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HomeMy WebLinkAbout11-1305ORIGINAL CLOYD GATRELL, 1304 White Birch Lane Carlisle, Pennsylvania 17013 Plaintiff V. CARLISLE REGIONAL MEDICAL CENTER 361 Alexander Spring Road Carlisle, PA 17015 CARLISLE HMA, LLC, Individually and d/b/a. CARLISLE REGIONAL MEDICAL CENTER 5811 Pelican Bay Boulevard, Suite 500 Naples, FL 34108 and c/o CT CORPORATION SYSTEM 1515 Market Street Philadelphia, PA 19102 and 361 Alexander Spring Road Carlisle, PA 17015 CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER c/o CT CORPORATION SYSTEM 1515 Market Street Philadelphia, PA 19102 and 361 Alexander Spring Road Carlisle, PA 17015 NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C. c/o Corporation Service Company 2704 Commerce Drive Harrisburg, PA 17110 and c/o Russ H. Harris, President 6200 S. Syracuse Way, Ste. 200 MS 100 Greenwood VI, CO 80111 EMCARE, INC. 100 Witmer Road, Suite 220 Horsham, PA 19044 Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO.? 2011 PRAECIPE FOR WRIT OF SUMMONS C:? N C- ?.- rn rn rn p D - i - -0 c-s F z , 66 6d? ?lP? ?SzlCpl/ w ? TO: PROTHONOTARY, CUMBERLAND COUNTY Please issue a Writ of Summons against Stephen M. Greecher, Jr. Supreme Court I.D. #36803 TUCKER ARENSBERG, P.C. 111 North Front Street P.O. Box 889 Harrisburg, PA 17108-0889 (717) 234-4121 the Oove captioned action. Date: _12011 WRIT OF SUMMONS TO THE ABOVE-NAMED DEFENDANTS: YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFF HAS COMMENCED AN ACTION AGAINST YOU. Prothonotary Date: i1 By Deputy HBGDB:117457,1' 024654-13,3302 CLOYD GATRELL, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA No. 11-1305,2011 Civil V. CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER, rn Co y' C') ?-- rs C) : G N NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C. EMCARE, INC. Defendants PRAECIPE FOR RULE TO FILE COMPLAINT To the Prothonotary: Kindly issue a Rule directing Plaintiff to file a Complaint within twenty (20) days of service of the Rule. Respectfully submitted, MARSHALL, DENNEHEY, WARNER, COLEMAN & GOGGIN BY: ??- , , CHRISTOPHW J. CONRAD, ESQUIRE I.D. No. 20231(8 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (717) 651-3531 cjconradgmdwc .com Attorney for Defendants, Carlisle Regional Medical Center and Health Management Associates CERTIFICATE OF SERVICE I, CHRISTOPHER J. CONRAD, ESQUIRE, hereby certify that I served a true and correct copy of the foregoing document upon all counsel of record, as listed below, via United States Mail, First Class, on March 3, 2011: Stephen M. Greecher, Jr., Esquire Tucker Arensberg, P.C. 111 North Front Street P.O. Box 889 Harrisburg, Pennsylvania 17108-0889 MARSHALL, DENNEHEY, WARNER, COLEMAN AND GOGGIN BY /?AJ,-, CHR PH J. CONRAD, A QUIRE I.D. No. 2023 8 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (717) 651-3531 cjconrad(a,mdwcg com Attorney for Defendants, Carlisle Regional Medical Center and Health Management Associates 051696966.v1 CLOYD GATRELL, Plaintiff V. CARLISLE REGIONAL MEDICAL CENTER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA No. 11-1305,2011 Civil CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER, NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C. EMCARE, INC. Defendants RULE TO FILE COMPLAINT AND NOW, this day of M (VUk _, 2011, upon consideration of the foregoing Praecipe, a Rule is hereby issued upon the Plaintiff to file a Complaint within twenty (20) days or suffer judgment of non pros. PROTHONOTARY -407'/' SEAL ORIGINAL CLOYD GATRELL, V. Plaintiff CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/ PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 11-1305,2011 Civil M ` r=- 73 -0m w C:? CIVIL ACTION COMPLAINT "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 buy 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 of other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. LAWYER REFERENCE SERVICE Cumberland County Bar Association 32 South Bedford Street Carlisle, Pennsylvania 17013 (717) 249.3166 - Toll Free (800) 990-9108 "AVISO" "Le han demandado en corte. Si usted desea defender contra las demandas dispuestas en las paginas siguientes, usted debe tomar la acci6n en el plazo de veinte (20) dial despues de esta queja y se sirve el aviso, incorporando un aspecto escrito personalmente o y archivando en escribir con la cone sus defenses u objeciones a las demandas dispuestas contra usted el abogado le advierte que que si usted no puede hacer asi que el caso puede proceder sin usted y un juicio se puede incorporar contra usted compta la corte sin aviso adicional paca cualquier dinero demandado en la queja o para cualquier otra demands o relevaci6n pedida por el demandante. Usted puede perder el dinero o la caiacteristica de otra endereza importante a usted. USTED DEBE LLEVAR ESTE PAPEL SU ABOGADO INMEDIATAMENTE. SI USTED NO HACE QUE UN ABOGADO VAYA A O LLAME POR TELEFONO La OFICINA DISPUESTA ABAJO. ESTA OFICINA PUEDE PROVEER DE USTED LA INFORMACION SOBRE EMPLEAR A UN ABOGADO. SI USTED NO PUEDE PERMITIRSE AL HIRE A UN ABOGADO, ESTA OFICINA PUEDE PODER PROVEER DE USTED LA INFORMACION SOBRE LAS AGENCIES QUE LOS SERVICIOS JURIDICOS DE LA OFERTA DE MAYO A LAS PERSONAS ELEGIBLES EN UN HONORARIO REDUCIDO O NINGLTN HONORARIO SERVICIO DE REFERENCIA LEGAL Cumberland County Bar Association 32 South Bedford Carlisle, Pennsylvania 17013 (717) 249.3166 - Toll Free (800) 990-9108 CLOYD GATRELL, V. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/ PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants CIVIL ACTION - LAW NO. 11-1305,2011 Civil COMPLAINT 1. The Plaintiff is Cloyd Gatrell, an adult individual who resides at 1304 White Birch Lane, Carlisle, Cumberland County, Pennsylvania 17013. Cloyd Gatrell is a medical doctor licensed to practice medicine in the Commonwealth of Pennsylvania. 2. Defendant, Carlisle Regional Medical Center is a community hospital operating and doing business at 361 Alexander Spring Road, Carlisle, Cumberland County, Pennsylvania 17015. 3. Defendant, Carlisle HMA, LLC, is a limited liability company with an address at 5811 Pelican Bay Boulevard, Suite 500, Naples, FL 34108, with an agent for service of process c/o the CT Corporation System, 2704 Commerce Drive, Harrisburg, PA 17110, which does business as Carlisle Regional Medical Center located at 361 Alexander Spring Road, Carlisle, PA 17015. 4. Defendant, Carlisle HMA, INC. is a corporation with an address at 361 Alexander Spring Road, Carlisle, PA 17015, with an agent for service of process c/o the CT Corporation System, 2704 Commerce Drive, Harrisburg, PA 17110, which does business at 361 Alexander Spring Road, Carlisle, PA 17015. 5. It is believed and therefore averred that Carlisle HMA, LLC is a successor by merger to Carlisle HMA, Inc., or otherwise a successor and liable as the successor entity or otherwise for all acts and omissions of Carlisle HMA, Inc. Hereinafter, Defendants will be referred to as Carlisle Regional Medical Center and all allegations made with respect to Carlisle Regional Medical Center shall be applicable to the Carlisle Regional Medical Center, Carlisle HMA, LLC, Individually and d/b/a Carlisle Regional Medical Center, and Carlisle HMA, Inc., individually and d/b/a Carlisle Regional Medical Center. Each allegation herein shall be applicable to each Defendant, individually and collectively. 6. New Jersey/Pennsylvania EM-1 Medical Services, P.C. is a corporation with an address of 6200 S. Syracuse Way, Ste. 200, MS 100, Greenwood VI, Colorado 80111, with an agent for service process c/o Corporation Service Company, 2704 Commerce Drive, Harrisburg, PA 17110. 7. EMCARE, Inc. is a corporation with an address at 100 Witmer Road, Suite 220, Horsham, PA 19044. 8. Cloyd Gatrell is a medical doctor licensed to practice medicine in the Commonwealth of Pennsylvania. He had been employed at the Carlisle Regional Medical Center Emergency Room as a physician since November 2006. 9. It is believed and therefore averred that during 2008, the Defendant EMCARE, Inc. entered in to an agreement with Carlisle Regional Medical Center for the purpose of providing emergency physicians and services at the Carlisle Regional Medical Center. 10. It is believed and therefore averred that EMCARE, Inc. sought to fulfill its obligations pursuant to its contract or other agreement with the Carlisle Regional Medical Center through Defendant New Jersey/Pennsylvania EM-1 Medical Services, P.C., a subsidiary or affiliate of EMCARE, Inc. fully under the direction and control of EMCARE, Inc. 2 11. On May 1, 2008, Cloyd Gatrell entered into a contract with New Jersey/Pennsylvania EM-1 Medical Services, P.C., pursuant to which Dr. Gatrell was to provide services as an emergency physician to the Carlisle Regional Medical Center as an employee of New Jersey/Pennsylvania EM-1 Medical Services, P.C. A true and correct copy of the Employment Agreement is attached hereto as Exhibit "A." 12. During the course of his employment at the Carlisle Regional Medical Center as an emergency physician, both before and after his employment with New Jersey/Pennsylvania EM-1 Medical Services, P.C., Dr. Cloyd Gatrell was an active advocate in favor of patient safety. 13. During the course of his employment at the Carlisle Regional Medical Center as an emergency physician, both before and after his employment with New Jersey/Pennsylvania EM-1 Medical Services, P.C., Dr. Cloyd Gatrell's wife, Kathryn Gatrell, a Registered Nurse, was employed at the Carlisle Regional Medical Center and she too was an active advocate for patient safety. 14. Dr. Cloyd Gatrell began working on improving nursing staffing and support for nurses at the Carlisle Regional Medical Center in January 2006 when he met with then-CEO Bill Leonard. 15. In February 2008, Dr. Gatrell and Kathryn Gatrell, R.N. met with Nathan Staggs, the CEO of the Carlisle Regional Medical Center and reported their concerns about inadequate staffing. 16. At the request of Mr. Staggs, Kathryn Gatrell, R.N., with assistance from Dr. Gatrell, drafted a letter dated February 22, 2008. Kathryn Gatrell, R.N. obtained 104 signatures with respect to the aforesaid letter, including 100 members of the nursing staff. Additionally, unit secretaries, respiratory technicians and a doctor signed the letter. The letter of February 22, 2008 reported to the CEO of Carlisle Regional Medical Center that the hospital was not staffed 3 to give patients the care that they deserve, stating that "inadequate staffing ... endangers patients." 17. On March 24, 2008, Dr. Gatrell met with Nathan Staggs, CEO of Carlisle Regional Medical Center and presented comparative data showing that every nearby hospital used a staffing model that results in better nursing staffing than at Carlisle Regional Medical Center. 18. On April 7, 2008, Dr. Gatrell presented the comparative data to the President of the Medical Staff. 19. On May 6, 2008, Kathryn Gatrell, R.N. voiced her concerns about nursing staffing and practices in a meeting Jay Finnegan, HMA Regional Vice President, held with nurses at Carlisle Regional Medical Center. 20. On May 14, 2008, Dr. Gatrell presented the comparative data at a meeting of the Medical Staff and was directed by the president of the Medical Staff to act as liaison to nursing and was appointed by the President of the Medical Staff to hold physician-nurse meetings for the purpose of getting more input and suggestions for improving the nursing staffing and support for the nurses. 21. On May 14, 2008, Dr. Gatrell spoke by phone with Jay Finnegan, and followed up with an email on May 15, 2008. Dr. Gatrell reported to Mr. Finnegan the widespread concerns about nursing staffing at Carlisle Regional Medical Center. Dr. Gatrell included data that the staffing at Carlisle Regional Medical Center was lower than at any other acute hospital in the area, and reported that inadequate staffing was hampering the hospital's ability to provide quality care. 22. On September 5, 2008, Dr. Gatrell submitted a lengthy report to the President of the Medical Staff regarding meetings he had held with the nurses and physicians. A major concern raised by nurses during the meetings was inadequate staffing. 4 23. On September 18, 2008, Kathryn Gatrell's employment at Carlisle Regional Medical Center was terminated. 24. Kathryn Gatrell, R.N. was allegedly terminated due to events that occurred on September 16, 2008, involving a particular patient and that patient's telemetry order and an order for the medication Lopressor. 25. The alleged reasons for Kathryn Gatrell's termination were pretextual and in fact Kathryn Gatrell, R.N. was terminated from her employment due to her personal efforts on behalf of patient safety, including her leading role in the February 22, 2008 letter reporting patient safety concerns and otherwise critiquing the Carlisle Regional Medical Center administration, her.comments to the HMA Regional Vice President transmitting concerns of the nurses regarding nurse staffing and practices, and the actions of her husband, Dr. Cloyd Gatrell, regarding nurse staffing, practices and patient safety implications. 26. After the termination of the employment of Kathryn Gatrell at Carlisle Regional Medical Center, Dr. Cloyd Gatrell continued to be employed at the Carlisle Regional Medical Center in the emergency room through New Jersey/Pennsylvania EM-1 Medical Services, P.C. 27. On October 6, 2008, Dr. Gatrell reported to the Medical Executive Committee with respect to the meetings between physicians and nurses and concerns raised in those meetings regarding nurse staffing, its impact on patient safety, and other issues voiced by physicians. The CEO and Chief Nursing Officer of the Carlisle Regional Medical Center were in attendance. 28. On October 8, 2008, Dr. Gatrell wrote to Dr. Deborah Sims as chair of the performance improvement committee regarding telemetry orders which were overlooked and delayed. Dr. Gatrell used as an example the incident that was alleged to have led to the termination of the employment of his wife, Kathryn Gatrell, R.N. Dr. Gatrell pointed out that there were improvements that could be made to the system that would lead to better patient 5 care. He also noted that the situation involving the telemetry order involving his wife was treated as an egregious error justifying immediate termination when, in fact, the doctor who gave the telemetry order was never notified as the Patient Safety Plan requires for an error, incident or event. Neither was the family or patient notified which would have been required for a serious event in accordance with the Patient Safety Plan and the MCARE Act. 29. On October 9, 2008, at the instigation of the Chief Nursing Officer, the CEO of the hospital, Nathan Staggs, made a physician decorum complaint against Dr. Gatrell. Included among the alleged breaches of physician decorum by Dr. Gatrell was the aforesaid letter of October 8, 2008 that Dr. Gatrell wrote to Dr. Sims, setting forth his concerns with respect to telemetry orders at the Carlisle Regional Medical Center. 30. Following a response by Dr. Gatrell to the physician decorum complaint, Dr. David Albright, then President of the Medical Staff at the Carlisle Regional Medical Center, determined that neither corrective nor disciplinary action was necessary or warranted with respect to Dr. Gatrell, which action was endorsed unanimously by the Medical Executive Committee. 31. Dr. Albright advised Dr. Gatrell that the physician's decorum complaint was intended to intimidate Dr. Gatrell. 32. On November 24, 2008, Dr. Cloyd Gatrell wrote to Georgeann Laughmann, Patient Safety Officer at the Carlisle Regional Medical Center. Dr. Gatrell was a member of the Medical Staff reporting the failure of the Carlisle Regional Medical Center to comply with its own Patient Safety Plan, particularly with respect to the handling of the incidents involving telemetry and Lopressor orders that allegedly led to the termination of the employment of Kathryn Gatrell. 33. On December 5, 2008, Dr. Cloyd Gatrell wrote to Mr. Bill Schoen, Chairman of the Board of Health Management Associates. Dr. Gatrell reported to Mr. Schoen the widespread concerns about inadequate nursing staffing at Carlisle Regional Medical Center; 6 that nurses who spoke up about poor staffing were watched until they made mistakes, which were then used as pretext for disciplinary action and termination in violations of the Patient Safety Plan. As a specific example of disciplinary action that violated the Patient Safety Plan, Dr. Gatrell cited the termination of his wife, Kathryn Gatrell. 34. On January 9, 2009, HMA's Region I President, Britt Reynolds, invited Dr. Gatrell to meet with him at the Carlisle Regional Medical Center. Dr. Gatrell reported the concerns he had been raising about nurse staffing, support and violations of the hospital Patient Safety Plan. 35. On April 29, 2009, Dr. Gatrell met with Denise Opiela, Chief Operations Officer, EMCARE Northeast. Dr. Gatrell reported his patient safety concerns to Ms. Opiela and presented her with a packet of documents setting forth his involvement with issues of nurse staffing, support for nurses, patient safety and the violations of the Patient Safety Plan at the Carlisle Regional Medical Center. 36. On May 1, 2009, Dr. Gatrell sent Dr. Russ Harris, CEO of EMCARE Northeast, a copy of a letter that detailed individuals within Carlisle Regional Medical Center and HMA to whom Dr. Gatrell had reported patient safety concerns about inadequate staffing and violations of the Patient Safety Plan. 37. In response to a report by Dr. Gatrell dated January 7, 2009, the Pennsylvania Department of Health carried out an unannounced investigation at the Carlisle Regional Medical Center on February 13, 2009, investigating allegations of (1) inadequate staffing posing a risk to the patients; (2) noncompliance with the Patient Safety Act; and (3) targeting and firing whistleblowers. The Department of Health determined that the facility was in violation of the "Patient Safety Act," and the hospital was cited with violations of the applicable state licensure regulations. - 38. As a result of the report made by Dr. Gatrell by telephone on or about February 15, 2009, the Pennsylvania Department of Health carried out an unannounced investigation of 7 the Carlisle Regional Medical Center on March 6, 2009, for the purpose of investigating allegations that the facility was boarding patients in the emergency department because of staff shQrtages. The Department of Health investigators "determined that the governing body failed to ensure the facility had sufficient personnel to meet the needs of the patients." As a result of the investigation, the hospital was cited with violation of the applicable state licensure regulations. 39. Dr. Gatrell's efforts on behalf of patient safety and regarding nurse staffing and support for nurses continued with the current Carlisle Regional Medical Center CEO John Kristel. 40. On July 21, 2009, Dr. Gatrell met with Mr. Kristel. Dr. Gatrell had previously provided Mr. Kristel with a letter dated July 15, 2009, with attachments detailing Dr. Gatrell's involvement with nurse staffing, support for nurses, and patient safety issues at the Carlisle Regional Medical Center, as well as Dr. Gatrell's observations of violations of the Patient Safety Plan. 41. On February 26, 2010, Dr. Gatrell reported concerns about inadequate staffing to the-CEO of the Carlisle Regional Medical Center observing that each R.N. on the medical surgical units had been caring for 10 patients the night before without any LPN help. 42. On July 7, 2010, Dr. Gatrell spoke by phone to Wayne Neislander, Director of Human Resources for HMA, corporate parent of Carlisle HMA, LLC, and Dr. Gatrell reported to Mr. Neislander his concerns over violations of the Patient Safety Plan in disciplinary actions, including the termination of Kathryn Gatrell, R.N. 43. On July 2, 2010, Dr. Gatrell was contacted by Jackie Meyer, EMCARE Southeast Regional Client Coordinator, who had taken over Ms. Opiela's responsibilities for Carlisle Regional Medical Center. Dr. Gatrell reported to Jackie Meyer his concerns for patient safety related to inadequate nursing staffing at Carlisle Regional Medical Center, and violations of the 8 hospital Patient Safety Plan in responding to nurses who spoke out about problems. Dr. Gatrell referred Jackie Meyer to the documentation on those issues previously provided to EMCARE. 44. Nurse staffing and support directly impact patient safety at Carlisle Regional Medical Center. 45. By letter dated August 9, 2010, Dr. Gatrell was advised by Jennifer Strouse, Director of Operations, NE Region, EMCARE, Inc. that his Employment Agreement with New Jersey/Pennsylvania EM-1 Medical Services, P.C., was being terminated at the request of the Carlisle Regional Medical Center. The August 9, 2010 letter is attached hereto as Exhibit "B." 46. The Carlisle Regional Medical Center directed EMCARE, Inc. and New Jersey/Pennsylvania EM-1 Medical Services, P.C. to terminate the employment of Dr. Gatrell because of Dr. Gatrell's long-term advocacy in favor of patient safety through his role with respect to nursing staffing, support for nurses, his reporting to responsible individuals within Carlisle Regional Medical Center and HMA of violations of the Patient Safety Plan, and his reports to the Department of Health. 