Loading...
HomeMy WebLinkAbout01-2979 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA HELEN P. FULTZ, CIVIL ACTION - LAW Plaintiff v. No. OI- Cio; JOYCE M. TIMMONS, Defendant JURY TRIAL DEMANDED NOTICE TO DEFEND You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must rake action within twenty (20) days afier this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with thc Court your defenses or objections to the claims set forth against you. You arc warned that if you fall to do so the case may proceed without you and judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 (717) 249-3166 (800) 990-9108 230550 IxRAS\MLB IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA HELEN P. FULTZ, CIVIL ACTION - LAW Plaintiff v. NO. JOYCE M. TIMMONS, Defendant JURY TRIAL DEMANDED NOTICIA Le hah demandado a usted en la torte. Si usted quiere defenderse de estas demandas expuestas en las paginas sugnuientes, usted tiene viente (20) dias de plazo al partir de la fecha de la demanda y la notificacion. Usted debe presentar una apariencia escrita o en persona o pot abogado y archivar en la corte en forma escrita sus defensas o sus objeciones a las demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tomara medidas y puede entrar una orden contra usted sin previo aviso o notificacion y por cualquier queja o alivio que es pedido en la peticion de demanda. Usted puede perder dinero o sus propiedades o otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO IMMEDIATEMENTE. SI NO TIENE ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA O LLAME POR TELEPFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABA JO PARA AVERIGUAR DONDE SE PUEDE CONSEQUIR ASISTENCIA LEGAL. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 (717) 249-3166 (800) 990-9108 2.51038. I\RAS~M LB IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY? PENNSYLVANIA HELEN P. FULTZ. CIVIL ACTION - LAW Plaintiff v. NO. 0~- ,9..9'7q ~ '7'".z,..-,- JOYCE M. TIMMONS, Defendant JURY TRIAL DEMANDED COMPLAINT 1. Plaintiff Helen P. Fultz is an adult individual and citizen of the Commonwealth of Pennsylvania, who resides at 347 Hummel Avenue. Lemoyne, Cumberland County. Pennsylvania. 2. Defendant Joyce M. Timmons is an adult individual and citizen of the Commonwealth of Pennsylvania who resides at 5430 Oxford Drive, Mechanicsburg, Cumberland County, Pennsylvania. 3. The facts and occmxences hereinafter related took place on or about January 23. 2000, at approximately 7:02 p.m. near the intersection of Carlisle Pike and Lambs Gap Road, in Mechanicsburg, Cumberland County. Pennsylvania. 4. At that time and place, Plaintiff Helen P. Fultz was a right, front seat passenger in a vehicle being operated by Matthew Shindel. 5. At that time and place, the Shindel vehicle was traveling westbound in the fight travel lane on the Carlisle Pike. Cumberland County. Pennsylvania. 6. At that time and place, Defendant Joyce M. Timmons was operating a 1993 Honda Accord LX on Lmnbs Gap Road, Cumberland County. Pennsylvania. 230550. I\R.AS\M L[I 7. At that time and place, traffic intending to enter the Carlisle Pike t~m Lamps Gap Road is controlled by a yield sign. 8. At that time and place, Defendant Joyce M. Timmons failed to yield the right-of- way to oncoming traffic, made a right turn onto the Carlisle Pike, entered the Shindel vehicle's lane of travel, and collided with the Shindel vehicle, causing it to spin 9. The foregoing accident and all of the injuries and damages set forth hereinafter sustained by Plaintiff Helen P. Fultz are the direct and proximate result of the negligent, careless, wanton and reckless manner in which Defendant Joyce M. Timmons operated her motor vehicle as follows: {a) failure to keep alert and maintain a proper watch for the presence of other motor vehicles on the highway; (b) failure to stay within her lane of travel; (c.) failure to travel at a safe speed; (d) failure to yield the right-of-way to the Shindel vehicle; {e) failure to keep a proper watch for traffic on the highway; (f) failure to drive her vehicle ~th due regard for the highway and traffic conditions which were existing and of which he was or should have been aware'- (g) failure to keep proper and adequate conlxol over her vehicle; and (h) driving her vehicle upon the highway in a manner endangering persons and property.' and in a reckless manner with careless disregard to the rights and safety of others and in violation of the Motor Vehicle Code of the Commonwealth of Pennsylvania. 230550 P. RAS".M LB 2 10. Plaintiff Helen P. Fultz sustained painful and severe injuries which include but are not limited to sternal fracture, cervical hyperextansion injuD', cervical, thoracic and lumbar sWain/sprain. 11. By reason of the aforesaid injuries sustained by Plaintiff Helen P. Fultz, she was forced to incur liability for medical treatment, medications, hospitalizations and similar miscellaneous expenses in an effort to restore herself to health, and claim is made therefor. 12. Because of the nature of her injuries, Plaintiff Helen P. Fultz has been advised and, therefore, avers that she may be forced to incur similar expenses in the future, and claim is made therefor. 13. As a result of the aforementioned injuries, PlaintilT Helen P. Fultz has undergone and in the future w/Il undergo great physical and mental suffering, great inconvenience in carrying out her daily activities, loss of life's pleasures and enjoyment, and claim is made therefor. 14. As a result of the aforesaid injuries, Plaintiff Helen P. Fultz has been and in the future will be subject to great humiliation and embarrassment, and claim is made therefor. 15. As a result of the aforementioned injt~es, Plaintiff Helen P. Fultz has sustained work loss, loss of opportunity and a permanent diminution of her earning power and capacity, and claim is made therefor. 16. As a result of the aforesaid injuries, Plaintiff Helen P. Fultz has sustained uncompensated work loss, and claim is made theretbr. 230550.1\RAS\MLB 3 17. Plaintiff Helen P. Fultz continues to be plagued by persistent pain and limitation and. therefore, avers that her injuries may be of a permanent nature, causing residual problems for the remainder of her lifetime, and claim is made therefor. WHEREFORE. Plaintiff Helen P. Fultz demands judgment against Defendant Joyce M. Timmons in an amount in excess of Twenty-Five Thousand Dollars ($25,000.00), exclusive of interest and costs and in excess of any jurisdictional amount requiring comptdsory arbitration. ANGINO~ R~c'~. S~tO~k, Esquire Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff Date: May 15. 2001 230550. I\RASXMLB 4 VERIFICATION 1, Helen ~f. Fultz, Plaintiff, have read the foregoing PLAINTIFF'S COMPLAINT and do hereby swear or affirm that the facts set forth in the foregoing are true and correct to the best of my knowledge, information and belief. I understand that this Verification is made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unswom falsification to authorities. Dated: . "L ., ' 230555 I~RAS~,ILB IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA HELEN P. FULTZ, CIVIL ACTION - LAW Plaintiff v. NO. 2001-2979 JOYCE M. TIMMONS, Defendant JURY TRIAL DEMANDED PLAINTIFF'S POINTS FOR CHARGE AND NOW comes Plaintiff, by and through her attorneys, Angino & Rovner, P.C., and provide the following jury instructions which she moves the Court to read to the jury. 4503 North Front Street Harrisburg, PA 17110 (717) 238-6791 //./{) Counsel for Plaintiff Date: ~ 230550. I~RAS\MLB 1. Based on the evidence and applicable law in this case and the Defendant's admission of liability, I hereby direct you to return a verdict finding Joyce M. Tirnmons negligent, and thus, liable to Plaintiff for her injuries in an amount of monetary damages which you will determine by applying the/aw of monetary damages, which I will explain to you in detail, to the evidence which you have heard, jff~[~ ~.. ~ 245256. I ~RAS\M LB 2. In order for the Plaintiff to recover in this case, the Defendant's negligent conduct must have been a substantial factor in bringing about the a~gn~C~s is what the law recognizes as legal cause. A substantial factor is an acmai, real factor, although the result may be unusual or unexpected, but is not an imaginary or fanciful factor or a factor having no connection or only an insignificant connection with the accident. Pa. SSJI (Civ) 3.25; _Whitner v. ~ieski, 437 Pa. 448, 263 A.2d 889 (1970). 245256. I\RAS\MLB 3. Under Pennsylvania laxv. the negligent party is liable for all damages which ordinarily and in the natural course of events have resulted from the commission of the original negligent act. Frank v. Volkswagenwerk, A. G. of West Germany, 522 F.2d 321. 323 (3d Cir. 1975); Simmons v. Mullen, 231 Pa. Super. 199, 331 A.2d 892 (1974). ' 245256. I XRASXM LB 4. In civil cases such as this one, the Plaintiff has the burden of proving those contentions which entitle her to relief. When a party has the burden of proof on a particular issue, his contention on that issue must be established by a fair preponderance of the evidence. The evidence establishes a contention by a fair preponderance of the evidence if you are persuaded that it is more probably accurate and tree than not. To put it another way, think, if you will, of an ordinary balance scale, with a pan on each side. Onto one side of the scale, place ail of the evidence favorable to the Plaintiff; onto the other, place all of the evidence favorable to the Defendant. If.. after considering the comparable weight of the evidence, you feel that the scales tip, ever so slightly or to the slightest degree, in favor of the Plaintiff, your verdict must be for the Plaintiff. If the scales tip in favor of the Defendant, or are equally balanced, your verdict must be for the Defendant. In this case, the Plaintiff has the burden of proving the following propositions: that the Defendant was negligent, and that that negligence was a substantial factor in bringing about the accident. If, after considering all of the evidence, you feel persuaded that these propositions are more probably true than not true, your verdict must be for the Plaintiff. Otherwise, your verdict should be for the Defendant. Pa. SSJI (Civ) 5.50: Sisk v. Dui'fy. 201 Pa~2 A.2d 251 (1963); " 231 Pa. Super. 444, 332 A.2d 518 245256.1~RAS~tLB 5. You will recall that Lee S. Segal, M.D. gave testimony of his qualifications as an expert in the field of orthopedics. A witness who has special knowledge, skill, experience, training or education in a particular science, profession or occupation may give his opinion as an expert as to any matter in which he/she is skilled. In determining the weight to be given to his opinion, you should consider the qualifications and reliability of the expert and the reasons given for his opinion. You are not bound by an expert's opinion merely because he is an expert; you may accept or reject it, as in the case of other witnesses. Give it the weight, if any, to which you deem it entitled. Pa. SSJI (Civ) 5.30. / 245256. I ~RAS\MLB 6. You will recall that Chris Tumpaugh, D.C. gave testimony of his qualifications as an expert in the field ofchiropracfics. A witness who has special knowledge, skill, experience, training or education in a particular science, profession or occupation may give his opinion as an expert as to any matter in which he/she is skilled. In determining the weight to be given to his opinion, you should consider the qualifications and reliability of the expert and the reasons given for his opinion. You are not bound by an expert's opinion merely because he is an expert; you may accept or reject it, as in the case of other witnesses. Give it the weight, if any, to which you deem it entitled. Pa. $SJI (Civ) 5.30. 245256.]XRAS'~MLB 7. You will recall that Michael H. lunes, D.C. gave testimony of his qualifications as an expert in the field ofchiropractics. A witness who has special knowledge, skill, experience, training or education in a particular science, profession or occupation may give his opinion as an expert as to any nmtter in which he/she is skilled. In determining the weight to be given to his opinion, you should consider the qualifications and reliability of the expert and the reasons given for his opinion. You are not bound by an expert's opinion merely because he is an expert; you may accept or reject it, as in the case of other witnesses. Give it the weight, if any, to which you deem it entitled. Pa. SSJI(Civ)5.30. 245256.1~RAS\MLB 8. The number of witnesses offered by one side or the other does not, in itself, determine the weight of the evidence. It is a factor, but only one of many factors which you should consider. Whether the witnesses appear to be biased or unbiased; whether they are interested or disinterested persons, are among the important factors which go to the reliability of their testimony. The important thing is the quality of the testimony of each witness. In short, the test is not which side brings the greater number of witnesses or presents the greater quantity of evidence; but which witness or witnesses, and which evidence, you consider most worthy of belief. Even the testimony of one witness may out weigh that of many, if you have reason to believe his testimony in preference to theirs. Obviously, however, where the testimony of the witnesses appear to you to be of the same quality, the weight of numbers assumes particular significance. Pa. SSJI (Civ) 5.03. 