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HomeMy WebLinkAbout10-7201 CRAIG A. STONE, ESQUIRE FILED _OFF1CL I.D. No. 1590 MICHAEL C.7MONGIELLO, ESQUIRE PRO Ty?NQ TAR I.D. No. 87532 2010 Noy Marshall, Dennehey, Warner, Coleman & Goggin 29 PH 4' () 4200 Crums Mill Road, Suite B CUMBERLAND COUNTY Harrisburg, PA 17112 PENNSYLVANIA (717) 651-3502 Attorney for Defendant Perini Services/Southamptom Manor Limited Partnership t/dlb/a Shippensburg Healthcare Center RICHARD GIPE, as Administrator For the Estate of Mary Gipe Plaintiff VS. BAXTER WELLMON, D.O. and PERINI SERVICES/SOUTHAMPTOM MANOR LIMITED PARTNERSHIP t/d/b/a SHIPPENSBURG HEALTHCARE CENTER Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA Docket No: 10-7201 Civil CIVIL ACTION JURY TRIAL DEMANDED ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly enter the appearance of the undersigned on behalf of the Defendant, Perini Services/Southamptom Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center, in the above-captioned case. C Dated: _ o b 0 , WARNER, By: Craig A. V3tone, Esquire Michael C. Mongiello, Esquire 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (717) 651-3500 CERTIFICATE OF SERVICE I, Sarah Kuhn, an employee of Marshall, Dennehey, Warner, Coleman & Goggin, hereby certifies that a true and correct copy of the foregoing Entry of VAppearance has been served upon the following known counsel and parties of record this ??1 day of November 2010, via United States First-Class Mail, postage prepaid: Zachary Campbell, Esquire Baxter Wellmon, D.O. RJ Marzella & Associates 127 Walnut Bottom Road 3513 North Front Street Shippensburg, PA 17257 Harrisburg, PA 17110 6, `G' ?__ - &d, Sarah Kuhn 05/663199,v l E %4 F1 ' b PA 17112 PENNSYLVANIA arns urg, (717) 651-3502 Attorney for Defendant Perini Services/Southamptom Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center CRAIG A. STONE, ESQUIRE FILED=4FFI?CE I.D. No. 15907 OF THE PROTNONO iAR Y MICHAEL C. MONGIELLO, ESQUIRE I.D. No. 87532 Zola NOV 30 PM 3: S6 Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B CUMBERLAND COUNTY RICHARD GIPE, as Administrator For the Estate of Mary Gipe Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA Docket No: 10-7201 Civil CIVIL ACTION VS. BAXTER WELLMON, D.O. and PERINI SERVICES/SOUTHAMPTOM MANOR LIMITED PARTNERSHIP t/d/b/a SHIPPENSBURG HEALTHCARE CENTER JURY TRIAL DEMANDED Defendant PRAECIPE FOR A RULE TO FILE COMPLAINT TO THE PROTHONOTARY: Kindly issue a Rule directing Plaintiff, Richard Gipe, as Administrator for the Estate of Mary Gipe, to file a Complaint in the above-referenced matter within twenty (20) days of service thereof or risk a judgment of non rhos. Y, WARNER, '4 Gr MARSHAL COLEMAN/&E Dated: t [ 4? p By: Craig)'S ne, $squire Michael C. Mo iello, Esquire 4200 Crum Mil Road, Suite B Harrisburg, A 7112 (717) 651-35 RICHARD GIPE, as Administrator For the Estate of Mary Gipe Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA Docket No: 10-7201 Civil CIVIL ACTION vs. BAXTER WELLMON, D.O. and PERINI SERVICES/SOUTHAMPTOM MANOR LIMITED PARTNERSHIP t/d/b/a SHIPPENSBURG HEALTHCARE CENTER JURY TRIAL DEMANDED Defendant RULE AND NOW, this day of , 2010, upon consideration of the foregoing Praecipe, Plaintiff is hereby ordered to file a Complaint within twenty (20) days hereof or suffer judgment of non pros. BY THE PROTHONOTARY: A O CERTIFICATE OF SERVICE The undersigned hereby certifies that a true and correct copy of the foregoing PRAECIPE FOR A RULE TO FILE COMPLAINT has been served upon the following known counsel and parties of record this __ l -day of November 2010, via United States First-Class Mail, postage prepaid: Zachary Campbell, Esquire RJ Marzella & Associates 3 513 North Front Street Harrisburg, PA 17110 Baxter Wellmon, D.O. 127 Walnut Bottom Road Shippensburg, PA 17257 A d/l??cJ'' L/ Sarah Kuhn 05/663215.v1 SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff Jody S Smith Chief Deputy Richard W Stewart Solicitor FILED-OFFICE OF THE PROTI-E0 GTAtRY 2010 DEC - 8 PH 3:49 CUMBERLAND COUNTY PENNSYLVANIA Richard Gipe, as Administrator for the Estate of Mary Gipe Case Number vs. Baxter Wellmon, D.O. 2010-7201 SHERIFF'S RETURN OF SERVICE 12/02/2010 04:21 PM - Ronny R. Anderson, Sheriff, who being duly sworn according to law, states that he made a diligent search and inquiry for the within named defendant to wit: Baxter Wellmon, D.O., but was unable to locate him in his bailiwick. He therefore returns the within Writ of Summons as not found as to the defendant Baxter Wellmon, D.O. Deputies were advised, Baxter Wellmon, D.O. is thought to be doing business in Shippensburg, Pennsylvania. NOAH LINE, D UTY SHERIFF COST: $51.00 December 03, 2010 SO ANSWERS, RONNY R ANDERSON, SHERIFF OF TiNtr 9n--'!t! n pt 2' i R. J. MARZELLA & ASSOCIATES,?j j? ?: BY: Zachary Campbell, Esquire po° Attorneys for Plaintiff Pennsylvania Supreme Court I.D. No. 93177 Richard Gipe, as Administrator 3513 North Front Street for the Estate of Mary Gipe Harrisburg, PA 17110 Telephone: (717) 234-7828 Facsimile: (717) 234-688 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA RICHARD GIPE, AS ADMINISTRATOR FOR THE ESTATE OF MARY GIPE PLAINTIFF, V. DOCKET NO. 10-7201-CIVIL CIVIL ACTION BAXTER WELLMON, D.O.; PERINI SERVICES/SOUTHAMPTOM MANOR LIMITED PARTNERSHIP T/D/B/A SHIPPENSBURG HEALTHCARE CENTER; DEFENDANTS --- JURY TRIAL DEMANDED COMPLAINT 1. Mary Gipe, deceased, and Richard Gipe, her husband, were at all relevant times herein adult individuals residing at 7500 Molly Pitcher Highway, Lot 30, Shippensburg, Pennsylvania 17257. 2. Mary Gipe passed away on or about November 18, 2008. 3. Richard Gipe, was subsequently named the Administrator of the Estate of Mary Gipe, and continues to reside at 7500 Molly Pitcher Highway, Lot 30, Shippensburg, PA 17257. Docket No. 10-7201 4. Defendant Baxter Wellmon, D.O. (hereinafter, Defendant Wellmon), an adult individual, is a physician who is licensed to practice medicine in the Commonwealth of Pennsylvania and who at all relevant times herein engaged in the practice of Family Medicine in Shippensburg, Pennsylvania. 5. Defendant Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center (hereinafter Defendant SHC) was at all relevant times a corporate medical institution with a principle place of business at 121 Walnut Bottom Road, Shippensburg, Pennsylvania, 17257. 6. At all relevant times herein, all physicians, interns, residents, emergency room staff, radiologists, and/or other medical support staff who provided care and treatment to Mrs. Gipe from November 13, 2008 through November 18, 2008 were the agents, apparent agents, servants and/or employees of Defendant SHC and were acting - within the course and scope of their employment when providing professional medical services to Mary Gipe. 7. At all relevant times herein, Defendant Wellmon, all physicians, interns, residents, nurses aides, and/or other medical support staff who provided care and treatment to Mrs. Gipe from November 13, 2008 through November 18, 2008 were the agents, apparent agents, servants and/or employees of Defendant SHC and were acting within the course and scope of their employment when providing professional medical services to Mary Gipe. 8. On November 7, 2008, Mrs. Gipe was admitted to Holy Spirit Hospital for triple bypass, cardiac surgery. Docket No. 10-7201 I 9. The surgery was performed by Sung J. Park, M.D. 10. Although the surgery was performed with relative success, Dr. Park was only able to perform on two of Mrs. Gipe's veins due to calcification, according to the medical records. 11. Following surgery, Mrs. Gipe was taken to recovery and was doing fairly well other than some problems with ambulation. 12. Mrs. Gipe would remain at Holy Spirit Hospital until her transfer on November 13, 2008. 13. On November 13, 2008, Mrs. Gipe was transferred to Defendant SHC for I rehabilitation of her lower extremity as she was barely able to walk without the use of a I walker. 14. Mrs. Gipe had a known history of problems with coagulation and had been ordered to take anticoagulation medications. 15. Mrs. Gipe had been on the anticoagulation medication, Coumadin, for I approximately three to four years because of previous clotting problems in her legs that I required the surgical insertion of stents to treat the clots. 16. Upon admission to Defendant SHC, Mrs. Gipe was given strict orders by her physicians at Holy Spirit Hospital regarding the regulation of her INR and the administration of Coumadin. 17. Holy Spirit provided written discharge instructions to Defendant SHC I regarding the physicians' orders. 3 Docket No. 10-7201 18. Specifically, her physicians gave very strict discharge instructions to maintain her INR level between 2-3. 