. Kronthal, Esquire bcc: David Woodruff, Sr. Acct. Rep. (w/encls.) Claim No.: P040299027 EXHIBIT E ALL-STATE^LEG4 B."I-o1'1 'L" SECVC?LL LT3 WAGMAN KREIDER b WRIGHT ATTORNEYS AT LAW 222 Bast Orange St-e t Poet Office Box 1522 Lancaster, Pennsylvania 17608-1522 MICHAEL W. WAGMAN (717) 397-7000 )EFFERY D. WRIGHT FAX (717) 394-0645 )EFFPEY P, OOELLET November 3, 2004 W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 OPCOUNSEL DAVID A.KREIDER Re: Straka v. Monroe Township, Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East Civil Action No.: 04-3009 (Cumberland Countyl Dear Mr. Henning: As you may recall from my letters of October 5, 2004 and October 18, 2004, your client's response to our Interrogatories and Request for Production of Documents served on August 27, 2004, are overdue. Unfortunately, despite repeated requests and the passage of considerable time, we have yet to receive those discovery responses. I would appreciate it if you would see to it that your client responds to these discovery requests as soon as possible. In the event the discovery requests are not received within ten (10) days from the date of this letter, I will have no option other than to seek Court assistance. Please feel free to contact me if you have any questions. yours, ?leffe?/yILD JDW/cam (\? cc: Barry A. Kronthal, Esquire EXHIBIT F i`" ? ` ?1 I i ?! ??. ? ?? r %,ndler, ¦ nningb 0 enberg, ATTORNEYS AT LAW Le51le B. Handler, Retired W. Scott Henning David H Rosenberg IPA, FL) Carolyn M. Anner (PA, NY, RN) Matthew S. Crosby SPA, NJ) Gregory M. Featner SPA, NJ) Stephen G. Held Jason C. Imler Jeffery D. Wright , Esq Wagman, Kreider & Wright 222 East Orange Street P.O.Box1522 Lancaster, PA 17608-1522 November 9, 2004 RE: Patrick Straka v. Hammaker East, Ltd. Dear Jeffery: MAIN OFFICE 1300 Linglestown Road Harrisburg, PA 171 10 717-238-2000 1-800-422-2224 717-233-3029 Ifmx LANCASTER OFFICE 717-431-4000 CARLISLE OFFICE 717-241-2244 www.HHRLaw.com Henning@HHRLaw.com I am responding with respect to your letter wherein you have inquired as to the whereabouts of our answers to your Discovery requests. We have prepared the responses to the Discovery requests and had sent them to our client for review some time ago. We have been pushing Mr. Straka to respond to the miscellaneous Interrogatories for which we did not have information and also to review the Interrogatories that we completed and sign and return the verification form. Unfortunately, Mr. Straka has been activated to be deployed to Kuwait for one and a half years and his activation to active duty has caused him to be pre-occupied over the last several weeks taking care of a number of issues with regard to his personal affairs We have prompted him to take the time to finalize his review of the Interrogatories and forward the verification form to our office, along with the missing tidbits of informations and I am hopeful that he complies with our request before he is deployed on Wednesday, November 10, 2004. 1 will keep you advised accordingly. Very truly yours, HANDLER,K1 NN W. Scott WSH/tgd cc: Patrick Straka Barry A. Kronthal, Esq. EXHIBIT G & ROSENBERG, LLP -? /" ? ? ? `r ? WAGMAN KREIDER & WRIGHT ATTORNEYS AT LAW 222 East Orange Street Post Office Sox 1522 Lancaster, Pennsylvania 17608-1522 M1Ct1AEL W. WAGMAN (717) 397-7000 JEFFERY D. WRIGHT FAX (717) 394-0645 JEFFREY P OUELLET November 29, 2004 W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 OF COUNSEL: DAVID A. KREIDER Re: Straka v. Monroe Township, Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East Civil Action No.: 04-3009 (Cumberland County Dear Mr. Henning: As you may recall, in your letter of November 9, 2004, you informed me that Plaintiff's discovery answers which I had requested by letters dated October 5, October 18 and November 3, 2004, would be received very soon. Unfortunately, quite some time has passed since that letter and I have yet to receive the responses or any explanation why the same have not been received. Moreover, it would appear that the need for these discovery answers is even more imperative in this case in light of your representation that Mr. Straka has been deployed to Kuwait for a considerable period of time. Accordingly, I would appreciate it if you would forward these discovery answers to me at once or let me know why you cannot. I look forward to hearing from you with regard to the above in the immediate future. Very truly yours, Jeffery D. Wright JDW/cam bcc: David Woodruff, Sr. Acct. Rep. Claim No.: P040299027 EXHIBIT H ? ???-? )( ? 1 } ?" ndler, ¦ Qnning& Zosenberg, LLP ATTORNEYS AT LAW Leslie B. Handler, Retired W. Scott Henning David H Rosenberg IPA, FL) Carolyn M. Anner IPA, NY, RN) Matthew S. Crosby IPA, NJ) Gregory M. Feather (PA, NJ) Stephen G. Held Jason C Irnler Jeffery D. Wright, Esq. Wagman, Kreider & Wright 222 East Orange Street P.O. Box 1522 Lancaster, PA 17608-1522 January 4, 2005 Barry A. Kronthal, Esq. Margolis Edelstein P.O. Box 932 Harrisburg, PA 17102-0932 RE: Patrick Straka v. Hammaker East, Ltd. Dear Jeffery and Barry: MAIN OFFICE 1300 Linglestown Road Harrisburg, PA 17110 717-238-2000 1-800-422-2224 717-233-3029 (faxl LANCASTER OFFICE 717-431-4000 CARLISLE OFFICE 717-241-2244 www,HHRLaw.com Henning@HHRLaw.com Enclosed you will find a partially completed set of Answers to Interrogatories, as well as Plaintiff's reply to Request for Production of Documents. Unfortunately, due to the fact that Mr. Straka has been called to active duty and is currently overseas in the military service, we have not been able to finalize the details of the Answers to Interrogatories. In any event, I wanted to provide you with the information that we have at our disposal at this juncture. As we had previously discussed, unfortunately we will need to keep this matter in the pending status until Mr. Straka returns from overseas. I will keep you advised accordingly. Very truly yours, HANDLER, HENNING & ROSENBERG, LLP W. Scott Hen WSH/tgd cc: Patrick Straka Enclosure EXHIBIT 1 r. .ec.i. ?.io o„ lY Vie.. ?,? PATRICK STRAKA, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. No. 04-3009 MONROE TOWNSHIP, RUSSEL: STANDARD CORPORATION and STERLINGWOOD, INC., CIVIL ACTION - LAW individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, Defendants JURY TRIAL DEMANDED PLAINTIFF'S ANSWERS TO DEFENDANTS' RUSSELL STANDARD CORPORATION AND STERLINGWOOD. INC. INTERROGATORIES PERSONAL BACKGROUND: Please state the following: (a) Date of birth; 5/27/1972 (b) Place of birth; Reading, PA (c) Social Security number; 164-56-7511 (d) Service and inclusive dates of military service and type of discharge; 01/27/1997 - 05/08/1999, activity duty, honorable discharge 05/08/1999 - present, Army reserve (e) Date, plate and spouse's name of each marriage; 0913012004, Carlisle, PA, Stephanie Fouts (f) Present home address and length of time at said address; Lot 19, Spring Garden Estates, Carlisle, PA 17013 (g) Type, policy limits, policy number, and name of insurance carrier for all medical or hospitalization insurance in effect both at the time mentioned in the Complaint and at present; Please refer to Plaintiffs Declarations Page attached to Plaintiffs Response to Request for Production of Documents. EXHIBIT J (h) Any other names by which you are or have been known. None 2. At the time of the accident, were you the possessor of a current and valid motor vehicle operator's license? Yes 3. If your answer to the preceding Interrogatory is in the affirmative, please identify the state issuing the license, the license number, and the date of expiration of the license. PA 23 228 939 4. At the time of the accident, did you possess a valid motor vehicle operator's license? Yes 5. If your answer to the preceding Interrogatory is in the affirmative, please identify the state issuing the license, the license number, the date you first obtained the license, and the date of expiration of the license. PA 23 228 939 6. At the time of the accident, did you possess a valid motorcycle operator's license? Yes - permit 7. If your answer to the preceding Interrogatory is in the affirmative, please identify the state issuing the license, the license number, the date you first obtained the license, and the date of expiration of the license. Pennsylvania 8. Have you ever had your motor vehicle operator's license suspended or revoked? Yes 9. If your answer to the preceding Interrogatory is in the affirmative, please state: (a) the dates of the revocation or suspension; and early 1990s (b) the reasons for the revocation or suspension. late fine payment 10. Have your ever had your motorcycle operator's license suspended or revoked? No 11. If the answer to the preceding Interrogatory is in the affirmative, please state: (a) the dates of the revocation or suspension; and (b) the reasons for the revocation or suspension. 12. Describe your driving experience, including how many years you had been driving prior to the date of the accident. Good. 11 years 13. MOTORCYCLES Describe your experience operating a motorcycle, including: (a) how many years you had operated motorcycles prior to this incident; 2 years (b) how many times you operated the motorcycle involved in this incident; at least 75 times (c) how many motorcycle accidents involving either property damage and/or personal injury you have had prior to this incident; one on the first day I had it because there were foot boards on it that were in the way as I found out (d) how many motorcycle accidents involving either property damage and/or personal injury you have had after this incident; and None - bike was totaled (e) what motorcycle safety course you have taken including the dates and locations. I was studying a course manual and waiting for an opening at Carlisle Barracks. 14. CURRENT EMPLOYMENT: Please state or describe: (a) Current place of employment and position; Now on active duty with the US Army Job on hold at US Army War College (b) Length of current employment; 3 years (c) The place of employment and position at the time of the incident, if different; US Army War College, Carlisle, PA - Assistant Chef (d) Educational background (include high school, college, postgraduate, special training); Carlisle High School, graduated 1990 (e) Qualifications required for person holding your current employment position and your employment position at the time of the incident, if different. 15. SUMMARY OF SPECIAL DAMAGES: State the total and types of expenses (special damages) which you claim resulted from the incident (answer, even if these were paid or reimbursed, such as through an insurance policy). (a) Medical; $6,766.63 (b) Physical Therapy; None (c) Wage Loss; $1,232.00 (d) Vocational Therapy; None (e) Property Damage; $1,300 for bike (f) Household help; John and Ann French took care of me for 2 weeks after hospital (g) Other (describe): None 16. INJURIES: (a) Describe separately each injury you sustained in the incident and the approximate date on which you recovered from each such injury; Abrasions on left elbow, left shoulder, left thigh and left knee Abrasions of the right arm Abrasions on the abdomen (b) If you believe you have not fully recovered from any of the injuries, state in what respect you have not fully recovered from each such separate injury. I have rotator cuff pain in my shoulder and numbness from time to time 17. HEALTH CARE FACILITIES: Identify each health care facility in which you have been confined, examined or provided out-patient treatment because of the incident, with dates of confinement and out-patient treatment received, the charges for same, and the amount of each such charge that has been paid and by whom paid. Please refer to Medical Records and Medical Bills attached to Plaintiffs Response to Request for Production of Documents 18. HEALTH CARE PROVIDERS: Identify each health care provider who has examined, treated or rendered services to you because of this incident, the inclusive dates of such services, the dates of all visits, the charges for same, and the amount of each such charge that has been paid and by whom. Please refer to Medical Records and Medical Bills attached to Plaintiffs Response to Request for Production of Documents. 19. X-RAYS: If x-rays were taken at any time because of this incident, identify the health care providers taking same, the dates taken, the persons who have interpreted the x-rays, and the parts of the body x-rayed. Holy Spirit Hospital 07/08/2002 Cervical spine, chest, pelvis, left elbow, left forearm, left hand, left femur 20. TERMINATION OF MEDICAL SERVICES: When and by whom were you last examined or given medical attention for the injuries received in this incident? Dr. John Stratis, 07/16/2002 21. CONTINUATION OF MEDICAL SERVICES: If you are still being treated for the injuries received in this incident, identify by whom and state how frequently such treatments are being given now, the nature of the treatment being administered, and the extent to which treatment will be required in the future. N/A 22. CONFINEMENT: If you were confined to a bed or confined to the house as a result of the injuries sustained in this incident, either in lieu of hospitalization or after such hospitalization was over, state the time period and location of any such confinement. N/A 22. PRIOR CONDITION: (a) Explain all prior health problems or injuries involving any portions of your body which you claim to have injuries in this incident; None (b) Describe the treatment received for prior health problems or injuries; (c) Identify all health care providers who treated you for prior health problems or injuries; (d) State the dates of treatment for prior health problems or injuries; (e) State whether you had recovered from said condition at the time of the incident here involved and the approximate date of your recovery; (f) State the name and address of your family physician(s) for the last ten (10) years. 24. PRIOR OR SUBSEQUENT INJURIES: If before or after the incident you were involved in any other incidents involving injuries to any part or parts of the body: None (a) State the place(s) and date(s) of such incident(s);; (b) Describe the injuries sustained, if any; (c) Identify all other parties involved and witnesses to such incidents; (d) State whether you made claims for such injuries; (e) Provide the court, attorneys and docket number of all litigation arising therefrom; and, (f) Identify all medical reports and records which concern such injuries, or provide a copy of each. 25. DISABILITIES: Do you contend that you have been permanently injured as a result of this incident? If so, please describe the exact nature of the alleged permanent injury, whether such injury is totally or partially disabling, whether the conclusion that such injury is permanent is based on competent medical advice or opinion, and the identity of all health care providers who have informed you that the injury is permanent. No 26. EMPLOYMENT HISTORY: Describe your employment history for the last ten (10) years, including each employer, job title, description of duties, inclusive dates of employment, and starting and ending rates of pay. I have been cooking and in the Army. 27. LOSS OF EARNINGS: If you are making any claim for loss of earnings or impairment of earning power because of this incident, provide the following information: (a) Each employer, job title, description of duties, and monthly or weekly rate of pay at the time of this incident; US Army War College, Assistant Chef, $14.00/hour (b) Your adjusted gross income and net income after taxes as shown on federal income tax returns for each of the three (3) years preceding the incident, the year of the incident, and each year since the incident; (c) The inclusive dates during which you allege you were unable to work as a result of this incident and the total amount of earnings you lost because of this absence; 07/08/2002 - 07/24/2002 $1,232.00 (d) The source and amount of any wages or salary received since the incident; I/ /i Just res pay (e) The source and amount of any other earned or unearned income or property received since the incident; None (f) The date on which you first returned to work following the incident and each employer for whom you have worked since the incident, with inclusive dates of employment, each job title you have held and each monthly or weekly rate of pay which you received from the date of starting work again after the incident until the present time; July 24, 2002 (g) Whether you have suffered any disability as a result of the incident, since returning to work; No (h) If you have not yet returned to work since the incident, explain why, identify all health care providers consulted with respect to returning to work, and describe each job for which application has been made since the incident and when such application was made; N/A (i) If you are self-employed, provide the address of the usual place of business, the name under which it is operated, the nature of the business, the nature and extent of interest in the business, the amount claimed to have been lost as a result of the incident and how same was calculated; and N/A (j) If self-employed, identify such employee hired as a result of your disability, if any, the dates of such employment, and the amount of money paid to each employee. NIA 28. HOUSEHOLD HELP: Is a claim being made for household help? If so: No (a) State whether or not you had any household help prior to the incident; (b) Provide the name, address and period of employment of each person employed since this incident and before the incident, if applicable; and (c) State the increase in cost of household help which resulted from the incident and how that amount was calculated. 