245256. I ~RAS~.tLB 9. If you find that the Defendant is liable to the Plaintiff. you must then find an amount of money damages which you believe w~ll fairly and adequately compensate the Plaintiff for all the physical ~ial injury, she has sustained as a result of the accident. The amount which you award today must compensate the Plaintiff completely for damage sustained in the past, as well as damage the Plaintiffwill sustain in the ~umre. Pa. SSJI (Civ) 6.00; Miller v. Weller, 288 F.2d 438 (3d Cir. 1961); Frankel v. United States, 321 F. Supp. 1331 (E.D. Pa. 1970). affd, 466 F.2d 1226 (3d Cir. 1972). 245256.1\RAS~MLB 10. The broad term "pain and suffering" includes a wide range of not only physical, but also emotional reactions to injuries and their consequences. In calculating damage for pain and suffering, you may place a value on the following: (a) Mental pain and distress; (b) Emotional suffering; (c) Anxiety; (d) Frustration; and (e) Loss of the feeling of well-being. Niederman v. Brodsk , 436 Pa. 401,261 A.2d 84 (1970); .Walsh v. Brady. 220 Pa. Super. 293, 286 A.2d 666 (1971); C~oreoran v. McNe_.~._alal. 400 Pa. 14, 161 A.2d 367 (1960). 245256 I~RAS~MLB 11. The Plaintiff is entitled to be fairly and adequately compensated for such physical pain, mental anguish, discomfort, inconvenience and distress as you find she has endured, from the time of the accident until today. ~ ~ ~~ ~..~ Pa. SSJI (Civ) 6.01E; Niederman v. Brodsk¥. 436 Pa. 401. 261 A.2d 84 (1970); Ponist, 518 Pa. 162, 542 A 2d 516 (1988). ' 245256.1XRAS\MLB / 12. In evaluating the amount to be for / suffering, you should ~ that the infliction of pain means taking person own to retain -- namely health and well-being - and the law loss to the extent that loss may be calculated i Coreoran v. McNeal,, Pa. 14, 161 A.2d 367 ' 403 Pa. 329, 169 A.2d 777 (1961); ,424 Pa. 77, 225 A.2d 913 (1967). 245256 IXRAS\MLB 13. The Plaintiff is entitled ~"~rly and adequately compensated for such physical pain, mental anguish, discomfort,~:~fvenience and distress as you believe she will endure in the fi~ture as a result of her7 Pa. SSJI (Civ) 6.01F~lurph¥ v. Taylor, 440 Pa. 186, 269 A.2d 4~1970)_· Cunnin.~am v. Davis, 688 F. Supp. 1030~tE.D. Pa. 1988). ~ -- 2452~6.1\[La.S\MLB 14. If you find that the Plaintiff's injuries will continue beyond today, you must determine the life expectancy of the Plaintiff. According to statistics compiled by the United States Department of Health, Education and Welfare, the average life expectancy of all persons of the Plaintiff's age at the time of accident, sex and race was 63.2 years. This figure is offered to you only as a guide, and you are not bound to accept it if you believe that the Plaintiff would have lived longer or less than the average individual in ~edher category.. In reaching this decision you are to consider the Plaintiff's health prior to the accident, her manner of living, her personal habits and other factors that may have affected the duration of her life. Pa. SSJI (Civ) 6.21: Rosche v. McCoy, 397 Pa. 615, 156 A.2d 307 (1959); Messer v. Bei hie , 409 Pa. 551, 187 A.2d 168 (1963); see, Life Expectancy, Vital Statistics of the United States, (1990) Life Tables. 245256. 15. The Plaintiff is entitled to be fairly and adequately compensated for such embarrassment and humiliation as you believe she has endured and will continue to endure in the future as a result of her injuries. Pa. SSJI (Civ) 6.01G; Frankel v. United States, 321 F. Supp. 1331 (E.D. Pa. 1970), affd, 466 F.2d 1226 (3d Cir. 1972); Marinelli v. Montour R.R. Co.. 278 Pa. Super. 403, 420 A.2d 603 (1980); Fish v. Gosnell, 316 Pa. Super. 565,463 A.2d 1042 (1983). ' 245256.1\RAS\MLB 16. The Plaintiffis entitled to be fairly and adequately compensated for past, present and future loss of her ability to enjoy any of the pleasures of life as a result of her injuries. Pa. SSJI (Civ) 6.01I; Frankel v. United States, 321 F. Supp. 1331 (E.D. Pa. 1970), arid, 466 F.2d 1226 (3d Cir. 1972); Corc~oran v. McNeal, 400 Pa. 14, 161 A.2d 367 (1960); Thom son v. lannuzzi, 403 Pa. 329, 169 A.2d 777 (1961); DiChiacchio v. Rockcraft Stone Products Co., 424 Pa. 77. 225 A.2d 913 ('1967). ' 245256.1~RAS~M LB will be paid. Your verdict must fully...c~nsate the Plaintiff for all injuries, past, present and future that she has sustained. ~,.,.~ ./ Dranzao v. Wiunterhalt .~395 Pa. Super. 578, 577 A. 1349, 1356 (1990). 24~256. I \RAS'uM LB HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED DEFENDANT'S REQUESTED POINTS FOR CHARGe 1. Pa. SSJI (Civ) 3.25 [legal cause] 2. Pa. SSJI (Civ) 5.03 [number of witnesses] 3. Pa. SSJI (Civ) 5.30, 5.31, 5.33 [expert witnesses] 4. Pa. SSJI (Civ) 5.50 [burden of proof] 5. It is for the jury to determine how seriously the Plaintiff has been injured and what allowance, if any, should be made to her for pain and suffering, past, present and/or futura. Even uncontradicted evidence of pain and suffering need not be accepted by the jury. Kirby v. Carlisle, 178 Pa. Super. 389 (1955); Reclo v. Nelson, 194 Pa. Super. 317, 166 A.2d 288 (1960). 6. Damages may not exceed compensation for compensable loss and damages should be awarded with the least burden to the wrongdoer consistent with the idea of fair compensation to the injured party. Incollin~, ~.~.~. Pa. 299, 282 A.2d 206 (1971). 7. The purpose of awarding monetary damages is not to punish a Defendant or to reward a Plaintiff, but rather the purpose is to faidy compensate the Plaintiff for any damages which you may find she has sustained. 8. There is no legal yardstick that can be used to measure accurately what would be reasonable compensation for pain and suffering. Damages for pain and suffering should not be awarded on the basis of sympathy, benevolence or sentimentality, but should be limited to reasonable compensation for the injury sustained. Bostwick v. Pittsburqh Railway, 225 Pa. 397 (1917); Bu__q[gan v. Pittsburg.b.h, 373 Pa. 608, 96 ^.2d 889 (1953). 9. Pain and suffering is not measured by what the jury or some other person would charge to undergo the same pain. Littman v. Bell Telephone Company, 315 Pa. 370, 172 A. 687 (1934) 10. Damages will not be presumed. They cannot be recovered unless the evidence affords a sufficient basis for estimating them with reasonable certainty. Damages should not be estimated on the basis of mere conjecture or speculation. Lorch ~, 369 Pa. 314, 85 A.2d 841 (1952). 11. The Defendant is only liable to pay Plaintiff those damages which are the direct and proximate consequence of the accident. In other words, Plaintiff is entitled to recover only those damages which are the direct and proximate consequence of the accident. Offensend v. Atlantic Ref. Co., 322 Pa. 399, 402 (1936). 12. The Defendant is only liable for those injuries which result from her negligence. Defendant is not liable for or responsible for the residual effects of a prior_ injur~pre-existing condition. ,~'{~ ~ e~J~Z[.~L-~_,, 354 Pa. 19, 46 A.2d 469 (1946). ~ ~, 324 Pa. 577, 188 A.2d 350 (1936). 13. Plaintiff beare the burden of proving by sufficient medical evidence that all of the injuries for which she claims damages were attributable to the accident. Mudano v. Philadell~hia Raoid Transit Co., 289 Pa. 51, 58 137 A. 104 (1927). 14. The credibility of witnesses is always a matter for the jury. It is the province of the jury to appraise the testimony and to either accept or reject the evidence given by a witness. ^ jury need not believe the testimony of a plaintiff and her witnesses concerning injuries; otherwise, there would be no way for a defendant to protect herself against fraudulent claims for injuries which never occurred. Gottlob v. Hille as, 195 Pa. Super. Ct. 453 (1961). 15. The jury is not bound to accept Plaintiff's testimony nor is it bound by the opinions of her medical witnesses or their version of the circumstances. Gaita v. Pamula, 385 Pa. 171,122 A.2d 63 (1956). 16. A jury may not reach its verdict on mere speculation or conjecture. Smith v. Bell Telephone Co_, 397 Pa. 134, 153 A.2d 477 (1959). 17. A jury may not reach its verdict merely on the basis of speculation, guess or conjecture, but there must be evidence, direct or circumstantial, upon which its conclusion may be logically based. Marrazzo v. Scranton Nehi Bottlinq Co., 422 Pa. 518, 223 A.2d 17 (1966). 18. Any verdict which you return must be based solely and entirely upon the evidence presented and the law which is applicable. You are instructed that you cannot return a verdict for or against either party based upon sympathy for the Plaintiff because of the injudes sustained or based upon bias or prejudice against the Defendant. In the eyes of the law, the Plaintiff and the Defendant in this case are equals, each having rights and responsibilities which you must resolve fairly, justly and impartially based upon your reason and not your emotion. 19. You should not allow sympathy, emotion or prejudice to influence your deliberations. You should not be influenced by anything other than the law and the evidence of the case. Pa.S.J.I. 20.00. THOMAS, THOMAS & HAFER, LLP C. Kent Pdce, Esquire 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 ATTORNEYS FOR DEFENDANT :166499.1 # 14 OLER HELEN P. FULTZ, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA : v. : CIVIL ACTION - LAW JOYCE M. TIMMONS, : Defendant : No. 01-2979 CIVIL TERM IN RE: PRETRIAL CONFERENCE A pretrial conference was held in the chambers of Judge Oler in the above-captioned case on Wednesday, April 10, 2002. Present on behalf of Plaintiff was Richard A. Sadlock, Esquire. Present on behalf of Defendant was C. Kent Price, Esquire. This is a negligence action for personal injuries allegedly sustained by Plaintiff arising out of a two-vehicle accident on the Carlisle Pike on January 23, 2000, at 7:02 p.m., which occurred when Defendant, entering the Pike from Lambs Gap Road, failed to yield to a vehicle passing by on the Pike in which Plaintiff was a passenger and struck it on the passenger's side. Liability on the part of Defendant for causing the accident is admitted, leaving factual issues for the jury to resolve of causation and damages. This will be a jury trial in which each side will have four peremptory challenges, for a total of eight. The estimated duration of trial is two days. Plaintiff's counsel will be unavailable for trial on April 29 and April 30, 2002, but indicated that he might be able to obtain substitute counsel, for purposes of jury selection only, on Monday, April 29, 2002. No unusual issues are expected to arise during the cass. This appears to be a non-economic damages case only, because economic damages have been paid by sources as to which evidence is not admissible at the trial. To the extent that deposition testimony will be shown or read to the jury and contains objections requiring rulings by the trial court, counsel are directed to furnish to the Court at least three days prior to commencement of the trial term a copy of the transcript(s) containing objections which require such rulings with the areas of objection being pursued by counsel highlighted and with brief memoranda in support of counsels' respective positions on the objections. With respect to settlement negotiations, Plaintiff has de~nded $37,500.00, and Defendant has offered $8000.00. It is difficult to predict whether this case will be resolved short of trial. By the Court, J~esley ~l_e~, Jr.~-~. Richard A. Sadlock, Esquire For the Plaintiff C. Kent Price, Esquire For the Defendant Court Administrator wcy SHERIFF'S RETURN - REGULAR CASE NO: 2001-02979 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND FULTZ HELEN P VS TIMMONS JOYCE M CPL MICK BARRICK , Sheriff or Deputy Sheriff of Cumberland County, Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon TIMMONS JOYCE M the DEFENDANT , at 0950:00 HOURS, on the 23rd day of May , 2001 at 5430 OXFORD DRIVE MECH3kNICSBURG, PA 17055 by handing to JOYCE M. TIMMONS a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: So Answers: Service 6.82 Affidavit .00 Surcharge 10.00 R. Thomas Kline .00 34.82 05/24/2001 RICI~3kRD SADLOCK Sworn and Subscribed to before By: ,~,~~~'~~~ me this 3~~ day of ' Deputy Sh~-iff ~ '~ ~! A.D. I Prothonotary ~ - HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED PRAECIPE FOR ENTRY OF APPEARANCE TO THE PROTHONOTARY: Please enter the appearance of THOMAS, THOMAS & HAFER, LLP as counsel on behalf of Defendant Joyce M. Timmons in the above-captioned matter. All papers may be served upon the undersigned at P.O. Box 999, Harrisburg, PA 17108-0999. T H O M,A S~l-t O,~.~ A F E R, LLP C. Kent Price, Esquire 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 A'I-I'ORNEYS FOR DEFENDANT CERTIFICATE OF SERVICE AND NOW, this "~day of June, 2001, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attorneys for Defendant, hereby certify that I have this day sensed the within Praecipe for Entry of Appearance by depositing a copy of the same in the United States Mail, postage Prepaid, at Harrisburg, Pennsylvania, addressed to.' Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 THOMAS, THOMAS & HAFER, LLP C. Kent Price, Esquire HELEN p. FULTZ, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, v. PENNSYLVANIA JOYCE M. TIMMONS, NO. 2001-2979 Defendant CIVIL ACTION _ LAW JURY TRIAL DEMANDED TO: Helen p. Fultz, Plaintiff c/o Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harr/sburg, PA 17110 YOU ARE HEREBY notified to plead to the enclosed New Matter within twenty (20) days of service you. hereof or a default judgment may be entered against THOMAs, THOMAs & HAFER, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 ATI'ORNEYS FOR DEFENDANT DATED: HELEN p. FUL'[~, ]~N THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANZA v. NO. 2001-2979 3OYCE M. T~MMONS, CW[L AC'I'JON - LAW Defendant .JURY 'rRZAL DEMANDED ANSWER W/TH NEW MATi'EF 1. Denied. After reasonable investigation, the Defendant is without information or knowledge sufficient to form a belief as to the truth of the allegations. 2. Admitted. 3. Admitted. 4. Admitted. 5. Admitted. 6. Admitted. 7. Admitted. 8. Denied in accordance with Pa.R.C.P. 1029(e). 9. Denied in accordance with Pa.R.C.P. 1029(e). 10. Denied. After reasonable investigation, the Defendant is without information or knowledge sufficient to form a belief as to the truth of the allegations. 11. Denied. After reasonable investigation, the Defendant is without information or knowledge sufficient to form a belief as to the truth of the allegations. :[2. Denied. After reasonable investigation, the Defendant is without information or knowledge sufficient to form a belief as to the truth of the allegations. ~[3. Denied. After reasonable investigation, the Defendant is without information or knowledge sufficient to form a belief as to the truth of the allegations. :[4. Denied. After reasonable investigation, the Defendant is without information or knowledge sufficient to form a belief as to the truth of the allegations. 15. Denied. After reasonable investigation, the Defendant is without information or knowledge sufficient to form a belief as to the truth of the allegations. :[6. Denied. After reasonable investigation, the Defendant is without information or knowledge sufficient to form a belief as to the truth of the allegations. :[7. Denied. After reasonable investigation, the Defendant is without information or knowledge sufficient to form a belief as to the truth of the allegations. WHEREFORE, Defendant Joyce M. ~mmons demands judgment in her favor and against Plaintiff. 18. The Plaintiff's claims may be barred or limited by provisions of the Motor Vehicle Financial Responsibility Law. [9. The Plaintiff's claims may be barred or limited by the applicable tort option election. 20. The Plaintiff's injuries may not constitute serious injuries so as to bar her claim for non-economic loss. 2:[. The Plaintiff's injuries and damages, as alleged, may have been caused by the acts or omissions of Matthew Shindel. 22. Some or all of the alleged injuries may be due to Pre-existing conditions. 23. The Plaintiff may have failed to mitigate her damages. WHEREFORE, Defendant Joyce M. Timmons demands judgment in her favor and against Plaintiff. THOMAS, THOMAS & HAFER, LLP 30.5 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 :~34o3e.~ A'I-I'ORNEYS FOR DEFENDANT VERIFICATION I verify that the facts set forth in the foregoing Answer with New Matter am true and correct to the best of my information, knowledge and belief. I understand that any false statements contained herein are made subject to the penalties of 18 Pa. C.S.A. ~4904, relating to unswom falsification to authorities. , Joyca'M. ~,~rnons CERTIFICATE OF SERVICF AND NOW, this ~day of July, 2001, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attomeys for Defendant, hereby certify that I have this day served the within Answer with New Matter by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 THOMAS, THOMAS & HAFER, LLP ent Price, Esquire IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA HELEN P. FULTZ, CIVIL ACTION - LAW Plaintiff v. NO. 2001-2979 JOYCE M. TIMMONS, Defendant JURY TRIAL DEMANDED PLAINTIFF'S REPLY TO NEW MATTER AND NOW comes the Plaintiff, by' and through her attorneys, Angino & Rovner, P.C., and hereby enter the following Reply to the New Matter of Defendant as follows: 18. Defendant's averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, all of Plaintiffs injuries and damages are recoverable in the instant action. The Pennsylvania Motor Vehicle Financial Responsibility Law in no way limits the damages Plaintiff may recover herein. 19. Defendant's averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, the Plaintiff selected the full tort option on her policy and is, therefore, entitled to maintain an action for non-economic losses. Further, Plaintiffdid suffer a serious injury. Plaintiffs Declaration Page is attached hereto as Exhibit A. 20. Defendant's averment is a conclusion of law to which no responsive pleading is required. To the extent the avem~ent may be deemed factual, it is hereby specifically denied. By way of amplification. Plaintiff's injuries do constitute serious injuries and may pursue a claim for non-economic loss. 230550. I\RAS\MLB 21. Defendant's averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Defendant's averment lacks the specificity required by the Pennsylvania Rules of Civil Procedure. Further, all of Plaintiffs injuries and damages were caused solely and directly as a result of the negligence, carelessness, wantonness and recklessness oftbe instant Defendant. 22. Defendant's averment is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, Plaintiff did not have any pre-existing conditions. All of Plaintiffs injuries and damages were caused solely and directly as a result of the negligence, carelessness, wantonness and recklessness of the instant Defendant. 23. Defendant's avemlent is a conclusion of law to which no responsive pleading is required. To the extent the averment may be deemed factual, it is hereby specifically denied. By way of amplification, where appropriate, Plaintiff properly mitigated her damages. WHEREFORE, Plaintiff respectfully requests this Honorable Court to dismiss Defendant's ~ I.IM~I~F/281 4503 N. Front Street Harrisburg. PA 17110 {717) 238-6791 Counsel for Plaintiff Date: July 23, 2001 232176.1\RAS\MLB ER~ ERIE '"SURANCE EXCHANGE INSURANC~ GROUP PIONEER MILY AUTO POLICY ./~/~.E.e..^ ~e~o CONTINUATION NOTICE AA?50? RONALD L SHINER 08/18/99 TO 08/18/00 Q08 1807880 H MELINDA M FULTZ 347 HUMMEL AVENUE LEMOYNE PA 17043-1951 AGENT - RONALD L SHINER 1001 S. MARKET STREET ***** SUITE C AGENT PHONE - (717) 766-1200 MECHANICSBURG PA 17055 4748 ITEM 4. AUTOS COVERED AUTO YR MAKE YIN ST TER SYM RATING CLASS DDP i 86 DODG CARAVAN SE 2B4FK41G6GR655526 PA 4D AIBS ITEM 5. INSURANCE IS PROVIDED WHERE A PREMIUM, OR INCL, IS SHOWN FOR THE COVERAGE. COVERAGES, LIMITS AND ANNUAL PREMIUMS ARE AS FOLLOWS- *****GOOD DRIVER RATES APPLY***** --- THE FULL TORT OPTION APPLIES TO ALL PRIVATE PASSENGER VEHICLES. --- LIABILITY PROTECTION- BODILY INJURY $100M/P~RSON $300M/ACC 109 PROPERTY DAMAGE S100M/ACC 93 FIRST PARTY BENEFITS- MEDICAL EXPENSE.S100M 73 INCOME LOSS SiM/MONTH, $15M MAXIMUM 15 ACCIDENTAL DEATH SSM 2 FUNERAL BENEFIT $2.5M 2 UNINSURED MOTORISTS COVERAGEt BOD INJ $100M/PERSON $300M/ACC-STACKED 20 UNDERINSURED MOTORISTS COVERAGE- BOD INJ $100M/PERSON $300M/ACC-STACKED 66 TOTAL ANNUAL PREMIUM FOR EACH AUTO 380 TOTAL ANNUAL POLICY PREMIUM $ 380 ITEM 6. APPLICABLE POLICY. ENDORSEMENTS. EXCEPTIONS TO 10/ 8', AFPA03 10Z 8'. DECLARATIONS ITEMS EXPLANATION OF ADULT &/OR YOUTHFUL DRIVER RATING CLASS AUTO 1-TO WORK LESS THAN 6 MILES ONE WAY, UP TO 8,500 MILES ANNUALLY MISCELLANEOUS INFORMATION ITEM 7. EACH AUTO WE INSURE WILL BE PRINCIPALLY GARAGED AT THE ADDRESS SHOWN IN ITEM 1, UNLESS ANOTHER ADDRESS IS SHOWN BELOW. ITEM 9. UNLESS A CO-OWNER OR LIENHOLDER IS LISTED BELOW, THE NAMED INSURED IS THE SOLE OWNER OF EACH AUTO WE INSURE. DRIVER ST LICENSE NUMBER BIRTH DATE ~'~' 1 MELINDA M FULTZ PA 17385677 07/18/56 ~1~! 3347 ND WFS 07/17/99 ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING. INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT. WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND CIVIL PENALTIES. THIS POLICY DOES NOT COVER COLLISION DAMAGE TO RENTAL VEHICLES. THE LAWS OF THE COMMONWEALTH OF PENNSYLVANIA. AS ENACTED BY THE GENERAL ASSEMBLY. ONLY REQUIRE THAT YOU PURCHASE LIABILITY AND FIRST-PARTY MEDICAL BENEFIT COVERAGES. ANY ADDITIONAL COVERAGES OR COVERAGES IN EXCESS OF THE LIMITS REQUIRED BY LAW ARE PROVIDED ONLY AT YOUR REQUEST AS ENHANCEMENTS TO THE BASIC COVERAGES. BELOW ARE ANNUAL PREMIUMS FOR THE MINIMUM REQUIRED COVERAGES AND LIMITS FOR FULL TORT. # 1 BODILY INJURY S15M/~ERSON $30M/ACC 62 PROPERTY DAMAGE SSM/ACC 78 FIRST PARTY BENEFITS - MEDICAL EXPENSE $5M 33 Q08 1807880 :3348 VERIFICATION I, Helen p~ Fultz, Plaintiff. have read the foregoing PLAINTIFF'S REPLY TO DEFENDANT'S NEW MATTER and do hereby swear or affirm that the facts set forth in the foregoing are true and correct to the best of my knowledge, information and belief. I understand that this Verification is made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unswom falsification to au~ofi~. 230555.1\RAS~MLB CERTIFICATE OF SERVICE I, Marcy L. Brymesser, an employee of the law firm of Angino & Rovner, P.C., do hereby certify that I am this day serving a true and correct copy of PLAINTIFF'S REPLY TO NEW MATTER on the following via postage prepaid, first class United States mail, addressed as follows: C. Kent Price, Esquire Thomas, Thomas & Hafer, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 l~Ia~ E. firy~es~' Date: July 23, 2001 232176 IXRAS\MLB HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED CERTIFICATE OF PREREClUlSITE TO SERVE SUBPOENAS PURSUANT TO RULE 4009.22 As a Prerequisite to service of Subpoenas for Documents and Things pursuant to Rule 4009.22, Defendant certifies that: 1. A Notice of Intent to Serve Subpoenas with copies of the Subpoenas attached thereto was mailed to each party at least twenty (20) days pdor to the date on which the Subpoenas am sought to be served. 2. A copy of the Notice of Intent including the proposed Subpoenas am attached to this Certificate. 3. No objection to the Subpoenas has bccn received. 4. The Subpoenas which will be served are identical to the Subpoenas which am attached to the Notice of Intent ~R, LLP 305 North Front Street P,O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 ATI'ORNEYS FOR DEFENDANT STEVEN D. GRASLEY, SR. HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff NO. 2001-2979 V. CIVIL ACTION - LAW JOYCE M. TIMMONS, JURY TRIAL DEMANDED Defendant NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 TO: Counsel of Record Defendant intends to serve a Subpoenas identical to the ones attached to this Notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the Subpoenas. If no objection is made, the Subpoenas may be served. TH,~MAS..T H O/M~.°.~ & .I-IAFE R. LLP 6'. 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 A'I-rORNEYS FOR DEFENDANT DATE: September 14, 2001 CERTIFICATE OF SERVICE AND NOW, this 14th day of September, 2001, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attorneys for Defendant, hereby certify that I have this day served the within Notice of Intent to Serve a Subpoena to Produce Documents and Things for Discovery Pursuant to Rule 4009.21 by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 THOMAS, THOMAS & HAFER, LLP C. Kent Pri(~-, Esquire HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THING.~ FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: ChrisTurnpau.qh, D.C. (Name of Person or Entity) Within twenty (20) days after sewice of this subpoena, you are ordered by the court to produce the following documents or things: Complete copies of any and all records, reports, correspondence, notes, memoranda and diaanostic studies re.qarding Helen P. Fultz; Date of Birth: 12/22/82 at: Thomas, Thomas & Hafer, LLP, 305 N. Front St., P.O. Box 999, Harrisbur.q, PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days alter its service, the party sewing this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 ATI'ORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Deputy HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 400922 TO: Dr. Michael Innes/Innes Chiropractic (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court lo produce the following documents or things: Comolete coDies of any and all records, reports, correspondence, notes, memorand~ and diaanostic studies reaardina Helen P. Fultz; Date of Birth: 12/22/82 at: Thomas, Thomas & Hafer, LLP, 305 N. Front St., P.O. Box 999, Hardsburq, PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 A'I-I'ORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Deputy HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009_22 TO: Dr. Lee Se(~al, Hershey Medical Center (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: Comolete ccoies of any and all records, reports, correspondence, notes, memoranda and dia(3nostic studies ref:lardinR Helen P. Fullz; Date of Birth: 12/22/82 at: Thomas, Thomas & Hafer, LLP, 305 N. Front St., P.O. Box 999, Harrisburq, PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this requast at the address listed above. You have the dght to seek in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its service, the party serving this subpoena may seek a court order cernpelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 A3-1'ORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Deputy HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009:22 TO: Dr. Vitaly Gordon, Hershey Medical Center (Name of Pemon or Entity) W'~hin twenty (20) days after service of this subpoena, you are ordered by tha court to produce the following documents or things: Comolete ccoies of any and all records, reports, correspondence, notes, memorand~ and diaglnostic studies re;lardinq Helen P. Fultz; Date of Birth: 12/22/82 at: Thomas, Thomas & Haler, LLP, 305 N. Front St., P.O. Box g99, Harrisbun:l, PA 17108-0999 (Address) You may deliver or mail legible copias of the documents or produce things requested by this subpoena, together with the certificate of compliance, to tha party making this request at the address listed above. You have the right to seek in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply wilh it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 ATI'ORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Deputy HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGR FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Dr. Christine Sheridan (Name of Person or Entity) Within twenty (20) days after sewice of this subpoena, you are ordered by the court to produce the following documents or things: Comolete copies of any and all records, reports, correspondence, notes, memorand~ and diac3nostic studies re,qardinq Helen P. Fultz; Date of Birth: 12/22/82 at: Thomas. Thomas & Hafer. LLP, 305 N. Front St., P.O. Box 999, Harrisburq, PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certiticete of compliance, to the party making this request at the address listed above. You have the right to seek in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 A'i-I'ORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Depu~ HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.:~ TO: Dr, Kwan Won (Name of Person or Entity) VVithin twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documer~s or things: Complete copies of any and all records, reports, correspondence, notes, memoranda and dia.qnostic studies reqardinR Helen P. Fultz; Date of Birth: 12/22/82 at: Thomas, Thomas & Hafer, LLP, 305 N. Front St., P.O. Box 999, Harrisburq, PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the dght to seek in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 ATI'ORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Deputy HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THING~ FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Hetrick Center (Name of Pemon or Entity) Within twenty (20) days after service of this subpoena, you am ordered by the court to produce the following documents or things: ComDlete coDies of any and all records, reports, correspondence, notes, memoranda and dia(=nostic studies re.qardinq Helen P. Fultz; Date of Birth: 12/22/82 at: Thomas, Thomas & Hafer, LLP, 305 N. Front St., P.O. Box 999, Harrisburq, PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance, the reasonable cost of preparing the copies or producing the things sougM. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its sewice, the party sewing this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 A'I-I'ORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Deputy HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THING~ FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Dr. Zoo, Hershe¥ Medical Center (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: Complete copies of any and all records, reports, correspondence, notes, memorand~ and diaanostic studies reqarding Helen P. Fultz; Date of Birth: 12/22/82 at: Thomas, Thomas & Hafer, LLP, 305 N. Front St., P.O. Box 999, Harrisbur.q, PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the dght to seek in advance, the reasonable cost of prepa~ng the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with It. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 A'FrORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Deputy HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGR FOR DISCOVERY PURSUANT TO RULE 4009 ~ TO: Penn State Sports Medicine (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you am ordered by the court to produce the following documents or things: Comolete cooies of any and all records, reports, corresr)ondence, notes, memorand; and diaqnostic studies regardin.q Helen P. Fultz; Date of Birth: 12/22/82 at: Thomas. Thomas & Haler, LLP, 305 N. Front St., P.O. Box 999, Harrisbuq:h PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with lhe certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance, the reasonable cost of preparing the copies or pmdudng the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its sen/ice, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 A'I-rORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Depu~ CERTIFICATE OF SERVICE AND NOW, this 19th day of September, 2001, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attomeys for Defendant Joyce M. Timmons, hereby certify that I have this day served the within Certificate of Prerequisite to Serve Subpoenas Pursuant to Rule 4009.22 by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 THOMAS, THOMAS & HAFER, LLP C. Kent Price, Esquire HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED CERTIFICATE OF PREREQUISITE TO SERVE SUBPOENAS PURSUANT TO RULE 4009.22 As a Prerequisite to service of Subpoenas for Documents and Things pursuant to Rule 4009.22, Defendant certifies that: 1. A Notice of Intent to Serve Subpoenas with copies of the Subpoenas attached thereto was mailed to each party at least twenty (20) days prior to the date on which the Subpoenas are sought to be served. 2. A copy of the Notice of Intent including the proposed Subpoenas are attached to this Certificate. 3. No objection to the Subpoenas has been received. 4, The Subpoenas which will be served are identical to the Subpoenas which am attached to the Notice of Intent TH~OMAS, THOI)~I~4S & HAFER, LLP C. Kent Price, Esquire 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 A'I-rORNEYS FOR DEFENDANT STEVEN D. GRASLEY, SR. HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff NO. 2001-2979 V. CIVIL ACTION - LAW JOYCE M. TIMMONS, JURY TRIAL DEMANDED Defendant NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 TO: Counsel of Record Defendant intends to serve a Subpoena identical to the ones attached to this Notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undemigned an objection to the Subpoena. If no objection is made, the Subpoena may be served. THOMAS. THOMAS & HAFER, LLP C. Kent Price 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 A3-rORNEYS FOR DEFENDANT DATE: October 26, 2001 HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4909 ~ TO: Holy Soidt Hospital, Medical Records Del~artment, 503 N. 21't Street. Camo Hill, PA 170211- 2288 (Name of Person or Entity) Within twenty (20) days after senrice of this subpoena, you are ordered by the court to produce the following documents or things: Complete copies of any and all records, reloorts, corresr)ondence, notes, memoranda and diaanostic studies reqardinq Helen P. Fultz: Date of Birth: 12/22/82 at: Thomas. Thomas & Hafer, LLP, 305 N. Front St., P.O. Box 999, Harrisburq, PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to lhe party making this request at the address listed above. You have the right to seek in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its cewice, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 A'I-I'ORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Deputy CERTIFICATE OF SERVICE AND NOW, this 26th day of October, 2001, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attorneys for Defendant, hereby certhSj that I have this day served the within Notice of Intent to Serve a Subpoena to Produce Documents and Things for Discove~J Pursuant to Rule 4009.21 by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Hardsburg, PA 17110 THOMAS, THOMAS & HAFER, LLP C. Kent Price, Esquire CERTIFICATE OF SERVICF AND NOW, this 1st day of November, 2001, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attorneys for Defendant Joyce M. Timmons, hereby certify that I have this day served the within Certificate of Prerequisite to Serve Subpoenas Pursuant to Rule 4009.22 by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 THOMAS, THOMAS & HAFER, LLP C. Kent Pric~, Esquire HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff' CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED CERTIFICATE OF PREREQUISITE TO SERVE SUBPOENAS PURSUANT TO RULE 4009.22 As a Prerequisite to service of Subpoenas for Documents and Things pursuant to Rule 4009.22, Defendant certifies that: 1. A Notice of Intent to Serve Subpoenas with copies of the Subpoenas attached thereto was mailed to each party at least twenty (20) days prior to the date on which the Subpoenas are sought to be served. 2. A copy of the Notice of Intent including the proposed Subpoenas are attached to this Certificate. 3. No objection to the Subpoenas has been received. 4. The Subpoenas which will be served are identical to the Subpoenas which are attached to the Notice of Intent THOMAS, THO[VI~S & HAFE,R, LLP C.'~en~ Price, Esquire 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 ATTORNEYS FOR DEFENDANT STEVEN D. GRASLEY, SR. HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff NO. 2001-2979 V. CIVIL ACTION - LAW JOYCE M. TIMMONS, JURY TRIAL DEMANDED Defendant NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 TO: Counsel of Record Defendant intends to serve a Subpoena identical to the ones attached to this Notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undemigned an objection to the Subpoena. If no objection is made, the Subpoena may be served. THOMAS, THOMAS & HAFER, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 A'I-I'ORNEYS FOR DEFENDANT DATE: November 1, 2001 HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4089.22 TO: Pinnacle Health System/Polyclinic Hospital, 2601 North Third Street, Harrisburq, PA 17110-2098 (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: Complete copies of any and all records, reports, correspondence, notes, memoranda and dia(=nostic studies reaardin¢~ Helen P. Fultz: Date of Birth: 12/22/82 at: Thomas. Thomas & Hafer. LLP. 305 N. Front St.. P.O. Box 999. Harrisburo. PA 17108-0999 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena, within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID#: 06776 ATTORNEY FOR: Defendant Joyce M. Timmons BY THE COURT: DATE: Seal of the Court Prothonotary/Clerk, Civil Division Deputy CERTIFICATE OF SERVICE AND NOW, this 1st day of November, 2001, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attorneys for Defendant, hereby certify that I have this day served the within Notice of Intent to Serve a Subpoena to Produce Documents and Things for Discovery Pursuant to Rule 4009.21 by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 THOMAS, THOMAS,& HAFER, LLP C,'"~6nt~Pdce, Esquire CERTIFICATE OF SERVICE AND NOW, this 6th day of November, 2001, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attorneys for Defendant Joyce M. Timmons, hereby certify that I have this day served the within Certificate of Prerequisite to Serve Subpoenas Pursuant to Rule 4009.22 by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 THOMAS, THOMAS & HAFER, LLP C. Ken~'P~ice, I%~Uire ' PRAECIPE FOR LISTING CASE FOR TRIAL (Must be typewritten and submit'ted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY Please list the following case: (Check one) (X) for JURY trial at the next term of civil court ( ) for trial without a jury CAPTION OF CASE (entire caption must be stated in full) (check one) ( ) Assumpsit HELEN P. FULTZ ( ) Trespass Plaintiff (X) Trespass (Motor Vehicle) v. ( ) Other JOYCE M. TIMMONS, Defendant The trial list will be called on April 2, 2002. Trials coramence on April 29, 2002. Pre-trials will beheld on April 10, 2002. (Briefs are due 5 days before pre-trials.) (The party listing this case for trial shall provide forthwith a copy of the praecipe to all counsel, pursuant to local Rule 314-1.) No. 2001 Civil 2979 Indicate the attorney who will try case for the party who files this praecipe: Richard A. Sedlock, Esquire, Angino & Rovner, P.C. 4503 North Front StreeL Harrisburg, PA 17110 Indicate trial counsel for other parties if known: C. Kent Price, Esquire, Thomas, Thomas & Haler, LLP Box 999, Harrisburg, PA 17108 305 North Front Street, P.O. ~ This case is ready for trial. Print Nam"er-Ridml~. Sedlock,Esquire Attorney for Plaintiff Date: March II, 2002 HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED CERTIFICATE OF PREREQUISITE TO SERVE A SUBPOENA PURSUANT TO RULE 4009.22 As a Prerequisite to service of Subpoena for Documents and Things pursuant to Rule 4009.22, Defendant certifies that: 1. A copy of the Notice of Intent including the proposed Subpoena attached to this Certificate. 2. Counsel was contacted via correspondence and has waived the 20 day requisite notice of intent to serve. 