19. To achieve this, Mrs. Gipe was ordered to take 5mg of Coumadin every night and another 2.5mg on Mondays and Fridays. 20. The staff at Defendant SHC was well aware and noted the potential for injury related to Mrs. Gipe's use of Coumadin, ASA, and Plavix. 21. It was explicitly noted that Mrs. Gipe not exhibit signs or symptoms of bleeding and for her prothrombin time (PT/INR) to be within normal range over the duration of her stay. 22. Additionally, when Mrs. Gipe was admitted, staff at Defendant SHC knew or should have known that she had coronary artery disease (CAD). 23. Also, because-of Mrs. Gipe's unsteady gait, she required assistance with her daily living activities. 24. Defendant SHC explicitly noted that Mrs. Gipe had a high risk of falling I and staff was instructed to organize her living area to reduce the chance of her falling. 25. In fact, Mr. Gipe was told that because of his wife's larger body size, at least two to three nurses would assist in ambulating Mrs. Gipe at all times. 26. The first few days of Mrs. Gipe's admission at Defendant SHC were fairly uneventful. 27. At around 11:00 p.m., on November 16, 2008, Mrs. Gipe fell during a transfer from her commode to her chair. 4 Docket No. 10-7201 28. Interestingly enough, only one nurse had been assisting Mrs. Gipe during this transfer. 29. Mr. Gipe was later told that no other staff members were available at the time. 30. Therefore, as a result of a clear violation of policy and procedure, only one staff member of Defendant SHC assisted Mrs. Gipe in ambulation and she was left injured after suffering the fall. 31. After the fall, Mrs. Gipe reported increased pain in her left chest area that she initially believed had existed prior to her fall. 32. In addition, she also complained of left shoulder pain and that her lower extremities felt numb. 33. The attending nurse documented that Mrs. Gipe's left shoulder pain "was not new," but did report the numbness in her legs. 34. After her fall, Mrs. Gipe was assisted back to her bed by the staff member. 35. Mrs. Gipe was still complaining of shoulder pain and she could not lift her shoulder above her head less than two hours after her fall. 36. Dr. Dell, the attending physician, was informed of this complaint and ordered a bedside x-ray around 2:30 a.m. on November 17, 2008. 37. The x-ray, however, would not be performed until sometime later that morning. s Docket No. 10-7201 38. For some unknown reason, her physician, Dr. Wellmon, was not informed of the results of the x-ray until approximately 4:30 p.m., on the afternoon of November 17, 2008. 39. The x-ray indicated that Mrs. Gipe had fractured her left arm as a result of the of the fall. 40. In between this time period, the staff was simply giving Mrs. Gipe medication for the pain she was complaining in her arm. 41. When Dr. Wellmon was notified that Mrs. Gipe had fractured her left arm he ordered a sling for her arm. 42. At this time, Dr. Wellmon also informed Mrs. Gipe that her PTANR levels were rising, indicating a high risk for bleeding. 43. Dr. Wellmon ordered her Coumadin to be held for the time being and the PTANR to be rechecked in the morning. 44. Despite knowing the cardiac surgery Mrs. Gipe underwent a few days earlier, her high risk of bleeding, and history of fall and fracture, Dr. Wellmon never ordered Mrs. Gipe to be transferred to the hospital. 45. Over the next 24 hours, Mrs. Gipe continued to complain of pain in her I left shoulder. 46. Mrs. Gipe did not want to use the sling and was simply given pain medications to manage her pain. 47. Again, at no time was a request made or was Mrs. Gipe ordered to be transferred to the hospital for further evaluation. 6 Docket No. 10-7201 48. By 2:00 p.m. on the afternoon of November 18, 2008, Mrs. Gipe's oxygen saturation was only 75%. 49. In addition, Mrs. Gipe's PTANR levels were 4.3. 50. Dr. Wellmon was notified of these alarming findings and he ordered the Coumadin to continue to be withheld. 51. Dr. Wellmon also finally ordered an orthopedic consult for her fractured arm. 52. Again, no measures were taken to transfer Mrs. Gipe to the hospital. 53. Later that evening, Mrs. Gipe actually was assisted out of bed for dinner, according to the nurses' notes, but she requested to be placed back in her bed because of pain shortly thereafter. 54. Throughout the evening Mrs. Gipe's oxygen saturation levels continued to decline and she struggled with staff in wearing the oxygen unit. 55. She was noted to have a productive cough with "light greenish-brown sputum" around 9 p.m. on November 18, 2008; however, no attending physician was contacted. 56. Inexplicably, 10 minutes later, Mrs. Gipe was found unresponsive, cold to the touch, pale and having no pulse. 57. The RN supervisor was notified and she also documented that Mrs. Gipe was unresponsive and had no vital signs. 58. No measures were taken to resuscitate Mrs. Gipe and she was pronounced dead at 9:15 p.m. on November 18, 2008. 7 Docket No. 10-7201 59. Plaintiff, Richard Gipe, individually and as the Administrator of the Estate of Mary Gipe, deceased, brings this action on behalf of the Estate of Mary Gipe under and by virtue of the Act of 1976, July 9, P.L. 586, No. 142, §2, 42 Pa. C.S.A. §8302. 60. Plaintiff, Richard Gipe, individually and as the Administrator of the Estate of Mary Gipe, deceased, brings this action for the wrongful death of Mary Gipe, deceased, on behalf of all persons entitled to recover damages under and by virtue of the Act of 1976, July 9, P.L. 586, No. 142, §2, 42 Pa. C.S.A. §8301. The Defendants in the above-captioned are jointly and severely liable to the Plaintiff for the injuries and damages set forth herein and incorporated by reference. 61. Plaintiff, Richard Gipe, individually and as the Administrator of the Estate of Mary Gipe, deceased, claims on behalf of said Estate, the damages suffered by said Estate by reason of the death of the decedent, for the pain and suffering of decedent prior to her death, for the loss of earnings and earning power for the decedent's life expectancy, for the loss of pleasures and enjoyment of her life and for all other damages sustained by reason of the death of the decedent. 62. Decedent, Mary Gipe, did not bring an action for her injuries during her lifetime. 63. The following are all persons entitled by law to recover damages for the wrongful death and the relationship to the decedent. A. Richard Gipe, Sr.- Husband B. Richard Gipe, Jr. - Son C. William Gipe - Son Docket No. 10-7201 64. As a result of the death of the decedent, the above-named beneficiaries have suffered pecuniary losses and incurred expenses and will incur such losses in the future, for all of which damages are claimed. 65. As a result of the death of the decedent, the above-named beneficiaries have suffered a loss of the care, comfort, society and companionship of Mary Gipe, for all of which damages are claimed. 66. At the time of her death, Mary Gipe was 68 years of age, having been born on November 16, 1940. 67. As a result of Mary Gipe's wrongful death, Plaintiff claims any and all damages recoverable under and by virtue of the Act of 1976, July 9, P.L. 506 No. 142, §2 42 Pa. C.S.A. §8001. 68. As a result of Mary Gipe's wrongful death, Plaintiff has incurred medical, funeral, burial and related expenses and a claim is made therefore. 69. As a direct and proximate result of the delay in assessing and treating Mary Gipe, deceased, she suffered the ultimate injury of death. 70. As a direct and proximate result of the delay in properly assessing and treating Mary Gipe, deceased Defendants significantly reduced Mary Gipe's chance of survival. 71. As a direct and proximate result of the negligence of Defendants and/or the agents, apparent agents, servants and/or employees of Defendants, Plaintiff, Richard Gipe, individually and as the administrator of the Estate of Mary Gipe, has suffered and 9 Docket No. 10-7201 will continue to suffer severe injuries including emotional distress and a claim is made therefore. 72. Plaintiff, Richard Gipe, individually and as the Administrator of the Estate of Mary Gipe, deceased, claims on behalf of said Estate, the damages suffered by said Estate by reason of the death of the decedent, for the pain and suffering of decedent prior to his death, for the loss of pleasures and enjoyment of his her life and for all other damages sustained by reason of the death of the decedent and a claim is made therefore. 