29. STATEMENTS: (a) Have you or anyone acting on your behalf obtained statements, reports, memoranda or testimony in any form from any person(s) in any way relating to or concerning the incident? Police Report - please refer to Police Report attached to Plaintiffs Response to Request for Production of Documents (b) If the answer to (a) above is affirmative, either attach copies or state: (1) The identity of each person making such statement(s) or report(s); (2) The identify of each person in whose presence such statement(s) or report(s) were made; (3) The date and place each such statement or report was made; (4) The form of each such statement or report, whether written, oral, or recorded, by a recording device or a stenographer; (5) Whether each such statement or report, if written, was signed and the number of pages thereof; and (6) The identify of each person presently having custody of each such statement or report or any notes or writings pertaining thereto. 30. WITNESSES: Please identify the following persons: (a) Those who you believe may have knowledge of or information as to the facts pertaining to the incident; Plaintiff Patrick Straka (b) Those who have been interviewed concerning this lawsuit, whether or not a statement was taken; None (c) Those who you or your representative have tried to interview or expect to do so in the future; None identified at this time (d) Those who actually saw the incident; Plaintiff Patrick Straka (e) Those who did not see the incident but were present at or near the scene at the time of the incident; and Fire, police and ambulance crews John French - friend (f) Those who you expect to call at trial, providing a summary of each witness' testimony and the identify of the documents each witness intends to use at trial. None identified at this time 31. EXPERT WITNESSES: (a) Have you or anyone acting on your behalf retained any expert who is expected to testify at the trial of this matter? None at this time (b) If the answer to (a) above is affirmative, state: (1) The name, residence, business address, occupation or profession, and the area of expertise and/or discipline of each such expert; (2) The substance of the facts to which each such expert is expected to testify; (3) The opinion with respect to which the expert will testify; (4) The grounds of each opinion to which each such expert will testify; and (5) In detail, the factual information supplied to each such expert which was used as a basis for the expert opinion, including all objects examined, the type, place and date of examination, as well as a description of all photographs and plans reviewed; (c) Attach a current curriculum vitae of each expert identified; (d) In place of answering Interrogatory No. 26(a) and (b), you may file as your answer, each expert's report or you may have the Interrogatory answered by the expert. 32, PHOTOGRAPHS. DOCUMENTS AND THINGS: (a) Do you or anyone on your behalf have or know of any photographs, motion pictures, maps, drawings, diagrams, measurements, surveys or other descriptions regarding or in any way relating to or concerning the incident? Diagram attached to Police Report Photographs of injuries and property damage attached to Plaintiff's Response to Request for Production of Documents. (b) If the answer to (a) above is affirmative, either attach copies thereof or state for each: (1) The nature of same; (2) Its specific subject matter; (3) The date it was made or taken; (4) The identify of the person making or taking same; (5) What it purports to show, illustrate or represent; and (6) The name and address of each person presently having custody of same. 33. DOCUMENTARY EVIDENCE: (a) Do you intend to use any book, magazine, or other writing at the trial of this case? None identified at this time. (b) If so, describe the writing in detail as to author, publisher, and copyright date, and give the name and address of the present custodian of said writing. 34. INSURANCE: (a) Describe each insurance policy including automobile/motor vehicle insurance, first party coverage, workers compensation, program, group contact, such as professional health services corporation, a hospital plan corporation or any other arrangement for payment of benefits, for which you are eligible to receive benefits. Motorcycle insurance with Allstate Aetna health insurance Please see Plaintiffs Declarations Page attached to Plaintiff's Response to Request for Production of Documents. (b) State the group, contract and policy number for each, and whether the policy is full tort or limited tort. Allstate, Policy # 9 01 021756 05/25, Full tort (c) State the amount of coverage available for each policy identified. (d) List all payments made, the dates of payments, the payor and the payee. None (e) Identify all registered motor vehicles owned by the Plaintiff(s), individually or jointly, at the time of the accident. Honda Goldwing, Ford F250 (f) Identify the name and policy number of the insurance company providing financial responsibility for the motor vehicle(s) at the time of the accident. Allstate - motorcycle insurance Geico - automobile insurance (g) Do you contend you have incurred any economic detriment which has not been compensated? If so: (1) Describe the economic detriment; Lost wages, sick leave days (2) State the amount of economic detriment and how that was calculated; 11 days off work, earning $112/day = loss of $1,232.00 (3) State the amount compensated and the balance that remains uncompensated; No compensation (4) State when and identify by whom compensation was made. (h) With regard to any other non-economic detriment for which you seek compensation (such as pain and suffering due to any injury), describe with specificity the detriment for which you are seeking compensation. Loss of bike and confidence to ride again. I still had to pay the bike off that I can't ride. 35. SETTLEMENTS: State whether you have received or agreed to receive, from any person, any sum or thing of value for any injuries or damages resulting from the incident; and if so, provide the amount(s) received or to be received and date(s) of payment. No. 36. THE INCIDENT: (a) State in detail your version of the events which led up to the incident, the surrounding circumstances, and the manner in which the incident occurred, including but not limited to, the exact location, date and time of the incident. I was coming into a left curve and slid on loose gravel. (b) What was your destination at the time of the incident? John French's house (c) From where were you coming at the time of the incident? My house (d) What was the purpose in traveling to the destination listed above? Dinner with his family (e) List the chronological order of routes you traveled and stops you made in traveling to the destination listed above. Tuckahoe Road to Pine Street, to Camp Ground Road, to 74 North, then onto Creek Road where the incident occurred. 37. Please describe as specifically as possible, the following: (a) The weather conditions at the time of the incident including lighting, cloud cover, temperature, and precipitation; Driving on dry road, daylight, warm weather. (b) The condition of the road surface on which you were traveling; Hard asphalt which transitioned loose gravel and hot tar (c) The extent to which there was other traffic on the road at the time and at the place of the incident; None (d) The speed at which your vehicle was traveling at the time of the incident. 35-36 mph 38. Do you contend any Defendant was negligent and therefore liable for injuries Plaintiff sustained? If so: (a) Identify any act or failure to act by Defendant which constitutes negligence; and Please refer to allegations set forth in Plaintiffs Complaint (b) State the action you contend Defendant could or should have taken which would have prevented Plaintiffs injuries. Better attempt at warning 39. Describe any actions taken by you to avoid the accident. Braking and slowing 40. Did you attempt to slow down or stop prior to the accident? If so, state what action was taken and what was the effect? Yes - see answer to Interrogatory No. 39 above 41. State whether you had taken any drugs, alcoholic beverages, medication, or stimulatnts within twenty-four (24) hours preceding the incident. If your answer is in the affirmative, identify such substance, the amount taken, where, when and with whom taken, why taken, and from whom received. None 42. Were there any drugs, alcoholic beverages, medication, or stimulants in your possession at the time of the incident? None 43. If the answer to the preceding Interrogatory is in the affirmative, please identify how much, what kind, and when and where each was obtained. 44. Please describe the vehicle you were operating at the time of the incident, including the make, model, year and mileage and person(s) with ownership interest in said vehicle. 1981 Honda Goldwing, owned by Plaintiff 45. (a) If Plaintiff was not the owner of the vehicle, please identify the owner, and who gave the Plaintiff permission to drive. (b) How long did the Plaintiff have the vehicle in his/her possession (whether or not you owned the vehicle)? Just about 2 years (c) Identify the owner(s) of the said vehicle now, and at the time of the incident. Plaintiff (d) Were any parts (i.e. brakes, lights, and steering mechanisms) of the vehicle operating improperly at the time of the incident? If so, did you know that at the time of the incident? No (e) Who normally did repair work and state inspections of the vehicle? Mechanics at Ray Hold and Cycle Tech (f) What was the last work done on the vehicle before the incident? When and by whom? New brakes and tires (g) Where is the vehicle located at present? In a Newville wrecked bike place, with a salvage guy 46. At the time of the accident, were you diagnosed as needing corrective eyeglasses or lenses? Yes 47. Subsequent to the accident, have you been diagnosed as needing corrective eyeglasses or lenses? Yes 48. At the time of the accident, were you wearing eyeglasses or lenses? If not, please explain. Yes 49. Describe your version of the events subsequent to the incident, including: (a) Your position in the vehicle just before and following the incident: Operating the vehicle (b) Did you lose consciousness at any time? No (c) Whether you were able to walk from the scene of the incident unaided? Yes (d) A description of assistance rendered; Ambulance crew, police and fire crews assisted me (e) Whether you notified any parties of your injuries and, if so, who was notified and when they were notified; 911 (f) Whether anyone called for medical assistance to help you following the incident and, if so, who called for medical help; Yes (g) Where were you found by those first rendering medical assistance; and By the bike (h) Whether anyone called for police assistance, and if so, who called, who was called, and who arrived. Pennsylvania State Police 50. Please describe: (a) Any and all immediate medical treatment received by you subsequent to the incident; Treatment by Yellow Breeches EMS at the scene (b) The identity of those giving such treatment; Yellow Breeches EMS (c) Whether or not you were taken to a health care facility immediately after the incident and, if so, how you were taken; and Yes - by ambulance (d) The identity of the person or organization who transported you to the hospital and the identity of the hospital. Yellow Breeches EMS to Holy Spirit Hospital 51. Approximately how often had you driven on the road where the incident occurred: (a) In the year prior to the incident? I can't count them - many because I have been friends with John for 7 years (b) In the month prior to the incident? 5-6 times (c) In the week prior to the incident? 2 possibly 52. If you allege that a dangerous condition existed on the roadway location in question, please state: (a) the exact dangerous condition that existed; excessive gravel and tar (b) when you became aware of the dangerous condition; As the stones started to hit the bike (c) Whether the amount identified in your answer to subpart (b) exceeds the quantity specified in the contract between Monroe Township and Hammaker East, Ltd; (d) Whether the amount identified in your answer to subpart (b) is in violation of any federal, state, and/or local statute, regulation, or ordinance, and if so, identify said statute, regulation or ordinance; and (e) Whether the amount identified in your answer to subpart (b) is in violation of any established industry standard and, if so, identify the source of that standard. 54. Does Plaintiff contend that the portion of the roadway where the accident occurred was still under construction? If so, state all facts supporting said contention. No 55. Does Plaintiff contend that Defendants failed to erect warning signs? If so, please state: (a) Whether Plaintiff contends Defendants were required to erect said signs pursuant to the contract between Monroe Township and Hammaker East, Ltd. (b) If your answer to subpart (b) is yes, specify where in said contract; (c) Whether Plaintiff contends Defendant was required to erect said signs pursuant to any federal, state and/or local statute, regulation or ordinance and/or established industry standard. Yes, state law (d) If your answer to subpart (c) is yes, identify said statute, regulation or ordinance and/or industry standard. 56. In feet, yards or miles, how far had Plaintiff traveled on the newly "tar and chipped" roadway prior to the incident in question? 10 to 15 feet 57. In seconds, minutes or hours, how long had Plaintiff traveled on the newly "tar and chipped" roadway prior to the incident in question? 58. Had Plaintiff traveled on the roadway either that day or any other time while it was being "tar and chipped?" If so, please state: No (a) How many times; (b) When; (c) The distance traveled each time. 59. Please identify the specific laws, statutes, and/or regulations of the Commonwealth of Pennsylvania regarding the maintenance of township roadways Plaintiff contends Defendants violated in Paragraph 33 (e) and 43 (e) of the Complaint. 60. For each said law, statute, and/or regulation identified in your answer to the preceding Interrogatory, please identify every fact supporting Plaintiffs contention that Defendants violated said laws, statutes, and/or regulations. 61. OTHER: (a) Identify or attach copies of any and all writings, notes, records or other documents in the nature of any communication between you and any insurance carrier or attorney, not otherwise privileged, which are related to the incident. (b) State the nature, time and conclusions of all investigations made by you or on your behalf into the incident or the circumstances surrounding it. (c) State whether you have ever been prosecuted, convicted, or pleaded guilty to a criminal offense, and, if so, for each offense, the court term and number of the proceeding, the charge, and the disposition. No (d) State whether you have made any other claim or demand to any other person/party or filed any other lawsuit for any injuries sustained in this accident. If so, identify the person/party to whom claim or demand was made, the date of claim, demand or lawsuit filed, the reasons for and damages claimed, and the resolution, if any. No (e) Identify by caption, number and court, any other lawsuit in which you are or have been involved, as either a plaintiff or defendant, and identify your attorney' and None (f) Identify all individuals who prepared or supplied information in the preparation of these Interrogatories, including such individuals' relationship to you, title, job and address. Plaintiffs Attorney, W. Scott Henning, Esq. 1300 Linglestown Road, Harrisburg, PA 17110 Respectfully Submitted, HANDLER, HENNING & ROSENBERG, LLP L W. Scott Henning, Fs Attorney for Plaintiff PATRICK STRAKA, Plaintiff V. MONROE TOWNSHIP, RUSSELL: STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 04-3009 CIVIL ACTION - LAW JURY TRIAL DEMANDED PLAINTIFF'S RESPONSE TO DEFENDANTS' REQUEST FOR PRODUCTION OF DOCUMENTS 1 2. 3. 4. 5. 6. 7. 8. 9. to. it. Please refer to Police Report attached as Exhibit A and photographs attached as Exhibit B. None. None. None. None at this time. None. Please refer to documents attached to Plaintiff's Response to Request for Production of Documents. None. Please refer to medical records and medical bills attached as Exhibit C. None at this time. Please refer to Declarations Page attached as Exhibit D. EXHIBIT K 12. Please refer to Declarations Page. 13. Please refer to documents attached to Plaintiff's Response to Request for Production of Documents. Respectfully submitted HANDLER, HENNING & ROSENBERG, LLP ALL 9,n1EL-AL 50FPRY CO.. 1 9W 1111511 mn LE"IL£ andlar MAIN OFFICE 1300 Linglestown Road / Harrisburg, PA 17110 717--2000 anning 1-soo-422azz-2zza 717-233-3029 (fax) oSQnbQrg,«? LANCASTER OFFICE 717-431-4000 ATTPRNEYS AT LAW Leslie andler, Retired W. Scott Henning David H Rosenberg (PA, FL) Carolyn M. Anner (PA, NY, RN) Matthew S. Crosby (PA, NJ) Gregory M. Feather (PA, NJ) Stephen G. Held Jason C. Imler Barry A. Kronthal, Esq. Margolis Edelstein 3510 Trindle Road Camp Hill, PA 17011 October 14, 2005 RE: Mr. Patrick Straka vs Monroe Township 04-3009 Dear Barry: CARLISLE OFFICE 717-241-2244 www.HHRLaw.com Henning@hhrlaw.com In response to your letter dated October 7, 2005, it is my understanding that Patrick has not yet returned from Iraq. Based upon the communication we received from one of Mr. Straka's relatives at the end of June 2005, it is my understanding that Patrick should be returning to the United States in December 2005. I will advise you as soon as I receive confirmation that Patrick has returned to Pennsylvania. Very truly yours, & ROSENBERG,LLP W. Scott He WSH/tgd cc: Patrick Straka Jeffery D. Wright, Esq EXHIBIT L ALL ?sn.F i..,u 5l,mu GI. 1.11"1I'll [Li tl63(lED tl ?