47. As set forth in the letter of August 9, 2010, EMCARE, Inc. acted on behalf of New Jersey/Pennsylvania EM-1 Medical Services, P.C. 48. Dr. Gatrell had reported to representatives of EMCARE, Inc. of the role he had been playing at Carlisle Regional Medical Center with respect to patient safety, nurse staffing, support for nurses and the violations of the Patient Safety Plan at the Carlisle Regional Medical Center. Dr. Gatrell provided EMCARE, Inc. with extensive documentation of these nurse staffing and patient safety issues on April 29, 2009. On April 29, 2009, Denise Opiela, COO of Northeast EMCARE told Dr. Gatrell that his contract could be terminated at the request of the Carlisle Regional Medical Center, and relayed a message from the Interim CEO of Carlisle Regional Medical Center to "back off." 9 49. The MCARE Act sets forth a strong and clear public policy of the Commonwealth of Pennsylvania in favor of patient safety, including the establishment of the Patient Safety Authority, and requirements for reporting of adverse events, and for adoption of and, most importantly, compliance with Patient Safety Plans. COUNTI Cloud Gatrell v. Carlisle Reaional Medical Center. Carlisle HMA LLC and Carlisle HMA. Inc. Tortious Interference with Contract 50. Paragraphs 1 through 49 and all subsequent paragraphs are incorporated herein by 'reference thereto. 51. Carlisle Regional Medical Center directed EMCARE, Inc. and/or New Jersey/Pennsylvania EM-1 Medical Services, P.C. to terminate the employment contract of Dr. Cloyd Gatrell. 52. The Carlisle Regional Medical Center directed the termination of Dr. Gatrell's contract because of Dr. Gatrell's patient safety activities, including his actions with respect to nurse staffing, support for nurses, reports he made of incidents of inadequate staffing, reports he made with respect to the violation of the Patient Safety Plan as set forth herein and the reports he had made to the Department of Health. 53. The Carlisle Regional Medical Center directed EMCARE, Inc. and New Jersey/Pennsylvania EM-1 Medical Services, P.C. to terminate Dr. Gatrell's employment contract because of Dr. Gatrell's patient safety activities involving the reports by Dr. Gatrell of the violations of the Patient Safety Plan of the Carlisle Regional Medical Center arising out of the termination of the employment of Kathryn Gatrell, R.N., Dr. Gatrell's wife, as set forth in Dr. Gatrell's letter to Georgeann Laughmann, Patient Safety Officer of the Carlisle Regional Medical Center dated November 24, 2008 attached hereto as Exhibit "C." 10 54. The Carlisle Regional Medical Center directed the termination of the employment contract of Dr. Gatrell, contrary to strong public policy of the Commonwealth of Pennsylvania in favor of patient safety, contrary to the MCARE Act and the Whistleblower Act as set forth herein. 55. The actions of the Carlisle Regional Medical Center were intentional, wrongful and outrageous and were done with the purpose of causing harm to Dr. Gatrell. 56. As a direct result of the interference by the Carlisle Regional Medical Center with the employment contract of Dr. Cloyd Gatrell, Dr. Gatrell has suffered a loss of earnings and earning capacity, damage to his professional reputation, embarrassment, humiliation, loss of life's pleasures and emotional distress. WHEREFORE, Plaintiff Cloyd Gatrell demands judgment in his favor against the Carlisle Regional Medical Center in an amount in excess of the amount requiring referral of this case to arbitration pursuant to local rules plus interest, cost of suit and punitive damages. COUNT II Cloud Gatrell v. Carlisle Reaional Medical Center Carlisle HMA LLC and Carlisle HMA. Inc. Violation of the Pennsylvania Whistleblower Act 57. Paragraphs 1 through 56 and all subsequent paragraphs are incorporated herein by reference thereto. 58. Pursuant to the Pennsylvania Whistleblower Act, an employee is defined as follows: A person who performs a service for wages or other remuneration under a contract of hire, written, oral, expressed or implied for a public body. 43 P.S. § 1422. Dr. Gatrell is an employee of the Carlisle Regional Medical Center pursuant to the Whistleblower Act's definition of an employee. Dr. Gatrell performed services for the Carlisle Regional Medical Center, he received remuneration and he was under a contract of hire expressed or implied. 11 59. An employer is defined in the Pennsylvania Whistleblower Act as follows: A person supervising one or more employees, including the employee in question; a superior of that supervisor; or an agent of a public body. 43 P.S. § 1422. The Carlisle Regional Medical Center is an employer as that term is defined in the Pennsylvania Whistleblower Act, it supervises one or more employees, including Dr. Gatrell who was a member of the Medical Staff and subject to supervision by the Carlisle Regional Medical Center. 60. Pursuant to the Whistleblower Act of Pennsylvania, a public body includes Any other body which is created by Commonwealth or political subdivision authority or which is funded in any amount by or through Commonwealth or political subdivision authority or a member or employee of that body. 43 P.S. § 1422. The Carlisle Regional Medical Center is a public body in that it receives funds from Medicaid, and other public funds. 61. Pursuant to the Whistleblower Act of Pennsylvania, No employer may discharge, threaten or otherwise discriminate or retaliate against an employee ... because the employee or person acting on behalf of the employee makes a good faith report or is about to report, verbally or in writing to the employer or appropriate authority an instance of wrongdoing or waste. 43 P.S. § 1423(a) 62. Pursuant to the Whistleblower Act of Pennsylvania, wrongdoing is defined as follows: A violation which is not of a merely technical or minimal nature of a Federal or State statute or regulation, of a political subdivision ordinance or regulation or of a code of conduct or ethics that is designed to protect the interest of the public or the employer. 43 P.S. § 1422 12 63. Pursuant to the MCARE Act, all medical facilities, which would include the Carlisle Regional Medical Center, are required to [d]evelop, implement and comply with an internal patient safety plan which shall be established for the purpose of improving the health and safety of patients. 40 P.S. § 1303.307(a) 64. Dr. Cloyd Gatrell reported the failure of the Carlisle Regional Medical Center to comply with the MCARE Act through its failure to comply with and enforce its Patient Safety Plan arising out of the termination of the employment of his wife, Kathryn Gatrell, R.N. Dr. Gatrell reported the violation of the Patient Safety Plan on September 23, 2008, in his meeting with the CEO of Carlisle Regional Medical Center, in his letter of November 24, 2008 to Georgeann Laughmann, Patient Safety Officer of the Carlisle Regional Medical Center, Exhibit "C" hereto attached, and in meetings with the current CEO of Carlisle Regional Medical Center. 65. As a result of the foregoing actions by Dr. Gatrell, Carlisle Regional Medical Center caused the termination of his employment in violation of the Pennsylvania Whistleblower Act. 66. In accordance with 43 P.S. § 1425, Dr. Cloyd Gatrell requests that the Court order: a. reinstatement of Dr. Gatrell; b. payment of his back wages; C. reinstatement of fringe benefits; d. actual damages; and e. costs of litigation, including reasonable attorney's fees and witness fees. WHEREFORE, Dr. Cloyd Gatrell requests judgment in his favor against the Carlisle Regional Medical Center as set forth herein and in an amount in excess of the amount requiring referral of this case to arbitration pursuant to local rules plus interest and costs of suit. 13 COUNT III Cloud Gatrell v. Carlisle Reailonal Medical Center. Carlisle HMA LLC and Carlisle HMA. Inc Violation of the MCARE Act 67. Paragraphs 1 through 66 and all subsequent paragraphs are incorporated herein by reference thereto. 68. Pursuant to the MCARE Act, 40 P.S. § 1303.308(c) : a health care worker who reports the occurrence of a serious event or incident in accordance with subsection (a) or (b) shall not be subject to any retaliatory action for reporting the serious event or incident and shall have the protections and remedies set forth in the Act of December 12, 1986 (P.L. 1559 No. 169, known as the Whistleblower Act). 69. Dr. Gatrell reported incidents as that term is defined in the MCARE Act: an incident, occurrence or situation involving the clinical care of a patient in a medical facility which could have injured the patient but did not either cause an anticipated injury or require the delivery of additional healthcare services to the patient. The term does not include serious event. 40 P.S. § 1303.303. 70. On September 18, 2008, Kathryn Gatrell, R.N. was terminated from employment at the Carlisle Regional Medical Center allegedly due to a missed telemetry order on September 16, 2008. Within 24 hours of his discovery of the missed telemetry order, Dr. Cloyd Gatrell reported the missed telemetry order. The missed telemetry order would constitute an incident pursuant to the MCARE Act. 71. Dr. Gatrell repeatedly reported, as set forth herein, deficiencies in nurse staffing and support which also would constitute incidents as defined under the MCARE Act, which reports were made within 24 hours of the ongoing deficiencies in nurse staffing and support. 72. Carlisle Regional Medical Center brought about the termination of Dr. Gatrell's employment due to his reporting of incidents in violation of the MCARE Act and the Pennsylvania Whistleblower Act. 14 73. In accordance with the Pennsylvania Whistleblower Act, Dr. Gatrell requests that the-Court order: a. reinstatement of Dr. Gatrell; b. payment of his back wages; C. reinstatement of fringe benefits; d. actual damages; and e. costs of litigation, including reasonable attorney's fees and witness fees. WHEREFORE, Dr. Cloyd Gatrell requests judgment in his favor against the Carlisle Regional Medical Center as set forth herein and in an amount in excess of the amount requiring referral of this case to arbitration pursuant to local rules plus interest and costs of suit. COUNT IV Cloud Gatrell v. New Jersey/Pennsylvania EM-I Medical Services P.C. and EMCARE. Inc. Violation of Whistleblower Act 74. Paragraphs 1 through 73 and all subsequent paragraphs are incorporated herein by reference thereto. 75. Dr. Gatrell was an employee of New Jersey/Pennsylvania EM-1 Medical Services, P.C., pursuant to the definition of employee under the Pennsylvania Whistleblower Act. 76. New Jersey/Pennsylvania EM-1 Medical Services, P.C. is an employer pursuant to the definition of employer under the Pennsylvania Whistleblower Act, and a public body pursuant to the Pennsylvania Whistleblower Act, in that it receives Medicaid Funds and other public funds. 77. EMCARE, Inc. controls and directs the activities of New Jersey/Pennsylvania EM-1 Medical Services, P.C. 15 78. EMCARE, Inc. was advised by Dr. Cloyd Gatrell per his communications with EMCARE, Inc., including his meeting with Denise Opiela on April 29, 2009, his report to Jackie Meyer and his report to Russ Harris of the ongoing issues between Dr. Gatrell and the Carlisle Regional Medical Center regarding nurse staffing and support, patient safety, and the violations of the Patient Safety Plan related to the termination of Kathryn Gatrell, R.N. 79. At the request of the Carlisle Regional Medical Center, EMCARE, Inc. directed New Jersey/Pennsylvania EM-1 Medical Services, P.C. to terminate the employment of Dr. Cloyd Gatrell. EMCARE, Inc. and New Jersey/Pennsylvania EM-1 Medical Services, P.C. knew that the Carlisle Regional Medical Center requested the termination of Dr. Gatrell because he had reported violations of the Patient Safety Plan and the MCARE Act. 80. EMCARE, Inc. and New Jersey/Pennsylvania EM-1 Medical Services, P.C. terminated the employment of Dr. Gatrell due to the reports that Dr. Gatrell had made concerning the violations of the Patient Safety Plan and the MCARE Act arising out of the termination of the employment of Kathryn Gatrell, R.N. and also because of his involvement in issues in nurse staffing, nurse support and patient safety. 81. The termination of the employment of Dr. Cloyd Gatrell by EMCARE, Inc. and New Jersey/Pennsylvania EM-1 Medical Services, P.C. was in violation of the Pennsylvania Whistleblower Act. 82. In accordance with the Pennsylvania Whistleblower Act, Dr. Gatrell requests the Court order: a. reinstatement of Dr. Gatrell; b. payment of his back wages; C. reinstatement of fringe benefits; d. actual damages; and e. costs of litigation, including reasonable attorney's fees and witness fees. 16 WHEREFORE, Dr. Cloyd Gatrell requests judgment in his favor against New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EMCARE, Inc., as requested herein, and in an amount in excess of the amount requiring referral of this case to arbitration pursuant to local rules plus interest and costs of suit. COUNT V Cloud Gatrell v. New Jersey/Pennsylvania EM4 Medical Services. P.C. and EMCARE. Inc. Violation of the MCARE Act 83. Paragraphs 1 through 82 and all subsequent paragraphs are incorporated herein by reference thereto. 84. New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EMCARE, Inc. knew that the Carlisle Regional Medical Center sought the termination of Dr. Gatrell because of his reports of incidents as set forth herein. 85. New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EMCARE, Inc. terminated the employment of Dr. Gatrell because of his reports of incidents as set forth herein. 86. The termination of employment of Dr. Gatrell by New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EMCARE, Inc. violated provisions of the MCARE Act and Dr. Gatrell is entitled to protection of the Pennsylvania Whistleblower Act. 87. In accordance with the Pennsylvania Whistleblower Act, Dr. Gatrell requests the Court order: a. reinstatement of Dr. Gatrell; b. payment of his back wages; C. reinstatement of fringe benefits; d. actual damages; and e. costs of litigation, including reasonable attorney's fees and witness fees. 17 WHEREFORE, Dr. Cloyd Gatrell requests judgment in his favor against New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EMCARE, Inc. as set forth herein and in an amount in excess of the amount requiring referral of this case to arbitration pursuant to local rules plus interest and costs of suit. COUNT VI Cloud Gatrell v. New Jersey/Pennsylvania EM4 Medical Services. P.C. and EMCARE. Inc. Wronnful Discharne 88. Paragraphs 1 through 87 are incorporated herein by reference thereto. 89. The termination of the employment of Dr. Gatrell by New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EMCARE, Inc. violated a strong public policy of the Commonwealth of Pennsylvania in favor of patient safety, and the public policy in the Whistleblower Act.. 90. New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EMCARE, Inc. knew that the Carlisle Regional Medical Center sought the termination of employment of Dr. Gatrell because of his involvement with respect to issues concerning nurse staffing, support, patient safety, reports of violations of the Patient Safety Plan, reports to the Pennsylvania Department of Health, and reporting of incidents 91. New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EMCARE, Inc. terminated the employment of Dr. Gatrell because of his involvement with respect to issues concerning nurse staffing, support, patient safety, reports of violations of the Patient Safety Plan, reports to the Pennsylvania Department of Health, and reporting of incidents. 92. As a result of the wrongful termination of his contract in violation of the strong public policy of the Commonwealth of Pennsylvania, Dr. Gatrell has suffered a loss of earnings and earning capacity, damage to his professional reputation, embarrassment, humiliation, loss of life's pleasures and emotional distress for which he makes a claim herein. 18 WHEREFORE, Plaintiff Cloyd Gatrell demands judgment in his favor against New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EMCARE, Inc. in an amount in excess of the amount requiring referral of this case to arbitration pursuant to local rules plus interest, cost of suit and punitive damages. Respectfully submitted, TU By: Attorney I.D. No. 36803 111 North Front Street P. O. Box 889 Harrisburg, PA 17108-0889 (717) 234-4121 ATTORNEYS FOR PLAINTIFF DATE: April ? , 2011 HBG DB:118428-1 024654-138302 VERIFICATION i, Cloyd Gatrell, hereby certify that I am the plaintiff in this action, and that the statements contained in the foregoing Complaint are true and correct to the best of my knowledge, information and belief. I understand that any false statements made to this verification are subject to the penalties of 18 Pa. C.S.A. §4904, relating to unswom falsification to authorities. DATE: f 7 011 cloy rel CERTIFICATE OF SERVICE And now, this day of April, 2011, I, Pamela J. Gordon, secretary to Stephen M. Greecher, Jr., attorney for the within Plaintiff, hereby certify that I have this day served the foregoing Complaint by depositing a true and correct copy of the same in the United States Mail, first class, postage prepaid, at Harrisburg, Pennsylvania, addressed as follows: Sharon M. O'Donnell, Esquire Christopher J. Conrad, Esquire Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Ste. B Harrisburg, PA 17112 ATTORNEYS FOR CARLISLE REGIONAL MEDICAL CENTER and CARLISLE HMA, LLC New Jersey/ Pennsylvania EM-1 Medical Services, P.C. c/o Corporation Service Company 2704 Commerce Drive Harrisburg, PA 17110 EMCARE, Inc. 100 Witmer Road, Suite 220 Horsham, PA 19044 Pamela J. Gordon Aug 15 10 05:52p The Gatrell Family 717-241-0671 p.2 EMPLOYMENT AGREEMENT THIS EMPLOYMENT AGREEMENT. (this "Agreement") is made effective for all purposes and in all respects as of May 1, 2008 by and between New Jersey/Pe.nnsylvania EM-1 Medical Services, P.C. (hereinafter the "Employer") and Cloyd Gatrell, MLA (Hereinafter the "Employee"). WHEREAS, the Employer desires to employ the Employee, a professional practitioner in the practice of emergency medicine; WHEREAS, the Employee desires to act for the Employer in the aforesaid capacity; and WHEREAS, the Employer and the Employee desire to set forth in writ;ng the terms and conditions of their agreements and understandings; NOW, THEREFORE, in consideration of the foregoing, of the mutual promises herein contained, and of other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, it is hereby agreed as follows: 1. REPRESENTATIONS Employee represents that he is a qualified physician duly licensed to practice medicine in all jurisdictions where he shall be required to perform his duties pursuant to this Agreement, including, but not limited to, the state(s) of Pennsylvania. Employee also represents that he is not currently subject to any professional disciplinary proceeding of any state or federal authorities or to any disciplinary action of any hospital or other hospital facility in any j urisdiction. 2. TERM OF EMPLOYMENT AND TERMINATION Subject to the provisions in Section 10 and 14, the Employer and all subsidiaries and affiliates of the Employer, shall employ the Employee and the Employee agrees to be so employed commencing on or about the date first written above. This Agreement shall not be effective unless and until Employee satisfactorily completes Employer's appliciLtion process and obtains medical staff membership along with all appropriate privileges at Hospital. The parties further agree that such employment shall continue until either party terminates pursuant to the terms of Section 10. I DUTIES OF EMPLOYEE A. Employee in accepting such employment by the Employer shall undertake and assume the responsibility of performing professional medical services in emergency medicine, as well as providing any administrative duties and additional services as specified in Appendix A, attached hereto. Employer shall have the power to determine and control, within reason and within the confines of professional ethics, the specific physical location (initially, Carlisle Regional Medical Center, Carlisle, Pennsylvania) and duties to be performed by the Employee provided; however, that Employer shall not relocate Employee to a location at wbuch Employee F Gavel]s.oa EXH1Brr ansnoos 1 If. Aug 15 10 05;52p The Gatrell Family 717-241-0671 p.3 does not currently provide medical services without the consent of Employee. Employee hereby agrees to act in a competent and professional manner in carrying out the duties of his employment and that he shall make all clinical decisions using his best medical judgment. Both the Employer and any hospital or other facility at which the Employee is on duty shall have the power to designate patients to be assigned to the Employee, and the Employee shall perform medical services for said patients. No person other than the Employer and said hospital shall have the right to designate, by name and description, the patients for whom Employee is to perform services and Employee shall not honor any designation by any other person or organization. Notwithstanding anything to the contrary herein, nothing in this Agreement shall be construed to restrict the Employee's duties and obligations under applica:-)le law or to his patients, including, but not limited to duties in the prescription or administration of medication and the performance of medical services with respect to any patient. B. During the term of this Agreement, the Employee shall (i) have and maintain a valid and unrestricted license to practice medicine in all jurisdictions in which the Employee provides services for, and on behalf of, the Employer pursuant to the terms of this Agreement and in those states in which the Employee becomes licensed to practice medicine during the term of this Agreement, (ii) comply with, be controlled and governed by and otherwise provide medical services in accordance with all legal requirements, and the ethics and standard of care of the medical community where the Employee provides medical services pursuant to this Agreement, and (iii) obtain and retain full medical staff membership with appropriate clinical privileges at any hospital or health care facility at which medical services are to be provided by the Employee for and on behalf of the Employer. Procurement of temporary staff privileges pending the completion of the medical staff approval process shall satisfy the requirements of subpart (iii) of the preceding sentence, provided that the Employee actively pursues full appointment and actually receives full appointment within a reasonable time. C. Within thirty (30) days of the Effective Date of this Agreement Employee shall self-query the National Practitioner Databank C PDB') and provide Employer with a copy of such report. D. Within seven (7) days of becoming aware, or being notifi:A of, an event reportable to the NPDB, including but not limited to loss or reduction of hospital privileges, felony conviction, disciplinary action by any licensing authority, or notification of loss of Medicare./Medicaid participation privileges, Employee shall provide Employer with information regarding such event and shall provide an updated NPDB query upon request of Employer. E. Employee agrees that he shall be on duty pursuant to this Agreement on average for the number of hours per month (initially, 130) specified by Employer. The Employer may modify the number of hours worked with the consent of the Employee. Any hours worked in a quarter, above 400 hours shall be paid at a premium of S25 per hour. F. The Employee agrees to abide by any rules, regulations and any other policies and procedures covering the Employee established by the Employer. G. The Employee shall be obligated to obtain required Continuing Medical Education ("CME") in compliance with state licensure requirements in all stares in which the FTGatrc114.08 (2) 2 4/16/2008 Aug 15 10 05:52p The Gatrell Family 717-241-0671 p,4 Employee is licensed to practice medicine at the time of this Agreement or in which the Employee becomes licensed to practice during the term of this Agreement, as well as the requirements of any Hospital at which Employee provides services. Upon request by Employer, Employee shall provide a copy of the CME certificate to the Employer or its designee. H. Notwithstanding anything to the contrary herein, the Employee agrees to provide the Employer with all information necessary to document Employee's citizenship and employment status and to sign all documents reasonably necessary to document the employment relationship contemplated herein and to properly designate the Employer or any subsidiaries or affiliates of the Employer as the designee of Employee's reassignment of rights pursuant to Section 7 hereof. The Employee acknowledges and agrees that notwithstandipg anything to the contrary herein, the Employer may withhold payment to the Employee until such documents as the Employer may reasonably request are produced or signed, as applicable. 