73. As a direct and proximate result of the Defendants' negligence, Plaintiff, Richard Gipe, has been forced to incur liability for medical bills relating to his wife's death, and has also suffered a loss of intimacy, consortium, services, society, advice and companionship and a claim is made therefore. COUNTI PROFESSIONAL NEGLIGENCE Richard Gipe, as Administrator for the Estate of Mary Gipe V. Baxter Wellmon, D.O. 74. Paragraphs 1 through 73 are incorporated herein by reference as if set forth at length. 75. Defendant Baxter Wellmon, D.O. is liable to the Plaintiff, Richard Gipe, individually and as the Administrator of the Estate of Mary Gipe, deceased, for the 10 Docket No. 10-7201 injuries and damages alleged herein which were directly and proximately caused by the Defendants' negligence with respect to Mary Gipe, deceased, by: a. Failing to timely diagnose and properly treat Mrs. Gipe's internal bleeding; b. Failing to recognize Mrs. Gipe's signs and symptoms on November 16, 2008 through November 18, 2008 as consistent with and characteristic of internal bleeding and ordering diagnostic tests necessary to confirm or rule out the same as the underlying cause of her symptoms; C. Dismissing the symptoms Mrs. Gipe was experiencing on November 16, 2008 through November 18, 2008 without a reasonable basis for doing so; d. Delaying the proper diagnosis and treatment of Mrs. Gipe's condition, which ultimately led to her death; e. Failing to recommend, order or further investigate Mrs. Gipe's condition on November 16, 2008 through and including November 18, 2008; f. Failing to timely investigate and respond to reports that Mrs. Gipe's oxygen saturation level was only 75% on November 18, 2008; g. Failing to recognize Mrs. Gipes' symptoms as consistent with internal bleeding; h. Failing to recommend or order any type of treatment to prevent or diminish the damage done to Mrs. Gipe in a timely fashion; Failing to appreciate and recognize that Mrs. Gipe's continuous complaints after her fall on November 16, 2008, as potentially life threatening; 11 Docket No. 10-7201 j. Failing to treat Mrs. Gipe after reports of her "light greenish-brown sputum" around 9 p.m. on November 18, 2008; k. Failing to order an ultrasound, CT scan or MRI in a timely fashion; 1. Failing to order a repeat x-ray in a timely fashion; M. Failing to review the results of the x-ray taken on November 17, 2008 in a timely fashion; n. Failing to order Mrs. Gipe's transfer to a hospital and/or medical center at any time after her fall on November 16, 2008, for further evaluation; o. Failing to recognize the risk the fracture in Mrs. Gipe's left extremity presented to her overall condition; P. Failing to consult with a physician or a supervisor in a timely fashion; q. Failing to consult with a surgeon in a timely fashion; r. Failing to provide accurate and complete information when Mrs. Gipe's condition began to decline; S. Failing to order blood transfusions or blood products in a timely fashion; t. Failing to order oxygen in a timely fashion; U. Failing to properly regulate Mrs. Gipe's INR level or administer her Coumadin at any time between November 16, 2008 through November 18, 2008; 76. Defendant, Baxter Wellmon, D.O. is liable to the Plaintiff for the injuries and damages set forth in paragraph 1 through 75 above which are incorporated herein by reference as if set forth at length. 12 Docket No. 10-7201 WHEREFORE, Plaintiff, individually and as the Administrator for the Estate of Mary Gipe, demands judgment against Defendant Baxter Wellmon, D.O. in an amount in excess of $50,000.00 exclusive of interests and costs and in excess of any jurisdictional amount requiring compulsory arbitration. COUNT II PROFESSIONAL NEGLIGENCE Richard Gipe, as Administrator for the Estate of Mary Gipe V. Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center 77. Paragraphs 1 through 73 and Count I are incorporated herein by reference as if set forth at length. 78. Defendant Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center is liable to the Plaintiff, Richard Gipe, individually and as the Administrator of the Estate of Mary Gipe, deceased, for the injuries and damages alleged herein which were directly and proximately caused by the Defendant's negligence, with respect to Mary Gipe, deceased, by: a. Failing to timely diagnose and properly treat Mrs. Gipe's internal bleeding; b. Failing to recognize Mrs. Gipe's signs and symptoms on November 16, 2008 through November 18, 2008 as consistent with and characteristic of internal bleeding and ordering diagnostic tests necessary to confirm or rule out the same as the underlying cause of her symptoms; 13 Docket No. 10-7201 C. Dismissing the symptoms Mrs. Gipe was experiencing on November 16, 2008 through November 18, 2008 without a reasonable basis for doing so; d. Delaying the proper diagnosis and treatment of Mrs. Gipe's condition, which ultimately led to her death; e. Failing to recommend, order or further investigate Mrs. Gipe's condition on November 16, 2008 through and including November 18, 2008; f. Failing to timely investigate and respond to reports that Mrs. Gipe's oxygen saturation level was only 75% on November 18, 2008; g. Failing to recognize Mrs. Gipes' symptoms as consistent with internal bleeding; h. Failing to recommend or order any type of treatment to prevent or diminish the damage done to Mrs. Gipe in a timely fashion; i. Failing to appreciate and recognize that Mrs. Gipe's continuous complaints after her fall on November 16, 2008, as potentially life threatening; j. Failing to treat Mrs. Gipe after reports of her "light greenish-brown sputum" around 9 p.m. on November 18, 2008; k. Failing to order an ultrasound, CT scan or MRI in a timely fashion; 1. Failing to order a repeat x-ray in a timely fashion; M. Failing to review the results of the x-ray taken on November 17, 2008 in a timely fashion; 14 Docket No. 10-7201 n. Failing to order Mrs. Gipe's transfer to a hospital and/or medical center at any time after her fall on November 16, 2008, for further evaluation; o. Failing to recognize the risk the fracture in Mrs. Gipe's left extremity presented to her overall condition; P. Failing to consult with a physician or a supervisor in a timely fashion; q. Failing to consult with a surgeon in a timely fashion; r. Failing to provide accurate and complete information when Mrs. Gipe's condition began to decline; S. Failing to order blood transfusions or blood products in a timely fashion; t. Failing to order oxygen in a timely fashion; U. Failing to properly regulate Mrs. Gipe's INR level or administer her Coumadin at any time between November 16, 2008 through November 18, 2008; V. Failing to adhere to protocol in Mrs. Gipe's transfer from her commode to her chair on November 16, 2008; W. Failing to have more than one staff member assist Mrs. Gipe in ambulating; X. Improperly ignoring orders regarding having two to three staff members assist Mrs. Gipe during ambulation; Y. Failing to have an appropriate amount of staff assigned to assist and/or treat Mrs. Gipe; 15 Docket No. 10-7201 Z. Failing to properly train and/or supervise and/or manage employees and/or agents and/or apparent agents and/or servants regarding the proper policies and protocols in assisting in ambulation of patients; aa. Failing to properly train and/or supervise and/or manage employees and/or agents and/or apparent agents and/or servants regarding the proper policies and protocols involving a patient who has fallen at the facility; bb. Failing to properly train and/or supervise and/or manage employees and/or agents and/or apparent agents and/or servants regarding the proper policies and protocols in communicating a patients complaints and/or symptoms to a physician. 79. Defendant, Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center is liable to the Plaintiff for the injuries and damages set forth in paragraph 1 through 78 above which are incorporated herein by reference as if set forth at length. WHEREFORE, Plaintiff, individually and as the Administrator for the Estate of Mary Gipe, demands judgment against Defendant Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center in an amount in excess of $50,000.00 exclusive of interests and costs and in excess of any jurisdictional amount requiring compulsory arbitration. 16 Docket No. 10-7201 COUNT III VICARIOUS LIABILITY Richard Gipe, as Administrator for the Estate of Mary Gipe V. Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center 80. Paragraphs 1 through 73 and Counts I and If are incorporated herein by reference as if set forth at length. 81. Defendant Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center is responsible, as a matter of law, for the negligent acts of its actual or ostensible agents, servants, and employees committed within the course and scope of their employment. 