3. The Subpoena which will be served is identical to the Subpoena which is attached to the Notice of Intent THOMAS, THOMAS & HAFER, LLP C. Kent Price, Esquire 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 ATTORNEYS FOR DEFENDANT HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff NO. 2001-2979 V. CIVIL ACTION - LAW JOYCE M. TIMMONS, JURY TRIAL DEMANDED Defendant NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 TO: Counsel of Record Defendant intends to serve a Subpoena identical to the ones attached to this Notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the Subpoena. If no objection is made, the Subpoena may be served. THOMAS, THOMAS & HAFER, LLP C. Kent Price, Esquire 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 ATTORNEYS FOR DEFENDANT DATE: March 18, 2002 HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA v. NO, 2001-2979 CIVIL ACTION - LAW JOYCE M. TIMMONS, Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Erie Insurance Exchanqe (Name of Person or Entity) Wlthln twenty (20) days after service of this subpoena, you am ordered by the court to produce the following documents or things: A complete cody of the first-DarN claim file, without limitation, your insured. Melinda Fultz, policy no. Q081807880H, claim no. 010170473576, arisinq out of a claim made by Helen P. Fultz arisinq out of an accident on January 23, 2000, includin~ but not limited to: applic-e_tion for benefrts, physician's statements, waoe verifications, oolicv declaration paoe[s) showin(~ coveraQes and tort ol3tion election, summaries of payments made,, medical records and reports, bills, Peer Review reports, IME reports and correspondence. at: Thomas, Thomas & Hafer, LLP, 305 N. Front St., Harrisbur.q, PA 17101 (Address) You may delNer or mail legible copies of the documents or produce things requested by tNs subpoena, together with the certJficete of compliance, to the party making this request at the address listed above. You have the right to seek In advance, the reasonable cost of preparing the copies or producing the things sought. If you fall to produce the documents or things required by this subpoena, within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: C. Kent Price, Esquire ADDRESS: P.O. Box 999, Harrisburg, PA 17108-0999 TELEPHONE: (717) 255-7632 SUPREME COURT ID~: 06776 A'I-I'ORNEY FOR: Defendant Joyce M. Timmons BY 'r_HE COURT: /'~ Seal of the Court' Prothonotary/Clerk, Civil Di~-h CERTIFICATE OF SERVICE AND NOW, this ~ ~'day of Mamh, 2002, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attorneys for Defendant, hereby certify that I have this day served the within Notice of Intent to Serve a Subpoena to Produce Documents and Things for Discovery Pursuant to Rule 4009.21 by depositing a copy of the same in the United States Mail. postage prepaid, at Harrisburg, Pennsylvania, addressed to: Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 THOMAS, THOMAS & HAFER, LLP C. Kent Price, Esquire CERTIFICATE OF SERVICE AND NOW, this, ~'~'~'day- of Mamh, 2002, I, C. KENT PRICE, ESQUIRE, for the firm of THOMAS, THOMAS & HAFER, LLP, attorneys for Defendant Joyce M. ~mmons, hereby certify that I have this day served the within Certificate of Prerequisite to Serve Subpoenas Pursuant to Rule 4009.22 by depositing a copy of the same in the United States Mail, postage prepaid, at Harrisburg, Pennsylvania, addressed to: Richard A. Sadlock, Esquire Angino & Rovner, P.C. 4503 North Front Street Harrisburg, PA 17110 THOMAS, THOMAS & HAFER, LLP C. Kent Price, Esquire HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff NO. 2001-2979 V. CIVIL ACTION - LAW JOYCE M. TIMMONS, JURY TRIAL DEMANDED Defendant TO THE PROTHONOTARY: Please enter judgment in favor of the Plaintiff and against the Defendant on the verdict of the jury in the amount of $1,000.00 as rendered at the conclusion of trial on April 30, 2002. THOMAS, THOMAS & HAFER, LLP C. Kent Price, Esquire 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 (717) 255-7632 I.D. No. 06776 ATTORNEYS FOR DEFENDANT HELEN P. FULTZ, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2001-2979 JOYCE M. TIMMONS, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED TO THE PROTHONOTARY: Please mark the judgment previously entered in this matter in favor of the Plaintiff and against the Defendant in the amount of $1,000.00 as satisfied. 21~03_J~ F-t~'~t Street Harrisburg, PA 17110 A'Iq'ORNEYS FOR PLAINTIFF ORIGINAL HELEN P. FULTZ, : IN T~{E COURT OF COMMON PLEAS PLAINTIFF : CUMBERLAND COUNTY, PENNSYLVANIA V : CIVIL ACTION - LAW : NO. 2001-2979 JOYCE M. TIMMONS, : DEFENDANT : JURY TRIAL DEMANDED DEPOSITION OF: CHRIS TUR/qPAUGH, D.C. TAKEN BY: PLAINTIFF BEFORE: BOBBI JO ~P~N, RPR NOTARY PUBLIC DATE: APRIL 12, 2002 PLACE: 6103 CARLISLE PIKE MECHANICSBURG, PENNSYLVANIA APPEARANCES: ANGINO & ROVNER, P.C. BY: RICHARD A. SADLOCK, ESQUIRE FOR - PLAINTIFF THOMAS, THOMAS & HAFER, LLP BY: C. KENT PRICE, ESQUIRE FOR - DEFENDANT 2080 Linglestown Road · Suite 107~ · Harrisburg, PA 17110 717.540.0220 · Fax 717.540.0221 · Lancaster 717393.5101 WITNESSES NAME DIRECT CROSS REDIRECT RECROSS ~HRIS TURNPAUGH, D.C. BY: MR. SADLOCK 3, 6 -- 32 -- BY: MR. PRICE -- 5 (ON QUAL.) .... 18 3 1 STIPULATION 2 It is hereby stipulated by and between 3 :ounsel for the respective parties that reading, 4 signing, sealing, certification and filing are hereby 5 waived. 6 7 CHRIS TURNPAUGH, D.C., called as a witness, 8 Deing duly sworn, testified as follows: 9 10 DIRECT EXAMINATION 11 BY MR. SADLOCK: 12 Q Would you state your full name, sir? 13 A Charles Christopher Turnpaugh. 14 Q And what is your occupation? 15 A I'm a chiropractor. 16 Q Can you briefly explain to the jury what's 17 involved in that practice? 18 A The practice of evaluating and treating 19 patients for ailments usually involving the spinal 20 segments and the nervous system. 21 Q Can you briefly explain your educational 22 background that led to you becoming a chiropractor? 23 A Yes, I graduated high school, Hempfield High 24 School. I went on to a four year degree at Bloomsburg 25 University, followed with a four year doctoral program 4 1 in chiropractic at Life Chiropractic College and then 2 [id a three year post doc -- post doctoral degree in 3 Leurology. 4 Q What was involved in the post doctorate 5 ~raining in neurology? 6 A Three hundred fifty hours of course work with 7 Neekly clinical follow-ups with a seven day exam. 8 Q And -- and that training, who was it provided 9 by? 10 A That was provided by Cleveland Chiropractic 11 College. 12 Q Are you licensed to practice in the 13 Commonwealth of Pennsylvania? 14 A Yes, I am. 15 Q Do you hold any other type of certificates or 16 licensures? 17 A Adjunctive procedures as well as chiropractic 18 and just the diplomate in neurology. 19 Q Do you have any specialty or special area of 20 ~ractice within the field of chiropractic? 21 A Chiropractic neurology. 22 Q And what does that mean specifically? 23 A Specifically, it just entails further 24 !ducation on the nervous system and functionality of 25 ~he nervous system to further assess possible 1 neurological damage. 2 Q Doctor, as part of your practice, do you 3 treat patients who have been injured in motor vehicle 4 accidents? 5 A Yes, I do. 6 Q And does that include patients who have 7 suffered neck or back injuries from a motor vehicle 8 mccident? 9 A Yes. 10 Q Doctor, is Helen Fultz a patient of yours? 11 A Yes, she is. 12 MR. SADLOCK: At this time, I'd like to offer 13 Dr. Turnpaugh as an expert in chiropractic care and as 14 one of Miss Fultz's treating chiropractors. 15 CROSS EXAMINATION ON QUALIFICATIONS 16 BY MR. PRICE: 17 Q How old are you, sir? 18 A Thirty-~hree. 19 Q What year did you graduate from Bloomsburg? 20 A I graduated from Bloomsburg in 1990. 21 Q How long have you been practicing 22 ~hiropractic medicine? 23 A Since 1995. 24 Q Okay. Just to make it clear for the jury, 25 ,ou're not a medical doctor? 6 1 A That is correct. 2 Q You're not an osteopathic doctor? 3 A That is correct. 4 Q Are you able as a chiropractor to prescribe 5 medication? 6 A No, I am not. ? Q Are you able as a chiropractor to do surgery? 8 A No, I'm not. 9 Q Are you able as a chiropractor to do any 10 lnvasive procedures whatsoever? 11 A No. 12 Q Okay. Are you able as a chiropractor to 13 perform CT Scans? 14 A Perform? Order but not perform. 15 Q Okay. How about MRI scans? 16 A Order but not perform. 17 Q So those would be done by, I guess, a 18 ~adiologist? 19 A Correct, or -- yes. 20 MR. PRICE: Okay. That's all I have. Thank 21 ,ou. 22 DIRECT EXAMINATION 23 ~Y MR. SADLOCK: 24 Q Doctor, do you have training in reading or 25 interpreting CT Scans, X-rays or MRI films, things of 7 1 that nature? 2 A Yeah, all of those. 3 Q Doctor, we established already that Helen 4 Fultz was -- is a patient of yours. Can you tell us 5 when you first saw her in your practice? 6 A I want to make sure I get this right. I 7 don't have it on my -- I have it, I believe. I'm going 8 to double-check, but it's January 16th of 2001. 9 Q And -- and how did Miss Fultz come to be seen 10 by you, Doctor? 11 A She was referred to me by Dr. Michael Innes 12 for a neurological and second opinion consult. 13 Q Had she been treating with Dr. Innes? 14 A Yes, she had. 15 Q Did Miss Fultz provide a history to you? 16 A Yes, she did. 17 Q And can you tell us what that history was? 18 A She stated she was in a motor vehicle 19 accident which she described she -- her head flew 20 Eorward, she smashed her chin against her chest and 21 flew backwards. She was taken to Holy Spirit Hospital, 22 follow-up with Dr. Little and then follow-up with Dr. 23 Innes. She sustained -- her neck hurt and her whole 24 oody hurt after the accident. 25 Q Did she have anymore specific or other 8 1 complaints when you first examined her? 2 A When she originally came to see me, she had a 3 numbness feeling in the back of her skull. She had tremendous muscle spasms across her shoulders. 5 Q The spasm across her shoulders, Doctor, is 6 5hat something that you were able to feel on 7 ~xamination? 8 A Yes, upon palpation and also visibly, I could 9 see there was increased muscle activity across the 10 ~rapezius muscles. 11 Q Would that be an objective finding? 12 A That would be objective, yes. 13 Q Did you conduct an examination then, Doctor, 14 Dn January -- 15 A Yes, I did. 16 Q And what did that involve? 17 A That involved upper as well as lower 18 neurological integrity tests such as reflexes, 19 sensitivity to different vibration and light touch as 20 Nell as strength testing, cranial nerve testing which 21 Ne check to make sure the eye moves correctly and have 22 normal distribution of sensation across the face and 23 activity for nerves that exit from the skull. 24 Q What was the result of your examination? 25 A We found a slight increase in the right 9 1 )atellar reflex, plus three slightly hyper. She had 2 ~al -- palpatory increased muscular activity across the 3 right levator scapular area. I'm sorry. She had a 4 positive foraminal compression test with no radiating 5 signs down the arms, no radicular signs. 6 Normal cardinal fields of gaze. There was a 7 negative Romberg's test. She did not get dizzy while 8 lying on her side and raising up quickly. There was no 9 ~ystagmus present. Vibratory sensations in the lower 10 xtremity were normal compared bilaterally as well as 11 he upper extremity and muscle strengths were five and 12 strong in the upper and lower extremity. 13 Q In lay terms, what did all those tests mean 14 or of what significance were they as you -- 15 A In lay terms, we wanted to make sure there 16 was no frank nerve impingement or squeezing of the 17 nerve which would cause -- similar to cutting a cord to 18 a television set, you wouldn't see the screen. She 19 wouldn't have the muscle strength to hold muscles 20 intact and she would also lose sensation on those 21 nerves that had been impinged or cut. 22 In addition, we wanted to rule out any type 23 of brain defect or neurological defect in the brain 24 area which would mean she would be dizzy or wouldn't be 25 able to follow my finger when I move my finger around 10 1 or wouldn't have normal activity coming from the brain 2 itself. 3 Q Did you review any diagnostic studies at that 4 ~ime, Doctor, such as MRIs or X-rays? 5 A Actually, I did. I reviewed an MRI as well 6 as X-rays at that time. 7 Q What was your interpretation of those films? 8 A There was a mild congenital stenosis in my 9 opinion which would be a -- something that happened at 10 birth, a congenital stenosis not to the point where it I1 was impinging or squeezing the spinal cord itself. 12 However, within the normal variation of the human body, 13 there are different sizes of -- of canal for the spinal 14 cord; and hers is smaller than the average. 15 There was no impingement of the spinal cord 16 in its neutral position. I did notice though on a 17 motion study of the cervical spine that there appeared 18 to be ligament laxity at the C4-5 level and decreased 19 segmental motion at C5-6, C6-7 and C7-T1; and I was 20 suspect that there may be some mild cord impingement 21 apon extreme ranges of motion. However, that was not 22 documented in the MRI. 23 Q And what does all that mean? 24 A Basically that means that some people are 25 sturdier and some people aren't, and I believe in her 11 1 case that her spine isn't as sturdy as maybe somebody 2 slse's spine. If it was -- if she was a linebacker per 3 se, she may have been able to handle it muscularly. 