4. NON LNTERFERENCE: A. Employee acknowledges that during Employee's association with Employer. Employee has been and will continue to be brought into contact with Employer's confidential methods of operation and trade secrets, including know-]tow, data and other information about Employer's operations and business of a confidential nature; and that such information gives to the relationship a special and unique value. B. Employer acknowledges that Employee was providing care at Carlisle Regional Medical Center before the effective date of EmCare's contract and already has information regarding the hospital's operations and business that such information gives to the relationship between Employee and the hospital a special and unique value. Therefore, Employee agrees thar during the term of this Agreement, and during the twelve (12) months after termination for any reason other than the loss of the contract with the Hospital by Employer or any of its affiliated entities, Employee will not directly or indirectly solicit to provide emergency department services at Hospital, nor will Employee persuade or attempt to persuade Hospital to terminate its relationship with Employer or any subsidiary or affiliate of Employer or EmCare, Inc. Nothing contained in this paragraph shall prevent Employee from providing services at Hospital after the termination of this Agreement in the absence of solicitation, inducement or persuasion as set forth above or upon the termination of the agreement between employer, or any of its affiliated companies, and the Hospital to provide Emergency Department management services to the Hospital. C. It is the intention of Employer to restrict the activities of Employee in a manner which reasonably protects the legitimate business interests of Employer. D. Employee agrees that the damages and remedies at law for any breach tinder this Sec:tiov 4 of this Agreement would be inadequate and that, in addition, in the event of a breach under this Section 4 of this Agreement, Employer may apply to a court of competent jurisdiction and be entitled to an injunction by such court to prevent a breach or further breach there of on the part of the Employee. 5. PATIENT RECORDS AND DISCLOSURE OF INFORAL4,TION The Employee shall prepare and maintain such medical records incidental to the medical services that he performs hereunder as required under standard medical pra0tices and as otherwise required by Employer. All patient records and case histories shall at all times remain the property of the Hospital or Employer. Included within the foregoing are all records and information coming into the possession of the Employer and Employee which are the property of any hospital and for which the Employer has assumed temporary or permanent custodial FTOatre1)4.08 (2) 3 411W2008 Aug 15 10 05;52p The Gatrell Family 717-241-0671 p,5 responsibility. Unless required by legal process, no medical or any other Employer or hospital records shall be displayed by the Employee to any person or entity not authorized by the Employer, except in strict accordance with medical ethics and such rules relating thereto as are promulgated by the Employer's Board of Directors or officers from time to timc. Employee shall maintain appropriate documentation in completion of all medical records in compliance with all rules, regulations and guidelines established by state or federal governmental authorities, including, but not limited to, CMS. Employer and Employee recognize that during the course of his employment under this Agreement the Employee shall have access to Employer information and documents which are recognized as sole, exclusive and confidential property of the Employer. The Employee therefore agrees that he will not, during the term of his employment, divulge or disclose any information relating to the Employer to any other person or entity whatsoever, for any purpose whatsoever, including the use of such information by the Employee himself for the purposes of employment or the practice of medicine other than for the Employer pursuant to the terms of this Agreement. It is understood that the prohibitions set forth in the preceding paragraphs do not apply to medical reports on patients for the purposes of consultation with, reference to other physicians for the patients' welfare and care, claims in connection with accidents or disability made by the patient, other legitimate uses in furtherance of the Employer's business and :he welfare of its patients or its contractual relationship with any hospital, or professional discussions with other Employees within the Emergency Department. 6. COAZFENSATION AND BENEFITS A. Compensation: In consideration for the services provided to Employer as contemplated herein, the Employee shall receive as compensation the amount(s) set forth herein on Appendix A, which compensation may be modified by Employer in its reasonable discretion. Ninety (90) day written notice is provided to Employee before and decrease in compensation. Employee and Employer recognize that proper reassignment of rights under Section 7 of this Agreement is a prerequisite to Employer's ability to obtain reimbursement from certain third party payers for Employee's services, and that this reimbursement is essential to Employer's ability to fully compensate its employees. Accordingly, Employer shall pay to Employee eighty percent (80%) of the hourly rate set forth on Appendix A hereto until such time as all Billing and Enrollment documentation necessary to accomplish such reassignment has been fully and accurately completed by Employee. After all Billing and Enrollment documentation is completed to the satisfaction of Employer, Employee's compensation shall be immediately and retroactively increased to one hundred percent (100%) of his hourly rate, with all retroactive amounts due to Employee payable on the next regularly scheduled payroll date. B. Benefits: Unless prohibited by law, the Employer shall make available to the Employee the same benefits that the Employer provides to other employees, which notwithstanding anything to the contrary provided herein, may be amended by the Employer from time to time. FTGatrcll4.08 (2) 4 411672008 Aug 15 10 05:53p The Gatrell Family 717-241-0671 p,6 7. FEES FOR MEDICAL SERVICES The Employee shall have no ownership interest in any amounts owed or collected for medical services performed by the Employee pursuant to this Agreement. The Employee hereby unconditionally assigns to the Employer and all subsidiaries and affiliates of the Employer to whom Employee is employed pursuant to Section 2 hereof, all amounts owed or collected for medical services performed by the Employee during the term of this Agreement, and shall assist the Employer in billing and collecting such amounts, which shall be the sole and exclusive property of the Employer. Upon request of Employer, Employee shall execute axed deliver such additional documents and instruments as may be necessary to evidence or effect this assignment of fees or to effect an assignment of fees to the appropriate hospital, including without limitation, any documents necessary in order to allow Employer to bill and collect all amounts owed for medical services performed from Medicaid, Medicare, and any other third party payors. 8. EXPENSES Employee shall be. entitled to reimbursement for required CME costs, professional fees or dues, subscriptions and medical equipment and supplies used directly in the hmployee's duties under this Agreement, for an amount not to exceed, in the aggregate, the amount so designated on Appendix A to this Agreement, which amount may be amended from time I o tame; provided, however, that the Employer shall retain the sole authority to determine if each such submitted expense is related to the Employee's duties herein and thus subject to reimbursement. Employee shall be reimbursed for business expenses for each calendar year in an amount not to exceed the Business Expense Reimbursement Limitation as specified in Appendix A. The total amount of reimbursement for which Employee is eligible shall be determined based on the date of Employee's first shift and in the event that Employee does not work a full year, Employee shall be eligible for one twelfth of the total annual amount multiplicd by the number of complete months of service and a pro rata portion of any partial month of service. Employee shall be eligible for reimbursement of expenses up to the maximum benefit available for the year at any time; provided, however, that Employee agrees that in the event this Agreement is terminated prior to the end of any calendar year in which he was reimbursed for expenses, Employee must repay Employer a pro rata amount of any reimbursement based on the number of months remaining in such calendar year after termination and Employee further agrees that Employer may deduct such pro rata amount from Employee's final paycheck. In order to receive such reimbursement, the Employee shall submit receipts for all such expenses upon occurrence. Employer shall review such expenses and if Employer determines such expenses were incurred for valid business reasons, Employer will reimburse Employee for such expenses within thirty (30) days of their submission. 9. INSURANCE The Employer shall cause professional malpractice insurance to be procured in favor of the Employee with respect to the medical services performed by the Employee pursuant to this Agreement. During the tern of this Agreement, such insurance shall be under a "claims made" policy with annual policy limits of at least One Million Dollars ($1,000,000) per medical incident and separate per provider aggregate limits in the amount of Three Million Dollars FTGatre11d.08 (2) 4!t62008 Aug 15 10 05:53p The Gatrell Family 717-241-0671 p.7 ($3,000,000) annually. Upon the termination of this Agreement, the Employer shall cause professional malpractice insurance to be maintained in the favor of the Employee with coverage limits of One Million Dollars ($1,000,000) per medical incident and separate per provider aggregate limits in the amount of Three Million Dollars ($3,000,000) annually for all claims against the Employee arising from medical services performed pursuant to this Agreement during the term of this Agreement. 10. TERMINATION OF AGREEMENT AND EMPLOYMENT A. The Employer and Employee hereby agree that during the term of this Agreement, and any extensions hereof, this Agreement and the employment of the Employee may be terminated and the Employee's compensation shall be measured to the date of such termination: (i) at will by either party with 90 days notice; (ii) immediately by mutual consent of both parties; or (iii) immediately upon the Employer providing written notice to the Employee upon the occurrence of any of the following events: 1. Suspension, revocation, cancellation or limitation of Employee's right to practice in any jurisdiction whether because of loss of Employee's license or any other reason, including, without limitation failure to obtain appropriate CAME credits. 2. Revocation, in whole or in part of Employee's medical privileges as extended to him/her by the appropriate authorities of any hospital at which the Employer conducts its business. 3. Failure or refusal by the Employee to comply with the rules, regulations or other policies established by the Employer or the appropriate authorities of any hospital at which Employee provides services. 4. Conviction of the Employee of any felonious crime in any federal or state jurisdiction of the United States of America. 5. Unprofessional, unethical; or fraudulent conduct by the Employee or a finding by any professional society of such conduct. Proof of Employee's dishonesty with respect to his duties and obligations to the business and affairs of the Employer. If Employer shall believe Employee to be guilty of the foregoing and pending the establishment of proof of the same, the Employer may place Employee on leave of absence with or without pay, at Employer's sole discretion until the resolution of such matter. 7. Termination for whatever reason of Employer's, EmCare, Inc.'s, or a subsidiary of EmCare, Inc 's contract to provide medical services at the hospital(s) or a hospital where the Employee is working. FTGatreI14.08 (2) 6 4!16/2008 Aug 15 10 06:00p The Gatrell Family 717-241-0671 p.3 will keep such Confidential Information confidential. If the Employee is requested or required by legal process to disclose or produce any Confidential Information furnished in the course of his employment with the Employer, the Employee will consult and cooperate with the Employer as to the advisability of the Employer taking legally available action to resis, or narrow such request. For the purposes of this Section, the tenn "Confidential Information" shall mean any business information of Employer (whether written or oral), including all business management or economic studies, patient lists, customer lists, proprietary foams, proprietary business or management methods, marketing data, fee schedules, or trade secrets of the Employer whether or not such Confidential Information is disclosed or otherwise made available to the Employee. Confidential Information shall also include the terms and provisions of this Agreement and any transaction or document otherwise executed by the parties to this Agreement. The terns and provisions of this Section do not prohibit or limit professional discussions of taus agreement or other Confidential Information with other Employees within the Emergency Department. The terms and provisions of this Section shall survive the termination of this Agreement 12. NOTICES Any and all notices required or permitted to be given pursuant to this Agreement to Employee shall be sufficient if in writing and mailed to his then residence address, e-mailed to his last known e-mail address, or a verbal communication actually communicated to Employee. In the case of notices by the Employee to the Employer, the same manner of delivery shall be sufficient, as shall hand delivery to the Medical Director at the bospital or to Employer's business address except that all communications from Employee to Employer mllst be in writing. 13. ASSIGNABILITY Neither this Agreement nor any right or interest hereunder shall be assignable by the Employee, his beneficiaries, or legal representatives without the Employe:-'s prior written consent; provided, however, that nothing herein shall preclude (i) the Employee from designating a beneficiary to receive any benefit payable hereunder upon his death, (ii) the executors, administrators, or other legal representative of the Employee or his estate from assigning any rights hereunder to the person or persons entitled thereunto, (iii) the assignment by the Employer of the compensation owed to the Employee hereunder to a garnishee upon the receipt of a gamishmcnt order of any local, state, or federal authority received by the Employer, or (iv) the assignment by the Employer of its rights and obligations under this .Agreement. 14. A-VIENDMENT No amendment or modification of this Agreement shall be effective unless or until executed in writing by the parties hereto. 15. WAIVER OF BREACH The waiver by any party hereto of a breach of any provision of this Agreement shall not operate or be construed as a waiver or breach of any other provision or any subsequent breach by any party. ITGat=114.08 (2) 8 4462008 Aug 15 10 06:05p The Gatrell Family 717-241-0671 p.2 16. TERMINATION DUE TO LEGISLATIVE OR AD1tiMISTRATIVL, CHANGE In the event that there are changes in the current federal or state laws or regulations regarding Medicare/Medicaid, the adoption of new legislation, or a change in other third party reimbursement systems which materially affect the reimbursement that ti)e Employer or Employee may receive for their respective services, the Employer may immediately terminate this Agreement by providing appropriate notice under Section 12. 17. GOVERNLNG LAW THE CONSTRUCTION AND INTERPRETATION OF THIS AGREEMENT SHALL AT ALL TIMES AND IN ALL RESPECTS BE GOVERNED BY THE LAWS OF THE PRI1biARY STATE IN WHICH EMPLOYEE PRACTICES MEDICINE PURSUANT TO THE TERMS OF THIS AGREEMENT. 18. SEVERABILITY If any provision of this Agreement shall be determined to be invalid, illegal or unenforceable in whole or in part, neither the validity of the remaining part of such provision nor the validity of any other provision of this Agreement shall in any way be affected thereby. 19. COUNTERPARTS This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. 20. GENDER Whenever the context of this Agreement requires, the gender of all words herein shall include the masculine and feminine. 21. TAX WITHHOLDING The Employee agrees that the Employer may withhold from any amount payable by the Employer hereunder such amounts as the Employer reasonably determines to I)e necessary for compliance with federal, state, and local. tax withholding requirements, in which event the Employer shall file such reports and make such payments as may be required thereunder. 22. ENTIRE AGREEMENT This Agreement and the attachment to this Agreement together cons-titute the entire agreement and understanding by and between the Employer and the Employee with respect to the employment herein referred to, and no representations, promises, agreements or understandings, written or oral, not herein contained shall be of any force or effect. No change or modification hereof shall be valid or binding unless the same is in writing and signed by the party intended to be bound. FTGatrel1<.08 (2) 9 4/162008 Aug 15 10 05:54p The Gatrell Family 717-241-0671 p.8 8. In the event, due to circumstances beyond Employee's control, Employee shall be unable to perform his duties under this Agreement for any period in excess of ninety (90) days covered by this Agreement. 9. In the event that the appropriate authorities of a hospital at which Employee is providing services request that Employee no longer provide such services at the hospital. 10. Employee's misrepresentation or omission of information provided pursuant to the application process for employment or medical staff privileges. 