} l WAGMAN KREIDER & WRIGHT PHILADELPHIA OFFICE V DIVISION OF 1601 MARKET S'1REE1 BRICKLIN & SALTZBURG LLP BENNETT 16CH FLOOII , PtIIIADEIPIIL\,PA 191x1-3393 ATLORNEYSATLAW (215) 561 4i0U 322 EAST ORANGE STRHET FAX: (213) 561 6661 4 LANCASTER, PENNSYLVANIA 17602 NEW JERSEY OFFICE FXEC U-1 IVE ME\A S (717) 397-7000 SORE X-I G FAX: (717) 394-0645 19111 LAS1 RIAIU:I'ON. PIKE CFIRKRYHOJ, NI IIS103 WE.BSITE'. wmw.bbs-lom.mm (S56) 751-318, FAX- (856)]513281 October 28, 2005 W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 BLUE BELL OFFICE I'IVr VALLEY SO( \RI SUFfP buI 3110AANlIIIP LINK ROAD BLUE BF11, Dd 1'14P2 (267) 034 1100 FAX: (267) 6i1 1133 Re: Straka v. Monroe Township, Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East Civil Action 4o.: 04-3009 (Cumberland Count Dear Mr. Henning: i aIn in receipt of your letter of October 14, 2005 indicating that Mr. Straka will be returning to the United States in December of this year. In anticipation of his safe return, I would like to address the issues previously raised in my letters of January 20 and February 24, 2005 so that we will be in a position to move forward with this case immediately upon Mr. Straka's return. Specifically, as you will recall from those letters, I provided you with a copy of the contract between Monroe Township and Hammaker East, Ltd. which specified the respective duties of each party for this particular project Thereafter, in paragraphs 51 through 53 of my client's New Matter and in Interrogatories 31, 52(c)-(e), 55, 59 and 60 there were certain questions specifically directed toward this issue. Unforhmately, these items were either not answered or improperly answered by your client prior to his being shipped overseas. Therefore, I would appreciate it if you could see to it that I receive a Reply to paragraphs 51-53 of my client's New Matter and answers to Interrogatories 31, 52 (c)-(e), 55, 59 and 60 in the immediate future. EXHIBIT M BENNETT, ERICKLIN & SALTZBURG LLP A ]'i' o KNEYSiA'I LAVr October 28, 2005 Page 2 1 look forward to receiving the above from you and if there is anything I can do to help expedite the resolution of this case, please do not hesitate to contact me. Very truly yours, Jeffery D. Wright JD W/cam bcc: David Woodruff, Sr. Acct. Rep. Claim No.: P040299027 ?u .u?L _r ,m ? ? y?r WAGMAN KREIDER & WRIGHT PHILADELPHIA OFFICE ;A DIVISION 01; 161-1 rsrar:Ir r gU<I. SI BENNETT B RIC%LIN & $A T IN IM L , L ZBURG LLP rIBI..voI '111H.v. P.v 1011!1-P9: I"1'O tN [1'ti V'r L.AW i215,5dl 4111-11 b:IS)-1i)i(d(661 222 I SAS' I' OIZAN(;I tiI'RI!F:'I' ? LANCr\,s I' FIR, PIANSl L\'.\NI \ 7611_ NEW JEBSFY OFFICE . I(SRCI_ MI'. III 1AA:? (717) 3 9 7--11111) ?t I'I P. S I], F AS'. l71?l 794-uG-{5 6191 11A 1 ,AI:AA1 ION NK< CIN I:P IIIJ,NI 1191-11: WICBSI rI _' Iclclc.66>-A,IV.rnm /9Yli ?il i'Ni I^ S. ,n5o1 -; 13391 December 8. 2005 W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg. PA 17101 BLUE BELL OFFICE riY1. A ?I1.1) ]I]CAItl It ]]I _'1-n I(M.WIHI'I_INi 91-AU I cc'?, ]'1, 1, In b.U' i_n ? n i+ I C] Re: Straka v. Monroe Township, Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East Civil Action No.: 04-3009 (Cumberland Countv) Dear Mr. Henning: As you may recall, I had previously been in touch with you about addressing certain problems and concerns with the discovery and pleadings which I thought we could address while Mr. Straka was out of the country. Unfortunately. that did not occur. Now, according to your letter of October 14, 2005. Mr. Straka is returning sometime this month and all parties should be in a position to turn their full attention to proceeding with this case. To that end, please provide me with your client's Amended New Matter and full, complete and verified answers to our discovery requests at once. If there has been some delay in Mr. Straka's return to the country. please let me know and we can adjust our efforts accordingly. Otherwise, I will anticipate receiving the above in the immediate future. JDW/cam cc: Barry A. Kronthal, Esquire Very`` truly yours, Jeffer "ght EXHIBIT N ,..o k.??a r o?_..a. ? ,i u..,??, / / I?; ? ?? ??X?"r.? PHILADELPHIA OFFICE 1601 MARKET STRLF.T 16TH FLOOR P HfLADELPHIA, PA 19103-2391 (215) 561-430U FAX. (215) 561-6661 4 NEW JERSEYOFFICE EXECUTIVE MEAS SUI'TL X 115 1910 LAST MAIU-TON PIKr CHERRY HILL, NI 08W3 (B56) 751-1285 FAX- (856) 7515281 WAGMAN KREIDER & WRIGHT ADIVISION OF BENNETT, BRICKLIN & SALTZBURG LLP ATTORNEYS AT LAW 222 EAST ORANGE STREET LANCASTER, PENNSYLVANIA 17602 (717) 397-7000 FAX. (717) 394-0645 WEBS1'rE.: www.hhs-laa.mm January 6, 2006 W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 BLUE BELL OFFICE FIVE VALLEY SQUARL SUITE 200 512 "f'OWNSUIP LAN. ROAD BLUE FELL, PA 19133 (267) 65-1-1100 FAX. (267) 65b 1123 Re: Straka v. Monroe Township, Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East Civil Action No.: 04-3009 (Cumberland County) Dear Mr. Henning: As you may recall from my letter of December 8, 2005, I had requested that Mr. Straka provide me with the full complete and verified answers to our discovery requests. Unfortunately, it is now more than 16 months since those discovery requests were served and more than one month has elapsed since Plaintiff's return and I have yet to receive those responses. Accordingly, I would appreciate it if you would see to it that 1 am provided with Plaintiff's discovery responses at once. Very truly yours, Jeffery D. Wright JDW/cam cc: Barry A. Kronthal, Esquire bee: David Woodruff, Sr. Acct. Rep. Claim No.: P040299027 EXHIBIT 0 rJ !) ^' i _ tYi D ' ` C` BARRY A. KRONTHAL, ESQUIRE Pa. Supreme Court I.D. No. 55672 MARGOLIS EDELSTEIN P. O. Box 932 Harrisburg, PA 17108-0932 Telephone: (717) 975-8114 Facsimile: (717) 975-8124 E-Mail: bkrouthal@margolisedelstein.com Attorneys for Defendant, Monroe Township File#38500.4-00069 PATRICK STRAKA Plaintiff COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION, and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership Defendants NO. 04-3009 CIVIL ACTION-LAW JURY TRIAL DEMANDED PRAECIPE TO AMEND VERIFICATION TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Kindly attach the Verification of Marjorie E. Metzger to the Answer and New Matter of Defendant, Monroe Township, filed on or about December 21, 2005, in the above-captioned matter. EDELSTEIN DATE: 2./ (o ( o Attorney No. 55672 3510 Trindle Road Camp Hill, PA 17011 717-975-8114 VERIFICATION I, `1?G e o, e E . me state that I have read the foregoing Answer and New Matter, and that the facts stated therein are true and correct to the best of my knowledge, information and belief. I understand that any false statements herein are made subject to penalties of 18 Pa.C.S.A. § 4904, relating to unswom falsification to authorities. Date: cwa?y 13, L rata \`rat c`-. Name: ZRocT c„z E.fRn?z1¢r Monroe Township Str,hs v. Ml my Township CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a true and correct copy of the foregoing on all counsel of record by placing the s in the United Wales mail at Camp Hill, Pennsylvania, first-class postage prepaid, on the day of 006, and addressed as follows: Scott Henning, Esquire 1300 Linglestown Road Harrisburg, PA 17110 Jeffery Wright, Esquire 222 E. Orange Street P.O. Box 1522 Lancaster, PA 1 7608-1 522 MARGOLIS EDELSTEIN By: Carol Moose M:\mdir\I Selective Insurance\38500.4-000691Ploads\Praecipe to Amend Verilication.2.8-06.wpd ,,_, ,? '? ? i1 t ' ? -.. ?`'1 _ ? + ? c. - -;i =? PATRICK STRAKA, Plaintiff v. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited Partnership, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 04-3009 CIVIL TERM ORDER OF COURT AND NOW, this 13`" day of February, 2006, upon consideration of Defendants Russell Standard Corporation and Sterlingwood, Inc.'s Motion to Compel, a Rule is hereby issued upon Plaintiff to show cause why the relief requested should not be granted. RULE RETURNABLE within 20 days of service, BY THE COURT, W. Scott Henning, Esq. 1300 Linglestown Road Harrisburg, PA 17101 Attorney for Plaintiff Jeffrey D. Wright, Esq. 222 E. Orange Street Lancaster, PA 17602 Attorney for Defendants Russell Standard Corporation And Sterlingwood, Inc. Barry A. Kronthal, Esq. 3510 Trindle Road Camp Hill, PA 17011 Attorney for Defendant Monroe Township :rc ORIGINAL 04-3009 BENNETT, BRICKLIN & SALTZBURG LLP ATTORNEY FOR DEFENDANTS BY: Jeffery D. Wright, Esquire Russell Standard Corporation and I.D. No. 41495 Sterlingwood, Inc. 222 EAST ORANGE STREET LANCASTER, PA 17602 (717) 397-7000 PATRICK STRAKA COURT OF COMMON PLEAS CUMBERLAND COUNTY VS. CIVIL ACTION - LAW MONROE TOWNSHIP, RUSSELL STANDARD JURY TRIAL DEMANDED CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited nartnershin DOCKET NO.: 04-3009 DEFENDANT RUSSELL STANDARD CORPORATION AND STERLINGWOOD, INC's PETITION TO MAKE RULE ABSOLUTE On or about February 6, 2006, Defendants Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East filed a Motion to Compel Plaintiff s Answers to said Defendants' discovery requests. 2. On February 13, 2006, this Court, per the Honorable J. Wesley Oler, Jr., issued a Rule upon the Plaintiff to show cause, if he had any, as to why the Motion to Compel should not be granted. 3. A true and correct copy of the Rule was served on Plaintiff s counsel on February 14, 2006. 4. The twenty (20) days in which to respond to the Rule have passed and yet, Plaintiff has filed no response thereto. 04-3009 WHEREFORE, Defendants Russell Standard Corporation and Sterlingwood, Inc. t/d/b/a Hammaker East request that this Honorable Court enter an Order directing Plaintiff to serve full, complete and verified Answers to said Defendants' Interrogatories and full, complete and verified Responses to said Defendants' Request for Production of Documents within twenty (20) days from the date of its Order or suffer such sanctions as may be appropriate. BENNETT, BRICKLIN & SALTZBURG, LLP BY: ght, Attorneys for Defendants .rd Corporation and Inc. I 04-3009 CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the foregoing Defendant Russell Standard Corporation and Sterlingwood, Inc.'s Petition to Make Rule Absolute on the persons listed below and in the manner indicated: Service by first class mail: W. Scott Henning, Esquire Handler, Henning & Rosenberg 1300 Linglestown Road Harrisburg, PA 17101 Barry A. Kronthal, Esquire Margolis Edelstein 3510 Trindle Road Camp Hill, PA 17011 BENNETT, BRICKLIN & SALTZBURG, LLP `y /3 -06 BY: , Attorneys for Defendants Corporation and Sterlingwood, Inc. 4 r> r .; _ -C7 J?? =• ?r;i " ?' c: : c.a ; , _a , E? -C BENNETT, BRICKLIN & SALTZBURG LLP BY: Jeffery D. Wright, Esquire I.D. No. 41495 222 EAST ORANGE STREET LANCASTER, PA 17602 (717) 397-7000 PATRICK STRAKA vs. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a limited partnership ORDER X16, ; 'i Aub $Y: _ 04-3009 ATTORNEY FOR DEFENDANTS Russell Standard Corporation and Sterlingwood, Inc. COURT OF COMMON PLEAS CUMBERLAND COUNTY CIVIL ACTION - LAW JURY TRIAL DEMANDED DOCKET NO.: 04-3009 AND NOW, this Z-L& day of -im 2.1 L, ?12006 upon Defendants Russell Standard Corporation and Sterlingwood, Inc.'s Petition to Make Rule Absolute: IT IS HEREBY ORDERED that Plaintiff is directed to serve full, complete and verified answers to said Defendants' Interrogatories and a full, complete and verified response to said Defendants' Request for Production of Documents within twenty (20) days from the date of this Order or suffer such sanctions as may be appropriate. 03? i !':J 1 G d'r, i a 47 PATRICK STRAKA, Plaintiff V. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 04-3009 CIVIL ACTION - LAW JURY TRIAL DEMANDED RULE 1312.1. The Petition for Appointment of Arbitrators shall be substantially in the following form: PETITION FOR APPOINTMENT OF ARBITRATORS TO THE HONORABLE, THE JUDGES OF SAID COURT: W. Scott Henning, Esquire, of Handler, Henning & Rosenberg, counsel for the Plaintiff(s) in the above action, respectfully represents that: 1. The above-captioned action is at issue. 2. 1 certify the amount in controversy is $35,000 or less. The counterclaim of the defendant in the action is N/A The following attorneys are interested in the case as counsel or are otherwise disqualified to sit as arbitrators: W. Scott Henning, Esq., Jeffery D. Wright, Esq., and Barry A. Kronthal, Esq. WHEREFORE, your petitioners pray your Honorable Court to appoint three (3) arbitrators to whom the case shall be submitted. Respectfully submitted, HENNI I.. D. 2298 ? 1300 Linglestown Rol~ Harrisburg, PA 17110 (717) 238-2000 Attorney for Plaintiffs ORDER OF COURT AND NOW, , 200 , in consideration of the foregoing petition, Esq., Esq., and , Esq., are appointed arbitrators in the above-captioned action as prayed for. By the Court, P.J. . -4 to --b p C) r Q4 ..- 1J 9-- a-- V ` m PATRICK STRAKA, Plaintiff V. MONROE TOWNSHIP, RUSSELL STANDARD CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, . Defendants CIVIL ACTION - LAW JURY TRIAL DEMANDED RULE 1312.1. The Petition for Appointment of Arbitrators shall be substantially in the following form: PETITION FOR APPOINTMENT OF ARBITRATORS TO THE HONORABLE, THE JUDGES OF SAID COURT: W. Scott Henning, Esquire, of Handler, Henning & Rosenberg, counsel for the Plaintiff(s) in the above action, respectfully represents that: 1. The above-captioned action is at issue. 2. 1 certify the amount in controversy is $35,000 or less. The counterclaim of the defendant in the action is NIA The following attorneys are interested in the case as counsel or are otherwise disqualified to sit as arbitrators: W. Scott Henning, Esq., Jeffery D. Wright, Esq., and Barry A. Kronthal, Esq. WHEREFORE, your petitioners pray your Honorable Court to appoint three (3) arbitrators to whom the case shall be submitted. Respectfully submitted, HANDLE , HENNI G RO GY 14 , '%-A By W. He ng, tq. I .D. 2298 1300 Linglestown RHarrisburg, PA 17110 / (717) 238-2000 Attorney for Plaintiffs ORDER OF COURT AND OW 3 , 200V , in consi ration of th fore oin petition, , Esq., B ttL .r N ? Esq., and 1-M At h-1-J4 aa& , Esq., area in arbitrators in the above-cap Toned action as prayed or. G P.J. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 04-3009 c?^ .+ 6Y • Y --o C4 X1 a l 5-5 y}` dui tb A PATRICK STRAKA, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. MONROE OWNSHIP, RUSSELL: STANDA CORPORATION and STERLINGWOOD, INC., individually and t/d/b/a HAMMAKER EAST, a Limited Partnership, Defendants No. 04-3009 CIVIL ACTION - LAW JURY TRIAL DEMANDED PLAINTIFF'S ARBITRATION EXHIBITS In accordance with Pennsylvania Rule of Civil Procedure 1305(b), the following documents are attached which the Plaintiff intends to introduce into evidence at the time of the arbitration of this case: 1. Medical Records from Holy Spirit Hospital 07/08/2002 - 07/09/2002 2. Medical Records from Aesthetic and Reconstructive Surgery 07/10/2002 - 07/16/2002 3. Medical Bill from Holy Spirit Hospital 07/08/2002 - 07/09/2002 4. Medical Bill from Aesthetic and Reconstructive Surgery 07/10/2002 - 07/16/2002 5. Medical Bill from Yellow Breeches EMS 07/08/2002 6. Medical Bill from Quantum Imaging and Therapeutic Associates 07/08/2002 7. Police Report. Respectfully Submitted, Date: December 27, 2006 HANDLER, HENN By W. Sett HehpWi? ; E I . D. #32298 1300 Linglestow R/C Harrisburg, PA 1711 (717) 238-2000 Attorney for Plaintiff ENBERG, LLP J., ?r VaquVV i'V, LLP ATTORNEYS AT LAW { Lealee B Handler Retired W Scott Henning Da+nd H Rosenberg (PA, FL) Carolyn M Anner (PA, NY, RN) Matthew S Crosby (PA, NJ) Gregory M Feather (PA, NJ) Stephen G Held Jason C War ATTENTION Medical Records Holy Spirit Hospital 503 N 21 st Street Camp Hill, PA 17011 Re: Our Client/Your Patient Patient SSN Date of Birth Dade of Incident July 25, 2002 w s: AUG 0 9 2002 Patrick` r W, 140 '184-36-711 5/27M072 7/812002 Dear Sir or Madam HARRISBURG OFFICE 1300 Linglotnim Road Harrisbwa, PA 17110 717-238-2000 1.900.422-2224 717-233-3029 (fax) LANCASTER OFFICE 140A E King Street Lancaster, PA 17602 717-431-4000 DIRECT MAIL TO P O Box 60337 Hameburg, PA 17106 wwW'HHRLnw cdm Henningehiviaw corn As referenced by the enclosed Authorization, 1 have been retained to represent the above- referenced individual Kindly provide me with a copy of the following. ? Discharge summary + ER and outpatient reports ? Patents chart (please retain a hard copy of the entire record ? History and physical ? Operative and pathology reports # X-ray reports (Please tag all x-ray films for possible court use # Lab reports ?a D" # Progress notes by physicians and nurses Fhq" 8 ? Dodoes orders peon ? Consultation reports ? Nurses' notes CtIfC rw pre car ? Alcohol and drug treatment notes pd e,;S-JF abs COP ? Physical therapy records log ? Psychiatric records If there are any questions as to what portions should be included, please call my office ,LLP WSHldlp Enclosure cc Patrick Straka 101 Tuckahoe Road Dillsburg, PA 17019 AIL AUTHORIZATION FOR MEDICAL ANDl4R HOSRLTAL 1NF©BM6JlQN This is to authonze any physician, medical attendant or others to furnish to the law firm of HANDLER, HENNING & ROSENBERG, or any representative thereof, any and all information or opinion, which they may request regarding my physical condition or treatment rendered therefor and to allow them to see or copy any X-rays or records that you may have regarding my condition or treatment. These records may include any and all information of a confidential nature, Including results of drug, alcohol or KIV testing and any psychiatric records, if applicable. My said attorneys have been retained by me to prosecute a claim against the insurance carriers or others for injuries sustained and your full cooperation with my attorneys is respectfully requested All prior authonzations are hereby canceled and medical information may not be released to anyone otherthan a representative of my said attorneys except for billing purposes only, provided a copy of such information is sent to my attorneys Permission is hereby granted to photocopy this authorization and any photocopy thereof shall be as by me an original WITNESS ?dt??ur? ;'F ??