4 ~e're talking about the spine itself and the bones of 5 the spine. She happens to have a smaller hole for her 6 spinal cord making her more susceptible. She has an 7 increased probability to sustaining injury than the 8 average person. 9 In addition, her bones don't move correctly 10 in her neck; and while if we took a picture in time it 11 may look okay, when we have her move around, we see 12 ~hat there's not normal function and some of the bones 13 don't move as well as they should and some move further 14 ~han they should. 15 And upon the MRI, that's taking a neutral or 16 nonstressed position; and my -- my suspicion is that 17 hen she goes into a stressed position and those bones 18 hove further than they should that may cause some 19 interference in the nervous system. 20 Q Is that of significance then given Miss 21 Fultz's history in which she explained to you during 22 the accident her head flew forward chin to chest and 23 then back again? 24 A Well, that injury would be significant to the 25 average person. However, I believe there -- there's an 12 1 increased probability of significance for her given 2 her -- her genetics, the way she's formed. 3 Q Did you formulate a diagnostic impression 4 'then, Doctor? 5 A Yes, I did at that time. 6 Q And what was that? 7 A We had ligament laxity at the C4 level 8 possibly compromising the nervous system and spinal 9 :ord as well as cervical subluxation. 10 Q And what does that mean, cervical 11 ~ubluxation? 12 A A subluxation is when the bones have lost 13 ~heir proper alignment in respect to the one above or 14 below or lost their proper motion with the bone above 15 Dr below to the point less than a dislocation. It's 16 Not a complete dislocation of a bone, but it's just a 17 little bit less than a dislocation. 18 Q And it's my understanding, Doctor, after that 19 Eirst examination Miss Fultz continued to treat with 20 Dr. Innes. 21 A That is correct. 22 Q Did she then ultimately come back under your 23 ~are starting in -- 24 A Yeah. 25 Q -- in March of 20017 13 1 A Yes, she did. 2 Q And has she remained under your care from 3 that time through the present? 4 A Yes, she has. 5 Q In March of 2001, were you working with the 6 same diagnostic impression? 7 a Yes, I was. 8 Q And what treatment plan did you follow at 9 that time? 10 A We followed -- we set her up on an initial 11 treatment plan of three times a week for four weeks. 12 Q And what was involved with her treatment? 13 A At that time, we did chiropractic adjustments 14 as well as we encouraged her to do some simple 15 exercises to just stimulate the nervous system. 16 Q What types of exercises? 17 A Well, more coordination type exercises or 18 simple stimulatory exercises, not -- not necessarily 19 complete spinal rehabilitation exercises as what we 20 wanted to do was actually drive her nervous system to a 21 ~oint of stability and thereby passively causing 22 ~tability to her spine as opposed to actually 23 physically doing exercises with her spine. 24 Q Were Miss Fultz's complaints when you began 25 seeing her again in March similar to the complaints 14 1 ~hat she made in January of 20017 2 A Yes. 3 Q And it appears, Doctor, you did see her as 4 ,ou indicated three times a week throughout the -- the 5 ~nd of March of 2001; is that correct? 6 A That is correct. 7 Q And then you saw her again May 21st of 20017 8 A That is correct. 9 Q And then it appears from July of 2001 through 10 Zhe early part of this year you've seen her either once 11 Dr twice a month, would that be correct? 12 A That is correct. 13 Q And is that your frequency for seeing her at 14 2his point? 15 A She is placed on an as-needed basis. She has 16 no prior scheduling routine, and that could be at an 17 increased frequency or decreased frequency for her. It 18 appears to be one to two times a month and -- 19 Q And why is it set up on that type of -- 20 A We want to eliminate doctor dependency. We 21 don't want to have her come and develop a doctor 22 dependency which would mean she feels she needs to come 23 in all the time. We want to encourage her to not have 24 doctor dependency, and it's set up on that basis simply 25 because as she feels the onset of symptomatology coming 15 1 back we want to intervene as soon as possible to 2 restore proper motion. 3 Q And what types of complaints is Miss Fultz 4 having currently? 5 A As of the last time that I saw her, she has 6 some neck pain, occasional headaches; and when she gets 7 her neck pain, she occasionally complains of mid and 8 low back discomfort. 9 Q And when was the date of that last 10 examination, Doctor? 11 A 4/1 of the Year 2002. 12 Q Are there any appointments scheduled for 13 future visits? 14 A No, she's not currently scheduled. 15 Q And what treatment did you provide at that 16 last visit? 17 A The last visit, some myofascial work to 18 alleviate some muscular tightness and adhesions as well 19 as chiropractic adjustments. 20 Q And what was being involved in the myofascial 21 technique and the adjustments? 22 A We would go into the tight musculature across 23 the shoulders typically and across the muscles along 24 the cervical spine and gently loosen up any adhesions 25 which would be there from increased muscle activity 16 1 Nithout relaxation. 2 Q Were you working with the same diagnosis, 3 Doctor, in April of this year as when you originally 4 saw her in January of 20017 5 A Yes, I was. 6 Q Was your understanding, Doctor, that Miss 7 Fultz had no prior history of any neck injury or 8 headache problem before this accident? 9 A That is my understanding. 10 Q And Doctor, do you have an opinion within a 11 reasonable degree of ~~tainty whether the 12 injury that you've diagnosed for Miss Fultz and 13 ~iscussed with us today is directly, causally related 14 ko her January 23rd, 2000 motor vehicle accident? 15 A Based on her history of no previous 16 ~omplaints and the complaints she has now, it's with 17 certainty that I feel that these are due to her motor 18 vehicle accident. 19 Q All right. Do you believe Miss Fultz will 20 require future care and treatment, Doctor? 21 A I do believe she will. 22 Q And why is that? 23 A I believe that she has scar tissue formed 24 from a hyperextension/flexion injury which that tissue 25 that has scarred will never be as strong as or as 17 1 stable as her original tissue. 2 Q Do you believe she sustained any permanent 3 injury to her cervical spine? 4 A I do. 5 '~ -----MK. TRICE ~_~A_ ~ ..... ~ the 6 any reports we've been provided with. 7 M~LOCK: It's containe~.,~ithin the 8 doctor's S~ptemb~r -- well, first patk'agraph refers to //~! /"i 9 Septembe~ 26th. Copy was provi~e{i to counsel. I'll / 10 show yo~ another ~opy. .."" 12 / THE WITNE~ I'm sorry. Could you repeat 14 BY MR. SADLOCK: 15 Q Doctor, based on your evaluation of Miss 16 Fultz and examination, testing, reviewing of the films 17 and whatnot, do you believe she sustained any type of 18 permanent injury to her cervical spine? 19 A I do believe she has. 20 Q And what is that? 21 A I believe that she'll have chronic 22 .nstability in the cervical spine due to the nature of 23 scar tissue being replacing healthy tissue. 24 Q ~.nd what effect will that have on her? 25 A That will lead her to have an increased 18 1 )robability of future neck problems, subluxations, 2 )ain, headache, associated myospasms. 3 MR. SADLOCK: Thank you, Doctor. I have no 4 ~urther questions right now. 5 CROSS EXAMINATION 6 BY MR. PRICE: 7 Q Okay. Doctor, if I understand your 8 testimony, you reviewed some X-rays, did you not? 9 A Yes. 10 Q Do you recall how many? 11 A No, I do not. 12 Q Were they taken at your request? 13 A I had ordered a set at my request, and there 14 was a previous study done. 15 Q Do you know who ordered the previous study 16 that you reviewed? 17 A I can't be certain, but I believe Dr. Michael 18 Innes or Hershey Medical Center. 19 Q Okay. Do you currently have all those X-ray 20 films in your possession? 21 A I do not believe so. 22 Q Okay. You also ~- did you review an MRI 23 scan? 24 A Yes, I did. 25 Q Was that something that you ordered or did 19 1 somebody else order it? 2 A I can't find a copy of the report. Do you 3 have a copy of the report? 4 Q I don't know if I do. 5 A Okay. 6 MR. PRICE: This is what I had. Off the 7 ~ecord. 8 (Discussion held off the record.) 9 THE WITNESS: I did not. I did not order 10 ~hat MRI. 11 BY MR. SADLOCK: 12 Q And that would seem to be proven out by the 13 fact that on your initial report of January 16, 2001 14 Zhe first day that you saw her you indicate there that 15 ,ou reviewed MRIs. 16 A Correct. 17 Q And so that would obviously have been 18 ~omething ordered by somebody else, would you agree 19 Nith me? 20 A Correct, correct. 21 Q Okay. You testified, if I recall, that upon 22 ,our examination of her on the first time that you saw 23 ler that she had tremendous I think was the word you 24 ~sed spasm in her neck. 25 A That is correct. 20 1 Q Okay. Now, I'm looking at your initial 2 report of January the 16th, 2001; and I see that you 3 indicate that upon physical examination there was 4 visible right levator scapular spasm. 5 A Uh-huh. 6 Q I don't see the word tremendous anywhere. 7 A Due to the fact that it was visible, that 8 would indicate that it would be, quote/unquote, 9 tremendous or a grade higher than just a moderate due 10 to the fact that it was visibly seen. 11 Q Okay. And I also note in your handwritten 12 notes for that particular visit that you indicate that 13 there was looks like trap/levator spasms. Again, no 14 reference to the word tremendous. 15 A That is correct. 16 Q Okay. Did you ever request medical records 17 from any of the other health care providers who had 18 ~ver seen Miss Fultz? 19 A I just saw a records release. I have an MRI 20 request, but I don't see a specific request of the 21 )roviders. 22 Q Okay. Specifically let me go down the list. 23 )o you have records from the other chiropractor, the 24 referring chiropractor, Dr. Innes? 25 A Do I have his records? 21 1 Q Yes. 2 A I conferred with him. 3 Q Okay. Did you ever see his records? 4 A No. 5 Q Okay. Did you ever see the records from 6 ~ershey Medical Center? 7 A I'd have to say no because I don't have them 8 in front of me. 9 Q Did you ever see the records from Dr. 10 Little's office or I think it's Mechanicsburg Family 11 Practice, Dr. Sheridan? 12 A No. 13 Q So when you talk about that she had no prior 14 history of neck -- neck problems before the accident, 15 would that be based upon the history that she gave you? 16 A That is correct. 17 Q Okay. Now, you indicated that she has been 18 under your care to the present time; and I think you 19 said that the last time you saw her was April the 1st 20 of this year. 21 A That is correct. 22 Q Can you tell me when you saw her before that? 23 A February the 12th of the Year 2002. 24 Q And before that? 25 A January 25th of the Year 2002. 22 1 Q And before that? 2 A January 3rd of the Year 2002. 3 Q Okay. So my calculations then, you've seen 4 her approximately 26 times since you saw her in January 5 of 19 -- I'm sorry, January of 2001. 6 A Approximately. 7 Q Okay. 8 A I did not count. 9 Q And that would -- on the average then, that 10 would come out to what, about once every two, two and a 11 half weeks since the time that you first saw her? 12 A Well, I wouldn't necessarily say that simply 13 due to the fact of the increased frequency in early 14 ~nset of care. 15 Q So you've tapered her off as -- as you've 16 ~een seeing her over time? 17 A Not technically. Either -- she was on a 18 specific treatment plan in the early part of the care; 19 and then she was released to -- released to PRN or 20 ~s-needed care. So I wouldn't say I tapered her off. 21 simply didn't have her on an active treatment plan 22 fter a certain point. 23 Q I think you said earlier one of your -- I'm 24 mot sure if goal is the right word -- I don't think you 25 ~sed that -- but were trying to eliminate doctor 23 1 dependency. 2 A That is correct, yes. 3 Q Are you -- from time to time, do you happen 4 to see patients who have been treated by a neurological 5 doctor, a neurosurgeon or orthopedic doctor? 6 A Yes, I do. 7 Q Do you typically see records from 8 Drthopedists or neurologists who see patients on the 9 ~agnitude of, you know, 26 times over the course of a 10 ,ear and a half? 11 A No, I do not. 12 Q And so what have you done in the case with 13 liss Fultz to eliminate her dependency on chiropractic 14 ~reatment? 15 A We have encouraged her to do home exercises. 16 ~e've also encouraged her to do neurological 17 rehabilitative training and continue to mobilize or 18 hove her segments which have fixation due to scar 19 ~issue. 20 Q In your opinion, have you, your treatment 21.provided her with any permanent relief from her 22 3ymptoms? 23 A I would say, yes, a permanent relief of her 24 3ymptoms but not an elimination of her symptoms. 25 Q And in what respect has your treatment 24 1 provided permanent relief to her? 2 A Decreased intensity as well as duration of 3 Lctive symptomatology. 4 Q You've indicated that you've not seen any of 5 ~he records from the Hershey Medical Center. 6 A I have to say yes because they're not here 7 Dut that -- yes. 8 Q Are you aware that the doctors at Hershey 9 ~edical Center -- I believe neurologists -- do not 10 ~oncur with your assessment that she has cervical 11 instability? 12 A I would say that I would -- I'm sorry. Would 13 you repeat the question? 