11. Failure or refusal by Employee to provide Employer with a self-query report from the NPDB in accordance with the terms of Section 3(C) or 3(D). B. In addition, this Agreement shall be automatically terminated should the Employer be declared by a Court of competent jurisdiction to be bankrupt tinder the Federal Bankruptcy Act or shall. be determined to be insolvent under the insolvency Iaws of the state of governance of this Agreement. C. The Employee agrees and understands that medical staff membership and privileges at hospitals contracting with Employer, affiliates of Employer or companies contractually affiliated with Employer are predicated and contingent upon such hospital's contractual relationship with such entity. Upon termination of this Agreement between Employer and Employee, regardless of cause, Employee relinquishes without recourse medical staff membership and privileges at the hospitals with which Employer, affiliates of Employer or companies contractually affiliated with Employer contract. Further, upon termination, for any reason regardless of cause, of any agreement between Employer, affiliates of Employer or companies contractually affiliated with Employer and a hospital where the Employee retains medical staff membership and privileges for the purposes of providing services under this Agreement, Employee shall relinquish without recourse such medical staff membership and privileges at such hospitals. Nothing in this paragraph shall prevent Employee from applying for privileges and/or medical staff membership from any such hospital after the termination of this Agreement. D. Introductory Period. The initial ninety (90) day period after Employee first provides services pursuant to this Agreement shall constitute an Introductory Period. During this Introductory Period, and notwithstanding subparagraphs 10.A and 103 above, Employer may terminate this Agreement, with or without cause, by providing ten (10) days prior written notice to Employee. 11. CONFIDENTIALITY The Employee will not disclose any Confidential Information (as defined below) of the Employer without the Employer's express written authorization, such Confidential Information will not be used in any way directly or indirectly detrimental to the Employer, and the Employee FTGauc114.08 (2) 7 4/160-008 Aug 15 10 06:05p The Gatrell Family 717-241-0671 p.3 IN WITNESS WHEREOF, the Employer and the Employee have each duly executed this Agreement under seal as of the date set forth below. New Jersey/Pennsylvania EIVI-I 'cal Services, P.C. By' Z?) Name: Denise K. O iela Atto e n Fact Date of Execution: 5 I Cloyd Gatrell, ND By: Name: > Date of Execution:-/?G- ?. FTGatrel*08 (2) 10 4/16/2008 • Aug 15 10 06:05p The Gatrell Family APPENDIX A 717-241-0671 p.4 COMPENSATION AGREEIVIENT EMPLOYER: New JerseyiPennsylvania EM-1 Medical Services, P.C. EMPLOYER IDENTIFICATION NUMBER: 75-2756076 PHYSICIAN (EMPLOYEE): Cloyd Gatrell, SID EFFECTIVE DATE: May 1, 2008 HOURLY RATE: 5135.00 Carlisle Regional Medical Center PREMTUM HOURLY RATE: $25.00 (Minimum required hours per quarter - 400) NIGHT DIFFERENTIAL: $5.00 additional per hour to be paid for all 1 Ipm-lam sbitls worked MONTHLY DISCRETIONARY BONUS: 51,250.00.'r (Contingent upon maintaining 120 hours worked a montli) *Less: Employee's Portion of FICA (Social Security) Taxes Employee's Portion of Medicare Taxes Employee's Elective Deferral Plan Contribution Employee's Elective 401(k) Contribution Employee's Other Elective Deductions Employee shall be paid one and one-half times the employee's hourly rate for any hours worked during the following twenty-four (24) hour holiday periods: Memorial bay 7:00 am - 7:00 am July 4th 7:00 am - 7:00 am Labor Day 7:00 am - 7:00 am Thanksgiving 7:00 am - 7:00 am Christmas Eve 7:00 pm - Christmas Day 7:00 pm New Year's Eve 7:00 pm'- New Year's Day 7:00 pm BUSINESS EXPENSE REIMBURSEMENT LIMITATION: $3,000.00 (Prorated for any partial calendar year of employment). Compensation Terms This Appendix A sets forth the compensation arrangements between Employer and Employee required by Section 6(A) of the Employment Agreement (the "Agreement"). Until modified or terminated as provided in the Agreement, Employee shall receive after the Effective Date as compensation for all services rendered pursuant to the Agreement the following: RETENTION BONUS: Employee shall be entitled to a Retention Bonus in the amount often thousand dollars ($10,000) payable as follows: 1) $5,000 to be payable within one (1) year after employee begins providing clinical services under this agreerent. 2) An additional 55,000 to be payable within two (2) years after employee begins providing clinical services under this agreement. FTGatre115.08 11 4/2511008 Aug 15 10 06:05p The Gatrell Family 717-241-0671 p.5 In addition to the Clinical Compensation set forth above, Employee shall also receive a R tion Bonus in the amount of Ten Thousand Dollars ($10,000), 1/ ich shall be payable within 30 days of Ma , 09, and 1/2 of which shall be payable within 30 days of may 1, 2010, continge maintaining Full Time an essful employment through May 1, 2010. In the event Employee does not remain employed Full b Co r a period of at least twelve (12) months due to voluntary resignation or termination for Cause, Employee shall re' Company for the first one half (1 /2) of such Retention Bonus on a pro rata basis. In the event Employee does n ain employ Time by Company for a period of at least twenty-four (24) months due to voluntary resignatio rmination for cause, Employee s 'mburse Company for the second one half (112) of such Retention Bonus o rata basis. The parties acknowledge that DOne o enefits granted to either party pursuant to this Agreemen n itioned on any requirement that either Employee make referrals a in a position to makq prEluencc referral , or otherwise generate business for the Employer. ??('? Employer will mail to Employee on or about the 25`h day of each month of Employee's services (the "Subject Month"): • Total clinical hours worked during the V'-15th of the Subject Month multiplied by the Houd-Rate. • Employee shall be entitled to a monthly discretionary bonus in the amount of $1,250.00. Such amount will be earned each month which Employee remains a full-time employee w•itb Employer and shall accrue each month, and is contingent upon Employee maintaining an average of 120 hours worked a month. 0 Effective 5/ 1 /2008 through 10/31/2008, Employee will receive a $10.00 per hour RVU incentive; • Effective It /1./2008, Employee will receive an RVU payment based on actual RVU's generated by the employee. If the employer is unable to establish an actual RVU value by this effective date, the S10.00 ner bourRW incentive will continue until such time as a value can be determined. Employer will mail to Employee on or about the 10th day of each month of Employee's services: a Total clinical hours worked during the 10 to the end of the month of the previous month. Employer must receive in its office a completed Physician Time Allocation Sheet before any applicable monthly check can be released for mailing, in order to comply with Medicare .Medicaid regulations. Employee will be paid an additional premium hourly rate of $25.00 per hour for each hour worked above and beyond the minimum required hours per quarter. If Employee works over their minimum required hours per quarter, the premium hourly rate shall be paid. The Quarters are as follows: in Quarter - January I- March 31 - paid on or about April 100' 2'd Quarter - April 1 - June 30- paid on or about July 10 3rd Quarter - July 1 - September 30 - paid on or about October 10th 4th Quarter - October I - December 31 - paid on or about January 10th Employee shall be reimbursed for business expenses for each calendar year in an amount not to exceed 53,000. in order to receive such reimbursement, the Employee shall submit receipts for all such expenses upon occurrence. Fmploycr shall review such expense and if Employer determines such expenses were incurred for a valid business reasons, Eml)loyuer will reimburse Employee for such expenses within thirty (30) days of their submission. SIGNATURES INTENTIONALLY APPEAR ON FOLLOWING PAGE r• i Catrcu5.0s 12 41152008 Aug 15 10 06:05p The Gatrell Family 717-241-0671 p.6 Additional Services This Appendix A also sets forth the additional services to be performed by Employee as required by Section 3(a) of the Agreement. Pursuant to the terms of the Agreement, the Employee shall perform the following additional services: O EXECUTED on the dates indicated below to be in effect as of the Effective Date. Services, P.C. By- Name:- Denise K. Opiela. Attorney in Fait Date of Execution: 5 0 Cloyd Gatrell, MD gY -A 011 - Namc Date of Execution: ?? FIGa=415.08 13 4/25/2008 1304 White Birch Lane Carlisle, PA 17013 November 24, 2008 Georgeann Laughmann Patient Safety Officer Chair, Performance Improvement/Patient Safety Committee Carlisle Regional Medical Center 361 Alexander Spring Road Carlisle, PA 17015 Ms Laughmann: Section 307 of the Medical Care Availability and Reduction of Error (MCARE) Act of March 20, 2002 (commonly referred to as Act 13 of 2002, or Act 13) requires each medical facility in Pennsylvania to "develop, implement and comply with an internal patient safety plan." Each medical facility's patient safety plan must be submitted to the Pennsylvania Patient Safety Authority for approval. Under Section 313(f) of Act 13, a facility's failure to comply with its patient safety plan is violation of the Health Care Facilities Act, and invites unfavorable action by State regulatory agencies. Management's noncompliance with the CRMC Patient Safety Plan undermines that program, endangering patients. I write this to fulfill my reporting responsibilities as a member of the Medical Staff. As Patient Safety Officer, take corrective action to ensure compliance with Hospital policy and State law. Stated Non-Punitive Plan and Policies A non-punitive approach to event monitoring and response is recognized as an essential principle for improving patient safety, and is a recurring theme of the approved Patient Safety Plan adopted by CRMC. The Patient Safety Plan (Policy PS2-01, page 2) states: "Punitive approaches toward individuals involved in various events pushes [sic] reporting and disclosure underground, thereby preventing an opportunity for the organization to appropriately intervene to correct underlying problems. CRMC is committed to developing ways to reward rather than discourage reporting of patient safety concerns and errors...." Management is directed to "establish a non-punitive culture that encourages reporting." (PS2-01, page 6) "CRMC has adopted a non-punitive approach in its management of adverse events and reporting. All members of the medical staff and employees are required to report suspected and/or identified medical errors and should do so without the fear of reprisal in relationship to their employment. CRMC focuses first and foremost on system/process improvements and will not blame the individual(s) involved in the event...." (PS2-01, page 10) EXHIBIT Culture of Safety Policy (PS-04) states that to enhance increased reporting, this process de-emphasizes the "who" but focuses on the "how" of errors/events. Management and administration have specific responsibilities to "establish a culture that encourages error/event reporting" and "focus on the 'how' of an error/event - how did it occur, etc. - rather than 'who' may have contributed to it" or.blaming." By policy, disciplinary action is not part of the event reporting and response process, except in cases of "...willful or malicious misconduct, sabotage, substance abuse, criminal activity... (failure) to report the event truthfully or in a timely fashion, or....egregious error demonstrating a lack of fundamental knowledge necessary to carry out his/her job responsibilities." (PS 2-01, page 10) Non-Punitive Reporting Policy (PS- 05) states as its purposes "to encourage open and host reporting," and "to limit disciplinary action to only those actions that involved willful or malicious misconduct or those in which the employee did not report or follow remediation recommendations." It further states "employees are not subject to disciplinary action" unless the "event is not reported in a timely fashion," or "involves sabotage, malicious behavior, chemical impairment or criminal activity." The policy refers repeatedly to "efforts at remediation," such as "verbal counseling, educational efforts ... (and) other preventive plan" as steps to be taken before disciplinary action. Management Response to Events Does Not Comply With Patient Safety Policies Kathryn Gatrell, RN, had worked at CRMC for seven years with no record of counseling or discipline for nursing practice issues. On her last evaluation, she received a 97. When Kathryn asked what she could improve, Alicia Williams said, "Nothing, I always appreciate the fact that you tell me what you think." On February 22, Kathryn and I drafted a letter expressing concern about staffing practices that shortchanged patient care, and citing fear that nurses who spoke up about that as patient advocates risked disciplinary action. See "Concerned Nursing Staff" Letter to CEO, in attached Report to Medical Staff (Tab F, pages 25-26). Over 100 members of the nursing staff signed the letter. The CEO had specifically asked us to provide him input from other nurses, and had pledged to protect the identity of those who had signed. However, it was widely known that Kathryn had spearheaded the letter. Over the next six months, she was targeted by Nursing in multiple ways, culminating in her termination on September 18. Kathryn was terminated allegedly for missing a telemetry order the evening shift on September 16. She was fired without any preceding counseling, remediation, or stepped discipline. Because neither she nor her coworkers on that shift were interviewed before Nursing decided to fire her, the Counseling Notification Form used as the pretext for termination contains factual errors. See attached Counseling Notification Form, and Kathryn's response to Human Resources. The event resulted in a 3 or 4 hour delay in implementing telemetry, with no harm to the patient. Telemetry had only been ordered because of the plan to give IV metoprolol, not because of underlying cardiac disease or risk for dysrhythmias. The Counseling Notification Form also alleges Kathryn "held" that medication, but no IV metoprolol was scheduled while 2 the patient was under her care. The overlooked telemetry order was corrected early in the next shift. Since telemetry was ordered only due to the planned IV metoprolol, and the missed order was corrected before any IV metoprolol was given, the event fits Category B2 (2): "An event occurred but it did not reach the individual ("near miss" or "close call") because of active recovery efforts by caregivers." (PS 2-01, page 11) Category B2 (2) fits the second lowest harm score for an event. Even the next higher level, Category C (3), still has one of the lowest harm scores. Yet Human Resources stated verbally that this event was an egregious error mandating termination. The Counseling Notification Form (Termination) mentions nothing akin to that term. The Patient Safety Plan defines egregious error as demonstrating a lack of fundamental knowledge necessary to carry out his/her job responsibilities. (PS 2-01, page 10) This event did not approach that. Simply calling something "egregious" does not make it so. The event was not disclosed to the patient, family, or physician. That indicates it was handled initially as an "insignificant or minor" incident; an error that did not require disclosure. See Serious/Adverse Event Notification Policy (PS-03), page 11. The patient's surgeon, Dr Mazza, only learned of the telemetry delay when I contacted him on September 21. (See my attached "Notes for CEO, Sep 23, 2008," presented to Mr Staggs on that date.) Dr Mazza affirmed that the patient had no significant cardiac issues, and that telemetry was only ordered to comply with policy (Nursing/ Pharmacy Policy, General Parenteral Medication Administration Guidelines, commonly called "IV Guidelines"). For metoprolol (Lopressor), the policy states, "Cardiac monitoring/ telemetry required." (page 22) Dr Mazza said, "I don't have any problem with her not being on telemetry for a few hours, as long as she was on it when she got the beta blocker." She was. When informed that the nurse who had overlooked the telemetry order had been terminated, he said incredulously, "She was fired over that?" After the sequence leading up to the overlooked order was explained, he said, "I agree 100% that it is a system issue." The CEO said September 23 that it doesn't matter what the doctor says about the event. On the contrary, the attending physician is the person most familiar with the clinical indications for any given order on a patient. The physician is best qualified to determine what potential harm an event could cause, and how serious any lapse in care is. The same order may have greater significance in one clinical situation than another. For example, a missed or delayed order for aspirin would be more serious in the setting of an acute myocardial infarction than in a chronic inflammatory condition. A missed or delayed order for telemetry would be more serious in a cardiac patient with a history of dysrhythmias than in a healthier patient being monitored as a matter of medication policy. Because the physician's opinion does matter, medical staff are actively involved in the patient safety data process (Performance Improvement Plan, LD3-15, page 4), and sit on the Performance Improvement/Patient Safety Committee (LD 3-15, page 7). Proceeding as if this were a serious event or an egregious lapse that warranted termination, without immediately notifying the physician, was a clear violation of patient safety policy. (PS-03, page 4, and Incident Reporting, PS1-02, page 2) 3 The CEO allowed Nursing to fire Kathryn allegedly over a, missed telemetry order. Termination showed obvious disregard for policy to focus "first and foremost on system/process improvements and... not blame the individual...." (PS2-01, page 10) The CEO acknowledged in an October 9 memo to the President of the Medical Staff that he is "concerned about the telemetry patient care process." Given his concern about the process, focusing on punishing an individual was an unconscionable violation of the Patient Safety Plan. Policy requires prompt filing of Event Reports. Incident Reporting, PS1-02 (page 3), states: "The Event Report Form (completed) should be delivered to the Risk Manager within 24 hours of the incident. The Risk Manager will log the reports into the data collection system as the reports are received." Noncompliance with the timeliness standard is particularly troubling when the event is used to terminate an employee. This event occurred September 16. Kathryn was terminated when she next reported to work on September 18. As of the morning of September 22, no Event Report had been logged by Risk Management at CRMC or at Corporate. Noncompliance a Pattern, Not an Isolated Incident The Director of Human Resources informed Kathryn that other nurses have been terminated for similar reasons. In meetings with members of the Medical Staff in June, numerous nurses echoed the February 22 letter's concerns about staffing, and management's targeting of nurses who speak out. Nurses again described how incidents or events are being used as basis for disciplinary action. See Report to Medical Staff, September 5, 2008, pages 11-13 and 17. (copy attached) In a Mock Trial presentation to nurses on September 17, Joseph Ricci, the Hospital Attorney, emphasized that quality improvement requires continual self-examination and analysis. Those depend on good reporting of variations, incidents, and adverse outcomes. Each report is an educational opportunity to learn from and improve. The process is meant to be educational, non-punitive, and uplifting. "Unfortunately," he said, "Event Reports at CRMC are down 50% - not because we are 50% better. Why?" The answer is that instead of promoting a non-punitive culture that fosters quality improvement, oppressive Nursing leadership is having an opposite effect. When discussing this event with me on October 7, the CNO said, "if I have to choose between a nurse and patient safety, I'll come down for patient safety every time." Those words sound good. However, her ill-considered punitive approach actually puts patients at risk, by undermining the culture of safety needed to improve patient care processes. Conclusion Management's systematic noncompliance with the Patient Safety Plan places CRMC in violation of State law. 4 Actions Required / Recommended Report CRMC's noncompliance with its Patient Safety Plan to the Patient Safety Authority. Inform the Patient Safety Authority what the Performance Improvement/ Patient Safety Committee is doing to correct that noncompliance. At a minimum: Review the handling and categorization of this event for compliance with the principles of the Patient Safety Plan and related policies. Recuse members of the Committee involved in the actions described above from any presence or participation in the consideration of this matter. Call additional members as needed to assist during consideration of this matter, including other members of the Medical Staff. Establish safeguards for employees that include multidisciplinary review of any patient care event that may warrant potential disciplinary action. Such multidisciplinary review must include the attending physician and at least one other member of the Medical Staff, must be completed before any adverse action is taken against the nurse or employee, and must allow the nurse or employee to present his or her side of the event to the reviewing panel. Amend the Performance Improvement/Patient Safety Committee rules to specify that if a patient care incident or event that may lead to disciplinary action is being discussed, a member of the Medical Staff must be present, or there is no quorum. Provide remedial Patient Safety Plan training to the following individuals, and establish a period of supervision for any of their involvement in patient safety- related actions: Nathan Staggs, Chief Executive Officer Donna Clews, Chief Nursing Officer Alicia Williams, Director, Medical/Surgical Nursing Kelly McCormack, Manager, Med Surg 3 Sandy Tartamella, Nursing Supervisor Dennette Moul, Director, Human Resources ?nclude in the corrective plan any other staff the Committee identifies as involved. Investigation and action by the Performance Improvement/Patient Safety Committee are necessary for the good of our hospital, for the well-being of our nurses, but most of all, for the safety of our patients. Cloyd Gatrell, MD 5 Attachments: Report to Medical Staff, September 5, 2008 (29 pages) Counseling Notification Form (Termination), September 18, 2008 Response to CNF, September 22, 2008 (3 pages) Notes for CEO, September 23, 2008 (2 pages) 6 Aug 25 10 11:01a The Gatrell Family Emergency Medidne. Customer Driven. August 4, 2010 Cloyd Gatrell, MD 1304 White Birch Ln Carlisle, PA 17013-3582 Dear Dr. Gatrell: 717-241-0671 p.2 I am writing on behalf of your employer New Jersey/Pennsylvania EM-1 Medical Services, P.C. (the "Company") for which you provide professional medical services at Carlisle Regional Medical Center (the "Hospital"). As you may be aware, EmCare, Inc., through a series of'M nagement agreements; provides various-rnanagement services to the Company, including but not limited to management of its contractual relationships with prol,iders. This letter shall constitute formal notice of the Company's decision to terminate your Employment Agreement (the "Agreement") pursuant to Section 10.A.