/?U Date PATFddC SfRA1CA m7S?o e ? ? w? ? a v r .w• I I ? I? I ! I { W W! 1..r t,? t.. ! ?I Y Lr ... Lf l 1 ? ? I r ? r HSH ER FORM RE G DATE: 07.'08/02 18:227 PT#: 19176098 MR#: 339737 NAME.' STRAK A . PATRICK SS # : 164-56-731'a ADDRESS: 101 TUCK AHOE RD /D I LLSSURG 'PA/17019 PH 1t : 717 432-822; SIRTHDATE: 05/'27/1972 AGE: a0 3EX., M M8: S RACE: I GEO: 041000 EMPLOYER: ARMY WAR COLLEGE OCCUPATION: CHEF ALaat?iF3$: f CAPL I SLE dl=All 17013 PH# 717 245-4174 CHURCH: NONE At1B: NONE C ;rIMENT ; EMERGENCY CONTACT INFORMAT:Ott NAME: H I NSON . PAULA REL TO PT: R w PH - ADDRESS: 117 OLD YORk RD rOILLSSUR07 IIPA 1'i7019 PH 717 -- 432--0506 NAll E : H I NSON . 9R i AN REL TO PT: `J wk PH -- ADDRESS: 117 OLD `r'DRh RD /DILLSBURG /IPA "1^01q PH "1:' -- 432--0506 CASE INFORMATION ADMIT DR: 180018 ED GROUP REG SOURCE: EO PATIENT TYPE: £ ATTND DR: 180015 ED GROUP HOSP SERV: ER1 FINANCIAL. CLS: P REFER DR: VISIT CLINIC CODE: ER1 AG19 I T D:, : I CD-4 DX COMPLAINT: MOTORCYCLE ACCIDENTS AMB SRT IN BY: YELLOW BREECHES BRT IN BY: BLS COMMENT'. ACCIDENT INFORMATION DATE/TIME: 07: 08102 17:30 ACC IND: 0 JOB RELATED: N LOCATION: DESCRIPTION: PT INVOLVED IN MOTORCYCLE ACC IGENT NAME: STRAKA ,PATRICK ADDRESS: 101 rUCKAH©E RD EMPLOYER: ARMY WAR COLLEGE ADDRESS INSURANCE Co SUBSCRIBER i I NSUR. ADDRESS: c I t?i.S UR . +=?dGRE3S 3 INSUR.ADDRESS: 4 GUARANTOR INFORMATION PT REL TO GUAR: S SS #: 164-56-7511 /'D I LLSBURG /PA/1701'? PH 717 - 432-8227 CONTACT NAME: /CARLISLE /PA/17013 PH 717 -- 245-4174 INSURANCE I NFORtIAT I ON GOB POLICY # GROUP # REL PC VF's CARD PRECERT/AUTH # PRECERT PHONE # N N N I NSUR . ADDRESS : Di` MENTS: FND POTTER PT HAS INS, NO CARD AVAIL 'AT IEIIT NAME: STRAKA . PATRI C. ' PT#: 09176098 IIR#: 339737 EGISTERED BY: L`,'US EDITED 8't; t'ATE: A END ;?F DOCUMENT -'^ - -•-_ ..? _?_ _ L5 it:Zrn is ?(4J r- 4..L1...-1 .!? _A' -L-. ADM. DATE: 07/08/2002 CHIEF COMPLAINT Motorcycle accident HISTORY OF PRESENT ILLNESS This 30 year-old gentleman was brought in by ambulance tonight He was riding on his motorcycle, went to turn to the left, hit some enders and the bike went out from under him He fell onto his left side He was wearing a helmet The patient states that he flippod twice on the macadam There was no loss of consciousness, the patient was ambulatory at the scene He states that he ran to the telephone to seek help The patent complains of pain mainly on the left side He has severe brush bums at the left elbow, left arm, left hip and left knee His last tetanus shot was in June of 2000 The patient denies chest pain, abdominal pain, back pain, neck pain or headache PAST MEDICAL HISTORY Negative for any surgery or illnesses MEDICATIONS On no medications ALLERGIES Ampicitlin and shrimp. SOCIAL HISTORY The patient has never been married He works as a chef at the War College He doesn't smoke, he drinks alcohol occasionally PHYSICAL EXAMINATION: VITAL. SIGNS See Nurse's notes GENERAL- The patient was initially immobilized on a long board with cervical collar immobilization. The neck was cleared clinically and he was taken out of ft cervical collar HEAD Normocephelic, atraumatic EYES. The patient has horizontal nystagmus (this is congenital, his pupils are equal) NECK. Supple with full range of motion and is nontender CHEST Nontender. LUNGS. Clear to auscultation. HEART The rate is normal, the rhythm is regular ABDOMEN Soft, nontender EXTREMITIES-77-T1 at thi left shoulder, HOLY SPI are multiple deep abrasions and lacerations mainly involving the left side elbow, left hand, left thigh and left knee, Pane 1 of ? ,,? Camp Hill, PA 17011 EMERGENCY ROOM REPORT NAME Straka, Patrick n? MR# 339737 ROOM 6WST637 01 DR THOMAS W ALDOUS, MD NAME: Straka, Patrick N: 33737 X-rays of the cervical spine, chest, pelvis, left elbow, left forearm, left hand, left femur are ali negative for fracture INTERVENTION The patient was given Morphine sulfate 5 milligrams IV along with IV fluids at 500 cc an hour Consultation was obtained with Dr Bret DeLone Dr DeLone will have the surgery resident see the patient DIAGNOSIS. Motorcycle accident with multiple lacerations and abrasions DISPOSITION. The patient apparently is being admitted to the hospital under the services of the Kunkel surgical group The Kunkel group has assumed patient care and will arrange for laceration repair and follow up treatment and diagnostic studies Signed THOMAS W ALDOUS, MD 07/17/2002 1915 THOMAS W ALDOUS, MD TAIjrs DOC #• 254246 D. 07/09/2002 T 07112/2002 4 19 P 004965 cc PaQe2of2 HOLY SPIPJT HOSPITAL Camp Hdl, PA NAME Straka, Patnck 1701'! MR#' 339737 ROOM 6WS'TS37 01 DR THOMAS EMERGENCY ROOM REPORT W ALQOUS, MD Date _ Mode of Arrival BL Triage Chief Comple Fr , n P?- Age FMD AC- & A149 In i?'ih? "T` BP I;'l _ O.SAT e` Triage (T-4 0 Other ? T P R _ Room r - 92q JA - Advanced DirecWes r"f-r/70 /Z to-Yes ? No he ii h?/nrr, s r? Attached PK ;'/Aw / Yes ? No R .t I 7?}O ?s - 1) etf I -f LII ??'~+¢Q r•?jee t~. L. Exposure ? to measles, chxn pox. TB? Y om . es PAIN ASSESSMENT r -- Location (? PMH Choghlist None C7 MI CI HTN 0 CAD 0 Intensity Scale .? 110 CHF ? ASTHMA ? CANCER ? STROKE ? Adutt ? Wong Baker El NtDDM ? IDDM ? s.• ;`?:?', r" , '• Surgeries C.] Character W Dull ? Sharp ? A che) Pressure D Burning- ' Other L7 Throbbing l? Radiating ? ?'+????*? ??3 Duration ' Allergies Frequency aa ;,. ,, ,, , f•, ,?A ''„ v, r ?•'tiky 1 r ; k- ;? • LLL\ ._ r Latex Allergy Yes 0 No X What relieves Pain?_ ; w I n atio s UTD Not UTD ? Triage Notes :f'_,i?? , ; 4D? LMP t T V e anus P1 40H ? swkw(s Foot Yes No [7 Treatment 6 Triage MedLgUons info obtained by EVIT C Medic CI List O Bottles D PatientO Maria Dose Meeks Dose Meds Dose SI ej737 I" STS#tt?1 ,?'ATRtCt Holy Spirit Hospital fit T •f c k # -yor Camp Hdl, PA 17011 t' t L L ' , ,, ` (?$! ;Z7 111)72 # t? ?x 7 John R Dietz ECU i- 9:- 7t? 11 EP GROUP t NurWng A. CHART COPY 201-Eou trot 10th Rev LS +? `41 Inltlal Lob ar X-Rny _Ord : [ ) Acetaminophen ( ] DOAS [ ) Thrombolybc Labs ( ] Acetone (SAGE) [ J ESA ( ] Tax Screen ( ] Alcohol (ALCO) ( j Glucose [ j Unne Tax Screen [ ] Amylese/Lipase [ ) HCGS [ ] TSHR [ j APTT [ J HIV ( ] Typ@&Crm It of unite [ ] SEW [ j Liver ) [ ] Blood Cultures Profile [ ype & [ ] BMP [ ] Lyles [ [ ] CSCP [ ] Phenoberb [ J Uri [ ] CMP [ ] PTP ( ] Ur no HCG [ ) CRP1 [ ] Salicylate [ ] WC Breath Alco Test [ ] Digoxin [ j Theo [ ] WC Drug Screen [ ) Dilantin AA O [ ] Other I [ ] AbdfObar Series [ ) KUB [ ] Ankle R L ( ) L/S Spine [ ] Clavicle R L [ ] Maridlble [ j Cerv Spine Rt / Lat [ ] Nasal [ ] Cheat Rtn / Port 1 TPA [ ] Orbit R L [ ] Elbow R L [ ] Pelvis [ ] Facial [ ] Pyetogram IVP [ ] Femur R L [ ] Ribs R L [ ] Finger - R L [ ] Shoulder A L [ ] Foot R L [ ) Skull [ ] Forearm R L [ ] Sternum [ ] Hand R L [ J T/Spine [] Hip R L ( J TO J Fib R L [ ] Humerus R L [ ] Toe R I. [ I Knee R L [] Wrist R L [ ] Other Tirne/CRTlint REASON S/7*CLRI PJ'?0: Ultrasound: CT: (W=With t, WO=Mthout) [ ) Abdomen ?W WO ( ] VQ Scan [ ) Duplex Doppler [ j &WmMead WO [ ] Echo- [ ] Gallbladder [ ] Chest W WO cardiogram [ ] Pelvic) [ [ Spiral ohow for PE Tranevaginal [ ] Other L Time1CRTAnt REASON s }or spw,? i puns [ ] Beta Strop AG Rapid [ j stool C & S [ ) Cervical/Genital ( ] Stool O & P ( ] Chlamydia ( ] Stool C Diffiryle ( j GC Culture [ ] Trichomones [ ] Monospot (rapid) ( ] Wound C & S ( J Sputum C a S [ ] Other Billing Clatset icaLtl m: PHYSICIAN CHARGE FACILITY CHARGE [ ] Level I [ ] Level I [ j Aocldent [ ]Level 11 [ ] Level 11 [ ] Mod"I [ ] Level III [ ] Level III [ ) Case 1 ( ] Level IV [ ] Level IV ( ] Extertdad Hm [ ] Level V [ ) Level V [ ) Monitor [ J ABG's [ ] EKG [ ] Peak Flows Before/After Rasp Tx ( 1 02 L/Min [ J Respiratory Tx ( ] 02 Saturation I WA&^m&& h%w 1 r?nft I Dictated` Ha f [ ] Cofnpleted [ ] CRITICAL CARE hire Diagnostic Improeskm. Consulting(Ada ttft physiian Signature: MD/DO/CRNP DOW Tinw. Holy Spirit Hospital Catnip MR, PA John R Dieu Emergency Center Physician Order S1tuet 20O-ECU REV I OW vrlMc CHART COPY 1 ?+ `? 3"737 f ERI I , y 17019 Initial* Signature _ k,/ RNAMA trice. i 9ttatus: RVP lnIto Qttlatrraintltlisttt?he# Trauma A T p 5 oonsaotrs Uunoooperatrve eymrneer d t7Deares pawn Ia kous6m IL WNL warm normal Upais DIOUd Uethargic Cloombebve Uconfused Uanxlous and e4 a Cal tntenaty Unausea Udrarrhee n ?? Q on pnuehet7lsiutred yUh Demacialed Ocyano?tatkabve CVPRQ to Qhyatarical ?iesptxise 5hmuh i4rts clear Ustndor ?wfre L i R t7 Lleoohyty s pdelorm? Dlaundi horeliGO numbling proprlate /rho ?raletdrhtxtchi L ! R La Ubumt. Gait ?mottled Orash l:]ae6 y Odelayed 30 cough o IS-ounda P:: contuelon UNIA ?normal Uabnormgl Uproductve O Oblesding restramUeealu -saw sheet c]02 L wa te _ % SAf ? lar ?chest pain 45danies Neuro UN/A GU / GYN NIA Candlovescu 4 Uheadache ERL L 1 LIMortitourhvthm arse y .denies s/s Jurethral Severity ---J10 ?st+ft neck Size Glasgow core ' ?neck pain Pinpoint ? U Ufrequency discharge Upacer Ucanstant Usharp ?feClal droop Dilated O ? Ourgency :]vaginal di ha a Oedema ?tntermittent Udull Unumbness Fixed U U UDysuria Uvagmal bleed) Ubutning ?heavy ?waakness Sluggish ? ? OHarnaturie Ufaley LIJVD LIStas ?pleuritic non-reactive 0 0 Uretention presen Ucapillery refill Qnaussa GLASGOW COMA SCALE :10ther LMP Urapid Jdatayed Unon,radlatmg l.7radiadng tencti) EYES MOTOR RESP? BAL 4 Spontaneous fi bays / 5 t? led EENT Udeniss sis A 3 To verbal co lae pain 4 Dis nt Eyes Elm Nose Throat 2 To pain 4 n- dra al 3 Inapp a words Ohlurrad vision / R .-.Pain L / R Jcongesbon Usore Acuity L,_..,/_ 1 No Rasp se 3 Ab ! Incom nsive sounds Udouble vision R Jdischarge Jdramage Odrooling R_J_ Ab 4 Mon o Res se J Pt-iqtoph L ! R Udysphasta Dwlth lenses 1 , ig Signature Initial Protocol In G one,_._tabs -ray done- UCell bell ' C- wdhm reach ? IderaU Campemon with pane procedure explained r N Therapy (condition codes 0=no mllararnationrcompication 1=edema 2-erythema 3=occhymosis ?ltlons Modj 4=pain 9=hardness ti-"nth ?maakbV) -11 1% at Time Amt Solution STte Race Attempts ( nd Ini Drug R Site Irohal eaporea t e Notes Time Notes t r U J, - TRANSFER OR DISCHARGE ?? J, --Ip harged /accompanied by v Jambulator Jw/c aambulance A y to Uhome Unursing home UAMA UOR r- U other Udlscharge Instructions given to Upatle ©m dy Op III verball g Qf d/ i -A k A k, ILU (IC called K Ud d records s t ? transferred to ? n a ` ition V C y atisfa J It I ? Deceased to morgue ? z Improve pain I 10 Alba *501 (Holy Sfiint H spl I Camp Hill, PA 17011 7 Sohn R Dietz ECU t i?? is A R I DE r Nursing Assessment/ Notes ? R ? P ? Lai 2tl?Ecu t)QJO1 8° Rev i_i_w (} 5/ Z7/ Iq 7 Z ? 12-q ?t 7 ? 1h4-b-?S??t ED GRIIt?p # CHART COPY ~` •? DATE P M, #IM 04 #I R T IT `? C6- v r HOLY SPIRIT HOSPITAL CAMP HILL, PENNSYLVANIA 17011 EMERGENCY AND 01WERVATION RECORD PATIENT CARE NOTES BIZ-'?39 7 37 Fom No IN ("s) 717 972 4652 P.01f01 RADIOLOGY 1ST PL liOLY SPBtff h.,& AL PA Y RADR)LOGLYTI IP'I 14 COPY ACCESSION 5ARCOOZ 1 1 2 3 DATE Jul 9 2002 7:Z PM - - STATUS: STAT HOW Wc: ER1 LQCATI2N: ER1 METHOD OF TRANS ??i it Yr?- .r..r? r.i___•..wi???-- rr PATIENT: STRAKA, PATRJGK ADDRESS 101 TUCKAHOE RD $aC SEC, 164-W,7511 DIL LSOURG. PA 17018 ORDER #: 94001 PHONE (717) 432-8227 ? .. WD REC * 339737 ADM #. 1917 TA I AGE 30Y DOP1 03!2711972 * . ORD DATE Jul $ 2002 7 23P'M SEX' - M ORD DR- A LDOUS. TF ohos - (717)1072-4 M GontraWaotope ToW 0 of Ffms; fV Pt Pregnant Y _N Tech ? EJA Akwghm Room S: .a EXAM DATE' Jul 62002 7:23PM PROC 2= zm I ms '61-11E +t1W 1825384 ? 2088 -"A +n nC SME 72082 162531 1288 182MM 1202 'FY!lR?l11i 794$0 1826387 '1368 FTA40t49-r3M 18253M 1888 lib I 182ma9 t 1682 IIAt1R 735W IM90 COMMENTS Oxyp*n. IV: Isolamm MOTORCYCLE ACCIDENT &e4a ONLY V- rr, _ -? ?r46e READING RADIOLOGIST' TIME READ. REPORT DICTATED- a? N TAT/"N 1"1 AA RUN DATSs 07/../02 HOLY BPTRIT ROSPA...", CAM HILL, PA 17011 PA= 1 RUN TnM 1 2240 D 1310'110MIF or LA == mule= 8TRPIUMSM S . P . hKMaD088 X. D . , DZR=TOR LOCATION loom' s STS , RATRI ax A"/ Iwo, 30/m At a or $ ZD GAUP Agat#: 6004JR170098 VA& t## 33973' XR LNat-iiOns $91 Spec 070$.U000709 Coll: 07/08/02-2205 Statue: COMP Req #: 02325930 Recd 07/08/02-2209 Sub Dr ED GROUP Ordered URIN, UMIC Test X*w4lt $1 ie1'mv*ma COLOR STRAW AM,ST,YE CWMITY CL t CL :PH 5.0 4 5-8 0 SPEC. GRAu. 1.020 1.003-1,030 GLUC. NORMAL NORMAL MG /DL KETO 99"TIV9 Ugc TVk NO, /=, BILI. NEGATI'E NEGATIVE OCC. Bit). Nagglyz lifBt3G'MV9 PROTRIN - 1+ H NEGA'TIV9 _ T NITRITE NEGATIVE NEGATIVE LEUK SST. 9=111VE NMAT I i01C > EPI. CELL 0-2 0-5 #/UPF > mucus 1+ > HYALINE CASTS ? 630 H 0-2 #/LPF > FINE GR CASTS { 3-s H 0 #/LPF NURSING USE ONLY DATEMME 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 19 20 21 22 MEDICAL USE ONLY DATE(TIME -19/at_- LAJ r fi 4? .., . Z-S ° D 6s [i V/s a 41V 44)) 1V{ rrZl ,.?. I - L L? /ZL I 1 f , ? ? d Vu lp I T6 I ORDERS FOR RADIOLOGY, PHYSICIAL THERAPY AND RESPIRATORY THERAPY MUST WA)JDE REASON 2 ACCOnMG TO FORMULARY POLICY, ANOTHER BRAND OR DRUG IDENTICAL IN 00SWE FORM AND GWENT OF ACTIVE INGREIENT MAY BE SUBSTITUTED UNLESS NO SUBBTnTTION 'UP" IS INDICATED 9 . -ter $3 7737 E HOLY SPIRIT HOSPITAL T a C j' A ,, a[ r,,, CAMP HILL, PA ',ft I' Pal 17011 1 172 PHYSICIANS' ORDERS ti A 4 3 2• g Z 2 7 w NS 169 (1/01) C' '? / i NURSING MEDICAL USE ONLY USE ONLY DATEMME DATERIME HOLY SPIRIT HOSPITAL CAMP HILL, PA PHYSICIANS' ORDERS k 07/08/02 NS 169 (1101) ,r PATIICX ')CKAHOE Pr. Eli 1 ORDERS FOR RADIOLOGY, PHYSICIAL THERAPY AND RESPIRATORY THERAPY MUST INCLUDE REASON ' n ` - 2 ACCORDING OFACTIVEE INGGRREYDIIEN MAYBE ANOTHER UP IDENTM IN TM ION°N""N 8PRIS AND PA INDICATED 17019 ' t l z 1 "+ 7 2 432-8227 1 u4- - x t E 0 GIC)UP ? ? ? ?' x w ? ?a ?,. ?7 ?; 5' Y A. !y4"l?l P S,?a ?t ? ? ` , ? ' ?t ...,, ?h r? `? ,? ?, ? i •x.vA i l 3r .. . e Progress Notle to include Admission note, progress at least every other day,, complications, charge in diagnosis, summary note on discharge. Enter Date, Time andSign Each Written Note. TIME nATF tMA/13W qj/6 L '+ ?- C ( a... r f Se 10 kit , "-S • "f C S 1 I:-k- 2..- 9.4- 1 J Ill r IS HOLY SPIRIT HOSPITAL Camp Hill, Pennsylvania 17011 PROORBSS Nt7TEA FOF1AA 21 (12M) j1 i-1 '0 "03 N1 33 173 7 E f rT'7%(t PATRICK ` I *I 7 4rlrr?p? 1r fRi rrl.t ?; rrt t?tl«19 s ? ?? 7:?a l ELI ?rRflJP ? A"t Progress Notes to TIME r A'Vf /Ak&A s Admb on. We, progress at least every otter day, oolrooakwiss, clan in dlagncais? summary note on discharge. Eater Dats, Time and Sign Each Written Note Its vt Z Loo ?o .. h,_. ' I e C-v C W JL Ism= J HOLY SPI Camp MITI, R FORM 21 (12199) - T HOSPITAL eyivanla 17011 S NOTES I f Chief Compcaint r , i , f? !4_.Z:L Ok 4 L, ( . r, r. A A -- vj-?, kt, 'k- . PN I ER Nieds ' Time e ' - - Tim ?, Med _ Tung Ntel.± Z im- __M !d ? --- TLi1? htt? , Ttrnt Med O Hotel to ? R -1ti1e?a-see ERr??d s%?e2: r vs BP I I ?? CT. IN. 0 kP1'T1PT/WR IY ---- --- -.---iaca.ion rU H y sPSt•- xosp FAX REPORT sxEET Tem?-___Skt,7O1 l? dry C7mo Est dhot dilate Teas (,/tldtine) Comment !f abnnrrrxT D EKG - CJedztna ------ _ ©CXR FR/luno souads_ _ L_.T c3/V?BOK_)SOLL?.a.S _.- Q'G3r -rays( cat;/ GGT 01 OCBC ? AAO?c3 Oro^Fl,?a des owe ?layed ab>ent f OCNtP [V ClrepeaP APPT _ '_l`' OCRP-! Cti' - - ---- ---1cca<<o-? OCR.F'-2 C]CRt'-3 ER L'O since (ti©?) OOther Lab tz3ta e / Out ut Oral J 2rG CT Admitttag Physicia AA Other S'001 CommcntslSta s on tranifzr to it or Allz re?z ? Foam` , r ' Rrl? Signal tm? I- Jahn R ietz Emergency Center r 1 ER 06 11:04PM O JUL2M2 MISCELLANEOUS . ,-- F- -- - - - . ?. --r oFWwv%x, lim-- L-T %I JFf . 11 91pm 9$} 63( 74) IahHg MR= 83 (NIBP ) 11 @ZpM 111/ 72( 83) *bH@ HR= 94 (HIBP) I To mount first report, pull off the two plastic Hilts UWasted iY the arrow e. Poettim mpmrt e" to top and skis goloa, iii, tIMeM past ties report down over the exposed a 2mm9w, The aaheslvo le prossuro-sensitive be sure to pass *a report over the two aftwolve afess, Press lightly to attach temporarily Press firmly to attach securely and permanently INTERVAL N q 1@ h in LAST Bp= B 11 @2p1rt p 07108 7 2 r PATIENT NAME - LAST RST1 INITIAL CHART NO [? Telephone Messages ? Other ? Physician's Advice ? Telephone Orders ? Pharmacy/RX Receipts JKAWN FOR CHIEF C ti L C_`G f G SIONIFICANT PAST MEDICAL. NWrORY Previous surgery MOST RECENT HOSPITALIZATION DATE ALLERGIESISENS (DESCRI E REACTION Food I ?'