82. Defendant Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center, acting by and through its actual or ostensible agents, servants, and employees for whom it is vicariously liable, was negligent in the following particulars: a. Failing to timely diagnose and properly treat Mrs. Gipe's internal bleeding; b. Failing to recognize Mrs. Gipe's signs and symptoms on November 16, 2008 through November 18, 2008 as consistent with and characteristic of internal bleeding and ordering diagnostic tests necessary to confirm or rule out the same as the underlying cause of her symptoms; Dismissing the symptoms Mrs. Gipe was experiencing on November 16, 2008 through November 18, 2008 without a reasonable basis for doing so; 17 Docket No. 10-7201 d. Delaying the proper diagnosis and treatment of Mrs. Gipe's condition, which ultimately led to her death; e. Failing to recommend, order or further investigate Mrs. Gipe's condition on November 16, 2008 through and including November 18, 2008; f. Failing to timely investigate and respond to reports that Mrs. Gipe's oxygen saturation level was only 75% on November 18, 2008; g. Failing to recognize Mrs. Gipes' symptoms as consistent with internal bleeding; h. Failing to recommend or order any type of treatment to prevent or diminish the damage done to Mrs. Gipe in a timely fashion; i. Failing to appreciate and recognize that Mrs. Gipe's continuous -complaints after her fall on November 16, 2008, as potentially life threatening; j. Failing to treat Mrs. Gipe after reports of her "light greenish-brown sputum" around 9 p.m. on November 18, 2008; k. Failing to order an ultrasound, CT scan or MRI in a timely fashion; 1. Failing to order a repeat x-ray in a timely fashion; M. Failing to review the results of the x-ray taken on November 17, 2008 in a timely fashion; n. Failing to order Mrs. Gipe's transfer to a hospital and/or medical center at any time after her fall on November 16, 2008, for further evaluation; 18 Docket No. 10-7201 o. Failing to recognize the risk the fracture in Mrs. Gipe's left extremity presented to her overall condition; P. Failing to consult with a physician or a supervisor in a timely fashion; q. Failing to consult with a surgeon in a timely fashion; r. Failing to provide accurate and complete information when Mrs. Gipe's condition began to decline; S. Failing to order blood transfusions or blood products in a timely fashion; t. Failing to order oxygen in a timely fashion; U. Failing to properly regulate Mrs. Gipe's INR level or administer her Coumadin at any time between November 16, 2008 through November 18, 2008; V. Failing to adhere to protocol in Mrs. Gipe's transfer from her commode to her chair on November 16, 2008; W. Failing to have more than one staff member assist Mrs. Gipe in ambulating; X. Improperly ignoring orders regarding having two to three staff members assist Mrs. Gipe during ambulation; Y. Failing to have an appropriate amount of staff assigned to assist and/or treat Mrs. Gipe; Z. Failing to properly train and/or supervise and/or manage employees and/or agents and/or apparent agents and/or servants regarding the proper policies and protocols in assisting in ambulation of patients; 19 Docket No. 10-7201 aa. Failing to properly train and/or supervise and/or manage employees and/or agents and/or apparent agents and/or servants regarding the proper policies and protocols involving a patient who has fallen at the facility; bb. Failing to properly train and/or supervise and/or manage employees and/or agents and/or apparent agents and/or servants regarding the proper policies and protocols in communicating a patients complaints and/or symptoms to a physician. 83. Defendant, Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center is liable to the Plaintiff for the injuries and damages set forth in paragraph 1 through 82 above which are incorporated herein by reference as if set forth at length. WHEREFORE, Plaintiff, individually and as the Administrator for the Estate of Mary Gipe, demands judgment against Defendant Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center in an amount in excess of $50,000.00 exclusive of interests and costs and in excess of any jurisdictional amount requiring compulsory arbitration. 20 Docket No. 10-7201 COUNT IV LOSS OF CONSORTIUM Richard Gipe, as Administrator for the Estate of Mary Gipe V. Baxter Wellmon, D.O. and Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center 84. Paragraphs I through 73 and Counts I through III are incorporated herein by reference as if set forth at length. 85. Defendants Baxter Wellmon, D.O. and Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center are jointly and severally liable to Plaintiff, individually and as the Administrator for the Estate of Mary Gipe for damages set forth herein. 86. By reason of the aforesaid injuries sustained by his wife, Plaintiff, Richard Gipe, was forced to incur liability for medical treatment, medicines and similar miscellaneous expenses in an effort to restore his wife to health and because of the nature of her condition, be will be forced to incur similar miscellaneous expenses in the future and a claim is made therefore. 87. By of the aforesaid injuries sustained by his wife, Plaintiff, Richard Gipe, has been, and in the future will be deprived of the assistance, companionship, consortium, and society of his wife, all of which has been and will continue to be to his great damage and loss and a claim is made therefore. WHEREFORE, Plaintiff demands judgment against Defendant in an amount in excess of $50,000.00 together with interest and costs thereon as allowed by law. 21 Docket No. 10-7201 R. J. Marzella & Associates, P.C. Dated: 1 L ?0 Zd 0 By: Za hary bell, Esquire Ati?rney entifcation No. 93177 22 Docket No. 10-7201 VERIFICATION I, Zachary D. Campbell, do hereby swear and affirm that the facts and matters set forth in the foregoing document are true and correct to the best of my knowledge, information and belief. I understand that the statements made therein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. 12 1(0 o 140 ?11 Dated 'Zacha . Campbell CERTIFICATE OF SERVICE I, Ryan David, hereby certify that a true and correct copy of the foregoing document was served upon counsel of record this 16`h day of December, 2010, by depositing said copy in the United States Mail at Harrisburg, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Craig A. Stone, Esquire Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Baxter Wellmon, D.O. Shippensburg Family Practice 97 Progress Boulevard, Shippensburg, Pennsylvania 17257 R. J. MARZELLA & AssocI ?.C. BY: RY DAVID, LAW CLERK Ir „ FILED-OFFICE OF THE PROTHONOTARY 2010 DEC 3 0 Ali I1' 48 R. J. MARZELLA & ASSOCIATES, P.C. BY: Zachary Campbell, Esquire CUMBERLAND COUNTY Pennsylvania Supreme Court I.D. No. 93177 P E N iN S Y LVA H I A 3513 North Front Street Attorneys for Plaintiff, Harrisburg, PA 17110 Richard Gipe, as Telephone: (717) 234-7828 Administrator for Facsimile: (717) 2346883 the Estate of Marv Gine IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA RICHARD GIPE, AS ADMINISTRATOR FOR THE ESTATE OF MARY GIPE PLAINTIFF, V. BAXTER WELLMON, D.O.; PERINI SERVICES/SOUTHAMPTOM MANOR LIMITED PARTNERSHIP T/D/B/A SHIPPENSBURG HEALTHCARE CENTER; DEFENDANTS DOCKET NO. 10-7201 CIVIL ACTION JURY TRIAL DEMANDED PRAECIPE FOR WITHDRAW/ENTRY OF APPEARANCE TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Kindly withdrawal my appearance on behalf of the Plaintiff in the above- captioned matter. By: lacha)y 4) . Campbell, Esquire Atty Identification No. 93177 Dated: 12 "Z2- 1/1 . f , f matter. Kindly enter my appearance on behalf of the Plaintiffs in the above-captioned R. J. Marzella & Associates, P.C. By: Dated: 12 22 )o Attorney Identifida?o. 86072 cmarsar@rjmarzella.com FILED-OFFICE OF THE PROTHONOTARY R. J. MARZELLA & ASSOCIATES, P.C. 2011 J;$ ! J P t i' S 9 BY: Zachary Campbell, Esquire Pennsylvania Supreme Court I.D. No. 93177 CUMBERLAND COUNTY 3513 North Front Street Attorneys i? 1 n4 N I A Harrisburg, PA 17110 Richard Gipe, as Telephone: (717) 234-7828 Administrator for Facsimile • (717) 234-68R the Estate of Mar.. Gip. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA RICHARD GIPE, AS ADMINISTRATOR FOR THE ESTATE OF MARY GIPE PLAINTIFF, V. BAXTER WELLMON, D.O.; PERINI SERVICES/SOUTHAMPTOM MANOR LIMITED PARTNERSHIP T/D/B/A SHIPPENSBURG HEALTHCARE CENTER; DEFENDANTS DOCKET NO. 10-7201 CIVIL ACTION JURY TRIAL DEMANDED PRAECIPE TO REISSUE THE WRIT OF SUMMONS TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please reissue the Writ of Summons attached hereto issued in the above-captioned action. R. J. Marzella & Associates, P.C. _3? - DATE: achary mpbell, Esquire R.. a la & Associates, P.C. 3513 North Front Street Harrisburg, PA 17110 Supreme Court ID No. 93177 a '0'.'55 S FOULKROD ELLIS Professional Corporation 4000 Market Street Camp Hill, Pennsylvania 17011 Telephone: (717) 909-7006 Fax: (717) 909-6955 Attorney for Defendant, Baxter Wellmon, D.O. FILED-OFFICE OF THE FROTHONOTAR'Y 201 ! 