(iii) 9, effective August 10, 2010, which reads as follows: 10. TERMINATION OFAGREEMENTAND EMPLOYMENT A. The Employer and Employee hereby agree that during the te--m of this Agreement, and any extensions hereof, this Agreement and the employment of the Employee may be terminated and the Employee's compensation shall be measured to the dale of such termination: (iii) immediately upon the Employer providing written notice to the Employee upon: the occurrence of rwy of the following events: 9. In the event that the appropriate authorities of a hospital at which Employee is providing services request that Employee no longer provide such services at the hospital. If you have any questions or wish to discuss this :hatter further, please contact Jackie Meyer, EmCare Regional Client Administrator at 1-800-507-8874. Sincerely, ennifer Strouse Director of Operations NE Region, EmCare, Inc. CC: Jackie Meyer, EmCare Regional Client Administrator Anthony Guarracino, DO, FACOEP, Medical Director, Carlisle Regional Medical Cen--er EXHIBIT 100 Witmer Road 215-442-5000 Suite 220 800-247-8060 Horsham, PA 1904 215-957-2875 FAX t i GREENBERG TRAURIG, LLP By: Robert M. Goldich, Esq. (ID No. 25559) Sabrina Mizrachi, Esq. (ID No. 209654) 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 Tel. 215.988.7800 Fax 215.988.7801 goldichr@gtlaw.com mizrachis@gtlaw.com CLOYD GATRELL, Plaintiff, V. CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/PENNSYLVANIA EM-I MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants. 01 I,PR 2910-- 22 ;.;UMBERLAND COUNT'S' ?Ef?P?S'tLYASiI A Attorneys for Defendants New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EmCare, Inc. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : NO. 11-1305,2011 Civil ENTRY OF APPEARANCES TO THE PROTHONOTARY: Kindly enter the appearances of Robert M. Goldich and Sabrina Mizrachi on behalf of Defendants New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EmCare, Inc. in the above- captioned action. TRAURIG, LLP Dated: April 28, 2011 Zr GolAd (I?25559) ac hi (I.D. No. 209654) 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 Tel 215.988.7800 Fax 215.988.7801 goldichr@gtlaw.com mizrachis@gtlaw.com Attorneys for Defendants New Jersey/Pennsylvania EM-I Medical Services, RC and EmCare, Inc. 2 CERTIFICATE OF SERVICE I, Sabrina Mizrachi, hereby certify that on the 28th day of April 2011, I caused a true and correct copy of the foregoing Entry of Appearances to be served via First Class Mail upon the following counsel of record: Stephen M. Greecher, Jr., Esq. Tucker Arensberg, P.C. 111 North Front Street P.O. Box 889 Harrisburg, PA 17108-0889 Attorneys for Plaintiff Sharon M. O'Donnell, Esq. Christopher J. Conrad, Esq. Marshall, Dennehy, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Attorneys for Defendants Carlisle Regional Medical Center n Carlisle HAM, LLC 7-- _ - .. CLOYD GATRELL, Plaintiff V. CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/ PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants OTGNAL IN THE COURT OF COMMON PLEAS t;?? `- CUMBERLAND COUNTY, PENNSYL?/?IIA. - a CIVIL ACTION - LAW NO. 11-1305,2011 Civil AFFIDAVIT OF SERVICE COMMONWEALTH OF PENNSYLVANIA ) ) ss: COUNTY OF DAUPHIN ) AND NOW, this day of May, 2011, before me, a Notary Public in and for said Commonwealth and County, personally appeared STEPHEN M. GREECHER, JR., known to me to be the attorney for Plaintiff in the above captioned action, who, being duly sworn according to law, deposes and says that he mailed the Complaint Certified Mail No. 70050390000290771905, Return Receipt Requested, on April 20, 2011, addressed to Person Authorized to Accept Service for Emcare, Inc., 1717 Main Street, Ste. 5200, Dallas, T471,(d the same w ceived by Anita Murillo on April 25, 2011, as indicated on the Retu V avd-v#ac veto. M. Greecher, Jr. SWORN TO AND SUBSCRIBED before me, this , of 2011 HBGD6:119133-1 024654-138302 J No ary Public L PwW? ? ? N Y .1/ U atir or oeit. - Ma am `L-- • Complete Items 1, 2, and 3. Also complete Item 4 if Restricted Delivery is desired. ¦ Print your name and address on the reverse so that we can return the card to you. ¦ Attach this card to the back of the mallpiece, or on the front if space permits. ? U) 7-C s'2.vo Article Addressed to: A Signature x 13 Agent ? Addressee B. Received by (Panted Name) C. Date of DeMvery D. Is delivery address different from gem 4? O Yes If YES, enter delivery address below: 0 No 3. Service Type X certified Mail 0 Express Mail ? Registered 0 Return Receipt for Memi widee ? Insured Mail 0 C.O.D. 4. Restricted .Delivery? ODdra Fee) 0 Yes 2' Article NiriM 7005 0390 0002 9077 1905 (ifanelbrfinrn,snda.rq PS Form 3811, February 2004 Domestic Return q 102595-02-M-1540 e? I R PRAECIPE FOR LISTING CASE FOR ARGUMENT TO THE PROTHONOTARY OF CUMBERLAND COUNTY: (List the within matter for the next Argument Court.) CLOYD GATRELL, Plaintiff, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V. CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants. : CIVIL ACTION - LAW NO. 11-1305,2011 Civil t-) rag zrn - ?' =zo -< r -urn A rn ©v O-- : =c c n ?m 1. State matter to be argued (i.e., plaintiff's motion for new trial, defendant's demurrer to complaint, etc.): Defendants New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EmCare Inc.'s Preliminary Objections to Complaint 2. Identify all counsel who will argue cases: (a) for Plaintiff Cloyd Gatrell: Stephen M. Greecher, Jr., Esq., Tucker Arensberg P.C. 111 N. Front Street, P.O. Box 889, Harrisburg, PA 17108-0889 (Name and Address) (b) for Defendants New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EmCare, Inc.: Robert M. Goldich, Esq. & Sabrina Mizrachi, Esq. Greenberg Traurig, LLP 2700 Two Commerce Square, 2001 Market Street Philadelphia PA 19103 (Name and Address) I will notify all parties in writing within two days that this case has been listed for argument. DAL 78,500,5324 4. Argument Court Date: (Print your name) Date: May 20, 2011 INSTRUCTIONS: 1. Two copies of all briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) before argument. 2. The moving party shall file and serve their brief 12 days prior to argument. 3. The responding party shall file their brief S days prior to argument. 4. If argument is continued new briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) after the case is relisted. -2- DAL 78, 500, 5320 SABRINA MIZRACHI. ESQ. Attorney for Defendants CLOYD GATRELL, Plaintiff, V. CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : NO. 11-1305,2011 Civil LIST OF COUNSEL Attorneys for Plaintiff Cloyd Gatrell: Stephen M. Greecher, Jr., Esq. Tucker Arensberg, P.C. 111 N. Front Street P.O. Box 889 Harrisburg, PA 17108-0889 Attorneys for Defendants Carlisle Regional Medical Center and Carlisle HMA, LLC: Sharon M. O'Donnell, Esq. Christopher J. Conrad, Esq. Marsahll, Dennehy, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Attorneys for Defendants New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EmCare, Inc. Robert M. Goldich, Esq. Sabrina Mizrachi, Esq. Greenberg Traurig, LLP 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 r CLOYD GATRELL, V. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/ PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants CIVIL ACTION - LAW NO. 11-1305,2011 Civil PRAECIPE TO REMOVE TO: David Buell, Prothonotary C -? « Please remove Corporation Service Company and Russ H. Harris as Defendants in the above captioned action. Respectfully submitted, TUCKER ARENSBEWG ?Ifll? By: H B G D B:120077-1 024654-138302 -tstepneff M. Greecher, Jr. Attorney's I.D. No. PA-36803 111 North Front Street P. O. Box 889 Harrisburg, PA 17108-0889 (717) 234-4121 ATTORNEYS FOR PLAINTIFF J c- 4 s7s3 R--O- .?La -Y7 A,, CERTIFICATE OF SERVICE And now, this 8th day of June, 2011, I, Stephen M. Greecher, Jr., attorney for the within Plaintiff, hereby certify that I have this day served the foregoing Praecipe to Remove by depositing a true and correct copy of the same in the United States Mail, first class, postage prepaid, at Harrisburg, Pennsylvania, addressed as follows: Christopher J. Conrad, Esquire Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Robert M. Goldich, Esquire Sabrina Mizrachi, Esquire Greenberg Traurig 2700 Two Commerce Square 2001 Market Street Philadelphia, N CLOYD GATRELL, V. Plaintiff CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/ PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 11-1305 2011 Civil t , c =0 r.n ca v ? -7. rn C 5 _ Z t < o - -?' aC ?. o trv -i t v A -? r, . JTS, NEW JERSEY/PENNSYLVANIA SERVICES. P.C.: and EMCARE. INC. 1. INTRODUCTION AND BACKGROUND 1. Admitted and part and denied in part. It is admitted that EM-1 Medical Services, P.C., (hereinafter EM-1) is a Corporation that provides professional medical services to hospitals. After reasonable investigations, Plaintiff is without sufficient knowledge and information or belief as to the truth of the remaining averments as to EmCare, Inc. 2. Admitted. It is admitted that Plaintiff entered into an employment agreement with EM-I, as is set forth in the Complaint. It is believed and therefore averred that EM-1 is a subsidiary or affiliate of EmCare, Inc., fully under the direction and control of EmCare, Inc. 3. The employment agreement is a written document and speaks for itself and no response is required. 4. Admitted. II. FIRST PRELIMINARY OBJECTION TO COUNT IV OF PLAINTIFF'S COMPLAINT ON THE GROUNDS OF LEGAL INSUFFICIENCY OF A PLEADING PURSUANT TO RULE 1028(a)(4) 5. The answers to paragraphs 1 through 4 are incorporated herein by reference. 6. Admitted. 7. The Whistleblower Law is a statute and it speaks for itself. It is admitted that the paraphrase of 43 Pa.Stat.Ann. §1423 is substantially accurate. 8. The Whistleblower Law is a statute and it speaks for itself. It is admitted that the paraphrase of 43 Pa.Stat.Ann. §1422 is substantially accurate. 9. Denied. Paragraph 9 is denied as EM-1 is a public body within the meaning of the Whistleblower Law. 10. Denied. As set forth in the Complaint, Defendant EmCare, Inc., is a public body within the meaning of the Whistleblower Law. The allegation as to whether Plaintiff had a contractual or employment relationship with EmCare, Inc., states a conclusion of law to which no response is required. Further, as set forth in the Complaint, EmCare, Inc., controls and directs the activities of EM-1. 11. The averments contained in paragraph 11 state conclusions of law to which no response is required. Further, EmCare, Inc. directed and controlled the activities of EM-1 as set forth in the Complaint. 12. The averments contained in paragraph 12 state conclusions of law to which no response is required. Plaintiff does allege facts sufficient to state a claim for violation of the Whistleblower Law by Defendants. WHEREFORE, Plaintiff requests that the Preliminary Objections of the Defendants be denied and dismissed. 2 III. SECOND PRELIMINARY OBJECTION TO COUNT V OF PLAINTIFF'S COMPLAINT ON THE GROUNDS OF LEGAL INSUFFICIENCY OF A PLEADING PURSUANT TO RULE 1028(a)(4) 13. The answers to paragraphs 1 through 12 are incorporated herein by reference. 14. Admitted. 15. The MCARE Act is a statute and it speaks for itself. It is admitted that the paraphrase of 43 Pa.Stat.Ann. §1303.308 is substantially accurate. 16. The MCARE Act is a statute and it speaks for itself. It is admitted that the paraphrase of 43 Pa.Stat.Ann. §1303.302 is substantially accurate. 17. The MCARE Act is a statute and it speaks for itself. It is admitted that the paraphrase of 43 Pa.Stat.Ann. §1303.302 is substantially accurate. 18. The averments contained in paragraph 18 state conclusions of law to which no response is required. Further, whether EM-I or EmCare, Inc., is a medical facility is not determinative of whether Plaintiff has a remedy against Defendants under the MCARE Act. 19. The averments contained in paragraph 19 state conclusions of law to which no response is required. Further, whether Plaintiff was a healthcare worker of either EM-I or EmCare, Inc. is not determinative of whether Plaintiff has a remedy against Defendants under the MCARE Act. 20. The averments contained in paragraph 20 state conclusions of law to which no response is required. Further, the MCARE Act is not merely a pass through statute with remedies and protections only under the Whistleblower Law. 21. The averments contained in paragraph 21 state conclusions of law to which no response is required. Further, it is not necessary for Plaintiff to meet the requirements of the Whistleblower Law in order to be entitled to the remedies under the Whistleblower Law that are provided to Plaintiffs by the MCARE Act. 3 22. The allegation in paragraph 22 state a conclusion of law to which no response is required. The Complaint states a claim for violation of the MCARE Act by EM-1 and EmCare, Inc. WHEREFORE, Plaintiff requests that the Preliminary Objections of the Defendants be denied and dismissed. IV. THIRD PRELIMINARY OBJECTION TO COUNTS VI, V, AND VI OF PLAINTIFF'S COMPLAINT ON THE GROUNDS OF LEGAL INSUFFICIENCY OF A PLEADING PURSUANT TO RULE 1028(a)(4) 23. The answers to paragraphs 1 through 22 are incorporated herein by reference. 24. Admitted. 25. Admitted. 26. Admitted. 27. The averments contained in paragraph 27 state conclusions of law to which no response is required. Further EmCare, Inc., directed and controlled the activities of EM-I. 28. The averments contained in paragraph 28 state conclusions of law to which no response is required. Further EmCare, Inc., directed and controlled the activities of EM-I. 29. Admitted. It is admitted that Plaintiff entered into an employment agreement with EM-I. Whether Plaintiff had such an agreement with EmCare, Inc., is not determinative of Plaintiffs cause of action. Further, EmCare, Inc., directed and controlled the activities of EM-1 as set forth in the Complaint. 30. The averments contained in paragraph 30 state legal conclusions to which no response is required. Further, as set forth in the Complaint, Plaintiff avers that EM-1 was a subsidiary or affiliate of EmCare, Inc., fully under the direction and control of EmCare, Inc. 31. Denied. EmCare, Inc., is properly named as a Defendant in this case and should not be dismissed. 4 WHEREFORE, Plaintiff requests the Preliminary Objections of EmCare, Inc., be denied and dismissed. V. FOURTH PRELIMINARY OBJECTION TO COUNT VI OF PLAINTIFF'S COMPLAINT ON THE GROUNDS OF LEGAL INSUFFICIENCY OF A PLEADING PURSUANT TO RULE 1028(a)(4) 32. The answers to paragraph 1 through 31 are incorporated herein by reference. 33. Admitted. 34. The averments contained in paragraph 34 state legal conclusions to which no response is required. 35. Denied. Plaintiff's Complaint sets forth a cause of action for wrongful discharge. 36. Plaintiff had a contract of employment with EM-I, but that does not preclude him from maintaining the cause of action he set forth in the Complaint. 37. The employment agreement is a written document and speaks for itself and no response is required. 38. Denied. The facts of the Complaint show a violation of a clear mandate of public policy. 39. Denied. Plaintiff cites the Whistleblower Law and the MCARE Act. 40. The averments contained in paragraph 40 state conclusions of law to which no response is required. The remedies available under the Whistleblower Act are available to Plaintiff in this action. 41. Admitted. It is admitted that Plaintiff is seeking relief under the Whistleblower Law and the MCARE Act. Whether Plaintiff has a contractual remedy under the facts of this case is a conclusion of law to which no response is required. 42. The averments contained in paragraph 42 state conclusions of law to which no response is required. The Complaint sets forth sufficient facts to establish a violation of a clear mandate of the public policy of the Commonwealth of Pennsylvania with respect to the 5 termination of Plaintiff's employment entitling Plaintiff to maintain a cause of action for wrongful discharge. 43. Denied. Plaintiff alleges sufficient facts to state a claim for wrongful discharge. WHEREFORE, Plaintiff requests the Preliminary Objections of MCARE, Inc., be denied and dismissed. TU DATE: June 1'7,2011 By Attorney's I.D. No. PA-36803 111 North Front Street P. O. Box 889 Harrisburg, PA 17108-0889 (717) 234-4121 ATTORNEYS FOR PLAINTIFF H BGDB:120001-1 024654-138302 6 1 // CERTIFICATE OF SERVICE And now, this ?_ day of June, 2011, I, Pamela J. Gordon, for the law firm of Tucker Arensberg, P.C., hereby certify that I have this day served the foregoing document by depositing a true and correct copy of the same in the United States Mail, first class, postage prepaid, at Harrisburg, Pennsylvania, addressed as follows: Christopher J. Conrad, Esquire Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Robert M. Goldich, Esquire Sabrina Mizrachi, Esquire Greenberg Traurig 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 Pamela J. Gordon 7 !iEV PRAECIPE FOR LISTI C FOR ARGUMENT (Must be typewritten and submitted in triplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Argument Court.) CAPTION OF CASE (entire caption must be stated in full) Cloyd Gatrell vs. Carlisle Regional Medical Center; Carlisle HMA; New Jersey/Pennsylvania EM-1 Medical Services, P.C.; and Em-Care, Inc. (List the within matter for tho-Aext-- MCD zM C- c "" --------------------------------- Z r -C ra X 0 = ? AG Z rV -t G No. 11-1305 Civil Term 1. State matter to be argued (i.e., plaintiffs motion for new trial, defendant's demurrer to complaint, etc.): Preliminary Obiections of Carlisle Regional Medical Center and Carlisle HMA 2. Identify all counsel who will argue cases: (a) for plaintiffs: Stephen M. Greecher, Jr., Esquire (Name and Address) 111 N. Front St., P. O. Box 889, Harrisburg, PA 17108 (b) for defendants: Christopher J. Conrad, Esquire (Name and Address) 4200 Crums Mill Road, Ste. B, Harrisburg, PA 17112 3. 1 will notify all parties in writing within two days that this case has been listed for argument. 4. Argument Court Date: Print your name Plaintiff Date: July 20. 2011 Attorney for M C-5t --4 C = --r,. E) CC1 --tom b' INSTRUCTIONS: 1. Original and two copies of all briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) before argument. 2. The moving party shall file and serve their brief 12 days prior to argument. 3. The responding party shall file their brief 5 days prior to argument. 4. If argument is continued new briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) after the case is relisted. Stephen M. Greecher, Jr. C YA- f P- PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted In triplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Argument Court.) CAPTION OF CASE (entire caption must be stated in full) Cloyd Gatrell vs. Carlisle Regional Medical Center; Carlisle HMA; New Jersey/Pennsylvania EM-1 Medical Services, P.C.; and Em-Care, Inc. (List the within matter for the rpxt ,., ---------------------------------- - MCD c?n D =O CDni C-:, C S' N C) tern C?- ;zi No. 11-1305 Civil Term 1. State matter to be argued (i.e., plaintiffs motion for new trial, defendant's demurrer to complaint, etc.): Preliminary Objections of New Jersey/Pennsylvania EM-1 Medical Services, P.C. & Em-Care.Inc 2. Identify all counsel who will argue cases: (a) for plaintiffs: Stephen M. Greecher, Jr., Esquire (Name and Address) 111 N. Front St., P. O. Box 889, Harrisburg, PA 17108 (b) for defendants: Robert M. Goldich, Esquire (Name and Address) 2700 Two Commerce Square, 2001 Market St., Philadelphia, PA 19103 3. 1 will notify all parties in writing within two days that this case has been listed for argument. 4. Argument Court Date: Print your name Plaintiff Date: July 20. 2011 Attorney for INSTRUCTIONS: 1. Original and two copies of all briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) before argument. 2. The moving party shall file and serve their brief 12 days prior to argument. 3. The responding party shall file their brief 5 days prior to argument. 4. If argument Is continued new briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) after the case Is relisted. Stephen M. Greecher, Jr. k,If# PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in triplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: (List the within matter for i ex6-- Argument Court.) rV ? --------------------------------------------------------------------------------------------------------------------- CAPTION OF CASE Cloyd Gatrell v. Carlisle Regional Medical Center > C ? rv (entire caption must be stated in full) Cloyd Gatrell C 'p VS. Carlisle Regional Medical Center, C`or??'6?e. Wmv U.i' 3r6.4 d, I ?D(a Cwr oake Qe%cno-? Wd'CAL den`IW No I 1-1305 2011 041010 - +* Term 4k Zrfl. C td. A, (br l6te ( . CGLyvskt 1. State matter to be argued (i.e., plaintiffs motion for new trial, defendant's demurrer to d pall complaint, etc.): ti li i Obj I P %C& CoL` ons ec m nary nc re Oey )o' Defendants NJ/PA EM-1 Medical Services P.C. and EmCare, 2. Identify all counsel who will argue cases: (a) for plaintiffs: Stephen M. Greecher, Jr. W, &c. ,t (Name and Address) (?