_ r! ?f bL Medications Qom' Cr- f • V ac -K ether a. _A'EX SENSITIVITY Yes No. MEN MEIMATION009WREG (Include Over LAST DOSE The Counter and complementary mods) DATE TIME Are you aware of being exposed to measles, chic enpox or TS m the past 30 days? Yeso NoPT' If YES. saecifv ao information obtained from Patient [ J Filiirriily/S 0 [ ] Old records [ ] Attempt answers to all questions desalte inability to interview uatient/famtiy Unable to intwvia ?. DISCHARGE PLANNING 1?4L Lives at Home-.-o D91 Alone ? With Spouse/ S 0 ED Home Health Agency El Supervised Living / EGF / Rehab Name of Facility / Agency Person to be notified / Relationship to pt Sk4 1?"W ¢ day phone # eve phone # e. Ambulance member? YES Non If YES, where VITAL SKUn Present weight I Hetght- Scale Est_ Temp Pulse Resp Rate Blood Pressure_ R/A[:] L/ACD COGN17 vE STATUS Oriented? Y.Ct No0 It NO. check degree of disorientation. n Person Family/MD/Nurse Time Day/Date n Place Location/Address Alert? Yes tla? if N0, check highest level of response Visual/Auditory Stimulus Q Wain Behavior appropriate? Y NoED If NO, indicate behavior exhibited- AgitaW - Hyperactive, Anxious Dssrupti" • Disturbs others by yelling/shouting Depressed - Expresses hopelessness/helplessness Other Present Appearance, Well groomed Poor hygiene r7 It disoriented, decreased level of consciousness or behavior inappropnate were probiesnt evident bake atilt sitriess? Yes M. No M *111JISK)UNC LI VRAL. SOM-any of the fohlowi rel usI cultural beliefs that we need to be aware of ? lone E ]Dietary E3Reltgioua practice/spemal days/holy gays Treatment concerns affected by rekgious/cultural beliefs SPECIFY, 1 Required Information[ material Riven to:Pt S 0 2 Type of Advance Directiye. a Living Will YES [:3 NOET b Durable Power of Attorney for Healthcare YESO NQP;:r Name, Day ptwne # ):wwvte phone 0 If th4 answer to #2a or 2b is YES, MOM SOCIAL SEItVM 3 Organ Honor Card YES] NoE?1` 33+9737 M? IVA collect riff data A / t_PN# JA JUuNdW 41 I ? RN/GN NS #389 8/d1/Rcs HOLY SPIRIT HOSPITAL CAMP HILL, PA PATIENT Apnihftusfclw Aasfrss CNT PAGE I OF 4 m 1-47 16 - 75 I t d ED 0vr 3 et ? c' ?_XFir I " V"Oor POP a0"vow DWO WOW t+l Ppfft !now lWF voo vow ?,,.,••..?+-mow""` ? ..?''- 000 C3 Nx C3 POOR" Iff4c,010 *Iwo* f? t ff?' 1 .?•-? 4 r PWAOA ?Q°d' ??' -?--?' ?' 'wit ? C. Ago*" owso M=W z cfi• "id , j IL --- [31 `` VIA toot vop" If* mhw Coo .WOW Ocs 0 calm -vow A-- r,.*, ?-3A :o a 0" UUWT & r ( rya Uksr RNk P+ Dom` ff P'?? ? -?? ? f ?NWppF1 aws"Im, MOl-Y P#- ,.. ,r^ _.............. 11. EDUCATIONAL CONSULTS NOTIFIED/DATE DWbotic Phan lst (lul ds? CIc mat! OIIw (Ifs Nutftn soa l si?a 111. INTERVENTIONWEYAL UATION "LEARNER *** i ill., 1. 1 2. Family e. PAMPHLET OIrrlt#y below) 13. KNOWLEOW COQ by 3. Sotlltcant 7. VIMO (Icily b0ow) PATENT v QNSMTION Other 8. VERBAL,. INSTRUCTION 14. REVIEW NE91 ?ED 4. OTHER: 9. WFdTTEN INSTRUC71ON 15. OTHER: 10. INTERACTIVE DISCUSSION 11. OTHER: Educ Data Init" INFORMATION PRESENTED Need -74 HOLY SPIRIT HOSPITAL Camp HH1, PA. PATIENT EDUCATION RECORD ICI '?CxA1t?E °D ERE rILL ;r Pal 17014 A: 2TI1' 72 432-6217 }. 144-? -7 11 10 GROUP ; 3 I 07108/02 # N.S. 200 10/94 1. EDUCATIONAL ASSEBS TI'L AN List patlant's laducafrt nal n a bvrW on eftinkm arWor ongoMg ment It ?RDISCIPLINARY PLAN OF CARE / PROM 1 LIST Selo the appropriate problem(s? and gaags) INV La =w - wolishmsia"m U11 moo= Edit pint ROM aftenpth (3 NO wldanaa Of cvmpomt1am, wctl as contracture co skin hreakdawn C) Other Init "m Dept 0 Reeotv+sd Intt Dept Cl CI Imammd-Am Roar -10 M%w* Absence of reddened etsNMs Ct No evidence of pelsolkwe eoc hymoses or hemetomA Q Skin rernarrs intact ? Wound dean, free of rimptic besue 13 beating envirartrne kt to Q Pswt re free from w4se-wn 0 Mier Ind-Del* 0 Rmwtwd Ind Da la Rapt. ....?. Q Q MWntmm pment srrwiay 0 Absence of sdverwflWA broth sounds Q MairdeM ABGS wkfein o*Vd range ? Able to wpbclo M aecre" Q Other Inn Date . Dept _ © MiMig- Init Dit pt Q Q pownt Is free from rnFsdioe © Ckw odorless nwplretory pecnations ? Inresrve line(s) *Wwl rn Ate(#) show no signs of mllamnretlon 0 wow ere clssn, *k arxt free of punftnt drainage O Cltlei Ind Date Dept a R od hdtDate Dept lSD ? lferbalm understenchng of disease proosss, hwiinant reQarren and/or nwdre?o+ka ? Verbahzew underetandrng of surgery Q Demonstratee underatermlino of info given Q Compisant wdh treatYnent reolaw O Partimpetes in care 0 Other Ind Date ' Dept 0 Resolved Ind UrN, Dept ?.- Q Need for Sow o Dechagpannng?provided see Progress notes b 0 Counselrng/r*ferrels are grAn ? Ocher - - Ind Date Dept Q R Ind - "-Datet D U Appears less anxious and rs bas dependent ? Asiss raabty-onented quesho?f 0 Uses effective coping rrwch ms Q Demonstrates understandrnont of anfo gnren ? Vwbowm need for additnat Irstp to deal with 00 pmb*m Q Other Ind Date O esi Dived knit Matik pt NS 38 Ptge 2 d j?tF.earr defir?t Q Able m perform ADU Q Domww t w andarswAng of alto ONW Q Other Ind Do 0 Rgi6wd " Ind. O lde dmm scares of nbWbnoe in filth due to sltuabon ? Via rwW for eddilrofrsal twwlp to deal with the problem Q fat metnwns spirituel foundation O Pt klaneifw nseou oW liar support Q Pt seeks out support group(s) Q Otlror Init Dept bred Init Dept D Na [a D I+wslhotiwttr eforrwtmwrwiml w nwa&ftstttiw verbally or non vorbidy U Follows senpis dmocoons to corrr kft tads C! Ptnarephardsrnsirwltretss MORMWdirwg oftrow to fleet with problems O Other Ind Deb Dept Q ea de "trot "-bete pt Ci C1 Tolera* di" end corapaat rM moddicetlon U No ewlerm of aspiration (c ongoshon, twW) ? Pore s in regR*W comperrrslory techniques for sale wrasowinp 0 Pt/camemer dwonstrsbs undarstandxv of pt edueaban Q Other Init Do O G;= Ind Q ? gosih set (am PT notes) ? Other Init Dow Dept Q RAs' lv*d Init Date ?? Dept INTERMOPLIMARY PLAN OF CAME / PROBLEM LIST Select the approprimis w*biern(s) and Qoel(s) 0 makomma MkI40 arwd Q Abeam of wpholonrs smwosted with HTN 0 C"Ap" t with antNtypsrtiela" mods ? Olttar Init. MR. DW C l ?a? fmt l ? 0 Normal cvrtslabsrevy of stw? O Absence of abdommal dietenbordcrampmg 0 Maintains am irW"MCy 0 Other Init to Dept 0 ink' ate pt C3 MarMsms or Improves neurb funcdon 0 Ottw Inrt• 081 C31C=-c&ed Irut Poin on a prop *1mi acale Vert alitesltrtdkatws behavWally relief of pain 0 other Inrt Dems a Irdt: 13 &Wmft in OWdtkm fl tertrdca nests nut MMI MN* O Adaquals source of nut ftn, O AMapdms diet conaislsngi provided 0 Serum s uminik-3.3 gW0 on PAB> 15 mod 0 Other ' Ind Data Dept 0 Resolved Init DO@ C?Apt ? C] Psi ton a ADLs with minhnal iassatance 0 odertled to environment ? other Irut: MO- 0 Resolved Init: DOM Dept p Maintalas stable viW signs , 0 Is free from cardiac dysrttythrmiss ? Absence of Q Other Ink. Dat Q Gk'fWInk: ? Baia (potenttal tort 13 birdnteins an asymptomaft navel of anomie Q Able to perfomt ADU 0 Compliant With pharmscotopiasl a"WdWi Q Other Ind t3sie Q e aCved Ink: " NS 38 oliomat 1101 CI At Rok for fait O a fee ham W#wy C1 Factors of risk are eliminated 13 Other Init Date Dept Q go-iWeir IrM Dew Dept UQVkw- .- C3 Frain at scoaptable level ? Able to share fears and concerns 0 Available resources ingowd for pt/fsmdy/30 Q Pstlentrfsmdy able to And support With staff, cWW or other reuomes 0 Other Init. Date Dept D Ind. Daft pt Q C7 A qff ptomada with normal electrolyte "is U Able to petiortft ADI.s Q Canoes t with dW*ry msttctrans CZ 0drer Ink. Dew Dept: (3 R s I+rs Init Dale _Dept 0 Makftins sbrtbia vIW aroma and weight Cx is teas of edema 0 Clear bilawal bnMtt *=Ws Q CofftMihrtt wJth Auld mtfIMon O Produces adequate unne output (>240cofS hr shift or >30oo/hr) O ww"m ncHrrtal alecimmse lavais O M&ftkw Auld beiartoa. 1+0 0 Other Init DO Q GO M' Ink ? C3 MWMWN t vital spit, 0 No evidence of prmw or oomM bleadrnp Q Pnxkms atdo Wrto urine output (440wM hr attest or:- 30cdhr) 0 Other Ind ate Dept CJ IIQ@;;R- Init ir. 7.70W Wm-*w a$ O cjmt (ea ^ wjw 13 IYfalr>I*s ootypsn satlrr MortY'8M C) xpraesea foolwg of cmfwt in rnau>takanp air exc hanip 0 IWrlintakta hemoglobin>tt?p/dl C l other Init. Date Dept. C) stp Qa Ind. `?" W HOLY SPIRIT HOSPITAL Camp HUi, PA LAICAL R 13 to Hpe Itsl Day Pact-Op Day 8 Q N d aD N "O N 'Q Qi ^ tO N $ d m ^ N S R 00 N tD 106 's . 105 104 103 .. . . . . . . .. . . 102 101 . . . . .. .. . . . . 100 . : : 99 . 98 - L 97 . 96 Flume 4 H (r Reanirations 41 W«ght Blood Pressure Y SKIN 11-7 7.3 3-11 11-7 7-3 3-11 11-7 7-3 3-11 11-7 7-3 3-11 11-7 7-3 3-11 Oral Tutx IV Trens- fusion r T WI T4? -- - -? FORM 50 (10/92) f Holy Spir"oapital Depart of Radflbldg4 and Diagnostic imaging Camp Hill, Pennsylvania 17011 (717) 763-2604 PATIENT: STRAKA, PATRICK DICTATION DATE: Jul 9 2002 6,31 A MR #-. 339737 TRANSCRIPTION DATE: Jul 9 2042 6 31 A SOC SEC. 164-5&7511 ORD DR: CHARLES DE?ONE M D PT TYPE: Q ADM DATE: 710912 DOS: 05/27/1972 ARRIVAL DATE: 0 2 1-OCATION: 6WST-63701 HOSP SERVICE: ECU 'Final. Report*" EXAMINATION: CT UPPER AtBDOWN AND PELVIS WO CONTRAST 72192 -0711812402 COMMENTS INDICATION Trauma Non contrapt scans were obtained through the upper abdomen and pelvis Contrast was not administered due to history of IV allergy C-1 , r L There is drlfuse fatly infiltration of the liver The upper abdominal organs otherwise appear normal r; t I;c No pelvic mass, adenopethy or intrapentoneal fluid Lc' I CONCLUSION: Fatty infiltration of the liver Otherwise unremarkable DICTATED BY: MARC SOSLE M D I SED I-AfTE OF EXAM: 07=/2002 SIGNED BY: SIMON WESTACOTT M D DATEITIME: Jul 9 2002 12 20P u y M?/DO hn%** Ssrlacrs co"Wsl mom Page 1 Holy spiospital Depatbnont of Radiolo% ..nd Diagnostc Waging Camp Hill, Pennsylvania 17011 (717) 763-2600 PATIENT: MR?tI: SOC SEC: ORD DR- ^T TYPE: DOW. LOCATION: STRAKA, PATRICK 339737 164-56-7511 CHARLES DELONE M D Q 05/27/1972 6MT-63701 DICTATION DATE: Jul 9 2002 6 33A TRANSCRIPTION DATE: Jul 9 2002 6 33A ADM DATE: 07/08/2002 ARRIVAL DATE: 07/09/2002 HOSP SERVICE: ECU 'Final Report' EXAMINATION: CT ABD WO CONTRAST 74150 - 0710912002 COMMENTS ?)6114CLUSION: M , SEE cT OF THE PELVI5 . S?. , 1 31 , P-1 DICTATED BY: MARC SOBLE M D 1 SED -'ATE OF EXAM: 07/0812002 SIGNED BY: SIMON WESTACOTT M D DATE/TIME: Jul 9 2002 12 20P /i J? < l d by Imaging Services Consultailion Page 1 F CONSENT M MEDICAL TREATMM " .• M 1 HEREBY CONSENT AND AUTHORIZE Holy Spirit Hospital, its agents, and employees, to the rendering of medical care, which may include routine diagnosbc procedures and such medical treatment as my attending or consulting physician considers to be necessary i also under- stand it is customary, absent emergency or extraordinary circumstances, that no substantial procedures will be performed upon me unless or until I have had an opportunity to discuss them with a physician or other health care piofiessional to my satlsfactlon It 1 am a oompetent adult, I have the right to consent or Wupe to consent I understand that the practice of medicine and surgery is not an exact science and that diagno- sis and treatment may involve risks of injury or even death and acknowledge that no guarantee has been made to me as to the results of any examination or treatment in this Hospital I understand many of the physic ans on the staff of Holy Spirit Hospital are not employees or agents of the Hospital, but rather are independent contractors who have been granted the pmAop of using these facilities for the care and treatment of their patients Further, t realize this Hospital is a teaching Hospital and at the Hospital are health care personnel in training who, unkm expressly requested otherwise, may participate or may be present during my care as part of their education Still or motion pictures and dosed circuit monitoring of patient care may also be used for educational purposes, unless I expressly request otherwise I understand that in order to ensure a safe environment for patients, visitors and staff all property on the premises of Holy Spr ospital is subject to reasonable search and/or seizure at any time without further notice initials r S RELEASE OF MEDICAL IWORMATION I authorize Holy Spirit Hospital to release to requesting health insurance career(s), their representatives and auditors, and any referring health care providers, such diagnostic and therapeutic information (including any information relating to treatment for alcohol and subotame_ Awse and/or treatment of ps dipor rs..a_n_d/or confidenbaj HIV related Information. as may be necessary for them to determine benefit enti- tlement, to process payment claims for health care services provided during this hospitalization/treatment episode, and for continuing care/treatment A photocopy or carbon copy of this authorization shall be considered as effective and valid as the original The undersigned also authorizes Medicare, when applicable, to release to another insurance carrier, upon their request, medical informaition needed to make payment upon that claim i understand and consent that the manufacturer of any implantable device inserted by my physician during the course of my sur gcedure may be provided with my identification mforrnation, including social security number, as mandated by Federal Law Initials INSURANCE ASSIGNMENT OF BENEFITS I authorize payment directly to Holy Spirit Hospital and my treating physicians of all benefits payable u)3der my insurance policies understand I am responsible to the Hospital and physicians for all charges not covered by this asagnment Initials STATEMENT TO PERMIT PAYMENT OF MEDICARE BENEFITS TO PROVIDERI, PHYSICIANS AND PATIENT I request payment of Authorized Medicare benefits to me or on my behalf for any services furnished me by or in Holy Spirit Hospital including physician services I authorize any holder of medical and other information about me, to release to Medicare and its agencies any information needed to determine these benefits for related services Initials MEDICAL ASSISTANCE RECIPIENT My signatures certifies that I received a service or items from Holy Spirit Hospital and Dr on the date listed below I understand that payment for tins service or Item will be from Federal and State funds, and that any false claims, statements, or documents, or concealment of material may be prosecuted under applicable Federal and State Laws I understand that certain tests and procedures may not be reimbursed by Federal and State funds and that 1 may be responsible for non covered charges Also, t agree that it at the time of service, if I am not eligible for Medical Assistance, I will be responsible for balances owed to Holy Spirit Hospital initials 1 have read and understand each of the sections contained above I understand that by signing this document, I am agreeing and providing the outhorfsstloN consent coookied In eadt of ft above seattons when my inNtNs aim located. I have had ilia opportuni- ty to ask q 7Wions and all such questions asked have been answeW to my satisfaction m8ii?T ? a regarding each of _ ?. 5 1. i 1 7- Signature r?. Witness Relationship to Patient S t_c_ Time _ Dat>. -Ar t-Q HOLY SPIRIT HOSPITAL, CAMP HILL, PA CONSENT FOR TREATMENT/ RELEASE OF INFORMATION INSURANCEASSIGNMENT 3?r=L RR 101^4 ' .Cif it I& ` i t L ". o " Y 14vA CIS T ok 17011 0 71 a T4/02 MED RFC 1661:1) (11M) CHART COPY e? I It t ; , w ' 4 i 1 1 ?I X I z c /h M M ? w O S rs, 1 dl? o 2Z Q d tii .c Z a 1? T-1 4 Kr•. ' ? f w i 1 ? ti i ¦ Do" at wWo &A ice[ rip . Wad alert r dented i ? NELMOXOGNITIVE ?ERCErTt1AL RFSPNIATORY/ CIRCt1EATORY D Oliver WMoves all extremities ?y ?-limited Movement 0 Amputee special kifectron Control Precautions 0 Contact 0 Droplet 0 Airborne Read)ness to 1w" ErnMnrxial - 0 +'f" Physical - ? *41101 Pain - LW 40 If + and pre-edsung complaW Dally FWn Amml if + and new initiate Initial Pair? Astaaal Bneath Sounds U Wheeze R /L 0 Cra6les R/ L ? Rhondhi R A- O Diminished R/ L Q Absent R IL Cough ? None-Le NM O PC O Describe Pulse Regular Irmpiar O S%m / Symptons of Bleeding +O Calf Tenderness + Cl PL-dal pulse -U' +.e Edema + O 0 Other D Nausea a varoklrt6 GI / GU INTEGUMENTARY W-Sok ? Fmn O Distended o Tender Bowel Sounds -0 Flatus 01?ypoaC n0 Ayperactrvc l? L3- Voiding ? Q ? Catheter (Docurrient Colw/Cianty) Ol]stomy NA Type - Fluid Fluid Amnsaeunt last yt Hours : NA 0 Balanced 0 Irte vwdion 10 arm -Normal for parent o H? ArCaw -7 y /V O-W a C4efuWdlD11MlMted O Pallor F ool ? Duskey ? Mast ?0 Other Turgor W lamt ? PM o Rash ? Erydwna ? Ecchymosis U Odle, Skin Breakdown ' + O (Check Heals, Sacrum, Hips) Skin Rlek Anewmew O o ?r.Iporrsive O b1a, es alt eatremm ! hDA Umlted Movementrr,„ Q Amputee specia? Mlfactlon Control Precautk w" 0 ConW D Droplet O Airborne ReadinMl to Loam Emotional - ? Physical - O + Pain -0 If + arid neew inNiMe Initial i An Phin Assault neA 0 wheeze Res a Cr K" R / L ? Rharchi R A 0 Dimintlhed R/ L ? Absent R /L Cough ? Nate NPC O PC Q Describe Pulse WAWM sir uiar O Calf + CA _ PWW pulse - Edema - 0 ??f Odes .1?41t???r a Olha a MV Wes Q van" a firm a DuWn" ? Tender Bowel Sounds +?.-?- Eck O Hypoactive a Flyperact"" maze - O +0 0 NA 0 Ca heir (Docuaiere CokwX tarhy) Q 00omy .,W NA Type "MW hd 24 MM-11 0 NA alanoed 0 Icirve ni" wlamol for potieat cool a Duskey ? Moro © other Turpr ElaNtc o FbW D Rash 0 Erytlmm n o i Q 011W 1 11 Skin Breakdown - O (Chock Hails, SbWuM Hips) ?It Aanwsoaet 0 Low I Holy Spirit Hospital Camp Hill, PA 17011 NURSING CARE RECORD _ ? ? t rte a ? a Cw1drttad ? 