14 Q Sure. Are you aware of the fact the doctors 15 at Hershey are of the opinion that she does not have 16 =ervical instability? 17 A Yes, I am. 18 Q Okay. Let's take a look at your report of 19 initial evaluation dated January 16th, 2001. 20 A Okay. 21 Q Okay. Under your physical examination, you 22 indicate that her cervical range of motion appears to 23 be full. 24 A That's correct. Q What's cervical range of motion mean? 25 1 A HOW well she can move her global or her 2 ~ntire cervical spine with respect to the top bone as 3 ~ompared to the bottom bone. 4 Q Okay. And -- and if you were to demonstrate 5 ~hat, would that include leaning your head to the left, 6 leaning your head to the right, tilting your head 7 ~orward to your chest, tilting your head backwards to 8 look up to the ceiling? 9 A And rotation. 10 Q And rotation. Meaning looking to the left 11 Dver the shoulder and looking to the right over the 12 shoulder? 13 A Correct. 14 Q And in all of those tests, you found that her 15 range of motion was full? 16 A Yes. 17 Q Okay. Now, a person -- a person who has 18 muscle spasm in the cervical spine, usually that 19 restricts or limits their range of motion, does it not? 20 A Sometimes it does. 21 Q Sure. You're aware of the concept of 22 guarding? 23 A Yes. 24 Q Okay. So guarding means that you're trying 25 to protect or avoid causing yourself discomfort or 26 1 ~ain? 2 A Correct. 3 Q Okay. And so if you're feeling pain when 4 ,ou're turning to the left or turning to the right, 5 .ooking up to the ceiling, dropping your chin to your 6 ~hest that you're not going to have a full range of 7 notion because you don't want to evoke pain, correct? 8 A I wouldn't necessarily agree with that. I 9 ~hink you can -- you can turn through -- through pain. 10 would say that many people it does prevent a full 11 ange of motion due to the fact that the muscles would 12 uause pain and therefore limit their range of motion. 13 Q Typically in your practice when people do 14 ~urn their neck in any of the particular directions 15 that we've talked about and if they encounter pain, do 16 they usually tell you that? I can -- I can turn my 17 head all the way to the left; but I'm having some 18 discomfort. Do they tell you that? 19 A Quite often. 20 Q Okay. And in this case, you -- you've not 21 made any indication that she indicated to you that she 22 was feeling pain as she went through the range of 23 motion? 24 A I did not note that. 25 Q You indicated muscle strengths are five and 27 1 strong in the upper extremity as well as the lower 2 extremity. What does that mean? 3 A She didn't have frank weakness or -- frank 4 weakness in her arms as well as her legs. 5 Q Okay. On the second page of your report, you 6 talk about your review of the MRI. 7 A Uh-huh. 8 Q And you say there that -- and this is a quote 9 -- it appears there is very, very mild congenital 10 cervical stenosis or at least a minimal, relatively 11 small foraminal canal, correct? 12 A Correct. 13 Q Okay. And you said before that congenital 14 means that she was born this way. 15 A That is correct. 16 Q Okay. You further indicate there that 17 there's no impingement on the spinal cord. 18 A In the neutral position, that is correct. 19 Q Okay. And the significance of that is if you 20 do have impingement upon the spinal cord, that's going 21 to evoke symptoms, is it not, the spinal cord being a 22 Oundle of nerves? 23 A Correct. 24 Q Okay. And so if there's no impingement, no 25 =ompression, no pressure on the spinal cord or the 28 1 nerves, you're not going to have any symptoms related 2 to that? 3 A That is correct. 4 Q Okay. You also talked about, if I recall 5 correctly, that you felt that she would continue to 6 have some difficulties referable to her neck because of 7 the -- the development of scar tissue. 8 A That is correct. 9 Q You -- first of all, in the radiological 10 studies that you reviewed, the MRI and the plain 11 radiological films, the plain X-rays, those would not 12 show scar tissue, would they? 13 A They would not, no. 14 Q They wouldn't show nerves or ligaments? 15 A An MRI would. 16 Q An MRI would show which, nerves, ligaments or 17 both? 18 A It would show nerves and ligaments of the 19 ~rea that was MRI'd. 20 Q Okay. Did you -- in any of the studies that 21 ,ou saw, were you able to visualize the presence of 22 ;car tissue? 23 A Directly, no. 24 Q Okay. And did you ever perform any of the 25 £nvasive studies -- arthroscopy or open surgery -- 29 1 where you could visualize whether or not there was scar 2 tissue? 3 A No. 4 Q All right. So would it be fair to say that 5 your opinion about the presence of scar tissue would be 6 an opinion that would not be based upon your actually 7 seeing the presence of scar tissue? 8 A That is correct. 9 Q It would be based what upon, your training 10 and your experience? 11 A And the fact that you can't have ligament 12 laxity without scar tissue. So the objective increase 13 ~r hypermobility of C4 upon C5 by definition means 14 ~here would be scar tissue. 15 Q Okay. So based upon your belief that there 16 is laxity, you believe that there would be scar tissue 17 that would be concurrent with that? 18 A Correct. 19 Q Okay. And again, is this based upon your 20 'eneral experience and education? 21 A As well as documentation. 22 Q Okay. Would it be fair to say that the 23 ,resence of scar tissue -- let me do it two ways. 24 ~ould it be fair to say first of all whether the 25 )resence or absence of scar tissue in the presence of 30 1 laxity would vary from person to person? 2 A I'm not sure I understand the question. 3 Q Okay. Are you -- are you telling the jury 4 that in every case where there would be laxity there 5 would be scar tissue? 6 A If the laxity is due to trauma, not if the 7 laxity is due to, you know -- laxity due to pregnancy 8 and delivery of a child would not cause scar tissue. 9 Q Then secondly, are you saying that the 10 formation, the extent, the nature and degree of scar 11 tissue as a result of laxity would be the same in every 12 )erson, in every patient? 13 A No. 14 Q So it would be variable? 15 A That is correct. 16 Q Okay. And again, we have no idea -- to the 17 ~xtent there may be scar tissue formation with this 18 particular patient, you're not in the position to tell 19 us the nature, extent or degree of that? 20 A I believe I am. 21 Q Based upon what? 22 A The secondary sequelae of scar tissue. In 23 other words, when she comes in and I feel adhesions and 24 they don't resolve and I can't -- and they lead to 25 active symptomatology approximately one time a month or 31 1 one time every other month, that tells me based on 2 clinical experience that there's a moderate degree of 3 residual scar tissue there. 4 Q Now, if she has scar tissue, what can you as 5 chiropractor do about that? 6 A Well, scar tissue does many things; and -- 7 nd one thing, it's not as stretchable as regular 8 tissue. I~'s not as elastic; and it's as if we 9 replaced rubber bands with Suran Wrap. And Suran Wrap 10 doesn't move very well. What we -- and that will cause 11 ~he bones that are connected to the scar tissue not to 12 hove as well as they should. So twofold. What we do 13 is we move the bones through their normal range of 14 motion and actually break up some scar tissue as well 15 as mechanically break up scar tissue itself. 16 Q When you break up scar tissue, does it go 17 away? 18 A It -- what will happen is it'll break up, the 19 tissue will become more elastic; but it will always 20 come back to scar tissue. 21 Q So it's a temporary fix? 22 A Correct. 23 MR. PRICE: Okay. That's all I have. Thank 24 ~ou, Doctor. 25 REDIRECT EXAMINATION 32 1 BY MR. SADLOCK: 2 Q Doctor, just a couple questions on 3 follow-up. In his Cross Examination, Mr. Price asked 4 'ou about the comparison of visits to a chiropractor 5 'ersus visits to an orthopedic surgeon. You remember 6 that question? 7 A Yes, I do. 8 Q Now, it's my understanding from an orthopedic 9 standpoint -- and you tell me if your understanding is 10 any different -- an orthopedist will generally render a 11 diagnosis and then refer a patient perhaps to physical 12 therapy where the hands-on treatment three times a week 13 will occur. Is that your understanding as well? 15 THE WITNESS: Okay. When I receive a 16 referral from an orthopedic surgeon, it's typically 17 Decause they rendered a diagnosis from -- for the 18 )atient and follow-up therapy was needed. However, 19 lurgery was not needed at that time; and their job is 20 ~o evaluate, manage and do surgery. 21 BY MR. SADLOCK: 22 Q knd that's -- that would be true as well if 23 ~n orthopedic surgeon referred the patient to a 24 physical therapy group? 25 A That is correct, physical therapy tends to be 33 1 on a more frequent visit. 2 Q Whereas if a patient came in to you directly 3 and you would render a diagnosis and treatment rather 4 than refer out like an orthopedic surgeon? 5 A Correct, at -- as -- if I may follow-up, as 6 when Dr. Innes referred her to me originally, I saw her 7 one time, referred her back to Dr. Innes. So 8 .herefore, I would not be treating her on a regular 9 ~asis. 10 Q In terms of the -- the issue regarding scar 11 tissue and whatnot, would the -- the duration or length 12 of time from the date of the accident to the present if 13 there's still being symptomatology reported be an 14 indication of the presence of scar tissue? 15 A Yes. 16 MR. SADLOCK: Thank you, Doctor. I have 17 nothing further. 18 MR. PRICE: That's it. 19 (Whereupon, the deposition concluded at 1:57 20 ~.m..) 21 22 23 24 25 34 1 2 3 COUNTY OF JUNIATA : SS 4 COMMONWEALTH OF PENNSYLVANIA : 5 6 I, Bobbi Hahn, a Notary Public, authorized to administer oaths within and for the Commonwealth of 7 Pennsylvania, do hereby certify that the foregoing is the testimony of CHRIS TUR/qPAUGH, D.C.. 8 I further certify that before the taking of 9 said deposition, the witness was duly sworn; that the questions and answers were taken down stenographically 10 by the said Reporter-Notary Public, and afterwards reduced to typewriting under the direction of the said 11 Reporter. 12 I further certify that the said deposition was taken at the time and place specified in the 13 caption sheet hereof. 14 I further certify that I am not a relative or employee or attorney or counsel to any of the parties, 15 or a relative or employee of such attorney or counsel, or financially interested directly or indirectly in 16 this action. 17 I further certify that the said deposition constitutes a true record of the testimony given by the 18 said witness. 19 IN WITNESS W~EREOF, I have hereunto set my hand this 16th day of April, 2002. 20 22 Om~,~ Tw~. ~n~ C~..~ Notary Public My Commission E~lr~ M~. 10, 2005 23 M~mb~. mm.~~ ~N~mmm 24 25 WORD INDEX Mulfi=png~TM 12 = congonital CHRIS TURNPAUGH, D.C. active 131 22:21 24:3 31:1 ~ t;f~.~t~5 H1 4:15 -!- 30:25 basis pi 14:15 14:24 ~rtification t~l 3:4 activity fsi 8:9 33:9 c~..rtify [Sl 34:7 34:8 12HI 17:12 8:23 9:2 10:1 b~coilt~ IH31:19 34:12 34:14 34:17 12th[il 21:23 15:25 bg~?4~ming st i 3:22 I~-rvica[ H4i 10:17 16[11 19:13 addition [21 9:22 begnn Hi 13:24 12:9 12:10 15:24 16th [41 7:8 20:2 11:9 17:3 17:18 17:22 24:19 34:19 adhesions [~1 15:18 belief t~1 29:15 24:10 24:16 24:22 1911! 22:5 15:24 30:23 b~]ow [21 12:14 12:15 24:25 25:2 25:18 1990 Ill 5:20 Adjunctive Ill 4:17 bt~ween tH 3:2 27:10 1995 ill 5:23 ~djllstn~nis [~1 13:13 beyond Hi 17:5 Charl©s pi 3:13 1'.17 HI 17:12 15:19 15:21 bilaterally ill 9:10 ~lg~k [i] 8:21 1:57 HI 33:19 ndmlnia2r Hi 34:6 birth [il 10:10 cl,'st [41 7:20 11:22 latHI 21:19 aft~lwards ill 34:10 bitlll 12:17 25:7 26:6 again[si 11:23 13:25 Bloomsburg[~l 3:24 child[il 30:8 14:7 20:13 29:19 5:19 5:20 ch~ [~1 7:20 11:22 -2= 30:16 Bobbi [~1 17:10 34:6 26:5 2000 HI 16:14 against [~1 7:20 34:21 ch~topl'~L~i~ [11] 4:1 2001 H21 7:8 12:25 agings[21 19:18 26:8 bodyt21 7:24 10:12 4:1 4:10 4:17 13:5 14:1 14:5 ah~nd [H 32:14 bollg~ [41 12:14 12:16 4:20 4:21 5:13 14:7 14:9 16:4 5:22 13:13 15:19 19:13 20:2 22:5 ~ilmcnt~ ill 3:19 25:2 25:3 23:13 24:19 alignn~nt [11 12:13 bol~g~s ['/] 11:4 11:9 11:12 11:17 12:12 ¢~i~opr~c~Ol" [~01 3:15 3:22 6:4 6:7 2001-2979 [H 17:4 all~via~ [il 15:18 31:11 31:13 6:9 6:12 20:23 20021~1 17:12 15:11 along pi 15:23 bol~ ill 27:14 20:24 31:5 32:4 21:23 21:25 22:2 always[il 31:19 bottom[il 25:3 chiropractors [H 5:14 34:19 A]q(~INO[ii 17:18 brain[~l 9:23 9:23 CI']RISI41 17:8 18:3 21still 14:7 nnswcr H1 32:14 10:1 3:7 34:7 23rd HI 16:14 answers iH 34:9 break [41 31:14 31:15 Chriatopber [il 3:13 251hHi 21:25 APPEARANCES[ii 31:16 31:18 chronic ill 17:21 26121 22:4 23:9 17:17 bri©flyt21 3:16 3:21 CMLHi 17:3 261h [11 17:9 nppea~ed Hi 10:17 bundle[il 27:22 cl©~r[ll 5:24 appoiotn~nts p I 15:12 Clewland ill 4:10 =3= April [41 17:12 16:3 =C= clinical [21 4:7 3[il 18:4 21:19 34:19 (~HI 17:21 31:2 32HI 18:4 al'~a [41 4:19 9:3 9:24 28:19 ~4121 12:7 29:13 Co111~'~ [21 4:1 3fdHI 22:2 ~rms [Zl 9:5 27:4 ~[=5 ill 10:18 4:11 .4= arthroscopy [H 28:25 (~51H 29:13 coming [~110:1 14:25 as=ng~"ded [Zl 14:15 C5=6HI 10:19 COMMON [H 17:2 4/I itl 15:11 22:20 C6-? HI 10:19 Commonwealth [~14:13 34:4 34:6 nsscssHI 4:25 C7-T! Ill 10:19 compamdtzl 9:10 -5- assessment ill 24:10 calculations iH 22:3 25:3 ~[11 18:5 associated HI 18:2 cannl [31 10:13 27:11 comparison [H 32:4 attorney [~1 34:14 caption Hi 34:13 complaiDs pi 15:7 -6- 34:15 cardinal Ill 9:6 complaints [~1 8:1 {~[tl 18:4 authorized ill 34:6 cal~ I~] 5:13 12:23 13:24 13:25 15:3 [~]03 [11 17:13 aVCl'll~ [41 10:14 13:2 16:20 20:17 16:16 16:16 11:8 11:25 22:9 21:18 22:14 22:18 complctc [~1 12:16 avoid [1! 