& ? &Ve&ee 111 North Front Street P.O. 889 Harrisburg, PA 17108 -TvtI?, (b) for defendants: Robert Goldich (Name and Address) 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 3. 1 will notify all parties in writing within two days that this case has been listed for argument. 4. Argument Court Date: August 26, 2011 Signature Robert Goldich Print your name NJ/PA EM-1 Medical Service and EmCare July 21, 2011 Attorney for Date: INSTRUCTIONS: 1. Original and two copies of all briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) before argument. 2. The moving party shall file and serve their brief 12 days prior to argument. 3. The responding party shall file their brief 5 days prior to argument. 4. If argument is continued new briefs must be filed with the COURT ADMINISTRATOR (not the Prothonotary) after the case is relisted. CLOYD GATRELL, Plaintiff, V. CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 11-1305,2011 Civil LIST OF COUNSEL Attorneys for Plaintiff Cloyd Gatrell: Stephen M. Greecher, Jr., Esq. Tucker Arensberg, P.C. 111 N. Front Street P.O. Box 889 Harrisburg, PA 17108-0889 Attorneys for Defendants Carlisle Regional Medical Center and Carlisle HMA, LLC: Sharon M. O'Donnell, Esq. Christopher J. Conrad, Esq. Marsahll, Dennehy, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Attorneys for Defendants New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EmCare, Inc. Robert M. Goldich, Esq.. Sabrina Mizrachi, Esq. Greenberg Traurig, LLP 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 f CLOYD GATRELL, PLAINTIFF V. CARLISLE REGIONAL MEDICAL CENTER, CARLISLE HMA, LLC, INDIVIDUALLY AND d/b/a CARLISLE REGIONAL MEDICAL CENTER, CARLISLE HMA, INC., INDIVIDUALLY AND d/b/a CARLISLE REGIONAL MEDICAL CENTER, NEW JERSEY/ PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C., AND EMCARE, INC., DEFENDANTS IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ez rnw x r" Z;o • 2d D C z N N rn cv z .,o 0 l.? rn ?. -ate; Co ;xj 11-1305 CIVIL TERM IN RE: MOTION FOR PARTIAL RECONSIDERATION ORDER OF COURT AND NOW, this day of February, 2012, upon consideration of the motion for partial reconsideration of our order of January 26, 2012, which was submitted on behalf of the Defendants Carlisle Regional Medical Center, Carlisle HMA, LLC, individually and d/b/a Carlisle Regional Medical Center, Carlisle HMA, Inc., Individually and d/b/a Carlisle Regional Medical Center (collectively the Hospital Defendants), and it being clear that our opinion and order of January 26, 2012 made no conclusions on the ultimate issue of whether Plaintiff was an employee of the Hospital Defendants, the motion for reconsideration is DENIED. By the Court, Albert H. Maslan , J. 11-1305 CIVIL TERM Stephen M. Greecher, Jr., Esquire 111 North Front Street PO Box 889 Harrisburg, PA 17108 For Plaintiff Christopher J. Conrad, Esquire 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 For Carlisle Regional Medical Center and Carlisle HMA, LLC ? Robert M. Goldich, Esquire 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 For New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EmCare, Inc. :saa ('''Op;''S yma . l-ed /P-/z t -2- ORIGINAL CLOYD GATRELL, V. Plaintiff CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 11-1305, 2011 Civil `T7 ? N ^i co a-) C C: D 77 c PLAINTIFF'S ANSWER TO DEFENDANTS CARLISLE REGIONAL THE COURT'S JANUARY 26. 2012 ORDER 1. The Hospital Defendants are concerned, based on certain language in the decision of Judge Masland that it has been conclusively found that Dr. Cloyd Gatrell was an employee of the Carlisle Regional Medical Center. Plaintiff agrees that any statements by Judge Masland in the court's opinion on the Preliminary Objections regarding the employment status of Dr. Cloyd Gatrell are based on allegations in the Complaint which are accepted for the purpose of deciding the Preliminary Objections. 2. The Court's Order on the Preliminary Objections simply states "And now, this 26th day of January, 2012, the Preliminary Objections filed by all Defendants are OVERRULED. The Defendants are directed to file Answers to Plaintiffs Complaint within 20 days of this opinion and order." 3. The employment status of Dr. Cloyd Gatrell has not been conclusively established at this stage of the proceedings. 4. In its Wherefore clause to the Motion for Reconsideration, the Hospital Defendants request in the alternative that the Court enter an Order either: (1) reversing its conclusion that Plaintiff was an employee of the Hospital Defendants during the relevant time period, or (2) clarifying that the Court did not actually conclude that Plaintiff was an employee of the Hospital Defendants during the relevant time period. 5. The Hospital Defendants have not set forth any reason for the Court to reconsider its opinion and order. 6. At this stage of the proceedings, it has only been determined that Plaintiffs Complaint stated sufficient facts to establish for purposes of the Preliminary Objections that Dr. Cloyd Gatrell was an employee of the Hospital Defendants. WHEREFORE, Plaintiff requests that the Court deny the Hospital Defendants' Motion for Partial Reconsideration. Respectfully submitted, TUCKER AR By: Stepheff M. Greecher, Jr. Attorney I.D. No. 36803 111 N. Front St., P. O. Box 889 Harrisburg, PA 17108-0889 (717) 234-4121 ATTORNEYS FOR PLAINTIFF DATE: February _E, 2012 H BG DB:124964-1 024654-138302 2 k• CERTIFICATE OF SERVICE 1?- And now, this oUl day of 2012, I, Pamela J. Gordon, secretary to Stephen M. Greecher, Jr., attorney for the Plaintiff hereby certify that I have this day served the foregoing Answer by depositing a true and correct copy of the same in the United States Mail, first class, postage prepaid, at Harrisburg, Pennsylvania, addressed as follows: Christopher J. Conrad, Esquire Sharon M. O'Donnell, Esquire Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Robert M. Goldich, Esquire Sabrina Mizrachi, Esquire Greenberg Traurig 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 Pa ela J. Gordo HBGDB:120651-1 024654-138302 3 GREENBERG TRAURIG, LLP By: Robert M. Goldich, Esq. (ID No. 25559) 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 Tel. 215.988.7800 Fax 215.988.7801 goldichr@gtlaw.com CLOYD GATRELL, f„ r T90N0TA"', ' 1: so Aftori'? } ? Mendants New Jersey/Pennsylvania EM-1 Medical Services, P.C. and EmCare, Inc. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff, V. CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., CIVIL ACTION - LAW NO. 11-1305,2011 Civil Defendants. ANSWER AND NEW MATTER ON BEHALF OF DEFENDANTS NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C., AND EMCARE, INC. Defendants New Jersey/Pennsylvania EM-1 Medical Services, P.C. ("EM-I") and EmCare, Inc. (collectively "Defendants") hereby answer the allegations of Plaintiff's Complaint as follows: 1. Defendants admit that Plaintiff is an adult individual and that he was licensed to practice medicine in the Commonwealth of Pennsylvania during his employment by Defendant EM-I. After reasonable investigation, Defendants are otherwise without knowledge or information sufficient to respond to the allegations of paragraph 1 of the Complaint. 2. Admitted. 3. These allegations relate to a party other than the Defendants. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to these allegations. 4. These allegations relate to a party other than the Defendants. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to these allegations. 5. These allegations relate to a party other than the Defendants. Defendants are without knowledge or information sufficient to respond to these allegations. 6. Admitted. 7. Defendants admit that EmCare, Inc. is a corporation and that it has an office at the address listed in paragraph 7 of the Complaint. 8. Defendants admit that Cloyd Gatrell was a medical doctor licensed to practice medicine in the Commonwealth of Pennsylvania during his employ by EM-I. After reasonable investigation, Defendants are otherwise without knowledge or information sufficient to respond to the allegations in paragraph 8 of the Complaint. 9. Admitted. 10. The allegations of paragraph 10 of the Complaint are denied. Defendants specifically deny that EM-1 is a subsidiary or affiliate of EmCare, Inc. under the direction and control of EmCare, Inc. To the contrary, EmCare, Inc. and EM-1 are separate and distinct corporate entities. 11. Defendants admit that Defendant EM-1 and Cloyd Gatrell entered in the agreement attached as Exhibit A to the Complaint effective May 1, 2008. Defendants deny that -2- the employment agreement attached to the Complaint is the entire agreement between the parties, as it was subsequently amended. 12. Defendants admit that Dr. Gatrell provided information to EmCare, Inc. concerning communications he had Carlisle Regional Medical Center (the "Hospital") regarding patient safety matters. After reasonable investigation, Defendants are otherwise without knowledge or information sufficient to respond to the remaining allegations contained in paragraph 12 of the Complaint, and they are therefore denied. 13. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 13 of the Complaint and they are therefore denied. 14. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 14 of the Complaint and they are therefore denied. 15. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 15 of the Complaint and they are therefore denied. 16. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 16 of the Complaint and they are therefore denied. 17. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 17 of the Complaint and they are therefore denied. -3- 18. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 18 of the Complaint and they are therefore denied. 19. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 19 of the Complaint and they are therefore denied. 20. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 20 of the Complaint and they are therefore denied. 21. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 21 of the Complaint and they are therefore denied. 22. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 22 of the Complaint and they are therefore denied. 23. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 23 of the Complaint and they are therefore denied. 24. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 24 of the Complaint and they are therefore denied. -4- 25. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 25 of the Complaint and they are therefore denied. 26. Defendants admit that Dr. Gatrell was employed by EM-1 and assigned to work by EM-1 at the Hospital. After reasonable investigation, Defendants are otherwise without knowledge or information sufficient to respond to the other allegations of paragraph 26 of the Complaint, and they are therefore denied. 27. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 27 of the Complaint and they are therefore denied. 28. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 28 of the Complaint and they are therefore denied. 29. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 29 of the Complaint and they are therefore denied. 30. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 30 of the Complaint and they are therefore denied. 31. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 31 of the Complaint and they are therefore denied. -5- 32. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 32 of the Complaint and they are therefore denied. 33. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 33 of the Complaint and they are therefore denied. 34. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 34 of the Complaint and they are therefore denied. 35. Admitted in part and denied in part. Defendants admit that a meeting took place on April 29, 2009 that included Denise Opiela, then the Chief Operating Officer of the Northeast Division of EmCare, Inc. and Anthony J. Guarracino of the Hospital. At that meeting, Dr. Gatrell presented a number of documents including correspondence between Dr. Gatrell and the Hospital as well as documents pertaining to a Physician Decorum Complaint against Dr. Gatrell. The documents are writings that speak for themselves and Dr. Gatrell's summary of their contents is denied to the extent inconsistent with the documents. 36. Admitted in part and denied in part. Defendants admit that Dr. Russ Harris of EmCare, Inc. was a carbon copy recipient of a letter dated May 1, 2009 from Dr. Gatrell to Dr. Guarracino identifying persons with whom Dr. Gatrell had addressed concerns. The letter is a writing that speaks for itself. The allegations in paragraph 30 of Plaintiff's Complaint are denied to the extent inconsistent with the letter. -6- 37. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 37 of the Complaint and they are therefore denied. 38. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 38 of the Complaint and they are therefore denied. 39. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 39 of the Complaint and they are therefore denied. 40. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 40 of the Complaint and they are therefore denied. 41. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 41 of the Complaint and they are therefore denied. 42. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 42 of the Complaint and they are therefore denied. 43. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 43 of the Complaint and they are therefore denied. -7- 44. After reasonable investigation, Defendants are without knowledge or information sufficient to respond to the allegations of paragraph 44 of the Complaint and they are therefore denied. 45. Admitted. 46. Denied. Defendants specifically deny that the Hospital directed Defendants to terminate Dr. Gatrell for the reasons stated in paragraph 46 of the Complaint. 47. Defendants admit that Defendant EmCare, Inc. sent the letter attached as Exhibit C to Dr. Gatrell. The letter is a written document which speaks for itself. 48. Admitted in part and denied in part. Defendants admit that Dr. Gatrell provided information to EmCare, Inc. regarding communications that he had with the Hospital regarding various issues as reflected in the documents provided to Denise Opiela at a meeting on April 29, 2009. The allegations of paragraph 48 of the Complaint are otherwise denied. Defendants specifically deny that Denise Opiela relayed any message from the interim CEO of the Hospital to "back off." To the contrary, it is averred that Dr. Guarracino represented the Hospital at the April 29, 2009 meeting. 49. Paragraph 49 of the Complaint states conclusions of law to which no responsive pleading is required. ANSWER TO COUNTS I THROUGH III 50-73. Counts I through III of the Complaint are directed against parties other than Defendants. Defendants accordingly are not required by the Pennsylvania Rules of Civil Procedure to respond to these allegations. -8- ANSWER TO COUNT IV 74. Defendants incorporate by references their responses to paragraphs 1 through 73 above. 75. Paragraph 75 of the Complaint states a conclusion of law to which no responsive pleading is required. 76. Paragraph 76 of the Complaint states conclusions of law to which no responsive pleading is required. 77. Defendants deny the allegations in paragraph 77 of the Complaint. 78. Admitted in part and denied in part. Defendants admit that Denise Opiela of EmCare, Inc. attended a meeting with Dr. Gatrell and Dr. Guarracino on April 29, 2009 and received documents from Dr. Gatrell relating to issues between him and the Hospital at that time. The allegations of paragraph 78 of the Complaint are otherwise denied. 79. Defendants admit that based on a request from the Hospital, Defendant EmCare, Inc. sent the letter attached as Exhibit C to the Complaint on behalf of Defendant EM-1 to terminate the employment of Dr. Gatrell. The allegations in paragraph 79 of the Complaint are otherwise denied. Defendants specifically deny that the Hospital requested the termination of Dr. Gatrell because of alleged reported violations of the Hospital's patient safety plan or the MCare Act. 80. The allegations of paragraph 80 of the Complaint are denied in their entirety. To the contrary, EM-1 as Dr. Gatrell's employer terminated his employment for the reasons set forth in the termination letter. EmCare, Inc. sent the letter on behalf of EM-1 and not as the employer of Dr. Gatrell. -9- 81. Paragraph 81 of the Complaint states a conclusion of law to which no responsive pleading is required. Defendants deny that the termination of the employment of Dr. Gatrell was in violation of the Pennsylvania Whistleblower Act. 82. Paragraph 82 of the Complaint contains a prayer for relief to which no responsive pleading is required. Defendants deny that Dr. Gatrell is entitled to the relief requested. ANSWER TO COUNT V 83. Defendants incorporate by reference their response to the allegations of paragraph 1 through 82 of the Complaint. 84. Denied. 85. Denied. 86. The allegations in paragraph 86 of the Complaint state conclusions of law to which no responsive pleading is required. Defendants deny that the termination of employment of Dr. Gatrell violated either the MCare Act or the Pennsylvania Whistleblower Act. 87. Paragraph 87 of the Complaint contains a prayer for relief to which no responsive pleading is required. Defendants deny that Dr. Gatrell is entitled to any relief. ANSWER TO COUNT VI 88. Defendants incorporate by reference their response to paragraphs 1 through 87 of the Complaint. 89. Paragraph 89 of the Complaint states conclusions of law to which no responsive pleading is required. Defendants deny that their termination of the employment of Dr. Gatrell violated any strong public policy of the Commonwealth of Pennsylvania or the public policy in the Whistleblower Act. 90. The allegations in paragraph 90 of the Complaint are denied in their entirety. -10- 91. The allegations in paragraph 91 of the Complaint are denied in their entirety. 92. Paragraph 92 of the Complaint states conclusions of law to which no responsive pleading is required. Defendants deny any wrongful termination of Dr. Gatrell's contract and therefore deny that he is entitled to any claimed damages. Further, after reasonable investigation answering Defendants are without knowledge or information as to any of Dr. Gatrell's claimed damages. NEW MATTER OF DEFENDANT EMCARE, INC. 93. EmCare, Inc. is a Delaware corporation with its principal place of business in the State of Texas. 94. EmCare, Inc. is a provider of administrative management services to hospital emergency departments and medical practices. 95. EmCare, Inc. does not itself provide medical care or treatment to patients. 96. EmCare, Inc. provided administrative management services to EM-I. 97. EmCare, Inc. never employed Dr. Gatrell. 98. Dr. Gatrell understood that he was not an employee of EmCare, Inc. 99. EmCare, Inc. sent the letter attached as Exhibit C to the Complaint in its role as a provider of administrative management services to EM-I. 100. Because EmCare, Inc. never employed Dr. Gatrell and accurately represented to him that it was only acting on behalf of his actual employer, EM-I, EmCare, Inc. has no liability to Dr. Gatrell on any of the claims asserted in the Complaint. 101. EmCare, Inc. is not a public employer subject to suit for violation of the Pennsylvania Whistleblower Act ("Whistleblower Act"). -11- NEW MATTER OF DEFENDANTS EMCARE, INC. AND EM-1 102. EM-1 is a physician practice group whose employees provide services as medical staff members at medical facilities. 103. The Pennsylvania MCare Act (the "Ware Act") imposes certain legal obligations on "medical facilities." 104. EM-1 is not a medical facility regulated by the MCare Act. 105. EmCare, Inc. is not a medical facility regulated by the MCare Act. 106. Neither of the Defendants were obligated to maintain or maintained a patient safety care plan as defined in the MCare Act. 107. Defendants did not terminate the Plaintiff for reporting the violation of any patient safety plan. 108. Plaintiff Gatrell never made any report to either of the Defendants of any "serious event" or "incident" as defined in the MCare Act. 109. Neither of the Defendants terminated Plaintiff's employed based in any respect on any report of a serious event or incident. 110. Plaintiffs Complaint fails to state a claim for violation of the MCare Act against Defendants. 111. Plaintiff Gatrell had a written employment contract with Defendant EM-I. That agreement was amended on two occasions. 112. By virtue of entering into the employment agreement, the Plaintiff voluntarily consented to the termination provisions in the agreement, including the provision allowing the Hospital to request his termination at any time and for any reason. -12- 113. Because the employment agreement was not breached, Plaintiff cannot assert a claim for wrongful termination against Defendants. 114. Plaintiff lacks standing to maintain any claim against the Defendants for violation of the Whistleblower Act. 115. Plaintiff never complained to the Defendants of any conduct on the part of the Defendants in violation of the Whistleblower Act. 116. Plaintiff's Complaint fails to state a claim against the Defendants for violation of the Whistleblower Act. 117. Defendants are not public bodies subject to suit for violation of the Whistleblower Act. 118. On information and belief, the Hospital and its related entities named as defendants in this action (collectively "Hospital Defendants") had valid reasons to request Plaintiff's termination from employment by Defendant EM-I. 119. On information and belief, Plaintiff's conduct at the Hospital warranted the Hospital's request that Defendant EM-1 terminate his employment. 