00W U Moves all eatlen loo O Limited W ven,e.e a Amputee spea.l Mrfac Im cowra4F?matNfol+1 O Gannet O Droplet v Airbwnle Ileadirrew to Lwnt Emotional - D +0 Physr l - Cl + D Fein -0 +13 N + and pre•arhftsrg coniplew Daily Fain Aneast If + and new b+ilfate Initial Phil Asiml Breadr 5ew140 O Gear a V*WM R A © Craddas R/ L O Rhord# R & 00 01minishad R / L U Absent R A. Coup+ D Nate D NAC O PC Describe Puke Rio plar o k egtdar O Siena / Sympton i of #Medi tB l? + a Caa Tenderness -0 +0 F1rdal pabe -0 +0 Edenta .0 +Q O other © None O Nava (? WbntlBtl? Abdomen 0 Sop a Firm 0 Distedded O Tentiff Bowel Sounds +U -13 13 Hypoaetra 0 Hyperactive Flaws .0 + a 0 NA D Vogling O Cmhdw 0Kwnv% Cokwtlarkyl O Oslo" D NA T ?'P'e now Aw"W"M last 74 Mona 0 NA Q 11114naed Q 111"n waft Caler Q warm Q Nomtal for Patient ? Dry D Atpor a Cool D Owilrer a Moist O otsn Twrt O flaws 0 Pow Q Rash a Eromma D Eahynwlh a Other _ - - Skin Breakdo" - ? + Cl (Check Halt, Scrum, Hips) Skin "11m= w I 11 Ioh- earl 70DI Pope 1 oNt ..b94i'?'1 . 1 1.. aite.m end of fist 5W1Ft _ f! NO sir U NPO J] Hold Breakfast Diet Supplements O fluid restriction NUTRITION U Fluid encouraged ? Tube feeding (see below) TUBE FEt_DNNG NA TYPE Strength Rate__ cc/hrr See 1&0 for Amount Residual amt cc 0 BaglTubing change cc ? Fit4h with cc of water ndependenr ? Needs aisistarlicep_ r ? CBR ;X4Re5os1tioned ACiIYITY O Feels off bed S-Appears to be steeping ? Dangled a ' Amikmake Ambulated f •ff Tolerated Fair Poor Sleepirest pattern NA Signature Al'Independent ? BRP with assist Q BSC I Bedpan I Urinal x U Foley / P - ? tF 3T .A--i ? ELIMINATION ? Urine ins ? Stool Inc O Incontinent Care Protocol J Stools x Describe NA Si nature 1f J ssi Cgmpleta HYGIENE Mouth care AWPM WE NA Signature site jVt ? N/A Site dl ? Staples/sutures intact ? Edges approx ? No Inflammation ? Redness Size cm ? Edema U Drainage --- i?iet B O NipO 775% 6 ? Refsrssd Diet L ? NPO 5% ] SOY. Q c50% a Refused 0 1 feed ? Assist Selt U Supplenwr is ? Fluid restriction ? Fluid encouraged Q Tube feedin (see below) NA Strength Rate CC/hr Residual amt cc 0 cc m ? Flush with cc of water 1WIndependent Q Needs assists ? CBR Q Repositioned ! ? Heels off bed L) Dangled i@ Q Ambulated ` Farr Poor NA 5 ture ndependent ? 80 with assist O BSC / Bedpan I Urinal x _ q col r Q Urine Inc ? Stool Inc ? Incontinent Care Protocol ? Stools x Describe NA Signature 0 Self O Asiou ? Coatpwe ? Mouth care NA Signature _ ? N/A Site # 1?.??^?, ? Staples/sutures m ? Edges approx U No rnflarrirn-to D Redness Size cm ? Edema 0 (don Q Odor ? Drain(s) Q DianMs) ressing dry and intact Dressing dry and intact ? Dsg change / treatment / irrigation Ds change / 1 totem / n ate°) .l _ _ _ r _ J?r ?i- t WOUND CHRONIC/ACUTE ? Tolerated ds Change we! ? Tolerate dig har -tr iW siiey doci,ri>crit in her C e Ct(her Nhent Care Notes Sue •2 77W 51te A2 - - ? Staples/sutures intact ? Edges a prox 13 No inflammation ? Redness Size cm ? Edema U Drainage ? Odor ? Drasn(s) ? Dressing dry and intact ? Dsg change / treatment / irrigation OTHER Signature Signature Signature Q N/A ?Sl rY? ?? - - ? Staples/sutures khcf U ;dpss as Q No inflammation ? Size cm p""""° ? Drainage Q Odur ? Oralnts) ? Dressing dry and intact ? Dsg change -TnenA vngatwn %..01 IF I ? Tolerated 0-W, well Tolerated dsg Chyt Be, ell f a-other _ (the ti.s -ll Q Emotional support (see notes) 7 ? Emotional support (see notes) Ter C1 s? Ct ltK??;?,-,"q't`r ? Total feed ? Assist ? Sot ? Supplements ? Fluid restriction ? Fluid encouraged ? Tube feedi3 (see below) ? NA Strength Rate r ccJhr Residual amt _ . _ cc LC 0 ? Flush with cc of water ? independent O Needs assistance ? CDR ? Repositioned 8 ? Heels off bed ? Dangled a ? Ambulated • Tolerated Good Fair Poor Sleep/rest pattern NA Signature ? Independent ? BRP with assist U BSC I Bedpan / Urinal x _ ? Foley ? Q Urine Inc _ 4 ? Stool Inc _ ? Incontinent Care Protocol ? Stools x Describe NA Signature • Self ? Assist o Complete ? Mouth care NA Signature ? WA Site e1 O Stapk-Autums intact O Edges approx ? No inflammation U Redness Size cm ? Edema ? Drainage ? Odor Q Drain(s) ? Dressing dry aid Intact ? Dig change / treatment / irrigation Q Tolerated dsg Change well ? Other Jtz------------ ------ --- Q Step) WiMres intact Q Edges app mx Q No inflammation ? Redness Size cm ? Edema ? Drainage ? Odor ? Drain(s) ? Dreising dry and intact ? Dsg change / treatment / Irrigation ? Tolerated dsg Change well Q Other Q Emotional support (see notes) M14 140 Signature P"o 2 r? ¦ Date at end of first shift ta3ie?t's Inafine ! - ?'- c'L ` - Q See Dressing d" S+te rl _ -- ? ? Situ z1 p - -- Dsg Intact ? Dig Intact ? Dressing change / Treatment / Irrigation ? Dressing change / Treatment / Irrigation Ste ? g ? Tolerated Dsg change well laa 1(( aY dyi Heel precautions Q Pillow ? Litter Q Boat Sirgng MeasweM" O Other For mote than 3 sues Slit 92 docurmtthis infamwim ? Dsg Intact by the site numb fnuniter Care Notes b ? Dressing change /Treatment/ Irrigation ? Tolerated Dsg change well Heel recautions Q Pillow o lifter Q Boot ? ....... ...... Site 92 ? Dsg Intact ? Dressing change / Treatment a Irrigation ? Tolerated Dsg change well Heel precautions ? Pillow U Lifter O Boot ? Other.._ ................... .._._ Site k3 a bsg Intact o Dressing change / Treatment / Irrigation O Tolerated Dig change well Hetf precautions Q Pillow ? Lifter QBoot ? Other Q Air Bolus Auscultated ? Irrigation Suction ? intermittent ? Cant ? tow ? High Drainage Drainage TUBES I Site Site Dsg. - Drainage f3 WA Ci Sire Dressling change Swe r i Q f Dig Intact Q Dressing change ITreatrtsent I Irrigation U Tolerated Dsg Change wail Heel precaunani G PlJImv Q Litter Q Boot Q Other fNe7l -w -------------------------- U Ng Intact • Dressing change / Treatment / irrigation • Tolerated Dsg change well Heel precautions ? pillow Q Lifter D Boot site 91 p Ng Intact a Dressing change /Treatment I Irrigation Q Tolerated Dig change well Heel rec"cins L7 Pillow U Lifter U Baal Cl Other ? Ali Bolus Auscultated Q Irrigation Suction O Intermittent ? and ? Low ? High Drainage Site Dsa Drainage site Dsg Drainage U iCtJJ 64 wr.-V v 1&.? ? Sofcare G Telemetry ? Sofcare ? Telemetry ? Sofcare O Telemetry ? Specialty bed _ _ __ _ _ _ __ _ O Specialty W O Specialty bed SPECK. EQUIYIr+IM ? ice bag / unit 0. O Ice bag / unit 01 ? Ice bag I unit 02 AND TREATMENTS o4 1 breathe / 156 ough and deep breathe / 158 ? Cough and deep breathe I IS8 ? Tolerated Dsg change well Heel precautions O Pillow U Lifter ? Boot 0 Other _ Site x3 p Dsg Intact ? Dressing change /Treatment / Irrigation ? Tolerated Dsg change well Heei pprecautions Q Pillow ? Lifter Q Boot ? Other 10 U Air Bolus Auscultated ? Irrigation Suction o Intermittent ? Cant ? Low Q High Drainage r Drainage _ ? ? At risk for falls EW-Calk bell in reach D400 2400 EP0200 up !r4s up tderal2400 a" tR300 0600 00 ? Siderad release signed ? Bed alarm ON / OFF ? Restraints (see Restraint Flow Record) ? Seizure precautions 2400 0100 0200 0300 0400 0500 0600 0700 ? Other J K-pad ? other 0800 0900 1000 1100 1200 1300 ? Siderail release sed o Bed alarm ON/OFF ? Restraints (see Restraint Flow Record Q Seizure precautions 0800 0900 1000 1100 1200 1300 1400 1500 tors on 1400 1500 140D 1500 l.43t 1 P:lient awake, alert and oriented to time place, person, follows verbal commands Moves all extremities with purposeful movement is UK * Patient awake and alert but nix onemed Follows simple commands Moves all extremities with purposeful rnoverrmt W in Patient aroused to verbal stimulus Does net fallow any commands Moves axtremthes without purposeful movement 1MK K IV patient responds to painful stimuli only O Kpad ? Other ? Call WI In reach 1600 1700 18M 1440 2000 2100 2200 2300 ? 4 siderails up ? Siderall pratedas an 1600 17DD 1800 1900 2000 2100 2200 230D O Siderail release signed O Bed alarm ON / OFF ? Restraints (see Restraint Flow Record) D Seizure precautions 1600 1700 IBM 1900 2000 2100 1200 2300 ? Other mm ..L* a 1W_ LH Left Hand LAF Left Anterior Fw+eamt RH Right Hand RAT: RI W Anterior Forearm By Electrumc Pump D No evidence of complications of Leg Lateral fbrnamr LPF Leh PWerwr Forearm RLF R[;M Lateral Forearm RPF Rt Poswior Forearm unless coded as 1 Edema 5 Hardness LMF,1eft Medial Forearm LUA Left Upper Arm RMF Right Medial Forearm RUA R Upper Arm FR In-line How 2 Erythema 6 Warmth Lf Lefi Foot RF Right Foot Regulator 3 Ecchymosis 4 Pam 7 Leakingg B Other (specify) O No IV Site to be changed (DATE) Tubing to be changed (DATE) U CVC DreminR change (every Wednesday ad PRN) CVC Une measurement a shift / /RATE Line Men• urettnent RA CONTROL N SITE CODE CONDITION ODE N O ATTEMPTS TUBING CHANCE INITIALS r cm . cm i cm Ern m cm cm cin cm cm PERIP"HIAL 1 Basellne weight then q Monday 2 Strict YO records Bete-,- e TL ?wrs,env vRUCrt? CENTRAL 1 Wtygh daily x 1 week then clMonday 5 Flushed unused ports of CVC q 8 hours and after each use with heparin per protocol 2 51rict I/O records 6 Change Luer-lock cap q week and PRN Dante at end of fiat shift ART SYRINGE-SYRING Start Date Start Time Medication Concentration Dose Lockout Interval 1 hour Dose Total total Syringe Volume Basal (= low level continuous) O Continuous J SYRINGE #2 Start Date Start Time Medication Concentration Dose Lockout Interval 1 hour Dose Total Total Syringe Volume Basal (, law level continuous) ? Continuous ? Start Date Start Time Medication Concentration PCA ON Dose Lockout Interval 1 hour Dose Total Total Syringe Volume Basal (= low level continuous) 4 Continuous ? S?. ----? Stan Time Medication Concentration PCA ONLY Dose - - - METHOD OF Loekaut Interval - 1 hour Dose Total Total Syringe Volume Basal (= low level continuous) Q C "Inuous ? T Initially as follows Y As follows SP, Pule, Resp, Level of Pain, LOC BPfPULSE q 15 min X 1 hr, q 30 min X 2 hr, q 1 hr X 2, q 4 hr X 24 Initially q 30 min X 1 hr, q 2 hr X 2 hr, q 4 hr until discontinued RR q 15 min x 1 hr, q 30 min X 2 hr, q 1 hr 2 Document PCA history q 4 hr (0400, 0800, 1200, 1600, 2000, 2400) Level of Pain q 1 hr on Daily Pain Assessment Flow Record 3 If basal rate ordered SaO, continuous with alarm at 90% SaO, continuous with alarm on at 90% (Record q 1 hr) (Record q 2 hr) 2 After 24 hours All of above parameters q 4 hr and prn Level of Pain q 1 hr on Daily Pain Assessment Flow Record (Continue to monitor RR & SaO, q 2 hr until 12 hr after last dose of medication) RP, Pulse, Resp, and LOC is documented on the Clinical Record Pain is documented on the Daily Pain Assessment Flow Record EPIDURAL PICA TIME V5 Rewd Syringe Rated Tot Vol cumulstne Achill W 4 Oocd l (nlusion Infused Dose Ae? kqecUm IldusvA l I(MIT ALS SIGNATILAW + ! €l1 'I 4 3: - ` , Y? E q 60440 Page 5 a - L; . Inltlak 'Action Ovould noted as # , in boa R taken and doctN.wnigd fully in_Ff lent Con Notes NW"l Ranges 3 E1G.P? M RdGT raullr ?eidktg 44WA " am 60-10 (Pregnant) 60-120 (pregnant) "caAArrtsed" by the Lab 60-110 (?p1egnard) 60-140 (Non jxWant) Holy Spirit Hospital Camp Hill, PA 17011 NURSING CARE RECORD r r , Alp n t;i lis 's lei ILit P31 t * ?td•??-7'x!1 ?? ? s l 6k MR '140 Par 6 STATUS R. Routine PS Post-surgery PP Plod-procedure PG. PG D5G' orewrig dry ana uuact Epi Epidural CAC; Change of cons l O Outer lgwtfy in Pt Care notes) PAIW Complains of pain see Pain Asaesanbrt flow Record RESP' Respiratody rempirations adequate, deep breaths, coughs, Adequate rate, rbydw% depth W IV sate without koiammation ant! Odom GIRC' Circulation BP stable and within paMk t% normal lamas Pulse rate, rhythm, quality WAIL SAIFETyu Call bell in reach COLOR' Norma) skin color and condition CWS• 0ic,latiodmo0on?% oration adequ4b q opera" exLrwvft LAC Level of Conscioujners alert, cohaeot, nasponds appropriately to we" stimuli • PATIENT DISCHARGE INST13UCTIONS This form serves as your discharge instructions and if necessary, provides orders for any home health agency tollow-up Follow-up appointment -- Name of Doctor 7C R= Phone - '?E41 ' Date / Time of Appointment ,.fall your Doctor's office within the next few days to make an appointrent ? days/weeks from now If you have any questions before your appointment, tali your doctor Q Home Care Agency - Other Important Numbers Phone 4you may resume your Regular Diet ? Special Diet ? PEG/Feeding Tube RATE ? You may resume normal activities as tolerated [] You may return to work FORMULA ? You should restrict your activities as follows SURGICAL WOUND CARE -- If you have increased pain, redness or drainage from your wound or a persistent temperature over 100 degrees, call Vour doctor ? Your incision may be gently cleansed with soap and water PAIN MANAGEMENT For management of pain, follow your doctor's instructions HOME CARE ORDERS/SPECIAL INSTRUCTIONS DISCHARGE MEDICATIONS -- Include dose, frequency, instructions (" indcates prescriptions given to patient) After review and discussion, patient / family / significant other verbalizes understanding of instructions and receives copy Signature of Patient / Significant Other • •, ¦ t f Ii ! 7 s HOLY SPIRIT HOSPITAL ? I T •, ? ? ? S?? ?? ?? ?-' Cam Hill, PA I y L S lt.?'t ` Ir lX 17I i i!' DISCHARGE tNSTRUCTIONS Form No 182 (2/01) 07104102 CHART COPY-FAX COPY TO HO JiEAt,TK C,ARk A6? , ? Mad cards with food/drug interaction guide givers I awil Wd Wd awil Ad Wd ? alep . f ale(] r aul?M la ajnleuft 00063 1810wo to ajnwu6i9 31NC3H IN31IVd 3H13>+b101 1N311Vd alll d0-Ni*=1O-1.X3N -Id:}3l /Ndl(3uvn!D lVD31/.lN3db'd AS C331NIQddV IHOOS3 ` VIOUJO 3Hl Wb I IVH1 SWdldd'd MO-138 3k nlVNOIS AN 30UVHOSICI JO hna NO IWOOS3 11 _ awl,L ale(] ssaullm 10 aml-Ru6ig Ad WH OLUil Ad Wb ale0 WNJO-1xeN le69-/ueppjent7 1e6e1puamd to eirweU61S -lVlldSOH 3H1 WOa= d3 UVHOSlG Sl 3HS13H N3HM 3WOH 1.N311bcd 3H1 1dOOS3 01 3'IGVNn 38 . nIM I '3JIJb'H0SIO 30 ltaa NO (luaRed yo aweN) (WOil'Vd of U01M911) --- d0 3Hl Wed `C73N9lSId3aNf1 3H1 `I NIN-AO-1X3N W03'1 NO NVlau ?tl) ivi3 td0 `IN3bad d0 -lVAO8ddv/3dnlVN0IS 'I lelidsoq woj) luailed ljoase of wed elgrsuodsaj to eweu 6urpje6aj lenojdde uelluM s,ui? -jo-lxau legal jo 'uerpjen6 1-091 's,luejed sumpo esjnu `lelydso>a wolf luallea l,oasa of alge lou al UIN-10-lxau pebal ro '„ squa,ed oool ury Burpuels uosied `ueipjpn6 luBal `luajsd uaLIM .(;vasuoo aplnoid oll elgau>n weadde oyM lenplnlp. -ui jagllo ao `palepoedeoul `;usladwooul `.ioulw) I-inav 1N3.1.3dWOO V ION S1 OHM 1N31l.Vd V 30 30EIVHOSIG x MTV 0- Tw i1 s Sf- 3w11 31'dCl S31ON 3SddH3Sla (up,wwns a6mipsip uo paluawnoop / passajppe eq lsnw senssr pelulaj sisou6eto (gill)) awEu -- awrj elep . t + o. s VN.0 Aq awt?u -- con4osip s+luailed to pstpl©u uosjed hq paiuedumoy paruedwoooeun a*?ueingwd .1leLlolea4m ? 1GolBFngwti ein _?. layl0 0 awoH I of pa6leg3sl(l VN [?] ON [] S3A F? lus'lled of peuin;ej awotl woal lg6noaq sualleatpsw (pagoelle Adoo) aaglo luea+lru6+s/luaged of u9n)6 19845 uorlonilsui orlmeds mlorshud u o r° L o 1-f oar dS / Udl sUSis PIA (pajinbeb) 96j$gosrp to step jol pateldwoo luawssasse Aped #aW aw?eu lusrled P1 indicua by numbe CIL,oT lc:_E Bathrobe Belt Blouse Boots _ Bra Coat Dress Girdle Gloves Handkerchief Hat Hosiery NeckgC Nightgown pajamas Shut Shoes Rut Slacks Shp Slippers Socks Suspenders Sweater Travie in,g B+sg Undershirt Underwear - - Vest 0*" v??I?u??s Amb Aides ]Bracelet Clack Contact Lans - Curling Iron Demres _ Upper Lower Partial Denture Cup brought from home Denture Cup provuWl by HospiW Earrings Glasses, 1 b above am I of clO*mg and vahnbles with me to the hospital. well as i ght to me as a painent in the hospital. Hair Dryer Hawing Aide Necklace Prosthesis P"M Rugs ROMY Watch Other retatiznyyg 4-11 as Relation W>.vrwent, Date. M? TRANSFER- Vert longuigs Traunsfemne UndStgnaturq/Date Receiving UntVSrgriature Pate SE ON D All clothing eXCW those listed above ware tirl w home by patient Nursing Personnel Relation to Patient Date; SE ON M (Staple Valunb?IN Receipt To This Seed") I have fumed over to Holy Spirit Hospital articles for safekeeping as listed on Valuables Inventory List to be placed in security vault. I DO NOT hold the Hospital responsible for any oilier money or vshwbla, which 1 am retammg or will have brought to me while a patient in the Ho:pW Patient- Security Officer Relation to Patient. Date Valuables returned to patient Secunty Officer F have received from Holy Spint Hospital A" artmies bated above disposed of Patient 1?ac'1 Relmian to Patmr HOLY SPH" HOSRMTAL CAW NUI, PA CLOTHING A" V ALU r NS 201 , Revad 5/98 Rav3d 9100 RcS Date All other articles not clarnsed within 30 days of discharge may be Nursm% Personmi: 1? 1 Y j Agt?E > D EIt 4 X13 t - 7737 a ¦ i,nnlng& osenber 9 ATTORNEYS AT LAW Leslie B. Handler, Retired W. Scott Henning David H Rosenberg (PA, FL) Carolyn M. Anner (PA, NY, RN) Matthew S. Crosby (PA, NJ) Gregory M. Feather (PA, NJ) Stephen G. Held Jason C.Imler John P. Stratis Aesthetic Reconstructive Surgery 816 Belvedere Street Carlisle, PA 17013 1300 Linglestown Road Harrisburg, PA 17110 717-238-2000 1-800-422-2224 717-233-3029 (fax) LANCASTER OFFICE ?"[?y 140A E King Street `?E Lancaster, PA 17602 ` 202 717-431-4000 August 29, 2002 t ii'tz, V [Q DIRECT MAIL TO: P.O. Box 60337 Harrisburg, PA 17106 www.HHRLaw.com Henning@hhriaw.com Re: Our Client/Your Patient Patient Date of Birth Patient SSN Date of Incident Dear Dr. Stratis: Patrick Straka 5/27/1972 164-56-7511 7/8/2002 This letter is to request that you provide me with copies of your office notes and a billing summary for the above-named individual. We would appreciate it if you would provide one-sided copies only. It will only be necessary for you to provide me with records dated after July 16, 2002. 