1: 2 7 CUM" ! I 3iT1' A RICHARD GIPE, AS ADMINISTRATOR FOR THE ESTATE OF MARY GIPE, Plaintiff V. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 10-7201 BAXTER WELLMON, D.O., PERINI SERVICES/ SOUTHAMPTON MANOR LIMITED PARTNERSHIP T/D/B/A SHIPPENSBURG HEALTHCARE: CENTER, Defendants PRAECIPE FOR ENTRY OF APPEARANCE CIVIL ACTION MEDICAL PROFESSIONAL LIABILITY ACTION JURY TRIAL DEMANDED TO: PROTHONOTARY Kindly enter our appearance on behalf of Defendant, Baxter Wellmon, D.O., with regard to the above-captioned action. Respectfully submitted, FOULKROD ELLIS PROFESSIONAL CORPORATION Date: l By: Leigh A.J. Ellis, Esquire Attorney I.D. No. 53229 Cindy N. Ellis, Esquire Attorney I.D. No. 83823 . 10 CERTIFICATE OF SERVICE I HEREBY CERTIFY that true and correct copies of the foregoing were served upon all G ?. counsel of record this ?a day of , 2011, by depositing said copy in the United States Mail at Camp Hill, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Charles Marsar, Esquire R.J. Marzella & Associates, P.C. 3513 North Front Street Harrisburg, PA 17110 (Counsel for Plaintiff) Craig A. Stone, Esquire Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (Counsel to Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center) FOULKROD ELLIS PROFESSIONAL CORPORATION By: Crystal L. Nemetz, Secr FOULKROD ELLIS Professional Corporation 4000 Market Street Camp Hill, Pennsylvania 17011 Telephone: (717) 909-7006 Fax: (717) 909-6955 C t f1 r• (pt\0 1 HO'NO IAR l toll J1?E? 25 ft'i 10-- 22 Attorney for Def t IT Baxter Wellmon ER Y?VAUAtT RICHARD GIPS, AS ADMINISTRATOR FOR THE ESTATE OF MARY GIPE, Plaintiff V. BAXTER WELLMON, D.O., : PERINI SERVICES/ SOUTHAMPTON MANOR LIMITED PARTNERSHIP T/D/B/A SHIPPENSBURG HEALTHCARE: CENTER, Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 10-7201 CIVIL ACTION MEDICAL PROFESSIONAL LIABILITY ACTION JURY TRIAL DEMANDED NOTICE OF INTENTION TO ENTER JUDGMENT OF NON PROS ON PROFESSIONAL LIABILITY CLAIM TO: Richard Gipe, as Administrator for the Estate of Mary Gipe c/o Charles Marsar, Esquire R. J. Marzella & Associates, P.C. 3513 North Front Street Harrisburg, PA 17110 DATE: January 24, 2011 Pursuant to Pennsylvania Rule of Civil Procedure 1042.7, I intend to enter a judgment of non pros against you after thirty (30) days of the date of the filing of this notice if a certificate of merit is not filed as required by Rule 1.042.3. I am serving this notice on behalf of Baxter Wellmon, D.O. The judgment of non pros will be entered as to the following claims: All claims. Respectfully submitted, FOULKROD ELLIS PROFESSIONAL CORPORATION 1. f /„ Date: t 611 _ By: U"`- eigh A.J. Ellis, Esquire Attorney I.D. No. 53229 Cindy N. Ellis, Esquire Attorney I.D. No. 83823 4000 Market Street Camp Hill, PA 17011 (717) 909-7000 CERTIFICATE OF SERVICE I HEREBY CERTIFY that true and correct copies of the foregoing were served upon all counsel of record this day of 2011, by depositing said copy in the United States Mail at Camp Hill, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Charles Marsar, Esquire R.J. Marzella & Associates, P.C. 3513 North Front Street Harrisburg, PA 17110 (Counsel for Plaintiff) Craig A. Stone, Esquire Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (Counsel to Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center) FOULKROD ELLIS PROFESSIONAL CORPORATION By: Crystal L. Nemetz, Secretary 1r-?O T=ICS: FILE, 2011 FEB 22 P11 1: R. J. MARZELLA & ASSOCIATES, P. BY: Charles W. Marsar, EsquirePNS'L' ;N,,, A Attorneys for Plaintiff Pennsylvania Supreme Court I.D. No. 6 72 Richard Gipe, as Administrator 3513 North Front Street for the Estate of Mary Gipe Harrisburg, PA 17110 Telephone: (717) 234-7828 Facsimile: (717) 234-6883 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA RICHARD GIPE, AS ADMINISTRATOR FOR THE ESTATE OF MARY GIPE PLAINTIFF, V. DOCKET N0. 10-7201-CIVIL CIVIL ACTION BAXTER WELLMON, D.O.; PERINI SERVICES/SOUTHAMPTOM MANOR LIMITED PARTNERSHIP T/D/B/A SHIPPENSBURG HEALTHCARE CENTER; DEFENDANTS JURY TRIAL DEMANDED MOTION TO EXTEND CERTIFICATE OF MERIT DEADLINE AND NOW COMES, Plaintiff, Richard Gipe, Individually and as the Administrator of the Estate of Mary Gipe, by way filing this Motion to Extend the Certificate of Merit Deadline: 1. On or about November 16, 2011, Plaintiff, Richard Gipe, Individually and as the Administrator of the Estate of Mary Gipe, initiated this action by filing a Writ of Summons upon the above-referenced Defendants. 2. On or about November 30, 2011, Defendants filed a Rule to file a Complaint. 1 Docket No. 10-7201 3. On or about December 21, 2010, Plaintiff filed a Complaint, alleging in part that Defendants were negligent in recognizing Mrs. Gipe's signs and symptoms on November 16, 2008 through November 18, 2008 as consistent with and characteristic of internal bleeding. 4. Under Pa.R.C.P. 1042.3, Plaintiff is required to file a Certificate of Merit verifying the validity of the claim against a licensed professional at the time of the filing of the Complaint or within 60 days after filing the Complaint. 5. Since the Plaintiff filed the Complaint on December 21, 2010, the deadline for filing Certificates of Merit is January 19, 2011. 6. Pa.R.C.P. 1042.3(d) states "The Court upon good cause shown, shall extend the time for filing a Certificate of Merit for a period not to exceed 60 days." 7. Plaintiff had previously identified an expert in theappopriate_fiel medicine to review the relevant medical records but that expert has since withdrawn due to other obligations from work. 8. Since this withdrawal, Plaintiff has identified another expert shortly before the expiration of the Certificate of Merit Deadline and that expert is currently in the process of reviewing the relevant medical records. 9. Due to the above facts, Plaintiff is requesting this Honorable Court grant a sixty (60) day extension to file Certificate of Merit. 10. Counsel for Plaintiff has sought but not has obtained concurrence from Counsel of Defendants. 2 Docket No. 10-7201 WHEREFORE, Plaintiff, Richard Gipe, Individually and as Administrator of the Estate of Mary Gipe respectfully requests this Honorable Court to grant Plaintiff's Motion to Extend Certificate of Merit Deadline. Respectfully submitted, R. J. Marzella & Associates, P.C. Charles W. Marsar, Esquire Supreme Court I.D. No. 86072 3513 North Front Street Dated: - / - /( Harrisburg, PA 17110 Docket No. 10-7201 CERTIFICATE OF SERVICE 1, Ryan David, hereby certify that a true and correct copy of the foregoing document was served upon counsel of record this 22nd day of February, 2011, by depositing said copy in the United States Mail at Harrisburg, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Craig Stone, Esquire Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Leigh Ellis, Esquire Foulkrod Ellis, P.C. 4000 Market Street Camp Hill, PA 17011 R. J. MARZELLA & ASSOCIATES, P.C. r, BY: RYAN DAVID, LAW CLERK TO CHARLES W. MAR SAR, ESQUIRE COMMONWEALTH Gipe, vs. Wellmon, PENNSYLVANIA, COUNTY OF CUMBERLA Plaintiff(s), '- CIVIL ACTION Case No.: 10-7201 O c? C:) Leigh A.J. Ellis, Esquire, atto ey for Defendant(s), 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 no objection is made, the subpoena may be served. To: Charles W. Marsar, Jr., Esqui R. J. Marzella & Associates, 3513 N. Front St., Harrisburg, PA 17110 Attorney for Plaintiff(s) Date : 02/15/2011 Craig A. Stone, Esquire .C. Marshall Dennehey Warner Coleman & Goggin 4200 Crums Mill Road, Ste. B, Harrisburg, PA 17112 Attorney for Defendant(s) /S/ Leigh A.J. Ellis, Esq. Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St. Camp Hill, PA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 Attorney for Defendant(s) Dr. Wellmon W.O. # 201591-001 Page 1 of 1 Oa_? COMMONWEALTH OFD PENNSYLVANIA, COUNTY OF CUMBERLAND Gipe, VS. Wellmon, Plaintiff(s), CIVIL ACTION No.: 10-7201 As a prerequisite to service of a subpoena for documents and things pursuant to h 4009.22, Leigh A.J. Ellis, Esquire, attorney for th? Defendant(s), certifies that: (1) a notice of intent to serve the subp delivered to each party at least twenty served; (2) a copy of the notice of intent, (3) no objection to the subpoena has (4) the subpoena which will be served intent to serve the subpoena. Date: 03/07/2011 W.C W_cptes 1591-001 with a copy of the subpoena attached thereto was mailed or prior to the date on which the subpoena is sought to be the proposed subpoena, is attached to this certificate; received, and; identical to the subpoena which is attached to the notice of /S/ Leigh A.J. Ellis Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St. Camp Hill, PA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 Attorney for Defendant(s) Dr. Wellmon Page 1 COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND Gipe, vs. Wellmon, Plaintiff(s), CIVIL ACTION Case No.: 10-7201 TO: Custodian of Records, Franklin Coun? Heart Center, 755 Norland Ave., Ste. 201, Chambersburg, PA 17201 Re: Mary Gipe DOB: 11/16/1940 SST: XXX-XX-8556 Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: Medical Records; See. "Attachment A." at Second Image National, 1805 Monument Ave, Ste 208, Richmond, VA 23220, Fax: (800) 611-4555 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 ost of preparing the copies or producing the things sought. If you fail to produce the documents or thi s required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a ourt order compelling you to comply with it. THIS Subpoena WAS ISSUED AT THE Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St., Camp Hill, PA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 SUPREME COURT ID NO.: 53229 Attorney for Defendant(s), Dr. Wellmon Date : a eal of the Court W.O. # 201591-001 w_.&-d- OF THE FOLLOWING PERSON.• V T: otary/C rk, Civil Division D. au Deputy Page 1 of 2 Attachment "A" Records for: Mary Gipe DOO: 11/16/1940 SSN: XXX-XX-8556 Complete medical records from 1990 to a present, including but not limited to any records/documents that may be stored digitally and/or electronically: documents, medical reports, doctor's entries, nurse's notes, progress reports, cardiology reports, radiology re rts, x-ray reports, MRI reports, CT reports, myelogram reports, lab reports, monitor strips, physical therapy cords, case history, emergency records, diagnosis, prognosis, condition, and admit and discharge recor . All emails between physicians and the patient regarding physical complaints, symptoms, and treatment, including 'secure messages'. To include any and all of these records from Dr. Aylmer Tang, M.D. W.O. # 201591-001 Page 2 of 2 W.O. # 201591-001 nonwealth of Pennsylvania county of Cumberland COURT OF COMMON PLEAS Case No.: 10-7201 (Plainti,,l (Demandante) vs. Wellmon (Defendant) (Demandado) On the I, (describe the method of service): Personally delivering a copy Certified mail to: Person served (name) Address where served: F-I _ I verify that the statements in understand that false statements her § 4904 relating to unsworn rn of Service day of Yr. served with the foregoing subpoena by Custodian of Records [R-"Franklin County Heart Center 755 Norland Ave., Ste. 201 Chambersburg, PA 17201 return of service are true and correct. I are made subject to the penalties of 18 Pa. C.S.A. to authorities. '2?z lyvwe S ?ature ?/ - Name of Witness Name of Person Served 10-200 (Rev. 7/99) (Reverse) A. COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND Gipe, vs. Wellmon, Plaintiff(s), )DU( E HT DR DI ELRSUANT TO 111111 am TO: Custodian of Records, Cardiovascul Surgical Institute, 423 N. 21 st St., Ste. 301, Camp Hill, PA 17011 Re: MaryGipe DOB: 11/16/1940 SS? : XXX-XX-8556 Within twenty (20) days after service documents or things: Of this subpoena, you are ordered by the court to produce the following Medical Records; See. "Attachment A." at Second Image National, 1805 Monum?nt Ave, Ste 208, Richmond, VA 23220, Fax: (800) 611-4555 You may deliver or mail legible copie 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 thi s required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a ?Ourt order compelling you to comply with it. THIS Subpoena WAS ISSUED AT THE Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St., camp Hill, PA 17011 Phone: (717) 909-7006 Fact: (717) 909.6955 SUPREME COURT ID NO.: 53229 Attorney for Defendant(s), Dr. Wellmon Date : _ To k Seal of the Court W.O. # 201591-002 pa_ d- OF THE FOLLOWING PERSON.• BY THE CIVIL ACTION Case No.: 10-7201 is jerk, ivil Division D. Feu Deputy Page 1 of 2 Attachment "A" Records for: Mary Gipe DO?: 11/16/1940 SSN: XXX-XX-8556 Complete medical records from 1990 to a present, including but not limited to any records/documents that may be stored digitally and/or electronically: ocuments, medical reports, doctor's entries, nurse's notes, progress reports, cardiology reports, radiology re rts, x-ray reports, MRI reports, CT reports, myelogram reports, lab reports, monitor strips, physical therapy cords, case history, emergency records, diagnosis, prognosis, condition, and admit and discharge recor s. All emails between physicians and the patient regarding physical complaints, symptoms, and treatment, in uding 'secure messages'. To include any and all of these records from Capital Area Cardiovacular Surgical Insti te, and Dr. S. Vincent Park, M.D. W.O. # 201591-002 .& 6. Page 2 of 2 W.O. # 201591-002 wealth of Pennsylvania my of Cumberland COURT OF COMMON PLEAS Case No.: 10-7201 (Plaintiff) (Demandante) VS. WelImon (Defendant) (Demandado) A On the I, Y Vic, /I r It:_- It11G (describe the method of service): Personally delivering a copy Certified mail to: Person served (name) : - Address where served: E I verify that the statements in understand that false statements her § 4904 relating to unsworn falsifica J, Name of Witness rn of Service day of Aec-4k , Yr. o?"W , , served with the foregoing subpoena by Q Custodian of Records Cardiovascular Surgical Institute 423 N. 21st St., Ste. 301 Camp Hill, PA 17011 return of service are true and correct. I are made subject to the penalties of 18 Pa. C.S.A. i to authorities. Name of Person Served 1 0.200 (Rev. 7/99) (Reverse) "-kw COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND Gipe, VS Wellmon, Plaintiff(s), CIVIL ACTION Case No.: 10-7201 TO: Custodian of Records, Cumberland alley Family Physicians, 757 Norland Ave., Ste. 101, Chambersburg, PA 17201 Re: Mary Gipe DOB: 11/16/1940 Within twenty (20) days after servi documents or things: Medical Records; See. "Attachment A." at Second Image National, 1805 Mont You may deliver or mail legible col together with the certificate of complian the right to seek in advance the reasonal XXX-XX-8556 of this subpoena, you are ordered by the court to produce the following Ave, Ste 208, Richmond, VA 23220, Fax: (800) 611-4555 s of the documents or produce things requested by this subpoena., to the party making this request at the address listed above. You have cost of preparing the copies or producing the things sought. If you fail to produce the documents or the required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek court order compelling you to comply with it. THIS Subpoena WAS ISSUED AT THE Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St., Camp Hill, PA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 SUPREME COURT ID NO.: 53229 Attorney for Defendant(s), Dr. Wellmon Date : of the Court OF THE FOLLOWING PERSON.- BY THE COURT: Pro /C erk, Civil -vision DAVID 8I)SI Deputy W.O. # 201591-003 °`-.4_d- Page I of 2 Attachment "A" Records for: Mary Gipe DOO: 11/16/1940 SSN: XXX-XX-8556 Complete medical records from 1990 to a present, including but not limited to any records/documents that may be stored digitally and/or electronically: ocuments, medical reports, doctor's entries, nurse's notes, progress reports, cardiology reports, radiology r rts, x-ray reports, MRI reports, CT reports, myelogram reports, lab reports, monitor strips, physical therapy r cords, case history, emergency records, diagnosis, prognosis, condition, and admit and discharge records. All emails between physicians and the patient regarding physical complaints, symptoms, and treatment, in uding'secure messages'. To include any and all of these records from Dr. Stephen Milback M.D. W.O. # 201591-003 F.-.& &. Page 2 of 2 W.O. # 201591-003 Com onwealth of Pennsylvania ounty of Cumberland COURT OF COMMON PLEAS Case No.: 10-7201 (Plainti, fl (Demandante) VS. Wellmon (Defendant) (Demandado) On the I, (describe the method of service): Personally delivering a copy ertified mail to: Person served (name) : _ Address where served: r-I I verify that the statements in understand that false statements § 4904 relating to unworn J Name of Witness rn of Service day of Yr., served with the foregoing subpoena by Custodian of Records Q Cumberland Valley Family 757 Norland Ave., Ste. 101 Chambersburg, PA 17201. return of service are true and correct. I in are made subject to the penalties of 18 Pa. C.S.A. to authorities. e- ignature Name of Person Served 10-200 (Rev. 7/99) (Revaw) P-&-- COMMONWEALTH Gipe, vs. Wellmon, TO: Custodian of Records, Ch Chambersburg, PA 17201 Re: Mary Gipe DOB: 11/16/1940 Within twenty (20) days after documents or things: Medical Records; See. "Attachment A." at Second Image National, 1805 PENNSYLVANIA, COUNTY OF CUMBERLAND Plaintiff(s), CIVIL ACTION Case No.: 10-7201 Hospital/Medical Records Department, 112 N. 7th St., : XXX-XX-8556 of this subpoena, you are ordered by the court to produce the following Ave, Ste 208, Richmond, VA 23220, Fax: (800) 611-4555 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 s 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. Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St., Camp Hill, PA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 SUPREME COURT ID NO.: 53229 Attorney for Defendant(s), Dr. Wellmon Date Seal of the Court OF THE FOLLOWING PERSON.• Deputy W.O. # 201591-004 pa_adt_d- Page 1 of 2 Attachment "A" Records for: Mary Gipe DO*: 11/16/1940 SSN: XXX-XX-8556 Complete medical records from 1990 to a present, including but not limited to any records/documents that may be stored digitally and/or electronically: ocuments, medical reports, doctor's entries, nurse's notes, progress reports, cardiology reports, radiology r rts, x-ray reports, MRI reports, CT reports, myelogram reports, lab reports, monitor strips, physical therapy records, case history, emergency records, diagnosis, prognosis, condition, and admit and discharge recors. All emails between physicians and the patient regarding physical complaints, symptoms, and treatment, inc uding 'secure messages'. W.O. # 201591-004 "-.& &u Page 2 of 2 W.O. # 2015914)04 LL Com onwealth of Pennsylvania ounty of Cumberland In the matter of: Gipe Case No.: 10-7201 I, (Plaint i (Demandante) VS. Wellmon (Defendant) (Demandado) On the COURT OF COMMON PLEAS 7,>"/-L (describe the method of service): F-J Personally delivering a copy ETCertified mail to: Person served (name) : Address where served: 0 eturn of Service day of , Yr.?` , served with the foregoing subpoena by IR-c-ustodian of Records ambersburg Hospital/Medical 112 N. 7th St. Chambersburg, PA 17201 I verify that the statements in phis return of service are true and correct. I understand that false statements her?in are made subject to the penalties of 18 Pa. C.S.A. § 4904 relating to unworn falsification to authorities. ,?;x ate *nature 11 Name of Witness Name of Person Served 10-200 (Rev. 7/99) (Rovem) pndt-M COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND Gipe, VS Wellmon, Plaintiff(s), CIVIL ACTION Case No.: 10-7201 TO: Custodian of Records, Vascular Asso iates, P.C., 800 Poplar Church Rd., Camp Hill, PA 17011 Re: Mary Gipe DOB: 11/16/1940 SS : XXX-XX-8556 Within twenty (20) days after service ?f this subpoena, you are ordered by the court to produce the following documents or things: Medical Records; See. "Attachment A." at Second Image National, 1805 You may deliver or mail legible copies together with the certificate of compliance, the right to seek in advance the reasonable If you fail to produce the documents or this the Party serving this subpoena may seek a THIS Subpoena WAS ISSUED AT THE Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St., Camp Hill, PA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 SUPREME COURT ID NO.: 53229 Attorney for Defendant(s), Dr. Wellmon Date : ah%, Seal of the court nt Ave, Ste 208, Richmond, VA 23220, Fax: (800) 611-4555 of the documents or produce things requested by this subpoena, to the party making this request at the address listed above. You have ost of preparing the copies or producing the things sought. s required by this subpoena within twenty (20) days after its service, ourt order compelling you to comply with it. OF THE FOLLOWINGPERSON.• BY THE GQLaT: 1 Ildmvnotaryic 1erk, civiDivision DAY to D. ab?t1 Deputy W.O. # 201591-005 P--.&-d.. Page I of 2 Attachment "A" Records for: Mary Gipe DO?: 11/16/1940 SSN: XXX-XX-8556 Complete medical records from 1990 to a present, including but not limited to any records/documents that may be stored digitally and/or electronically: documents, medical reports, doctor's entries, nurse's notes, progress reports, cardiology reports, radiology r rt s, x-ray reports, MRI reports, CT reports, myelogram reports, lab reports, monitor strips, physical therapy records, case history, emergency records, diagnosis, prognosis, condition, and admit and discharge recor s. All emails between physicians and the patient regarding physical complaints, symptoms, and treatment, inc uding'secure messages'. W.O. # 201591-005 d. Page 2 of 2 Com onwealth of Pennsylvania W.O. # 201591-005 ounty of Cumberland In the matter of Gipe (Plainti (Demandante) Wellmon VS. (Defendant) (Demandado) On the I, (describe the method of service): Personally delivering a copy ertified mail to: Person served (name) : _ Address where served: F-I I verify that the statements in understand that false statements § 4904 relating to unsworn 3. Name of Witness 10-200 (Rev. 7199) (Reverse) Case No.: 10-7201 rn of Service day of served with the foregoing subpoena by COURT OF COMMON PLEAS Custodian of Records D-Vvascular Associates, P.C. 800 Poplar Church Rd. Camp Hill, PA 17011 return of service are true and correct. I are made subject to the penalties of 18 Pa. C.S.A. to authorities. Ile //W/ 4e Si "re Name of Person Served "*A-- COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND Gipe, vs. Wellmon, Plaintiff(s), S). CIVIL, ACTION Case No.: 10-7201 TO: Custodian of Records, Moffitt Heart Vascular Group, 1000 N. Front St., Wormleysburg, pA 17043 Re: Mary Gipe DOB: 11/16/1940 SST: XXX-XX-8556 Within twenty (20) days after service Of this subpoena, you are ordered by the court to produce the following documents or things: Medical Records; See. "Attachment A." at Second Image National, 1805 You may deliver or mail legible copie, together with the certificate of compliance, the right to seek in advance the reasonable If you fail to produce the documents or thij the party serving this subpoena may seek a THIS Subpoena WAS ISSUED AT THE Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St., Camp Hill, PA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 SUPREME COURT ID NO.: 53229 Attorney for Defendant(s), Dr. Wellmon Date : a lio%i Seal of the Court W.O.# 201591-006 w_ d- nt Ave, Ste 208, Richmond, VA 23220, Fax: (800) 611-4555 of the documents or produce things requested by this subpoena, :o the party making this request at the address listed above. You have ost of preparing the copies or producing the things sought. ;s required by this subpoena within twenty (20) days after its service, ourt order compelling you to comply with it. OF THE FOLLOWING PERSON.• Deputy Page 1 of 2 Attachment "A" Records for: Mary Gipe DOO: 11/16/1940 SSN: XXX-XX-8556 Complete medical records from 1990 to a present, including but not limited to any records/documents that may be stored digitally and/or electronically: documents, medical reports, doctor's entries, nurse's notes, progress reports, cardiology reports, radiology re rts, x-ray reports, MRI reports, CT reports, myelogram reports, lab reports, monitor strips, physical therapy m cords, case history, emergency records, diagnosis, prognosis, condition, and admit and discharge recor s. All emails between physicians and the patient regarding physical complaints, symptoms, and treatment, including 'secure messages'. W.O. # 201591-006 P`-id-do Page 2 of 2 Corn onwealth of Pennsylvania W.O. # 201591-006 ounty of Cumberland In the matter of: Gipe (Plaintiff) (Demandante) VS. Wellmon (Defendant) (Demandado) ?GL On the I, (describe the method of service): F] Personally delivering a copy ?rtified mail to: Person served (name) Address where served: Case No.: 10-7201 eturn of Service day of 0&q/ , Yr. 611 served with the foregoing subpoena by COURT OF COMMON PLEAS P'tustodian of Records D 14offitt Heart & Vascular Group 1000 N. Front St. Wormleysburg, PA 17043 I verify that the statements in this return of service are true and correct. I understand that false statements heroin are made subject to the penalties of 18 Pa. C.S.A. § 4904 relating to unsworn falsification to authorities. Name of Witness / gnature Name of Person Served 10-200 (Rev. 7/99) (Reverse) pe"-M COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND Gipe, vs. Wellmon, Plaintiff(s), CIVIL ACTION Case No.: 10-7201 TO: Custodian of Records, Dr. Michael nning, 9435 Molly Pitcher Hwy., Shippensburg, PA 17257 Re: Mary Gipe DOB: 11/16/1940 S : XXX-XX-8556 Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: Medical Records; See. "Attachment A." at Second Image National, 1805 Monument Ave, Ste 208, Richmond, VA 23220, Fax: (800) 611-4555 You may deliver or mail legible copie 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 s 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 Leigh A.J. Ellis, Esquire (SBN: 53229) Fouikrod Ellis 4000 Market St., Camp Hill, PA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 SUPREME COURT ID NO.: 53229 Attorney for' Defendant(s), Dr. Welltnon Date : - = - g/, p S 1 of the Court OF THE FOLLOWING PERSON .