120. Defendants had no knowledge or information that the request by the Hospital Defendants that Plaintiff's employment be terminated was in any manner improper. 121. Defendants assert as affirmative defenses any and all defenses based on the right and privilege of the Hospital Defendants to seek termination of Dr. Gatrell's employment. 122. Because Plaintiff was employed pursuant to the terms of a written employment agreement, he cannot assert a claim against Defendants for termination in violation of public policy. -13- 123. Plaintiff has no entitlement to any equitable relief or reinstatement as a remedy for any alleged injury. 124. Plaintiff's claims for equitable relief are barred by the doctrines of laches, waiver and estoppel. 125. Some or all of Plaintiff's claims are barred by the applicable statutes of limitations. 126. Plaintiff has not alleged any reckless, willful and/or intentional conduct on the part of Defendants. Therefore, Plaintiff is not entitled as a matter of law to punitive damages. 127. Plaintiff's claims for punitive damages are limited by the 14th Amendment of the United States Constitution. Plaintiff is not entitled to any recovery of punitive damages that would deprive Defendants of due process of law. 128. Any and all common law remedies asserted by the Plaintiff are pre-empted by available statutory remedies. 129. Plaintiff is not entitled to a duplicative or multiple recovery. 130. To the extent that Plaintiff obtains full relief for his claimed injuries from the Hospital Defendants, Plaintiff is not entitled to any further or additional recovery against Defendants. 131. Plaintiff's Complaint fails to allege a basis for joint and several liability between Defendants and the Hospital Defendants. 132. The actions of Defendants were not the proximate cause of Plaintiff's alleged damages. 133. Plaintiff had a duty to mitigate any damages claimed against the Defendants. -14- 134. Defendants are entitled to a set off for all amounts which Plaintiff has earned or which Plaintiff could earn in the exercise of reasonable diligence to mitigate his claimed damages. 135. Defendants reserve the right to amend their New Matter as permitted by law or based on facts not presently known to Defendants. Respectfully submitted, GREENBERG TRAURIG, LL Dated: March 22, 2012 19- Robert M. Goldich (I.D. No. 25559) 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 Tel 215.988.7800 Fax 215.988.7801 goldichr@gtlaw.com Attorneys for Defendants New Jersey/Pennsylvania EM-I Medical Services, RC and EmCare, Inc. -15- VERIFICATION I,Y-?re..,U,,?niake this verification on behalf of New Jersey/Pennsylvania EM- I Medical Services, P.C., and hereby declare that the statements made in the foregoing Answer and New ivlatter on behalf of Defendant New Jersey/Pennsylvania ENI-I Medical Services, P.C. are true and correct to the best of my knowledge, information, and belief. These statements are made subject to the penalties of 18 Pa. C.S.A. § 4904 relating to uns-vvorn falsification to authorities. Date: Marcha1 , 2012 DAL 78,826,2660 092094.100400 VERIFICATION 1,???,? , make this verification on behalf of EmCare, Inc., and hereby declare that the statements made in the foregoing Answer and New Matter on behalf of Defendant EmCare, Inc. are true and correct to the best of my knowledge, information, and belief. These statements are made subject to the penalties of 18 Pa. C.S.A. 5 4904 relating to unsworn falsification to authorities. - KA , tALp ? a &w #) Date; Nlarch)A , 2012 DAL 78,826.2860 092094.100400 CERTIFICATE OF SERVICE I, Robert M. Goldich, hereby certify that on the 22nd day of March 2012, 1 caused a true and correct copy of the foregoing Answer and New Matter on Behalf of Defendants New Jersey/Pennsylvania EM-1 Medical Services, P.C., and EmCare, Inc. to be served via First Class Mail upon the following counsel of record: Stephen M. Greecher, Jr., Esq. Tucker Arensberg, P.C. 111 North Front Street P.O. BOX 889 Harrisburg, PA 17108-0889 Attorneys for Plaintiff Sharon M. O'Donnell, Esq. Christopher J. Conrad, Esq. Marshall, Dennehy, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Attorneys for Defendants Carlisle Regional Medical Center and Carlisle HMA, LLC &-irtj Robert M. Goldich ORIGINAL F1LEE-O FIC:: ROT H0H0 iii CLOYD GATRELL, 211? APR 17 AM 10: Plaintiff v. rLI"i lC<LRLAND COUNT`," "-ENI NSYLVAt1I, CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER; NEW JERSEY PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C.; and EMCARE, INC., Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 11-1305, 2011 Civil REPLY TO NEW MATTER OF NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES. P.C.. AND EMCARE, INC. 102. It is admitted that EM-1 is a physician practice group whose employees provide services as medical staff members at medical facilities. It is denied that that is the sole function of EM-I. 103. The allegations of paragraph 103 state legal conclusions to which no response is required. The Mcare Act speaks for itself. 104. The allegations in paragraph 104 state a legal conclusion to which no response is required. 105. The allegations in paragraph 104 state a legal conclusion to which no response is required. 106. The allegations in paragraph 104 state a legal conclusion to which no response is required. 107. Denied. Defendants terminated Plaintiff because Plaintiff reported violations of the patient safety plan all as averred in the Complaint. 108. Denied. The allegations in paragraph 108 are denied based on the allegations of the Complaint. 109. Denied. The allegations in paragraph 109 are denied based on the allegations of the Complaint. 110. The allegations in paragraph 110 state a legal conclusion to which no response is required. 111. Admitted. 112. The Employment Contract entered into by Plaintiff Gatrell is a written document that speaks for itself. Plaintiff did not consent to termination of his services based on the facts and circumstances at issue in this case and any termination provision in the Employment Contract is not a bar to Plaintiff's causes of actions in this litigation. 113. The allegations in paragraph 113 state legal conclusions to which no response is required. 114. The allegations in paragraph 114 state a legal conclusion to which no response is required. 115. Denied. The allegations in paragraph 115 are denied based on the allegations in the Complaint. 116. The allegations in paragraph 116 state a legal conclusion to which no response is required. The Plaintiffs Complaint does state a claim against Defendants pursuant to the Whistle Blower Act as has been determined by the Court pursuant to its decision on the Preliminary Objections in this case. 117. The allegations in paragraph 117 state legal conclusions to which no response is required. As set forth in the Complaint, Defendants are public bodies and are subject to suit pursuant to the Whistleblower Act. 118. Denied. As set forth in the Complaint, the hospital Defendants did not have valid reasons to request Plaintiff's termination from employment. 119. Denied. Plaintiff's conduct at the hospital did not warrant that EM-1 terminate Plaintiff's employment as is more fully set forth in the Complaint. 120. Denied. As set forth in the Complaint, the Defendants knew and had information that the request by the hospital Defendants that the Plaintiffs employment be terminated was improper. 121. Denied. Defendants are not entitled to any defenses. Further, the allegations of paragraph 121 state legal conclusions to which no response is required. 122. The allegations in paragraph 122 state legal conclusions to which no response in required. Further in its decision in the Preliminary Objections, the Court has determined that Plaintiff does have a claim against Defendants for termination of his employment in violation of public policy based upon the allegations in the Complaint. 123. The allegations in paragraph 123 state legal conclusions to which no response is required. The Court in its decision on the Preliminary Objections has determined that Plaintiff is entitled to equitable relief or reinstatement based on the allegations in the Complaint. 124. Denied. The allegations in paragraph 124 state legal conclusions to which no response is required. 125. The allegations of paragraph 125 state legal conclusions to which no response is required. It is denied that the statute of limitations is a bar to any of Plaintiffs claims. Plaintiff timely filed suit. 126. Denied. Plaintiff has alleged reckless and intentional conduct on behalf of the Defendant's. Defendant's conduct was outrageous as is set forth in the Complaint. Based on the allegations in the Complaint, Plaintiff is entitled to punitive damages as has been determined by the Court in its decision on the Preliminary Objections. 127. The allegations of paragraph 127 state legal conclusions to which no response is required. 128. The allegations of paragraph 128 state legal conclusions to which no response is required. 129. The allegations of paragraph 129 state legal conclusions to which no response is required. 130. The allegations of paragraph 130 state legal conclusions to which no response is required. 131. The allegations of paragraph 131 state legal conclusions to which no response is required. 132. The allegations of paragraph 132 state legal conclusions to which no response is required. By way of further answer, Defendants' conduct was a legal cause of Plaintiff's damages. 133. The allegations of paragraph 133 state a legal conclusion to which no response is required. By way further answer, Plaintiff has mitigated his damages. 134. The allegations of paragraph 134 state legal conclusions to which no response is required. 135. The allegations of paragraph 135 require no answer. WHEREFORE, Plaintiff requests that judgment be entered in his favor as requested in the Complaint. TUCKER ARENS669rm P.C. By: geAen M-;Mfeecher, Jr. A orney I.D. No. 36803 2 Lemoyne Drive, Ste. 200 Lemoyne, PA 17043 (717) 234-4121 ATTORNEYS FOR PLAINTIFF, CLOYD GATRELL H B G D B :125868-1 024654-138302 VERIFICATION I, Cloyd Gatrell, hereby certify that I am the plaintiff in this action, and that the statements contained in the foregoing document are true and correct to the best of my knowledge, information and belief. I understand that any false statements made to this verification are subject to the penalties of 18 Pa. C.S.A. §4904, relating to unswom falsification to authorities. DATE: , 2012 Cloyd 59611 CERTIFICATE OF SERVICE And now, this day of April, 2012, I, Pamela J. Gordon, secretary to Stephen M. Greecher, Jr., attorney for the Plaintiff hereby certify that I have this day served the foregoing document by depositing a true and correct copy of the same in the United States Mail, first class, postage prepaid, at Harrisburg, Pennsylvania, addressed as follows: Robert M. Goldich, Esquire Sabrina Mizrachi, Esquire Greenberg Traurig 2700 Two Commerce Square 2001 Market Street Philadelphia, PA 19103 Christopher J. Conrad, Esquire Sharon M. O'Donnell, Esquire Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Pame a J. Gordon HBG D B:125868-1 024654-138302 I°ILED O HDL. THE �,.. -�� � it Of" €HE �C T HC0 TAR 2013 NOV 15 PM 2: 12 CUMBERLAND COUNTY PENNSYLVANIA CLOYD GATRELL, : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PA Plaintiff : No. 11-1305, 2011 Civil v. CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER •• •CARLISLE HMA, INC., Individually and •• d/b/a CARLISLE REGIONAL MEDICAL CENTER, • NEW JERSEY/PENNSYLVANIA EM-1 MEDICAL SERVICES, P.C. • z . EMCARE, INC. • Defendants •• • NOTICE OF CHANGE OF ADDRESS TO THE PROTHONOTARY' Please be advised that the new address for the undersigned counsel is as follows: Marshall Dennehey Warner Coleman & Goggin 100 Corporate Center Drive Suite 201 Camp Hill,PA 17011 PHONE: (717) 651-3531 FAX: (717) 651-3707 ti 1 All notices and orders should be served on the undersigned counsel for the Respondent at this address as of October 28, 2013. Respectfully submitted, MA: * - Zh,DENNEHEY, WARNER, ILEM 4GI _ _ By: li■ Sharon M. 0'0 ell, Esquire PAIDN• '457 Christopher J. Conrad, Esquire PA ID No. 202348 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (717) 651-3500 Dated: November 14, 2013 Attorneys for Defendants 2 CERTIFICATE OF SERVICE The undersigned, as counsel for, hereby certifies that a copy of the foregoing Motion for Partial Reconsideration was served via United States Mail, postage prepaid, on the 14th day of November 2013, upon the following counsel of record: Stephen M. Greecher, Jr., Esquire Tucker Arensberg, PC 111 North Front Street PO Box 889 Harrisburg, PA 17108-0889 MARSHALL,DENNEHEY,WARNER, COL u N & GOGGIN f _ Sharon M. 'Donnell, Esquire PA ID N.. 79457 •. • opher J. Conrad, Esquire PA ID No. 202348 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (717) 651-3500 Attorneys for Defendants 05/1131463.v1 3 Sharon M. O'Donnell, Esq. ID.#79457 Marshall Dennehey Warner Coleman & Goggin 100 Corporate Center Drive, Suite 201 Camp Hill, PA 17011 Attorney for Carlisle Regional Medical Center, Carlisle HMA, LLC, Individually and d/b/a Carlisle Regional Medical Center, Carlisle HMA, Inc., Individually and d/b/a Carlisle Regional Medical Center CLOYD GATRELL, : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PA Plaintiff No. 11-1305, 2011 Civil v. CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER, NEW JERSEY/PENNSYLVANIA EM -1 MEDICAL SERVICES, P.C. EMCARE, INC. Defendants NOTICE TO PLEAD TO: Cloyd Gatrell, Plaintiff c/o Stephen M. Greecher, Jr., Esquire Tucker Arensberg, PC 111 North Front Street PO Box 889 Harrisburg, PA 17108-0889 Page 1 of 23 You are hereby notified to plead to the following New Matter within twenty (20) days after service hereof, or a default judgment may be entered against you. Respectfully submitted, MARSH : ► . . Y WARNER, OGGIN By: Sharon M. t" Connell, Esquire PA ID ► ' 9457 100 Corporate Center Drive Camp Hill, PA 17011 Page 2 of 23 Sharon M. O'Donnell, Esq. ID.#79457 Marshall Dennehey Warner Coleman & Goggin 100 Corporate Center Drive, Suite 201 Camp Hill, PA 17011 Attorney for Carlisle Regional Medical Center, Carlisle HMA, LLC, Individually and d/b/a Carlisle Regional Medical Center, Carlisle HMA, Inc., Individually and d/b/a Carlisle Regional Medical Center CLOYD GATRELL, : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PA Plaintiff No. 11-1305, 2011 Civil v. CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER, NEW JERSEY/PENNSYLVANIA EM -1 MEDICAL SERVICES, P.C. EMCARE, INC. Defendants ANSWER WITH NEW MATTER OF DEFENDANTS, CARLISLE REGIONAL MEDICAL CENTER, CARLISLE HMA, LCC, INDIVIDUALLY AND D/B/A CARLISLE REGIONAL MEDICAL CENTER, AND CARLISLE HMA, INC., INDIVIDUALLY AND D/B/A CARLISLE REGIONAL MEDICAL CENTER Page 3 of 23 The Defendants above named, by and through legal counsel, Marshall, Dennehey, Warner, Coleman & Goggin, hereby answers the Complaint filed by Plaintiff and asserts the following New Matter: 1. Admitted upon information and belief. 2. Admitted. 3. Admitted. 4. Denied. Carlisle HMA, Inc. is no longer a corporation. 5. Admitted in part; denied in part. The allegations of paragraph 5 are admitted except as follows. The allegations are denied in that Carlisle HMA, Inc. is no longer a corporation. By way of further response, Carlisle HMA, LLC is the successor entity to Carlisle HMA, Inc. By way of further response, Defendant, CRMC, incorporates its response to paragraph 2 above. 6. The allegations of Paragraph 6 are not directed to the Answering Defendant and no response is made thereto. 7. The allegations of Paragraph 7 are not directed to the Answering Defendant and no response is made thereto. 8. Admitted in part; denied in part. It is admitted upon information and belief that at all times material to the alleged causes of action, Plaintiff was a legally licensed physician in the Commonwealth of Pennsylvania and worked at CRMC in the Emergency Department. It is further admitted from March 23, 2007 to April 30, 2008, he was employed by Carlisle HMA Physician Management, Inc. The remaining allegations are denied in that, although he continued to work in the Emergency Department of CRMC, from September 15, 2005 to March 23, 2007, Plaintiff was employed by Central Penn Page 4 of 23 Management Group and from May 1, 2008 to August 9, 2010, he was employed by EmCare, Inc. 9. Admitted in part; denied in part. The aforesaid contract is a writing that speaks for itself. 10. The allegations of Paragraph 10 are not directed to the Answering Defendant and no response is made thereto. 11. The allegations and averments of Paragraph 11 are not directed to the Answering Defendant and no response is made thereto. 12. Admitted in part; denied in part. It is admitted only that sometime after May 1, 2008, leadership teams at Carlisle Regional Medical Center became aware that Dr. Gatrell had begun to voice concerns in an organized fashion about nurse understaffing. It is believed and therefore averred that his efforts re -doubled after his wife, Kathryn Gatrell, was separated from her employment as a per diem nurse on the Med-Surg Unit of CRMC in September of 2008. It is admitted that Dr. Gatrell, among others, also voiced concerns and opinions about maximizing patient safety, although Dr. Gatrell's concerns in that regard were voiced less frequently than his concerns about nurse understaffing. However, most of Dr. Gatrell's concerns were focused on having his wife's employment reinstated. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments of Paragraph 12. 13. Admitted in part; denied in part. It is admitted only that Kathryn Gatrell was a Registered Nurse, working per diem for the Carlisle Regional Medical Center, through September 2008. It is admitted that, from time to time, the Page 5 of 23 Answering Defendant was aware that at times, Ms. Gatrell voiced concerns about her own duties and responsibilities, at and other times, she expressed concerns about the duties and responsibilities of other nurses. The remaining allegations are denied in that after reasonable investigation the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 14. Denied. After reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 15. Admitted in part; denied in part. It is admitted that on February 22, 2008, Dr. Gatrell and Nurse Kathryn Gatrell, met with the then CEO, Nathan Staggs. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 16. Admitted in part; denied in part. It is admitted that Dr. Gatrell and Kathryn Gatrell, R.N., presented to the then CEO of the Answering Defendant, Nathan Staggs, a two-page letter signed by over 100 nurses. It is further admitted that, within the document, the Gatrells described their perception of nurse staffing as a "crisis," however Hospital administrators, and much of the nursing leadership team, did not share the same views with the Gatrells. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 17. Admitted in part; denied in part. It is admitted only that the Answering Defendant is aware that Dr. Gatrell met with Nathan Staggs, the former CEO Page 6 of 23 of Carlisle Regional Medical Center, on or about March 24, 2008. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 18. Denied. After reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 19. Denied. After reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 20. Denied. After reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 21. Denied. After reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 22. Denied. After reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 23. Admitted with qualification. It is admitted that on September 18, 2008, Kathryn Gatrell's employment at Carlisle Regional Medical Center was terminated as the result of her falsification of documents indicating that she had provided certain patient care to a Med-Surg patient, who had recently returned from surgery, when in fact, she had not. Page 7 of 23 24. Admitted in part; denied in part. It is admitted that part of the reason underlying Mrs. Gatrell's termination was the fact that she had failed to implement physician orders and provide the patient with care as per those orders, but documented that she had done so. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these allegations. 25. Denied. It is specifically denied that Kathryn Gatrell was terminated for her efforts to publicize nurse understaffing and patient safety concerns. To the contrary, Ms. Gatrell's employment was terminated because she falsified medical records indicating that she had provided patient care, per a physician's orders, when in fact, she had not. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. The remaining allegations are denied as conclusions of law to which no further response is required. 26. Admitted in part; denied in part. It is admitted that Dr. Gatrell's employment with EmCare, Inc., through a contract, was discontinued sometime in 2010, and that Kathryn Gatrell's employment was terminated with the Carlisle Regional Medical Center in September 2008. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. The remaining allegations are denied conclusions of law to which no further response is required. Page 8 of 23 27. Denied. After reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 28. Denied. The allegations and averments of Paragraph 28 are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 29. Admitted in part; denied in part. It is admitted that the then CEO, Nathan Staggs, levied a physician decorum complaint against Dr. Gatrell. The complaint was based upon his belief that Dr. Gatrell clearly overreached when the Chief Nursing Officer expressed her concerns about being physically intimidated by Dr. Gatrell during a meeting he requested for the purpose of having his wife's employment reinstated. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 30. Admitted in part; denied in part. It is admitted only that Dr. David Albright, the then President of the Medical Staff at Carlisle Regional Medical Center, was involved with the handling of the physician decorum complaint against Dr. Gatrell. Dr. Albright's intervention resolved the complaint without further admonishment or discipline of Dr. Gatrell. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these allegations. 31. Denied. After reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these Page 9 of 23 allegations. The Complaint was resolved amicably in attempt to re-establish professional harmony within that setting. 32. Denied. The November 24, 2008 correspondence to Georgeann Laughmann, speaks for itself. 33. Admitted in part; denied in part. It is admitted that on December 5, 2008, Plaintiff wrote the Chairman of the Board of Health Management Associates, William Schoen. The remaining allegations are denied in that the content of the December 5, 2008 letter speaks for itself. 34. Admitted in part; denied in part. It is admitted that on January 9, 2009, Britt Reynolds met with Dr. Gatrell. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 35. The allegations and averments of Paragraph 35 are not directed to the Answering Defendant and no response is made thereto. 36. The allegations and averments of Paragraph 36 are not directed to the Answering Defendant and no response is made thereto. 37. Admitted in part; denied in part. It is admitted that an investigation was conducted on the premises of Carlisle Regional Medical Center on February 13, 2009. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 38. Admitted in part; denied in part. It is admitted that an investigation was conducted by the Department of Health on March 6, 2009. The remaining allegations are denied in that after reasonable investigation, the Answering Page 10 of 23 Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 39. Denied. After reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 40.Admitted in part; denied in part. It is admitted only that Mr. Kristel agreed to meet with Dr. Gatrell on July 21, 2009. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 41. Denied. The allegations of Paragraph 41 are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 42. Admitted in part; denied in part. It is admitted that on July 7, 2010 Dr. Gatrell spoke by phone to Wayne Neislander, Director of Human Resources for HMA. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these averments. 43. The allegations and averments of Paragraph 43 are not directed to the Answering Defendant and no response is made thereto. 44. Admitted in part; denied in part. It is admitted generally that nurse staffing and support may (among other factors) directly impact patient safety at Carlisle Regional Medical Center. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without Page 11 of 23 knowledge or information sufficient to form a belief as to the truth of this allegations. 45. The allegations and averments of Paragraph 45 are not directed to the Answering Defendant and no response is made thereto. 46. Denied. It is specifically denied that Carlisle Regional Medical Center, or any of its agents or employees, directed EmCare, Inc., and/or New Jersey/Pennsylvania EM -1 Medical Services, PC, to terminate the employment (contract with) of Dr. Gatrell. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these allegations. 47. The allegations and averments of Paragraph 47 are not directed to the Answering Defendant and no response is made thereto. 48. The allegations and averments of Paragraph 48 of Plaintiffs Complaint are not directed to the Answering Defendant and no response is made thereto. 49. Denied. The MCARE Act, and in particular, specific provisions that may apply to the instant proceeding, speaks for itself. The Answering Defendant denies that any provision of the MCARE Act was violated in any matter and denies further these allegations as conclusions of law to which no further response is required. COUNT I— CLOYD GATRELL V. CARLISLE MEDICAL CENTER, CARLISLE HMA, LLC AND CARLISLE HMA, INC. • TORTOUS INTERFERENCE WITH CONTRACT Page 12 of 23 50. The Answering Defendant incorporates herein its responses to Paragraphs 1 through 49 of the Plaintiffs Complaint as fully as if the same were set forth at length. 51. Denied. It is specifically denied that any employee of Carlisle Regional Medical Center directed EmCare, Inc., and/or New Jersey/Pennsylvania EM -1 Medical Services, PC, to terminate the employment contract of Dr. Cloyd Gatrell. To the contrary, Carlisle Regional Medical Center, through its agents and employees, requested that Dr. Gatrell not return for further service within the Emergency Department at Carlisle Regional Medical Center as the result of the Department's deteriorating performance. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without knowledge or information sufficient to form a belief as to the truth of these allegations. 52. Denied. It is specifically denied that any employee of Carlisle Regional Medical Center directed the termination of Dr. Gatrell for any reason. To the contrary, Carlisle Regional Medical Center lawfully exercised an option under its contract with Em- 1 requesting that Dr. Gatrell not return to the Emergency Room for performance reasons, compounded by the fact that Dr. Gatrell's persistent efforts in attempting to have his wife's employment reinstated was growing tiresome. Dr. Gatrell was fully aware of the provisions of his contract with EM -1, and knew that, if for any reason he was not invited back to Carlisle Regional, his contract with Em -1 would end. It should be noted that Dr. Gatrell refused subsequent, alternative employment alternatives at different hospitals within the local area offered by Em -1. The remaining allegations are denied in that after reasonable investigation, the Answering Defendant is without Page 13 of 23 knowledge or information sufficient to form a belief as to the truth of these allegations. 53. Denied. It is specifically denied that Carlisle Regional Medical Center, through its agents and employees, directed EmCare, Inc., and New Jersey/Pennsylvania EM -1 Medical Services, PC, to terminate Dr. Gatrell's employment contract. The remaining allegations are denied as conclusions of law to which no further response is required. 54. Denied. The Carlisle Regional Medical Center, through its agents and employees, did not direct the termination of the employment contract of Dr. Gatrell. The remaining allegations are denied as conclusions of law to which no further response is required. 55. Denied. It is specifically denied that Carlisle Regional Medical Center, through its agents and employees, acted intentionally, wrongfully or outrageously, to cause harm to Dr. Gatrell. The remaining allegations are denied as conclusions of law to which no further response is required. 56. Denied. The allegations of Paragraph 56 are denied in that after reasonable investigation, the Answering Defendant is without knowledge or inform sufficient to form a belief as to the truth of these averments. It is specifically denied that at any time during the existence of Dr. Gatrell's contract with EmCare, Inc. , the Carlisle Regional Medical Center, through its agents and/or employees, unlawfully or intentionally interfered with that contract. WHEREFORE, the Answering Defendant requests this Honorable Court to dismiss Count I of Plaintiffs Complaint with prejudice. COUNT II Page 14 of 23 CLOYD GATRELL V. CARLISLE MEDICAL CENTER, CARLISLE HMA, LLC AND CARLISLE HMA, INC. VIOLATION OF THE PENNSYLVANIA WHISTLEBLOWER ACT 57. The Answering Defendant incorporates herein its responses to Paragraphs 1 through 56 as fully as if the same were set forth at length. 58. Denied. 43 P.S. §1422, otherwise referred to as the Pennsylvania Whistleblower Act, speaks for itself. Moreover, Dr. Gatrell is not an employee of Carlisle Regional Medical Center. The remaining allegations are conclusions of law to which no further response is required. 59. Denied. The Pennsylvania Whistleblower Act, 43 P.S. §1422 speaks for itself. Dr. Gatrell is not an employee of Carlisle Regional Medical Center.The remaining allegations are denied as conclusions of law to which no further response is required. 60. Denied. 43 P.S. §1422 of the Pennsylvania Whistleblower Act speaks for itself. The remaining allegations are denied as conclusions of law to which no further response is required. 61. Denied. 43 P.S. §1423(a) of the Pennsylvania Whistleblower Act speaks for itself. The remaining allegations are denied as conclusions of law to which no further response is required. 62. Denied. 43 P.S. §1422 of the Pennsylvania Whistleblower Act speaks for itself. The remaining allegations are denied as conclusions of law to which no further response is required. 63. Denied. 40 P.S. §1303.307(a) of the Pennsylvania MCARE Act, speaks for itself. The remaining allegations are denied as conclusions of law to which no further response is required. Page 15 of 23 64. Denied. It is specifically denied that the Carlisle Regional Medical Center violated the MCARE Act by terminating the employment of Dr. Gatrell's wife, Kathryn Gatrell, in September 2008. Proof thereof is demanded. The remaining allegations are denied as conclusions of law to which no further response is required. 65. Denied. Carlisle Regional Medical Center, through its agents and employees, did not cause the termination of Dr. Gatrell's employment with EmCare, Inc. The remaining allegations are denied as conclusions of law to which no further response is required. 66. Denied. The remedies requested are unavailable to Dr. Gatrell as against the Carlisle Regional Medical Center, with whom Dr. Gatrell did not have an employment contract. WHEREFORE, the Answering Defendant requests this Honorable Court to dismiss Count II of Plaintiffs Complaint with prejudice. COUNT III CLOYD GATRELL V. CARLISLE MEDICAL CENTER, CARLISLE HMA, LLC AND CARLISLE HMA, INC. VIOLATION OF THE MCARE ACT 67. The Answering Defendant incorporates herein by reference its responses to Paragraphs 1 through 66 of Plaintiffs Complaint as fully as if the same herein set forth at length. 68. Denied. The MCARE Act, 40 P.S. §1303.308(c) speaks for itself. The remaining allegations are denied as conclusions of law to which no further response is require. Page 16 of 23 69. Denied. The MCARE Act, 40 P.S. §1303.303, speaks for itself. The remaining allegations are denied as conclusions of law to which no further response is require. 70. Admitted in part; denied in part. It is admitted that Kathryn Gatrell, R.N., was terminated from her employment with the Carlisle Regional Medical Center on September 18, 2008, to a lesser extent, due to a missed telemetry order. However, Mrs. Gatrell falsified the patient's medical chart by documenting that she had implemented physician's orders and started telemetry for the patient, as well as that she had administered Lopressor, a prescribed medication, to the patient, when in fact, she had not. Dr. Gatrell is not an appropriate "reporter" for the purposes of administrative/performance-based terminations. The remaining allegations are denied as conclusions of law to which no further response is required. 71. Admitted in part; denied in part. It is only admitted that Dr. Gatrell, repeatedly, over the course of several years, complained about nurse staffing, and the fact that his wife's employment was terminated. The remaining allegations are denied in that they are conclusions of law to which no further response is required. 72. Denied. It is specifically denied that the Carlisle Regional Medical Center requested Dr. Gatrell's contract termination with EmCare, Inc. Carlisle Regional Medical Center lawfully exercised an option under its contract with EmCare, Inc. and requested that Dr. Gatrell not return to the Emergency Department. Dr. Gatrell was aware that such a request would automatically terminate his contract with Em -1. Surprisingly, he refused subsequents offers Page 17 of 23 by Em -1 to be placed at other local hospitals. The remaining allegations are denied as conclusions of law to which no further response is required. 73. Denied. Inasmuch as Dr. Gatrell did not have a contract with Carlisle Regional Medical Center, he is not entitled to the relief sought. WHEREFORE, the Answering Defendant requests this Honorable Court to dismiss Count III with prejudice. COUNT IV CLOYD GATRELL V. NEW JERSEY/PENNSYLVANIA EM -ONE MEDICAL SERVICES, PC AND MCARE, INC. VIOLATION OF THE WHISTLEBLOWER ACT 74. The Answering Defendant incorporates herein by reference its responses to Paragraphs 1 through 73 of Plaintiffs Complaint as fully as if the same herein set forth at length. 75-82. The allegations and averments of Paragraphs 75 through 82 of Plaintiffs Complaint are not directed to the Answering Defendant and no response is made thereto. WHEREFORE, the Answering Defendant requests this Honorable Court to dismiss Count IV of Plaintiffs Complaint, with prejudice. COUNT V CLOYD GATRELL V. NEW JERSEY/PENNSYLVANIA EM -ONE MEDICAL SERVICES, PC AND MCARE, INC. VIOLATION OF THE MCARE ACT 83. The Answering Defendant incorporates herein by reference its responses to Paragraphs 1 through 82 of Plaintiffs Complaint as fully as if the same herein set forth at length. 84-87. The allegations and averments of Paragraphs 84 through 87 of Plaintiffs Complaint are not directed to the Answering Defendant and no response is made thereto. Page 18 of 23 WHEREFORE, the Answering Defendant requests this Honorable Court to dismiss Count V of Plaintiffs Complaint. COUNT VI CLOYD GATRELL V. NEW JERSEY/PENNSYLVANIA EM -ONE MEDICAL SERVICES, PC AND MCARE, INC. WRONGFUL DISCHARGE 88. The Answering Defendant incorporates herein by reference its responses to Paragraphs 1 through 87 of Plaintiffs Complaint as fully as if the same herein set forth at length. 89-92. The allegations and averments of Paragraphs 89 through 92 of Plaintiffs Complaint are not directed to the Answering Defendant and no response is made thereto. WHEREFORE, the Answering Defendant requests this Honorable Court to dismiss Count VI of Plaintiffs Complaint. NEW MATTER 93. Cloyd Gatrell was not an employee of the Carlisle Regional Medical Center throughout the time he entered into an employment agreement with the New Jersey/Pennsylvania Emcare, Inc./EM-1 Medical Services, PC, as of May 1, 2008. 94. Carlisle Regional Medical Center, through its agents and employees, did not request the termination of Dr. Gatrell from his contract with EmCare, Inc. 95. Carlisle Regional Medical Center, through its agents and employees, exercised a contract option with EmCare, Inc./EM-1 Medical Services, PC, to request that certain physicians, and in this case, Dr. Cloyd Gatrell, not return to perform services and duties within the exercise of that physician's professional judgment. Page 19 of 23 96. At no time did the Carlisle Regional Medical Center, its agents or employees, direct or control the activities of Dr. Cloyd Gatrell and in particular, all such activities that were performed within the exercise of Dr. Gatrell's professional judgment. 97. Carlisle Regional Medical Center, through its agents and employees, did not deter and/or interfere with Dr. Gatrell's advocacy on behalf of nurses concerning staffing issues, but in fact, cooperated with Dr. Gatrell and met with him on numerous occasions to discuss his concerns. 98. Plaintiffs letter to Defendant CEO dated February 22, 2008, and the alleged concerns expressed therein, and subsequently regarding nurse staffing, did not constitute a report of a "serious event or incident" as defined under the Medical Care Availability and Reduction of Error ("MCARE") Act, 42 P.S. §1303.307. 99. If it is judicially determined that Cloyd Gatrell was an employee of Carlisle Regional Medical Center, the same being expressly denied, its actions were not retaliatory, unlawful, wrongful or otherwise in violation of §1303.307 or §1303.308 of the MCARE Act, or of the Pennsylvania Whistleblower Act, 43 P.S. §§1421-1428. 100. Plaintiffs February 22, 2008 letter directed to Defendant's CEO, and the concerns allegedly expressed therein, were not reports of an "instance of wrongdoing or waste" in violation of the Pennsylvania Whistleblower Act, 43 P.S. §1423(a). 101. Plaintiffs claims fails as a matter of law inasmuch as he failed to make a report of any such "serious incident or event" within twenty-four (24) hours of such incident or event, as he was required to do under 40 P.S. §1303.308(a). 102. Plaintiffs objection to the termination of his wife's employment, Kathryn Gatrell, does not present an issue of "patient safety" and is not tantamount to "reporting a serious event or incident" under 43 P.S. §1303.307(b)(4) so as to give rise to a claim for wrongful termination or wrongful retaliation. Page 20 of 23 103. Some or all of Plaintiffs claims may be barred by the applicable statutes of limitation. 104. Plaintiff has failed to mitigate his damages to the extent required by law. 105. Defendants incorporates herein by reference its responses to Paragraphs 1 through 92 of Plaintiffs Complaint as fully as if the same were set forth at length. WHEREFORE, The Answering Defendants Carlisle Regional Medical Center, Carlisle HMA, LLC, individually and d/b/a Carlisle Regional Medical Center, and Carlisle HMA, Inc., individually and d/b/a Carlisle Regional Medical Center, respectfully submit that Plaintiffs Amended Complaint be dismissed in its entirety, together with such other relief as the Court may deem appropriate. Dated:December 22, 2014 B Respectfully submitted, MARSHALL DENNEHEY WARNER nnel , squire 9457 orate Center Drive Suite 201 Camp Hill, PA 17011 (717) 651-3503 Attorneys for Defendant Carlisle Regional Medical Center, et al. Page 21 of 23 VERIFICATION I am authorized by the Defendant to make this verification. By this statement, I hereby verify that the facts set forth in the foregoing Answer are true and correct to the best of my knowledge, information and belief. This Verification is made subject to the penalties of 18 Pa.C.S.A. §4904, relating to unsworn falsification to authorities. Date: 4146 aquik-- CARLISLE REGIONAL MEDICAL CENTER Page 21 of 22 CERTIFICATE OF SERVICE The undersigned, as counsel for Defendants, hereby certifies that a copy of the foregoing Defendants' Answer with New Matter was served via United States Mail, postage prepaid, on the day of /u on the following counsel of record: 05/825740.v1 Stephen M. Greecher, Jr., Esquire Tucker Arensberg, PC 111 North Front Street PO Box 889 Harrisburg, PA 17108-0889 By: MARSHALL DENNEHEY WARNER COLEMAN & GOGGIN Sharon 0' r o uire PA I 0. 79457 0 Corporate Center Drive Suite 201 Camp Hill, PA 17011 (717) 651-3503 Attorneys for Defendant Carlisle Regional Medical Center, et al. Page 23 of 23 MARSHALL DENNEHEY WARNER COLEMAN & GOGGIN By: Sharon M. O'Donnell, Esquire PA I.D. No.: 79457 100 Corporate Center Drive Suite 201 Camp Hill, PA 17011 (717) 651-3503 Fax: (717) 651-3707 smodonnellAmdwcg.com Attorney for Defendant, Carlisle Regional Medical Center CLOYD GATRELL, Plaintiff V. CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER, NEW JERSEY/PENNSYLVANIA EM -1 MEDICAL SERVICES, P.C. EMCARE, INC. Defendants 11J15 JI -IN -2 Pi.1 !:25 CUMBERLAND COUNTY PENNSYLVANIA : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PA : No. 11-1305, 2011 Civil KATHRYN GATRELL, : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PA Plaintiff v. No. 10-5976 CIVIL, 2010 CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, LLC, Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER CARLISLE HMA, INC., Individually and d/b/a CARLISLE REGIONAL MEDICAL CENTER, Defendants STIPULATION FOR THE DEPOSITION OF JOHN KRISTEL Counsel for the Plaintiffs, Kathryn Gatrell and Cloyd Gatrell, M.D., Stephen Greecher, and counsel for Defendants, HMA and Carlisle Regional Medical Center, Sharon M. O'Donnell, Esquire, hereby stipulate and agree that the Plaintiffs' deposition of former CEO, John Kristel, shall be held at a mutually convenient date and time at the offices of Defendants' counsel in Camp Hill, Pennsylvania; that the deposition shall inquire into matters regarding the allegations of the Complaints filed to the above term and numbers and will not go beyond the four corners of the Complaints filed in this matter. By way of further stipulation and agreement, Mr. Kristel has no obligation and may refrain from answering questions that are irrelevant to the Plaintiffs' claims and/or are not reasonably calculated to lead to the discovery of admissible evidence at the trial of the above -captioned matters. The parties further agree that "relevant evidence" shall be probative evidence, i.e., facts that tend to credit or discredit the allegations of Plaintiffs Complaints or the Defendants' defenses, or that which is reasonably calculated to lead to the discovery of admissible evidence at trial. 2 By signing below, counsel for the respective parties acknowledge that they have the consent and approval to enter into this Stipulation from their respective clients. DATE: /02/i��y DATE: 05/1326678.v1 3 TUCKER ARE BERG BY: /f . eph n . Gr-ec • , Jr., s•uire Tucker Arensberg, PC 111 North Front Street PO Box 889 Harrisburg, PA 17108-0889 Attorney for Plaintiffs Cloyd Gatrell, M.D. and Kathryn Gatrell MARSHALL, DENNE -! Y, WARNER, COLEMAN & onnell, Esquire 9457 orporate Center Drive, Suite 201 Camp Hill, PA 17011 (717) 651-3503 Fax (717) 651-3707 smodonnell(a�mdwcg.com Attorney for Defendants Carlisle Regional Medical Center, Carlisle HMA LLC, ind. and d/b/a Carlisle Regional Medical Center. New Jersey/Pennsylvania EM -1 Medical Services, P.C. and EMCare, Inc.