1 am enclosing a current Medical Authorization which will allow you to release this information. If you have any further questions concerning this or require anything else, please do not hesitate to contact me. Thank you for your assistance in this matter. Very truly yours, HANDLER, HENNING& ROSENBERG, LLP WSH/dlp Enclosure cc: Patrick Straka 101 Tuckahoe Road Dillsburg, PA 17019 y?Ak- d I l? L- i ? rr Sell rucve of Central Pennsylvania, P.C. John P. Stratis, M.D. William P. Graham, III, M.D. 2025 Technology Parkway 816 Belvedere Street Suite 309 Carlisle, PA 17013 -? .,Mechanicsburg, PA 17050 (717) 249-0100 (717) 728-1700 Fax (717) 249-8889 Fax (717) 728-1701 July 10, 2002 Emergency Room Director Holy Spirit Hospital N. 21st St. Camp Hill PA 17011 RE: Patrick Straka Dear Sirs: I saw Patrick Straka in followup and just wanted to give you some feedback. Apparently he was in the Emergency Room on or about the 7"' or s"' of July, having suffered multiple abrasions and lacerations after dropping his motorcycle. According to the patient he did receive IV antibiotics and was told he was going to be taken to the Operating Room for cleanup. He originally came in 5:30 pm on one day and was discharged 2;30 pm the next day. The patient indicated, he was not seen by a physician after the initial encounter and was discharged by a nurse., without instructions, but was given a prescription for Keflex and Tylenol 3. Apparently a DEA number was not placed on the Tylenol 3 prescription either. The patients main concern is that there was no follow through with his care while he was in the Emergency Room and inadequate instructions after he was discharged. send you this letter just as a point of information. Sincerely, Q67P. Stratis, M. D. JPS/klf Plastic/Cosmetic Surgery • Breast Procedures • Micro Surgery • Laser Capabilities • Hand Surgery Binh Defects • Endoscopic Plastic Surgery • Biomedic Skin Care Program John P. Stratis, M.D. 0y, c?e lcl? M u u cy of Central Pennsylvania, P.C. William P. Graham, III, M.D. 2025 Technology Parkway Suite 309 Mechanicsburg, PA 17050 (717) 728-1700 Fax (717) 728-1701 CONSULT ON PATRICK STRAKA JULY 10, 2002 816 Belvedere Street Carlisle, PA 17013 (717) 249-0100 Fax (717) 249-8889 This is a 30 year old white male who apparently was riding his motorcycle several days ago and apparently dropped it on a gravel road and sustained multiple abrasions and lacerations. He was seen at Holy Spirit Emergency Room, but according to the patient did not receive any care and was discharged the following day. He was put on antibiotics and pain medication, got IV antibiotics also. He is a friend of Dr. Robert Davis' and Dr. Davis was asked to see him. Dr. Davis called me to further evaluate the patient. Past medical history is noted on the chart. He is allergic to Ampicillin. He is currently taking Cephalexin and Tylenol #3. On examination the patient is awake, alert and oriented. He has multiple abrasions pf the I9ft grrp #th full thickness skin loss of the left elbow, multiple abrasions of the right prm and padomen, and left leg. No signs of infection. I can't tell if there is any dermal tattooing. This patient has multiple lacerations and abrasions. I told him to put Bacitracin ointment on the right arm, abdomen and left leg and use Xeroform on the left arm, change it once a day and shower. He is to continue his antibiotics and pain medication. He is going to return to see me on Tue y in Carlisle. John P. Stra is, JPS/klf Plastic/Cosmetic Surgery • Breast Procedures • Micro Surgery • Laser Capabilities • Hand Surgery Birth Defects • Endoscopic Plastic Surgery • Biomedic Skin Care Program ana . e ? osenberg,«P ATTORNEYS AT LAW Leslie B. Handler, Retired W. Scott Henning David H Rosenberg (PA, FL) Carolyn M. Anner (PA, NY, RN) Matthew S. Crosby (PA, NJ) Gregory M. Feather (PA, NJ) Stephen G. Held Jason C. Imler John P. Stratis, M.D. 816 Belvedere Street Carlisle, PA 17013 ?vG Re: Our Client/Your Patient : Patrick Straka Date of Incident : 7/8/2002 SSN : 164-56-7511 Patient Date of Birth : 5127/1972 Dear Stratis: 1300 Linglestown Road Harrisburg, PA 17110 717-238-2000 1-800-422-2224 717-233-3029 (fax) LANCASTER OFFICE 140A E King Street Lancaster, PA 17602 717-431-4000 DIRECT MAIL TO: P.O. Box 60337 Harrisburg, PA 17106 www.HHRLaw.com Henning@hhrlaw.com This office has been retained to represent the above individual relative to injuries sustained as the result of an incident, for which injuries I understand you have been rendering treatment. Please provide us with records concerning this incident only at this time. I am enclosing a properly executed medical release authorization and would respectfully C request that you forward to this office at your earlie t-cQnvenience copies_of_a11 _a r office records- regarding your care of the patient, as well as a complete billing history. We would appreciate it if you would provide one-sided copies only. You may release information to your patient's insurance carrier for billing purposes MI . If any further treatment is required, please send copies of further bills to this office. If you are submitting these bills for payment to an insurance company, please provide this office with copies of the bills you submit. PLEASE DO NOT RELEASE ANY INFORMATION REGARDING THE ABOVE CAPTIONED MATTER TO ANYONE OTHER THAN A REPRESENTATIVE OF THIS OFFICE. Please bill this office for any charges incurred as a result of supplying the above information. Please contact me with any questions or comments. , Thank you for your anticipated cooperation in this matter. Very truly yours, HANDLE, KE4RA)81?NBERG, LLP WSH/dlp Enclosure cc: Patrick Straka 101 Tuckahoe Road Dillsburg, PA 17019 August 1, 2002 sr l.e (\ L W. Scott Henni n.r.ru-??G n1?1A VV V ARS 24 / ?f;? j /, 1 )ohn P. Svacis, M.D. William P. Graham, III, M.D. (? ulc?ve u?e>? of Central Pennsylvania, P.C. John P. Stratis, M.D. William P. Graham, III, M.D. 2025 Technology Parkway 816 Belvedere Street Suite 309 Carlisle, PA 17013, Mechanicsburg, PA 17050 (717) 249-0100 (717) 728-1700 Fax (717) 249-8889 Fax (717) 728-1701 July 16, 2002 Robert Davis, M.D. 6125 Stephens Crossing Mechanicsburg, Pa. 17055 RE: Patrick Straka Dear Dr. Davis; I saw Patrick Straka in the office today. He is doing much better. Most of his wounds are healed. The left elbow wound, however, continues to be open and still has some apparently nonviable tissues. He is going to continue with Bacitracin ointment and I will check him again in two weeks. I have asked him to stop using the Bacitracin ointment on his left hand in about a week. Most of the grime is gone from the wounds and I don't anticipate any traumatic tattooing. I'll keep you abreast of his progress. If you have any questions, please let me know. Sincerely, JPS/klf Joh . Stratis, M.D. Cc; Jeffrey Potter, M. D. 850 Belvedere St. Carlisle, Pa. 17013 Plastic/Cosmetic Surgery • Breast Procedures • Micro Surgery • Laser Capabilities • Hand Surgery Birth Defects e Endoscopic Plastic Surgery • Biomedic Skin Care Program AUTHORIZATION FOR MEDICAL AND/OR HOSPITAL INFORMATION This is to authorize any physician, medical attendant or others to furnish to the law firm of HANDLER, HENNING & ROSENBERG, or any representative thereof, any and all information or opinion, which they may request regarding my physical condition or treatment rendered therefor and to allow them to see or copy any X-rays or records that you may have regarding my condition or treatment. These records may include any and all information of a confidential nature, including results of drug, alcohol or HIV testing and any psychiatric records, if applicable. My said attorneys have been retained by me to prosecute a claim against the insurance carriers or others for injuries sustained and your full cooperation with my attorneys is respectfully requested. All prior authorizations are hereby canceled and medical information may not be released to anyone other than a representative of my said attorneys except for billing purposes only, provided a copy of such information is sent to my attorneys. Permission is hereby granted to photocopy this authorization and any photocopy thereof shall be as by me an original. J PATRICK STRAKA WITNESS: 3 I TYPE OF BILL DATE OF BILL DATE OF PREV. BILL SAUDD HO' v SPIRIT HOSPITAL PAGE NO. 5" I 21ST ST Q i CAMP HILL, PA 117011 717 763-2141 BOJ BIRTH-DATE HOSP.NO. I t a PATIENT NAME 05/27/72 3000 PATIENT NUMBER SEX AGE ADMISSION DATE DISCHARGE DATE DAYS 19176098 M 30 07/08/02 INSURANCE COMPANY NAME I GROUP NUMBER I POLICY NUMBER GUARANTOR NAME AND ADDRESS PATRICK T STRAKA 101 TUCKAHOE RD DILLSBURG PA 17019 IDELONE J BRET PLEASE RETURN THIS PORTION' WITH YOUR PAYMENT. r? 1/ /? ?? AMOUNT OF ????C??? Q? PAYMENT DATE 'OSTED DESCRIPTION OF HOSPITAL SERVICES SERVICE CODE TOTAL CHARGES EST. COVERAGE INS. CO. NO.1 EST. COVERAGE INS. CO. NO.2 EST. COVERAGE INS. CO. NO.3 EST. COVERAGE INS. CO. NOA PATIENT AMOUNT IETAI L OF CURRENT CHARGES, PAY MENTS AND ADJUSTME NTS '/08 PUMP SET 3Y TYP0116139313 48.00 48.00 '/08 MORPHINE 5MG V10144283257 3.00 3.00 '/08 URINALS DISP 0114126916 1.00 1.00 '/08 NACL 0.9 1000 0116130635 19.00 19.00 '/08 NACL 0.9 1000 0116130635 19.00 19.00 '/08 IV CATH 0117207002 14.00 14.00 1/08 TRANSPARENT DRE0117207028 1.00 1.00 '/08 URIN, (NO MICRO012522i102 19.00 19.00 '/08 MICROSCOPIC, UR0125221904 18.00 18.00 '/08 STAT HANDLING F0125103680 14.00 14.00 '/08 CHEST 2V 0136501005 194.00 194.00 '/08 LEFT ELBOW 0136501286 151.00 151.00 1/08 LEFT FOREARM 0136501302 112.00 112.00 '/08 LEFT HAND 0136501369 112.00 112.00 '/08 LEFT FEMUR 0136501682 151.00 15i.00 '/08 PELVIS 0136501989 22'S.00 225.00 '/08 CERVICAL SPINE 0136502086 265.00 268.00 '/08 CT ABD WO CONT 0136536126 1389.00 1389.00 1/08 CT PEL WO CONTRO13653625 1149.00 1149.00 '/08 ED LEVEL III PCO117105826 170.00 170.00 1/08 LEVEL IV 1-4 HRO117105917 573.00 573.00 '/09 SECONDARY SET 0116139339 20.00 20.010 1/09 PERCOCET 0244021574 8.00 8.00 '/09 PERCOCET 0244021574 8.00 8.00 1/09 PERCOCET 0244021574 8.00 8.00 '/09 CEFAZOLIN 500MG0244080364 22.00- 22.00 '/09 CEFAZOLIN 500MG0244080364 22.00 22.00 '/09 CEFAZOLIN 500MG0244080364 22.00 22.00 '/09 CEFAZOLIN SOOMG0244080364 22.00 22.00 '/09 CEFAZOLIN 500MG024408036 02.00- 22.00 '/09 BACITRICIN TOP10144840031 3.00 3.00 '/09 SUTURE REM SET 011412252 3.00 3.00 1/09 SUTURE REM SET 0114122527 3.00 3.00 FEDERAL IDENT. NO. 23.1512747 PATIENT NUMBER REFER ALL QUESTIONS TO THE PLEASE SEND PAYMENT TO: BUSINESS OFFICE (717) 763.2136. HOLY SPIRIT HOSPITAL 503 NORTH 21ST STREET CHARGES NOTiPOSTEDLWHEN THIS BILLEWAS PREPARE[ OR DO NOT PAY PART OF CAMP HILL, PA. 17011-2288 TTH EIFAMOUNTSCSHOWNIEUNDEER ESSTIMA EDNNSURANCCE COVERAGE. 1 TYPE OF BILL DATE OF BILL DATE OF PREY. BILL BAUDD HO' " SPIRIT HOSPITAL 5s 1 21ST ST CAMP HILL, PA 717 763-2141 BOJ PAGE NO. ® 21 17011 BIRTH-DATE HOSP. NO. 05/27/72 X000 { PATIENT NAME PATIENT NUMBER SEX AGE ADMISSION DATE DISCHARGE DATE DAYS STRAKA PATRICK 19176098 ?} 3O 07l48/02 C.O.B. INSURANCE COMPANY NAME GROUP NUMBER POLICY NUMBER GUARANTOR PATRICK T STRAKA NAME 101 TUCKAHOE RD AND DILLSBURG PA 17019 ADDRESS DELONE J BRET PLEASE RETURN THIS PORTION WITH YOUR PAYMENT. AMOUNT OF PAYMENT $ -? DATE 'OSTED DESCRIPTION OF HOSPITAL SERVICES SERVICE CODE TOTAL CHARGES EST. COVERAGE INS. CO. NO.1 EST. COVERAGE INS. CO. NO.2 EST. COVERAGE INS. CO. NO.3 EST. COVERAGE INS. CO. NO.4 PATIENT AMOUNT '/09 SPONGE OVER 4X401141^23038 1.00 1.00 '/09 SPONGE OVER 4X40214123035 2.00 2.00 'x'09 DAPT DRESS 3X80114124549 5.00 5.00 '/09 DAPT DRESS 3XS0114124549 5.00- 5.00 '/09 ANDAGE STATITE0214125660 8.00 2.00 'x`09 DMISSION KIT 0114126056 10.50 10.50 'f09 TRIPS TELFA 4XO114127211 1.00 1.00 '}'09 APE MEDIPORE 20114128607 15.75 15.75 '/09 ANDAGE STATITE0114605687 2.00 2.00 'i09 ANDAGE STATITE03i4605687 6.00 6.00 709 ACL .9% 250ML 0116130668 13.00 13.00 '/09 UMP SET 2Y TYPOi16139321 48.00 48.00 709 BSER 1ST HR MS0123135007 110.00 110.00 '/09 BSER ADDHR Mf S1223135056 180.00 i80.00 DX 959.8 DX 881.01 tALAN CE FORWARD 0.00 ?UMMA Y OF CURRENT CHARGES PHARMACY 250 120.00 120,00 M/S SUPPLIES 270 161.25 161.25 LABORATORY 300 51.00 51.00 DX X-RAY 320 1213.00 1213.00 CT SCAN 350 2538.00 2538.00 EMERGENCY ROOM 450 743.00 743.00 OBSERVATION 760 290.00 290.00 ;UB-T OTAL OF CURB. CHARGES 5116.25 5116.2E FEDERAL IDENT. NO. 23-1 5 1 2747 T O T A L S 5116.25 5116.25 PATIENT NUMBER REFER ALL QUESTIONS TO THE PLEASE SEND PAYMENT TO 19176098 : BUSINESS OFFICE (717) 763-2136. HOLY SPIRIT HOSPITAL PAY THIS AMOUNT S116.25 503 NORTH 21ST STREET CHARGES NOTIPOSTEDLWHENATHS BILLEWAS PR PARES HOLY SPIRIT HOSPITAL CAMP HILL, PA. 17011-2288 TTHEIAMOUNTS CSHOWN IUNDER ESTIMATED NNS RANCI CAMP HILL, PA COVERAGE. ?F T 7-1 y. AUG 0 9 2002 712-2 48 i `.?L130 1 f ti?T. - r ! '7C' 3 u Pr' 7 L :IRiJ_ _. .: --- ----------- ---- ---- ----- -------- •sl ci.,? }:?,. -. .. ?rS t}a._Q.1 DP ?J=.(l. i..tli ii .C , - .:.?i ir.'?... r ('i_fT J i?...,t •t3I.;dL,L': t -SHOW 4: f 9r. ( ?S( 't t_LI i. . S;Sia,1?rt.iY .:JNi --------------- 531 ll('ct?l? c its c'tii ._ ca 00 12, T_ n r Tat:al Of + a. "..:L.3L:.. r•;3v's:iil•? '?•,??fit 1u? _. ;i !,K 'I ?:x Gnu, y 1 A, F ---------- Li T; ir({.Jer, Pfta_ L_l' t 5 10 00 LAO T 65. .. ':.-.. ?„ ?.,.:. _, .... . .:..?- _.. .. .. ,. ., .'... _ ?:_..- .. - .. .... .., .. .. ,..._ .. .....,... z.,. .. ,.. .. .?.?...?_ ?.,.. .?.. 4 41...+7.4. ?..,,.... _ 7 "' _. .. .. _ J.- 1 0 15 1, 6, -17 -i-r'r., . it •-':5 - 1. = :._: ?idT ; iAtulE: ct:.s` T f =':QTIENT JUIUs?ER: LL !'JU1118ER: T' i 100'_i; F F ;,!RANGE: iATEOFCALL: 7i'si Tl ?c OF CALL: 1'-1L 1 ;:J Rl 'T `.t..E"-iF x'11_ ".1,A •.SPORT MOTORCYCLE DESCRIPTION OF CHARGE CMANTITY UNIT PRICE AMOUNT ! r-1 Ps r_i r_ s r "r' 'r fn t, ) I _ JJ _ t i?! 1.._ (-- 1. r_' 4 I i I i i I OESCP:I!DT:('l;,! OF `' AW.,lEfd r,_ PAYMENTBATE AMOUNT T!_.'T;,"'. L I- -1"! °I HE. LJA(._1_.. i i I _ _ ACC ALONG PERFOR?NATION -' N;D RE T UMN STUB WITH PA"I'MENT AMOUNT DUE - -- i'= 1 T NAI`vlE: CALL PdUiv1EE EF; _. .. _ _ ._ , AMOUNT S ' Ti_ IT!'Jl3t!BrR: _ BILLING DATE: _ -: - ENCLOSED _ I I I ! .,. ,J .., r•,! -`.' t..i .? 1.., .. ? ._ _? ,i? t.. 1 11.,' }"! C? ,:? [" L! ?'-i :._..i. r? .? 1.... ? , „ - _ :t;•tt:;;,{i - ??''! - I sue' 10 :3s,_AN I'UM I Mfi,C I NI ?` L< THERAPEUTIC 911 -= INC. LING OFFICE / A43 R SERVICES RENDERED AT: # 2527 CRANBERRY HIGHWAY HOLY SPIRIT HDSPITAL WAREHAM, MA 02571-55010 503 N 21ST STREET 800 299 9770 / 508 295 5'1556 ',CAMP HILL PA 17011 PLEASE KEEP THIS PORTION FOR YOUR RECORDS. ****FIRST-CLASS AUTO* *3-DIGIT 170 PATRICK STRAKA A93*028075*725*09 101 TUCKAHOE RD DILLSDURG, PA 17019-9475 11111 llffflllflff9111111111111111ff111111311111111111111111111 PATRICK STRAKA E I N: 25-1792806 ACCOUNT NUMBER BILLING DATE 028075A93 06/05/02 257.00 07/08/02 7355026 959.7 FEMUR, 3 VIEWS IF CHARGES ARE ELATED TO AN AUTO ACCIDENT OR WORKMA 'S COMPENSATION, RETURN BILL WITH THE ACCIDENT INSURANCE, 07/08/02 7217026 959.6 PELVIS IF CHARGES ARE ELATED TO AN AUTO ACCIDENT OR WORKMA 'S COMPENSATION, RETURN BILL WITH THE ACCIDENT INSURANCE. 07 / OB/ 02 7313026 59.4 HAND, :3 VIEWS IF CHARGES ARE ELATED TO AN AUTO ACCIDENT OR WORKMA 'S COMPENSATION, RETURN BILL WITH THE AC C I DEN r INSURANCE. 07/08/02 7309026 59.3 FOREARM, 2 VIEWS IF CHARGES ARE ELATED TO AN AUTO ACCIDENT OR WORKMAN-.S COMPENS IONt, RETURN BILL WITH THE ACCIDENT INSURANCE. 07/08/02 7307026 59.2 ELBOW, 2 VIEWS IF CHARGES ARE ELATED TO AN AUTO ACCIDENT OR WORKMAN 'S COMPENSATION, R TURN `B I L.L WITH THE ACCIDENT INSURANCE. 07/08/02 7204026 959.09 CERVICAL SPINE LESS THAN FOUR VI IF CHARGES ARE ELATED TO AN AUTO ACCIDENT OR WORKMA 'S COMPENSATION, R TURN BILL WITH THE ACCIDENT INSURANCE, 07/08/02 7102026 959.1 CHEST PA LATERAL t 2 VIEWS 7 IF CHARGES ARE ELATED TO AN AUTO ACCIDENT OR WORKMA 'S COMPENS ION, R TURN BILL WITH THE ACCIDENT INSURANCE. AGED BALANCE 35.00 34.00 ?5. 00 32.00 31. 00 A•5. 00 A•5. 00 =PRIMARY INSURANCE** *SECONDARY INSURANCE* DNE NONE QUANTUM IMAGING & THER BILLING OFFICE / A9? 2507 CRANBERRY HIGHWAY WAREHAM, MA 02571-5010 11113{{!1l111s11111111fsllslfl111fsfst,llllti11f1311111111,111 CONTINUED PATRICK S,TRAKA 028075A93 08/05/02 3111 !!€ !ll ! ii !l 8!!i € €!!3€! f€!!€ fliff fill 11111€€ [fill 1111(l [it 02B075 257. 00 1_'1 I? r:. Ir' }i- ~l-Rv j c i:!_N J-r?°.tt C.? ? H i f=1=7 ?r,i?•fu R N Y' i i .l ::t'iail{ T' L't' SPIRIT HOSP I ! AL. IIA 02"5 :i. -5 010 ?C3 N r I ST STRT=ET 800 299 9770 / 508 2'75 55r.i6 CAMP HILL PA 17011 PLEASE KEEP THIS PORTION FOR YOUR RECORDS. E I ICI : 25-1792806 ti Wsifi b t.tai5 i -4,L.??•`??4 AlJ T O **3--DIGIT 1'7{) 7 23 PATRICK 3TRAKA A9L ?L],.'q , 101 TUCKAHOE RD DILL ST?URG, Pia, 1701?--94-/y5 PATR ICI: STRAKA ACCOUNT NUMBER BILLING DATE - . ' "?, 339737A? 3 081/05/02 500.00 .. Sr^` -? - w- !^. ?Ae?f?v+n+2iT??.T?mR.1.a-.w:r•-np((_r '1T " - '.T 5?? _ _ . '. I _.._.__. ...,..?_n... .. _...y...-u_..`....e........ __....._..W ?..r....?._. a.a.?_-... .,. ...._?..?. _ _ ?..- 07/08/02 7 !.=5026 19 )_'. 1 C•? I- ABDOMEN 250. 00 07/08/02 I7211=:G,'6 1959). 1 ICT PELVIS WITHOUT CONTRAST ?5©. GAO *WE DO NDJ HAVE I{1\1SURANCE INFORMATION ON FILE FOR YOU. I PLEA-ME PROVIDE II;-,.1RAIdCE ' NFORf"1ATION 01`4 BACK OF FORM. AGED BALANCE CURRENT OVER 30 DAYS OVER 60 DAYS OVER 90 DAYS OVER 120 DAY 500. C10 oo .00 .00 00 AMO? ,*PRIMARY `: NSUiiAP•ICF* ? i-SECONDARY p INSURANCE'; ENCLO 100E {.I(::)NE 1111111111111111111 x.39737 Q UP,hlTl +I:i I Mf')G• I I.?IG ?- TF }EF BILLING OT=FI-E i A93 '25-27 CRANBERRY Y HIGHWAY WAREHA11, iyiA 02571-501.0 500. 00 11111111111111111 H i 11 1101il 11111 loll 1111 500. 00 PATRICK STRAKA 08;'05102 q r IVA POLICE CRASH R -=PORTING FORM 1W New P 0 4 2 5 7 3 5 ?C T- 2 164992.-? AA'45 1 1 F'a gF -t rills-watlon :, r lrr police Agency t0r0T Gne ?- y Invt-st!rtation Date (MM-i)D-YYYY) S (A E PC L_ t C E C -AkuS a C -7 2- C i ';rnf' Invest! ator Arnv;rl :. ... ----? ..... Sadqe Number _ __...? u ! 7 _3 -1 ! -7 y `? TFR. "b I C 0A e t. A. R ?C? N ! 