• BY onotary/Cler Civil Division bAVID A. 'BUEl,(_ Deputy W.O. # 201591-007 P.-.#-d- Page 1 of 2 Attachment "A" Records for: Mary Gipe DO#: 11/16/1940 SSN: Ma-XX-8556 Complete medical records from 1990 to a present, including but not limited to any records/documents that may be stored digitally and/or electronically: uments, medical reports, doctor's entries, nurse's notes, progress reports, cardiology reports, radiology rep rts, x-ray reports, MRI reports, CT reports, myelogram reports, lab reports, monitor strips, physical therapy r cords, case history, emergency records, diagnosis, prognosis, condition, and admit and discharge recor . All emails between physicians and the patient regarding physical complaints, symptoms, and treatment, inc uding'secure messages'. W.O. # 201591-007 p -_-h dm Page 2 of 2 AAAL In the matter of: Gipe (Plainti (Demandante) vs. Wellmon (Defendant) (Demandado) On the I, l1 (describe the method of service): Personally delivering a copy Certified mail to: Person served (name) Address where served: F-1 _ I verify that the statements in understand that false statements hex nwealth of Pennsylvania Linty of Cumberland W.O. # 201591-007 COURT OF COMMON PLEAS Case No.: 10-7201 eturn of Service day of Yr. d4j/ , , served with the foregoing subpoena by Q,-6stodian of Records Michael Denning 9435 Molly Pitcher Hwy. Shippensburg, PA 17257 return of service are true and correct. I are made subject to the penalties of 18 Pa. C.S.A. § 4904 relating to unsworn falsification to authorities. 3 k/w Zldl? ate ature Name of Witness Name of Person Served 10-200 (Rev. 7/99) (Remse) ,,. COMMONWEALTH Gipe, vs. Wellmon, TO: Custodian of Records, Pharmacare, 3 Re: Mary Gipe DOB: 11/16/1940 PENNSYLVANIA, COUNTY OF CUMBERLAND Plaintiff(s), s). CIVIL ACTION Case No.: 10-7201 Dr., Cumberland, MD 21502 XXX-XX-8556 Within twenty (20) days after service ?f this subpoena, you are ordered by the court to produce the following documents or things: Pharmacy Records; Medical Records; See. "Attachment A." at Second Image National, 1805 You may deliver or mail legible copie, together with the certificate of compliance, the right to seek in advance the reasonable If you fail to produce the documents or this the party serving this subpoena may seek a THIS Subpoena WAS ISSUED AT THE Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St., Camp Hill, pA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 SUPREME COURT ID NO.: 53229 Attorney for Defendant(s), Dr. Wellmon Date : 1311J. Seal of the Court nt Ave, Ste 208, Richmond, VA 23220, Fax: (800) 611-4555 If the documents or produce things requested by this subpoena, :o the party making this request at the address listed above. You have ost of preparing the copies or producing the things sought. s required by this subpoena within twenty (20) days after its service, ourt order compelling you to comply with it. OF THE FOLLOWINGPERSON.• BY THE T. Clerk, Ci ' Division bAv i b a. ave[.L Deputy W.O.# 201591-008 P+_- &_d-Page I of 2 Attachment "A Records for: Mary Gipe DO#: 11/16/1940 SSN: XXX-XX-8556 Complete pharmacy records from 1990 t the present, including but not limited to any records/documents that may be stored digitally and/or electronically: pharmacy records, prescriptions Pertaining prescription drugs, original doctors' pr scription forms, and any other pharmacy, medical, and issuance sale records- All emails between physicians and the patient regarding physical complaints, symptoms, and treatment, including 'secure messages'. W.O. # 201591-008 pe_.dt_dm Page 2 of 2 W.O. # 201591-008 Com onwealth of Pennsylvania ounty of Cumberland COURT OF COMMON PLEAS Case No.: 10-7201 (Plainti (Demandante) VS. Wellmon (Defendant) (Demandado) On the I, / V,c,I/ C L?//? (describe the method of service): Personally delivering a copy ©' Certified mail to: Person served (name) Address where served: E _ I verify that the statements in understand that false statements her § 4904 relating to unsworn falsifica turn of Service day of Yr. served with the foregoing subpoena by D-6u,stodian of Records Pharmacare 3 Commerce Dr. Cumberland, MD 21502 return of service are true and correct. I are made subject to the penalties of 18 Pa. C.S.A. to authorities. 114 Name of Witness Name of Person Served 10-200 (Rev. 7/99) (Reverse) 7-1rm COMMONWEALTH Ot PENNSYLVANIA, COUNTY OF CUMBERLAND Gipe, vs. Wellmon, Plaintiff(s), CIVIL ACTION Case No.: 10-7201 TO: Custodian of Records, Orthopaedic Associates, 1035 Wayne Ave., Chambersburg, PA 17201 Re: Mary Gipe DOB: 11/16/1940 SS : XXX-XX-8556 Within twenty (20) days after service ?f this subpoena, you are ordered by the court to produce the following documents or things: Medical Records; See. "Attachment A." at Second Image National, 1805 Monum?nt Ave, Ste 208, Richmond, VA 23220, Fax: (800) 611-4555 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 s required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a ourt order compelling you to comply with it. THIS Subpoena WAS ISSUED AT THE Leigh A.J. Ellis, Esquire (SBN: 53229) Foulkrod Ellis 4000 Market St., Camp Hill, pA 17011 Phone: (717) 909-7006 Fax: (717) 909-6955 SUPREME COURT ID NO.: 53229 Attorney for Defendant(s), Dr. Wellmon Date : ajh,11, Seal f the court OF THE FOLLOWING PERSON.• BY THE T: P Clerk, Civil D vision DAVID b- 13oeU Deputy W.O. # 201591-009 p d- Page 1 of 2 Attachment "A" Records for: Mary Gipe D04:11/16/1940 SSN: XXX-XX-8556 Complete medical records from 1990 to a present, including but not limited to any records/documents that may be stored digitally and/or electronically: ocuments, medical reports, doctor's entries, nurse's notes, progress reports, cardiology reports, radiology re rts, x-ray reports, MRI reports, CT reports, myelogram reports, lab reports, monitor strips, physical therapy m cords, case history, emergency records, diagnosis, prognosis, condition, and admit and discharge records. All emails between physicians and the patient regarding physical complaints, symptoms, and treatment, in uding 'secure messages'. To include any and all of these records from Dr. Robert Richards, M.D. W.O. # 201591-009 p•_.ft-d- Page 2 of 2 W.O. # 201591-009 A&- Com onwealth of Pennsylvania ounty of Cumberland In the matter of Gipe rn of Service day of / ! / , Yr. Case No.: 10-7201 (Plainti (Demandante) Wellmon VS. (Defendant) (Demandado) On the /l I, (describe the method of service): F-I Personally delivering a copy ?ertified mail to: Person served (name) : Address where served: served with the foregoing subpoena by I verify that the statements in understand that false statements § 4904 relating to unworn falsi COURT OF COMMON PLEAS 19-tustodian of Records Orthopaedic Associates 1035 Wayne Ave. Chambersburg, PA 17201 return of service are true and correct. I are made subject to the penalties of 18 Pa. C.S.A. to authorities. ,- ?7/// D to re Name of Witness 10.200 (Rev. 7/99) (Reverse) Name of Person Served n••k- FILED-OFFICE O T HE PROTHONOTARY 2011 APR -5 AM 11: 27 R. J. MARZELLA&ASSOCIATES, P.C. CUMBERLAND COUNTY PENNSYLVANIA BY: CHARLES W. MARSAR, JR, ESQUIRE PA SUPREME COURT I.D. No. 86072 3513 NORTH FRONT STREET ATTORNEYS FOR PLAINTIFF HARRISBURG, PA 17110-1438 RICHARD GIPE TELEPHONE: (717) 234-7828 FACSIMILE: (717) 234-6883 EMAIL: CMARSAR@RIMARZELLA COM IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA RICHARD GIPE, AS ADMINISTRATOR FOR THE ESTATE OF MARY GIPE DOCKET NO. 10-7201 PLAINTIFF, CIVIL ACTION V. BAXTER WELLMON, D.O.; PERINI SERVICES/SOUTHAMPTOM MANOR LIMITED PARTNERSHIP T/D/B/A SHIPPENSBURG HEALTHCARE CENTER; DEFENDANTS JURY TRIAL DEMANDED PRAECIPE TO DISCONTINUE TO THE PROTHONOTARY, CUMBERLAND COUNTY: Please mark the above-referenced action settled and discontinued, with prejudice as to Defendant, Baxter Wellmon, D.O. and Perini Services/Southampton Manor Limited Partnership t/d/b/a Shippensburg Healthcare Center. (1 / it Dated: 9 R. J. MARZELLA & ASSOCIATES, P.C. Respectfully sub ' ed, By: rles rsar, Jr , quire Supreme Cour Identi o.86072 CERTIFICATE OF SERVICE 1, Ashley M. Rogers, hereby certify that a true and correct copy of the foregoing document was served upon counsel of record this 1St day of April, 2011, by depositing said copy in the United States Mail at Harrisburg, Pennsylvania, postage prepaid, first class delivery, and addressed as follows: Leigh A j. Ellis, Esquire Foulkrod Ellis 4000 Market Street Camp Hill, PA 17011 R. J. MARZELLA & ASSOCIATES, P.C. BY: C&I& 0-0? ASHLEY M. ROG S, LAW CL R