7 Q y q I ~ ! '< : ;; -r &sd a Number ^,_pprovai Date (MM DD•YYY t) ,21 r i c c .r:^ 1 County Name Municipality. Municipality Name Day of Week ( z CIL)M6fe?aA,ro i 32- `e -7 mcr.,r k Sun c Thu roon .i Gfi Trash TIrF`i.-. f V ;Jr.. rrl. . t i},Sf,!. s Pj :e it S j- •;r! d,J L,l7 ..? .% ttti3f ^ .. ?. .,... ;F?,.i .. .?!:•, S{..:i.t.... -.i, .. ,. I^?..;Si_.ti Ir+.r..t?)l./? (`rl.iterty % - d+i S(J'J f-t S =l K r 7r7-W37- ?32Z-7 vehicle Ym -T 1, C. K. -?)H C .. ?- 7 b t LL.S IR v f-' c, C; A ?,7y y ?y In,.;t;,nta t-ompany Policy No Insurance Compi-iny Phone iin 4 «STArr 11 q4/ 021-756 4S?2S! _-_- •+' 4 1 knov,i + l TovvE:d Tc Towed By (oov Agency Phone ( ,.; UoFnt,AKkitS TOW !'U G- S 41Y1f ' .. t rrid,.ty "arG.c':; . Nan Motorized do"porl I r r Pedestrian on Skates, , C r: acrl:*ci : ttun Pedestrian lr,3ir1 I I in Wheelchair, etc - ?reviuu'. .-t.aat, Phantom Vehicle 1+3' !?j 41 ;7 'ororn, AA 45 3 1} fl tJll ,t i r rf h!?rr;e tiun.tr Corryn) 'rclal t ; Vehicle lily State Zip Yes No V"t{,c!1- f4t.3k? ` Ml. de.l ye 4., --T- - (Ii 'res, Complete fornr AA 45 C 1) Re,; Travel Speed i ,fes to Ci t." ...1, rntpany Pcr{icy t. Ci n;t(,anp Phone Pr,.>nr = NINIONVIEALTH OF PENNSYLVANIA '-J POLI(H CRASH PEPORTING FORM. P0425735 AA 45 2 1 000815 i ' fl,:rr:her Tr, ,,g U-1,11-; Unit - ' r .:Ir tj I I.14 Y:O Tag Pa?sena"r Veh J rai! r 9 , i I :t r I,hno -, Ja:sny Truck ` . tru Trailer Year State _ ! y•..t J t + ?)Thvr Tag or Modular Home 9-Unknown Year ! State i i tr ry.e. ? _' q Y?.??l?T.Y1.?? ? 2 ?nt_ttrr? ; ,n E;ue 12=Commercial p8 =Gold 22=Horse.. and Buggy n'7-f1ot Applicable Passenger Carrier 01=Automobile 11 _'farrnl Equip 13=Taxi 4hihe 09=6rown 02=Motorcyde 12=Construction Equip 23_Hcirse and Rider i_fire Veh 21=Tractor Trailer 04=Green 10--Orange 03=Bus 18=Other Type Special Veh 24=Train 02=Ambulance 22=Twin Trailer 05=Black 11 =Purple D4=;mall Truck 19=Unknown Type Special Veh 25=Trolley 03=Police ` 06=yellow 12=0ther 05=.arge Truck 20=Unicycle, Bicycle, Tricycle 98=other r)B=Other Emergency 23=Triple Trailer 07=sliver 99_Unknown 10=Snowmobile 21=Clher Pedalcycle 99=Unknown Vehicle 31-Modified Veh 11=Pupil Transport 99=Unknown , ! t' (;T:r,7Cr f'ornt • C {lJtr!.3?i lnd r?, Z ;!„i , :. _ ._ 3 + ii:-r?U!:-i +I}iE{o:i .?. 1 .•.., .'i - - - ; r :? slit' (C.Urla ' C% a t, , r:c 08=1-eft of lrctfficway t, 0:' f;,<T^t c,f lrafficway r, r.. r ,! 4=.5agiBottom of Hill i. Crulr ;l t aif3l;t Flu.rrlw ry ` k•. Cr,• 1 of iiit1 I ;;;3 ? -aPt 3 r Trtff?cL.:iis = _ _ 1a 1 , 1") i .. J -Y )St,i ? ?.,•bri-tJMlrt(] y!t't? !' .reY.,•111 ,!; .:5 •.:!!i• t( 1.- St!d ?:I:I ?' Ill[ iii I e „r! ', C Lt •,•+n z1 Parki:,a 6'ocit,l,r? oil P Irkf ; . of I t +li,n 1 =Towing Truck ; sc :;! i rsiier "+ .__ ... Ur}its: 3: Tov!nng Utility Trailer $vother ! ay Tay : No j t 4 !Mobile or Modular Home 9:-Unknowr, yea State i .._. 1 .. C'4f.::? ?!}•3Q3'' 12=Commercial I ;$=C,eld c2 ric: _U+.orr,obiie t7=farm, Egalp ind 1 !y°; p 1'+'-No: APf 311cable Passenylrr Carrier [' . 13=Taxi r l rc:an lotorcyc(e 72 Conr.rl,cU r, 1<-:hrtse ,Ird p t' t__F, i ? litlh 21=Tractor 1 railer -! 1{,=(} rl'`. Cf f' ?: 14 18 r1tf;,P lyla, ,)I:t.,t!`r ! ?tT;,ll? !t:. f111-tJCi: atlCt• 22;:Ttivin Trwi+_r i+ i.:: !ruck 1' l1€ r.nc 4 n y! pe { f "v ` 23=Tri le Trailer -11.: 1 Ir 3, Truck r .rrc r' F,: c 4,• eb tit.,e't l f:.:Cltt . r f rner ieney p l?nnn.r,vr 1C- mobile 1 .,}tilt w) cftr 31=_PAodif,ecf Veh c talc 94. Unl now" t ! i',,,r,l ! ).ur,?or? 99?Unknowri !r•hrr ?r PI, Orr 0- None :1_tdt?r Appilt It;le 1 Ot7-;.v•:, .?? !:. iii (C ., 3I-?-? ?_!€l( ;,i!SlCVI ?? -) 2-F.1 :nun,l' Strli lrc, ,' F iciht Turn Lane 08=left of Trafficway + =Left L.me 09=Right of Tr.,fficway eft 'ruin Lane 10_110V Lane M'iq Not be isr .•_::,;,) :both ;,s.;).;,!Ig t!._?-Direc!lor; 11-Shoulder Right I? l.¦ qtr: 1 .:err 3=c .;,biir c i.` .•:°m r! d 5!r;,c?; Center Turn Lane 12=Shoulder left 1= .T-yti, , . , {:'.hair Fr, ..r3rr1 13=Qtte lant• R("I f i ..,: 95.-()Thor 9B--Unknowr- t 3'.Downhill ,: rl:, !'• . ! 4_%mj/f3ott0m of Hill • ,: J COMMONWEALTH OF PENNSYLVANIA POLICE CRASH Rt=PORTING FORM 400 New P0425735 AA 45 3 1 [? - - - - --- 000816 Pd9e 3 Change Continuation _?i Unt t Number List Lime t T A Adcsress license Number Ft MI Telephone Number _- l -7r7- y3 Z _. $zz 7 j City State Zip AlcoltouDrups Suspected! _ -- a& No I• legal Dn.rgs 0 Medicatim Alcohol _..__',•_ilcohol and Drugs 0 Unknown c 0 a z c +4 ar t? ! U 1 n 17 Alcohol Test Type dollt, Tett Not Grvu:n _.. ' BiorJd Alcohol Ti fa Remll,t, I treath Other 1 r,,,! Unknown if Test Given Ur!known R.t.5ults > J .. U Jr7 ,r! Apparently Iliega Drug ivrrnal Use Had Beer, Sick Dnnkrng O i Fatigue C) Medication I Asleep) Unknown ..... . . . .... _.- . ? _ .. ._ _ . _.... _ _. _. . -.? State - I P E 1 If License Number is unknown or driver is not licensed see manual Pedestrian Signal at Scene of Crash 0 No Pedestrian Signal 0 Not at i ntersection 0 Pedestrian Signal- C Pedestrian Location ?- FJtarkeci Crosstivatks In Roadway < 10 Feet Off Road O at Intetwooor. Not in Roadway , 10 Feet C At lntrtsa ,!ore - ko . M!7d:an Off R:rad rA ? - = CF055wn1k5 _ - Outside Trafficway r-• Non-Intersection island - Shared Paths/ a - CTOSSL'.. ;a Shoulder Trail: V Ct ?inE';h°ilik. u!+c.llol4rt Vehicle Code t+.! :x ; v• ' e !-' Jt S c,cti-; th;_ dr:v--' !Ix , ,ryrc? :with oD(3 r " t>:d (har k it they were nXtrge> Uutraticn? ?Rsvf 0 C41ACU 'Of7 Z?4? Spy ED Yes ? No Yes t._. No ;'J tiivt App:lcanle 03,Rented Vehicle 08;aOther Munic:p4a! Driver Presence ill !..Privatr ve;oc;c Owned/ 04=State Police Vehic'.e Government Whit e - 1 1-Driver Operated 3=Criver fled Scene awed u, w r!a t 05=PennDOT Vehicle 09=Federal Gov Vehrc - Vr w! ,;,. ; R;rrt t;Z Private Veh+,ie Not 06-Otfrer State Gov Vehicle 98=Other Owned/ Leaped by Driver 07=Municipal Police Vehicle 99-Unknowns Address r•;i; j'rer at;?r , city State Zip Luense Number _.__- ___._ _ --•-.- _ _ _- , _ __..? _ _.._ .? ?._-.. State It License Number is unknown or driver is not licenser, see manual +cnn4lrs Susw7i _tea Pedestrian Signal at Scene of Crash I! s.v I;i € a r { J.;S } Dedication 0 No Pedestrian Signal Not at Intersection ! Alcohol Aiwlml and Drugs Unknown 0 Pedestrian Signal Ah yr, >I tez* Tvnt' r Pedestrian Location 10 Feet l ,) In Roadway < -' k_7 Test N ,,,.t G!v+.'!, Other Marked Cross Nalks Off Road P4ooci Unknown if 0 at Intersectio t-' Not in Roadway > 10 Feet Test Given - At Intersectioa No Median Off Road Crosswalks Island y Alcohol Test Outside Trafficwa He>su`ts Unknown (Non•Intersect+on - t Refused N ) Shared Paths/ - Results d Crosswalks Shoulder Trails 0 Test C ven, 'o C ttarnrnated Results rs°' Driveway Access Sidewalk Unknown '" 'r ac " r Vehrrle Cody Laa ar Vc hole Code Section •hr, driver h r> charged with { f a , r,, ?, ,;rr violate d and mark if they were charged. Violation? fatigue Medication . ad r re! + Yep. ? No D,,.r f. Asleep Unknown Yep No j3.::Rentc d Vehrcl., - ?A tf r f t!. r , _ _ _ = Ott tj,.tl u:•rr N: ?•srV t(c• ". j .a,-fc• PC-1 rc. V fttclr. Gov'rnnm>r,t l r:!•; Urivr>r >liver 'led Scene .:rn! ?t> 09. fed r,ti C,ov k,: ' Veltuit• rill and H;ut ' r 1 Lr C:t1Mfrll C NIWEALTII OF PENNSYLVAN IA POLICE CRASH RI:PORTING FORM P 0 4 2 5 7 3 5 ? AA 45 4 1 P.tr,i: y i csnhnutti;;?rt I ," ;:" i 1_Dr ,er }: r'(75(IlQrl: --,:??t A Passenger occupant E SJfet Equipment One. 00_ None Used / Not ApE,I (obie Ejelmon: G 0::Not Applicable 2=Passenger 01 =Driver -All Vehicles 01=Shoulder Belt Used 1=Nat Ejected y 7=Pr:rjr:strlan 02=Front Seat Middle Position 02 =tap Belt used 2=Totally Ejected ? 8=Other 03 _Front Seat Right Side 03=Lap And Shoulder Belt Used 3=Partially Ejected 9=uui .r;o wn 04= Second Row - Left Side Or 04=Child Safety Seat Used 9=Unknown Motorcycle Passenger 05=Motorcycle Helmet Used 05 :Second Row - Midtfle Position 06; sir cle Helmet Used l Sex: 06Second Row - Right Side 07 Thi O d 10 Safety Belt Used lmpropedy II Child f ffertron Path.: H O=Not Ejected / Not A licable F xEe+riale r r Row r Greater - = Sa ety Seat Used improperly pp r 1 Th h Sid D O llil=Male Left Std _ .. 12=HelmetUsed lmproperiy = roug oor e pening y U =Unlrrmvvr? 06=Third Row Or Greater- 90=RestraintUsed, Type Unknown t 2rYftrpugh Side Window ,l.4 dd,e P tsi on 99--Unknown 3=Through Windshield Windshield . Asa :- Vhird Ptow Cdr Greater. 4=Through Back Door ; o Fright Sid+e:. 1O Sl Of T s k ?tl b F S. afv,& f r eni Twr : 66 d 5=Through Back Dom T??119ate OpentnsY . ; 6=Throu h Roof [? enin Sunr f/ n!,iw y 5 v rrty ; = eeper ruc e on ca = one Use / Not Appiicabie g p ua n D-fiat Injured V 11 _ln OtlierEnclosed 01=Front Air Bag Delilovt ! rx„ I w '>vat) Convertible Top Dow = , 1?Killed i ,.sr ngerOr Car D Ares, g' t!7=Side A4 r, .r r Racy D ,,{ y r ; 7 zThrough Roof Opening (Convertible t n 2%, fvl+s t ire t s, 1 ' ; +, r;? arks r t '-tJtFtwr T +.. r } t l . ` Top. l1p) 3 .N1or,' ;?.r. {r :?clf Of Pickup, Etr.) J++-=?Vlultlple Air §.;r,f; t+::t ni ntf?rtn )q unit :ia? C+t6rCyC1° l: yt, Pr::, f .. i '.s{:.t:t.i'.: 6 11111f 7'.ltl'. ?- , rrtr 1 tit/L ??' t "ftty}'IC.r11i1,' pp 1,1`-Alt l; Stl Not ilc 1. Nit ?.irt,otatl t :!•.t_ ;3b°:;ti 11 Ali 8 ,Au Not Dt pil i y , nir;rtet•{1 * fAvOlain(al Means ' # 1 { 12-,Air lia•? r N7)'tf" t't, t ? y. . Link SVwit(h sr tl tm r..11,-t.:1 1i}' l.!?J11 ? tLqL'Cili1!llCiil frZC'ilClS i . 1?-AtrFSacf Ptrru . c1;€' ,:: 5.:: 0ttif.. 9 lirt'r.l?vwn 19A)11knovwri ?f Air f',tq 0,: `J9vttnkr:osvn _ .........,..,.-...r ...................w >.. Pr ;: t'. r:. ..M..____...._.,.. _..., ticlr f!r' 13tr li (?1"r1 DD YYY•r. ..-.. ..,'`! ' • t: F V 5 2 -7 - 7 z m s a o; 3 LMS Transport ,Y t R t t K fi• `a 1 R K A A5, O ltf rC' ti ! F' c= i ri" i +Jr dC: t.r ,r; :a„ tt'+'Jilr!t3 iA"f9 I ;5 { YY e 31 11 7 EMS +• ---- ?;< t..., ?.. _.,_,? 1. „..._-t.. _. I ` .__. _ »,. r`?. _ ..., - - tf Transport a;3 eS No- I Unit ado Person lit! DuteofBirth (MM-VD-YYYY) A B C U E F G H 1 r. . 13r-(Ett ? -__ , 1 '0 t:MSTranspoirt ?a es CD No L: ni t No F'e.r sr>rk No Date of Birth (MM-DD-YYYY C E F G N 1 Deletes Fdrs;75e ? ltdclre ,s - P:rort?. . EMS Transport Q Yes C_7 No iifw Nf,, P. rson No Date of Birth (MM-DD-YYYN) A B --- D ..,,- i- I , s.?flit No r°, ?,, 1'4:.f U ite of Birth to hi D1)-YYY'1) A 1i t ??)) E F G H I EMS Transport 0) Yes (-_J No I l'MS Transport Yt No ( Q Ness. ._.g POD °? ASH REPORTING ORMNtA P 4 4 2 5 7 3 5 ? AA 4 5 51 U 0 Q 810 Page: S Chanw, °Y" tn;ersect!on Off Ramp dial location 40 !1IIdClock Traffic Circle! C Crossover Z? Not Applitable t 3ridge (_ ? Cross Over Related } 4 Way Intersection -' Round About (° j Untierpttss _.i Tunnel ) Driveway/Parking tctt' -t T Multi Leg C _i 3td[lroad Crossing T " tntersectiom ( ng C_ ,, Ramp - !Toll Booth f Ramp & Bridge Intersection Unknown Unknown F" r Can Ramp other (if RamF' 1s indicated, please see mantr>e/) 5 Cgn,E;It t:% trte Principal Road Section for ill type of crashes, Eor crashes at intersections, enter informatrun in the Intersecting Road Section or the GPS , F the GPS Section, or Ow "MW Nu#*X , ou should (flier fitfo jt iOo in thu -0i5trtullt* ilmM itVWftW " Section idblocb crtah h , y ave a w S+rction, If you , Section in the Principal !toad area. ; county flown, Number Segment (Optional) Travel.tanes Speed Limit - "itse Number (if applicable),_ 'fort cs t 1 ! I i? ??j .,.. South ? . L Street Natnt: Street Endinc ,t c fast .uL ? R ! i Unknown _ Roc.: _ H1^fhsv.ay . ._ « €iu3d n d.._ ttr rt I,? u9 ?._ _.._._ '..fr ! r ?r, v (.. • t , , i r ,clr„F ttt (optior- Travel Lanes Spe;-d Ornit ?' ' ?! t ' `ant!;+ Street !:lltl,i l) 4i ra Unknown i art( t?tC ?UYr'r.. l![l !c rnpike .Ptatr t..i; i:!!Q?; r!Cdi tt4ri;S S'1'r V:'itt' f)tI'i 4°t' If.d,, st) Spur 3•P"ghvray Road 7! Street Road Ur!k110'4v 1k ' ?, I,,, ?.•t. t?„rt LI ?t!i!i! (11 Nfilr• Po"t Of Si7g111 `ol ??({.13 ?'. ?wr l 0r trte?rsr?rtrt a %rri•. F 3d.,s. _ { fa.t L Mil Ent(- W"' Or es I F Landmark Intersei.ting I;t Num Or rtrle Post Or Seg ment Marker ?± 1 if Using 4- Th i ! (5 Narth ` i Distance from Crash Scene to Landmark ! # is Opt on South 00 " Str 2 N l St Endin st E r Crash between (Fo am Cr Int sect+ Y . ._. ? •_ -_ ____. .. _ _ g a Landmark I and K O ' # Y , ? i t pp 11 ; West Landmark 2 .......,............_,........w__..._...?..?,.,....?...?._ ,;: .......,.. ..,,.........,.......? _, ,.,...,_.? ........,..w...,,.?.? fir.. ,r ei ,?cunUi 4 t n Degrees Minutes Seconds a o g.rtude: t_:a,,tu(ir . ?lratt c Con*rn) 1)t1vicr - Passive RR } j TCR Functioning Stop Sign Crossing Controls i r dw riot Applicab!t Y r,; c „ Police Officer or S; (j I No Controls I Device Functioning ' Improperly Emergency , Prectnptive Signat a U c , , Flar?ntan F1;,,Iii•,vg Tt,, t i F i i i e S gn ji t+Ctive RR ?sassi!:g Other Type TCt! ce Not l j Dev unct on ng - ; Dev ce i Unknown Controls Functioning Properly 1 Traf`i "'vol n_t Unknown 17 TZI,t t,t Work Zor, • (tr ',,l or a Work Zone", skip rest of Work Zone section) 1 Work Zone (Mark aft fiat apply) Lane Closure Work on "houiclf•r F1,,goer Control r- Transition Area , Road Closet! vri h Or Med1.u1 , rv I r E'•(?torF 'S? L'Jo,k ; . Drtnur Internllttent Or nth+_?! ?,. Zone ti,r.rn;riy sign Activity Area moving work fc..a;?n, ti ncc Warning Iermi'tation Area Work Zone - Workers tlnknovvn iJc \ < i i L1rr:; Speec?Iimit t . e r? n r f ?t Other _ u,,. r,.,• ,t r lrtr/t ra;t! C,I of 0111 tale 00.urr6sef601)) UnknUxltl ,rr ul!r. Uet?'dwe i Ye, NC• • t:OiV;eION'4"ILALTH OF PENNSYLVANIA P LI E CRASH Ri:PORTiNG FORi",r! P 0 4 2 5 7 3 5 AA 4S 6 1 VOC S19 0=Non•Co11i;1an On 1 t.la_ 6 =Sideswipe i estrian 1_^hc sr Cnd tc it to P, rr fOni osite Di r 1 Ped (Eacking) .! ( _t±;t nixed C)bytc' j-,aherlUnkrtown 1M0r; ',,.iv,. n, u'w<iy J ..c '?,; nt;, Ya? L_:Sft::k.t<fvr •1_.Roadside b_In Parking ; imp 1 r 1: Daylight 3-Dark • Street S- Dawn Z:hark No iir3ittti 6?,Dark Unki,,wn Street Lights 4_Dusk Roadmiiy I igh1mg a twNo Adverse Conditions 3=Sleet (Hail) 5-F09 i v 2-Rain 4=Snow 6=11ain & Fog b_Aty 2;=Sand, Mud, Dirt, 4_: Slush ??.. ,.. ?tIronS -1Nkt Oil 3=Sno•.v Coverer' 5ke Hatm Event - L/R I4ost7 Utility Pole Nu nber 7? ( r(1 f ,`3. I7T ' f!F i. vy (i f<1 1 5 ` Unit No *idrtri t.' k r, L;R 3f flit f Ul lit•y 6=1ce Patches 8=Other 7-Water - Standing or Moving 30?zffit Fence Or Willi 31zHit Building ? .' -Flit Culvel f magk her Or Abutment 34=1-iit P-arauet End F iI Br;ti_;• Rail tilt 5:.0.. Ei.ink . i'.it I tata,!!1)r.icy ?. :r?'.trtJl ti=>n h Irrl"t .1; tt?r t,) ? F xett ?< ifrct t vin F xt r' ':)iJ;• ct Oil '..1 ...,., Ti t):_0;ht:r Uz- UfikiicwV Jr!i' I4 4 Harm g :ant M_Q.s3 l.nw No Hatr: 15_.Drivin The Wrong Way rs??tlf3d Sul On 1-Way Street Can! to 5 Z : r, nt in Z )0 No Contributing Action 17=Careless Or Illegal 'fIf`. la?jt t€ L ! 01 -Dtiv"r L'ras D-v wed o. king On Roadway a+ r:.. 0 L7rr. r (I _ h +id ti,ld P1ioriv 18=0,, ink The '' _ )irlJrlvlll ., . ,!?r,) !`. 11 r8t f lttit;e a CSIi rUn(3 RoA ' i r'lak ng improper i + ) I rill 11 -• ! k t i t:' wilk, i tr,, pa'?lritr t G !!opor: f )-suastGrrt ]r' RC,„1,?,>., 1 rom tsryhway rati t) lt} t 3,. pu i,olei f! ``1 1 + Jrtllt <, 4';rklli(?'ttnF, lrklnC? i n+,i J 1. r7vertUndar k , ui> ky 14 :11(nk n Of 'At ii"cl ".r :, f rn! u ! i , u+ ,, K'•+ ! ,. Compeiiwtlon At t"mve Of Spoe+diny I t.1+rr1f!, *,!, 1 ! ..:ct --{)riviil loo Fast foi Conditions s O,i,cr Rk ui ? t ' f ,i.''ure 7(i Man r•r Proper Speed :..:. --ii. .. , ._ . __ u n i(,•, nu -t r t Driver FI eincli r'o1!ct n ? i ?l l,y Road P Jr lain ) Polio C se i _ 1 )nv., ?r Iriexperien(, ;titt. 1 .. ;, • ' rtr ratiurt, To Use Speswlized Equip 1 _. t, imprope rig tions R?Other 7=Sleet & Fog 4=Unknown E_Qther 7-Gore (Ramp Intersection) rj Unknown COMMONWEALTH OF PL.,*NSYLVANIA ?OL{CE CRASH REPORTING FORM ? New P 0 4 2 5 7 3 5 - Change/ AA 45 7 1 9JOVS20 page 7 Continuation Deiete Page C. ' 9p o -1 , G 11? I l upo ( I 7,-? f4 .:Y J t?-OMMONWEALTH OF Pl. SYLVANIA P04257 35 ...J PO.-!CF CRASH PF-PORT;NG FORM Ov N1w ' • Gsar.yc•?? • 0Conttnuatron Ark 45 8 1 Faye $' r,a.e ?rrte: :_r;ty t.a;,>por',, v.'an_ss, and other information here. it is not required to resLate information from the form. q, ?;,,,,,, .. :,'...;,?nc?• s h+t??tlit??1 Facility. Address: ? Phone: 4h,ts,ess 2 Address: Phone: !Narrative: . -- -- --- _-' - E LL - T! -_.e- 0S7 _-Q'LTje ?"'?___._y_ F'eEStl G.?vEL -- ?. r,55.?57??.--------.B--?----•-!?14`?,CGE_,..._---__?-?-"?_-_ __ ?-`-!?-`? _Cc.-m.A(.Y??' - ?`v.D c,t?'h S P Q 0 r S 's c/pI? t. I Lb 7-0 cl,,?)E e? 1 1 fl GPE,4Z ?'/ U, -As IIT-4 4vrfw f D f> t c <. <'s r° n ;L U h' C v121I ?,f? t C 8`/? ? 4 17 ° AE V 41 y? -? h ? y?yy }2Y. IaTO(C. 4 SfRZkiz Plaintiff rNr?l?(Bv? ?q, Defendant In The Court of Common Pleas of Cumberland County, Pennsylvania No. ©Y - W09' Civil Action - Law. Oath We do solemnly swear (or affirm) that we will support, obey and defend the Constitution of the United States and the Constitution of this Commonwealth and that we will discharge the duties of our office with fidelity. e Signs d A . 1??k Name (Chairman) 6?me- Law Firm Signature Name Law Firm for s..?? Address Address, AC?4145;4'0 9 1746- - City, ip City, z 4104U Award Signature Name Law Firm address zip city, zip W*, the undersigned arbitrator,, having been duly appointed and sworn (or affirmed), make the following award: (Note: If damages for delay are awarded, they shall be separately stated.) Date of Hearing: /-W Date of Award: Notice of Entry of Award I. Y r,r: ,- (Chairman) D-W Now, the 1$+'' day of , 2001 , at a oo , _P.M., the above award was entered upon the docket and notice thereof Pd en by mail to the parties or their attorneys. Arbitrators' compensation to be paid upon appeal: $ oZ9?.OD By: o notary Deputy . Arbitrator, dissents. (Insert name if applicable. C l , 0 i.? .._ F 5 ?