25:25 22:20 13:19 -A- awal~ 131 24:8 24:14 (~ARLISLI~- iH 17:13 complcssJOll [11 9:4 ab]© Ssi 6:4 6:7 25:21 ¢a8~ [41 11:1 23:12 27:25 6:9 6:12 8:6 awayuI 31:17 26:20 30:4 compromisinglll 12:8 9:25 11:3 28:21 catl~a]ly [H 16:13 concL'pt ill 25:21 above [2] 12:13 12:14 .B= causing [21 13:21 concluded[il 33:19 ab~co HI 29:25 25:25 acoidentl,l 5:8 background [H 3:22 coilings21 25:8 26:5 oonoltr[tl 24:10 7:19 7:24 11:22 backwards [~1 7:21 ~cntcl' [41 18:18 21:6 conc~t [H 29:17 16:8 16:14 16:18 25:7 24:5 24:9 conduct[il 8:13 21:14 33:12 bandspl 31:9 ccrtain[2l 18:17 22:22 conf~c~[[i] 21:2 accidents pi 5:4 based 1~1 16:15 17:15 certainty [2] 16:11 COnl~itai [41 10:8 action[z] 17:3 34:16 21:15 29:6 29:9 16:17 10:10 27:9 27:13 29:15 29:19 30:21 HUGHES, ALBRIGHT, FOL~Z & NATALE Index Page 717=540-0220~717-393-5101 connected - front Mult/-Pager" CHRIS TURN'PAUGH, D.C. ouum~.~-~ [II 31:11 I d~-mDnstfal~ [i] 25:4 driv~ [i] 13:20 9:I1 9:12 27:1 =onstitut~s [ti 34:17 dependency ts] ]4:20 dropping[ti 26:5 27:2 consult ill 7:12 14:22 14:24 23:1 duc il01 16:17 17:22 Cy~ [1] 8:21 contained iii 17:7 23:13 20:7 20~9 22~13 continue [2] 23=17 dcp~ition [$] 17:8 23:18 26:11 30:6 -F- 28:5 33~19 34=9 34:12 30:7 30:7 34:17 duly[el 3:8 34:9 face Itl 8~22 continmxI ill 12:19 dcscl'ib~111] 7:19 duration [21 24:2 fBct [?] 19:13 20:7 coordination[z] 13:17 d~vclop Iii 14:21 33=11 20;10 22:13 24=14 cop~ [4] 17:9 17:10 development ltl 28~7 during itl 11:21 26:11 29:11 19;2 19=3 fair[e] 29:4 29:22 cord [11] 9:17 10:11 diagnosed[il 16~12 29=24 10:14 10:15 10~20 diag1208is [41 16:2 -i~- Family ltl 21:10 11:6 12:9 27:17 32:11 32;17 33:3 early [3] 14~10 22:13 F©bruary ill 21:23 27:20 27:21 27~25 diagnostic [31 10:3 22~18 feeling [31 8~3 26~3 corfcct [~41 6:1 12;3 13:6 cd~lcatio~ [21 4:24 26:22 6:3 6~19 12=21 diffcl~nt [~1 8:19 29:20 fccl8 [2] 14:22 14:25 14:5 14;6 14:8 10:13 32~10 educational it i 3:21 felt [Il 28:5 14:11 14:12 19:16 difficulties it i 28~6 effect it i 17:24 field itl 4~20 19~20 19:20 19~25 diplomate itl 4:18 20:15 21:16 21;21 either[21 14:10 22:17 fields[t1 9:6 23:2 24~24 25:13 DIRECT [~1 18:2 elastic [21 31:8 31;19 fifty it i 4:6 26:2 26~7 27:11 3:10 6:22 27:12 27=15 27:18 dillgL'tioG it i 34:10 ~]imina~ [31 14:20 filing[il 3=4 22~25 23:13 fillGs [si 6:25 10~7 29:8 27:23 29:18 28:3 28:8 30:15 di/~tly 14] di]~ctioGs iii 26~14 16;13 elimination[il 23;24 17=16 18:20 28;11 31:22 32:25 33:5 28:23 33~2 34:15 ~mploycc lei 34:14 financially[il 34:15 ~oi'rt~tl), lei 8:21 discomfort[el 15~8 34;15 ;findiGg it 18~11 11:9 28~5 25~25 26:18 ~ncolmtcr 111 26~15 finger [2] 9:25 9:25 counsel [4] 3;3 i~iacuss~d ill 16:13 ~ncouragc ill 14:23 17:9 34:14 34:15 fJl'st [9] 7~5 8:1 t:ount iii 22:8 Discussion [~] 19:8 ~cncourag~d lei 13:14 12~19 17:8 19:14 23~15 23:16 19:22 22:11 28~9 COUNTY[e] 17:2 dislocation[el 12;15 c~d ill 14~5 29:24 34:3 12:16 12:17 ~o~lpl¢[tl 32:2 distributioll[tl 8~22 c~tails[tl 4:23 five[el 9~11 26;25 ~our~cl2] 4:6 23:9 di~y[21 9~7 9:24 ,~ntirc[i] 25:2 fix[ti 31:21 COURT[ii 17:2 doc [1] 4:2 ESQUIRE[el 17=19 fixation it i 23:18 17:21 flew i~] 7:19 7;21 cranial[ti 8:20 doctorleOl 5~2 5:10 established ill 7~3 11:22 5:25 6~2 6:24 Cro88141 18:2 5~15 7:3 7:10 8~5 evaluate[ti 32:20 follow[el 9:25 18:5 32:3 8~13 10:4 12~4 evaluating [~] 3:18 follow-up[si 7~22 (~T [21 6:13 6;25 12:18 14:3 14:20 cvaluatioG lei 17:15 7:22 32:3 32:18 CUMI~ERLAND [il 14=21 14~24 15:10 24~19 33:5 17:2 16:3 16~6 16:10 cvok~ [21 26:7 27:21 follow-ups[i] 4~7 cut[ii 9:21 16:20 17:15 18~3 18~7 22:25 23;5 ~xnm iii 4:7 followed [21 3:25 Clstting [1] 9:17 23~5 31:24 32:2 ,"xnmh~ation [ts! 3:10 13;10 33;16 5:15 6:22 8:7 follows[ti 3:8 -D- doctor'~ ill 17~8 8:13 8:24 12:19 foram/nnl [2] 9~4 D.C [4] 17:8 18~3 doctoral lei 3:25 15~10 17:16 18;5 27:11 3:7 34~7 4:2 19:22 20:3 24:21 fol~goi~g [il 34:7 31:25 32:3 fOlllmtion [~] 30~10 dltmlgc it 15:1 doctollttc iii 4:4 ~amin~! [~1 8:1 30~17 dltt~ [3] 17:12 15~9 doctors [~] 24:8 24:14 ~.xcrciscs [71 13:15 formed lei 12;2 16:23 33:12 documentation [~] 29;21 13:16 13~17 13:18 dat4;d it i 24:19 dOCllmcllt~ ill 10:22 13:19 13:23 23:15 formlt[a~ ill 12~3 decreased [~] 10;18 doc~n't itl 31~10 exit fl] 8~23 forward[el 7:20 11~22 25:7 14:17 24:2 donc lei 6:17 18=14 gxpcl'icllcc lei 29:10 found[el 8:25 25:14 defect [21 9~23 9~23 23~12 29:20 31:2 four [3] 3:24 3:25 DEFENDANT[el 17:5 dollblc-4~lc:clc[i] 7:8 ~xpcrt[i] 5=13 13~11 17:22 down[el 9:5 20:22 ~xp]ain[2]3:16 3:21 frank[31 9:16 27:3 definition ii I 29:13 34 ~9 :xplaincd I t I 11:21 27=3 cJegl~[6] 3~24 4:2 Dr[lei 5:13 7:11 ~xt~t[el 30~10 30:17 fl~qu~ncy[41 14:13 16:11 30:10 30:19 7:13 7~22 7=22 30:19 14:17 14:17 22:13 31:2 12:20 18~17 20:24 delivery [t i 30:8 21:9 21~11 33:6 cxWclllC ill 10:21 frcqlltent it i 33;1 DEMANDED[ii 17:5 33:7 eXtl~:mi~ i~l 9:10 front[i] 21:8 Index Page 2 HUGHES, At. BRIGHT, FOLTZ & NATALE 717-540-0220~7 i 7-393-51 Multi=Pag~TM full = motion CHRIS TURNPAUGH, D.C. fulltsl 3:12 24:23 I-I~Fsh~"y [~l 18:18 in[crested [11 34:15 28:16 28:18 25:15 26:6 26:10 21:6 24:5 24:8 intcrfmG,,~c 111 11:19 light Itl 8:19 Fultz IiSI 17:2 5:10 24:15 interpretation ill 10:7 [ilnit ill 26:12 7:4 7:9 7:15 high [21 3:23 3:23 intcrp~ting pi 6:25 limits pi 25:19 12:19 15:3 16:7 higher ill 20:9 intcrv~lo ill 15:1 lincbnckcr pi 11:2 16:12 16:19 17:16 history[vi 7:15 7:17 lnvnnivc [2] 6:10 list[ti 20:22 20:18 23:13 11:21 16:7 16:15 28:25 Littl©'s [1121:10 Fultz's DI 5:14 11:21 21:14 21:15 13:24 hold[21 4:15 9:19 involve pl8:16 LLPpl 17:21 involved [51 3:17 look [21 11:11 24:18 function pi 11:12 hole[ti 11:5 4:4 8:17 13:12 25:8 functionality111 4:24 Holy[ti 7:21 15:20 looking[4] 20:1 fut311~[3] 15:13 16:20 holng[ll 23:15 involvingo] 3:19 25:10 25:11 26:5 18:1 Hospital Ol 7:21 issue pi 33:10 loolrs [11 20:13 -4~- hours[t] 4:6 it'll[ti 31:18 looscUlll 15:24 hi.mn[ti 10:12 itsclf[4l 10:2 10:11 Il}sC[ti 9:20 gOz~ Itl 9:6 hulldfcd It I 4:6 11:4 31:15 lost [21 12:12 12:14 g~ncFal itl 29:20 h~rt [21 7:23 7:24 Iow[ti 15:8 ~crallypl 32:10 hypcrPl 9:1 -J- lower[41 8:17 9:9 genetics It I 12:2 hypcrextcnsion/flexion itl January o21 7:8 9:12 27:1 gcntlyo] 15:24 16:24 8:14 14:1 16:4 lyingpl 9:8 given[al 11:20 12:1 hypcrmobilityttj 29:13 16:14 19:13 20:2 34:17 21:25 22:2 22:4 global pi 25:1 -!- 22:5 24:19 -M- JO[2l 17:10 34:21 Mill 17:4 goal[ti 22:24 idea[ti 30:16 job[t] 32:19 23:9 goes ltl 11:17 magtlitude it ] gradc: [il 20:9 impinged ['1 9:21 JOYCF. pi 17:4 In~ngC Ill 32:20 tmpingclncnt [61 9:16 July [11 14:9 March [41 12:25 13:5 glldllatc ill 5:19 10:15 10:20 27:17 graduated [21 3:23 27:20 27:24 JUNIATA ill 34:3 13:25 14:5 5:20 impinging pi 10:11 jtiry [41 17:5 3:16 may [?1 10:20 11:3 group [11 32:24 impression [2l 12:3 5:24 30:3 30:1711:11 33:511:18 14:7 guarding 121 25:22 13:6 25:24 include [215:6 25:5 =K- mcnn [21 4:22 9:13 9:24 10:23 12:10 gucssp] 6:17 Increase[21 8:25 ]~lR. bJtll] 17:21 14:22 24:25 27:2 29:12 Menuiug pi 25:10 -H- increased iai 8:9 -t- ln~fms [41 10:24 25:24 HAFER [11 17:21 9:2 11:7 12:1 27:14 29:13 14:17 15:25 17:25 last[si 15:5 15:9 Hahll [31 17:10 34:6 22:13 15:16 15:17 21:19 m~chanically o] 31:15 34:21 indicat~161 19:14 LAW[ii 17:3 Mechanicsburg[2] 17:14 hnlfl21 22:11 23:10 20:3 20:8 20:12 laxity [IOl 10:18 12:7 21:10 halld Iii 34:19 24:22 27:16 29:12 29:16 30:1 me.,al[cai [?] 5:25 handle pi 11:3 indicated [~1 14:4 30:4 30:6 30:7 16:11 18:18 20:16 hands=on[ii 32:12 21:17 24:4 26:21 30:7 30:11 21:6 24:5 24:9 hendwrittcn pi 20:11 26:25 hy[21 9:13 9:15 medication pi 6:5 head 171 7:19 11:22 indication [2] 26:21 [Icad [21 17:25 30:24 medicine [11 5:22 25:5 25:6 25:6 33:14 leaning [2] 25:5 25:6 Michael [2l 7:11 25:7 26:17 indirectly itl 34:15 least[il 27:10 18:17 hcfldschc [2] 16:8 initial [4] 13:10 19:13 led [ti 3:22 midol 15:7 mild ol 10:8 10:20 18:2 20:1 24:19 [crt [41 25:5 25:10 27:9 IEadsr, has iq 15:6 mjurcd pi 5:3 26:4 26:17 health pi 20:17 lnjttrics [1] 5:7 legs Ill 27:4 minimal pi 27:10 Miss[la] 5:14 7:9 hcalthypl 17:23 lnjury[?l 11:7 11:24 Icngth[l] 33:11 7:15 11:20 12:19 bcldltl 19:8 16:7 16:12 16:24 less 121 12:15 12:17 13:24 15:3 16:6 17:3 17:18 Helen[al 17:2 5:10 levator[2] 9:3 20:4 16:12 16:19 17:15 7:3 Innes 181 7:11 7:13 7:23 12:20 18:18 I©ve] [2] 10:18 12:7 20:18 23:13 Hcmpfield pi 3:23 20:24 33:6 33:7 licensed [11 4:12 mobiliz~ itl 23:17 hereby ol 3:2 3:4 instability 131 17:22 liccnsllrcs [11 4:16 mmicratc [2] 20:9 34:7 24:11 24:16 Life[Il 4:1 31:2 month [41 14:11 14:18 h~rcofpl 34:13 in[nc[Itl 9:20 ligament[31 10:18 30:25 31:1 h~n3unto ill 34:19 intcglit]t it i 8:18 12:7 29:11 hoes [11 10:14 intensity pi 24:2 ligaments [3] 28:14 motion 1141 10:17 HUGHES, ALBRIGHT, FOL'I'Z & NATALE Index Page 3 717-540=0220~717-393-5 ! 01 motor - radiating Multi-Pago TM CHRIS TURNPAUGH, D.C. 10:19 10:21 12:14 ncvca' ]il 16:25 P.C ]il 17:18 possible [21 4:25 15:2 24:22 24:25 nonstmsscd [~1 11:16 p.m[2] 17:12 33:20 15:1 25:15 25:19 26:7 26:11 26:12 26:23 nolmal [71 8:22 9:6 page ]il 27:5 Pussibly [*1 12:8 ~ 31:14 9:10 10:1 10:12 pain[to] 15:6 15:7 post]al 4:2 4:2 11:12 31:13 18:2 26:1 26:3 4:4 nlOtOF['q 5:3 5:7 ]qotal~[31 17:11 34:6 26:7 26:9 26:12 practic~[s] 3:17 7:18 16:14 16:17 34:22 26:15 26:22 3:18 4:12 4:20 move it q 9:25 11:9 note [21 20:11 26:24 pal ]ti 9:2 5:2 7:5 21:11 11:11 11:13 11:13 ]]:18 23:18 25:1 ilO]CS I~1 20:12 palpatio~ ]il 8:8 26:13 31:10 31:12 31:13 Ilothing [1] 33:17 palpatory pi 9:2 ~racticing 1ml 5:21 llM}VCS[II 8:21 notice],] 10:16 paragraph]l] 17:8 plrt~gnancy[tl 30:7 MRI p21 6:15 6:25 now 171 16:16 18:4 port ]si 5:2 14:10 prcscribc [t i 6:4 10:5 10:22 11:15 20:1 21:17 25:17 22:18 presence f71 28:21 18:22 19:10 20:19 31:4 32:8 particu]aF [~] 20:12 29:5 29:7 29:23 27:6 28:10 28:15 numbucss ]ti 8:3 26:14 30:18 29:25 29:25 33:14 28:16 nystagmus pi 9:9 part]cs [Zl 3:3 34:14 present [4l 9:9 13:3 MRI'd pi 28:19 passivcly [~1 13:21 21:18 33:12 MRIs 121 10:4 19:15 -O= patellar [~] 9:1 pressure [ti 27:25 muscle [~1 8:4 8:9 )l'ovo~t it 126:10 9:11 9:19 15:25 oathspi 34:6 pa]ion][si 5:10 7:4 )roviousp] 16:15 25:18 26:25 Obj~ti01~ [21 17:5 30:12 30:18 32:11 18:14 18:15 muscles [4l 8:10 32:14 32:18 32:23 33:2 l~cc [12J 17:21 18:5 9:19 15:23 26:11 objective [~l 8:11 mticnts t~1 3:19 muscular [2] 9:2 8:12 29:12 5:3 5:6 23:4 5:16 6:20 17:5 23:8 17:11 18:6 19:6 31:23 32:3 32:14 15:18 obviously]ti 19:17 Pennsylvania 181 17:2 33:18 musc~ftFly ]il 11:3 occasional pi 15:6 17:14 4:13 34:4 musculature ]il 15:22 occasionally pi 15:7 34:7 PRNpl 22:19 myofascial [21 15:17 occupation 1~1 3:14 people [41 10:24 10:25 ~mbabillty ]31 11:7 15:20 occur [~] 32:13 26:10 26:13 12:1 18:1 myospasms ]il 18:2 off [41 19:6 19:8 tot]il 11:2 troblcm[~l 16:8 22:15 22:20 JCl'form]si 6:13 )robloms [21 18:1 -N= offer]Il 5:12 6:14 6:14 6:16 21:14 ~ namol2l 18:2 3:12 offi~o[tl 21:10 28:24 prooodlLrCS[21 4:17 Ilatul~[4] 7:1 17:22 ofton[~l 26:19 pOdlapS[l] 32:11 6:10 30:10 30:19 ~ldpl 5:17 tOl~lall~llt is] 17:2 pro~ram pi 3:25 17:18 23:21 23:23 proper [~l 12:13 12:14 · o~o~s~r~ly [~] 13:18 DI~O [~l 14:10 22:10 24:1 15:2 22:12 26:8 Dnolsl 5:14 12:13 i~l~on[?l 11:8 11:25 profoot]ti 25:25 nccir[12] 5:7 7:23 14:18 22:23 30:25 25:17 25:17 30:1 prOV~fl[q 19:12 11:I0 15:6 15:7 31:1 31:7 33:7 30:1 30:12 providf~ [2] 7:15 16:7 18:1 19:24 onset [21 14:25 22:14 physical iSl 20:3 15:15 21:14 21:14 26:14 28:6 open [1] 28:25 24:21 32:11 32:24 pFovidcd ]si 4:8 needed [2] 32:18 32:19 opinion r;] 7:12 32:25 4:10 17:6 17:9 10:9 16:10 23:20 physically 1~] 13:23 23:21 24:1 I~Od~[ll 14:22 24:15 29:5 29:6 pictu~pl 11:10 p~ovidm~[~l 20:17 !ncgativc [1l 9:7 opposed [t ] 13:22 PIKI~ ill 17:13 20:21 ncrvc[s] 8:20 9:16 ordm'[4] 6:14 6:16 placer2] 17:13 34:12 Public]41 17:11 34:6 9:17 19:1 19:9 plaaod ltl 14:15 34:10 34:22 I~CrVCS[7] 8:23 9:21 o~dl~l~d[4118:13 18:15 plain]21 28:10 28:11 27:22 28:1 28:14 18:25 19:18 28:16 28:18 original [~1 17:1 PLAINTIFF [31 17:2 '~= nervous [?l 3:20 originally]al 8:2 17:9 17:20 QUAL [11 18:5 4:24 4:25 11:19 plan [4] 13:8 13:11 QUALIFICATIONS p] 12:8 13:15 13:20 16:3 33:6 22:18 22:21 5:15 noltrologionl i0l 5:1 ofihopodi~ [q 23:5 PLEA8 [~117:2 quo$tion~ [31 18:4 7:12 8:18 9:23 32:5 32:8 32:16 23:4 23:16 32:23 33:4 }lu~ [~1 9:1 32:2 34:9 orthopodi$t i~1 32:10 point [si I0:10 12:15 qni©lrly ]ti 9:8 usuroiogi$ts [~1 23:8 13:21 14:14 22:22 Qttito p i 26:19 24:9 oflhopodist~ [11 23:8 ntqlrolc~ [4] 4:3 osteopathic [t i 6:2 )os]]ion [si 10:16 quot~ pi 27:8 11:16 11:17 27:18 quotc/unquotc [i] 20:8 ~ 4:5 4:18 4:21 30:18 ncuFostiFgCon [I I 23:5 -P- )os]rive [I] 9:4 -R- n~utrnl [31 10:16 11:15 Piti 17:2 }osscssion iq 18:20 27:18 radiating [11 9:4 Index Page 4 HUGHES, ALBRIGHT, FOL'I-~. & NATALE 717-540-0220~717-393-5101 Multi=PageTM radicular = surgery CHRIS TURN-PAUGH, D.C. radicular ill 9:5 RcporteF-Notary tnl scheduling [il 14:16 20:4 25:18 Fadiologicalt21 28:9 34:10 school[2] 3:23 3:24 spasmst2] 8:4 20:13 28:11 rcportstn] 17:6 scopcpl 17:5 special[il 4:19 radiologist[al 6:18 rcqucstt5] 18:12 18:13 sci'cch[ti 9:18 spccialtytll 4:19 ralsingtnl 9:8 20:16 20:20 20:20 sc[ti 11:3 specific [31 7:25 F~ngC[9] 24:22 24:25 ~quirctn] 16:20 scaling[nj 3:4 20:20 22:18 25:15 25:19 26:6 residual[il 31:3 second [21 7:12 27:5 , specifically [31 4:22 26:11 26:12 26:22 resolve [i] 30:24 secondary i1] 30:22 4:23 20:22 31:13 ~CSl~'Ct 1~1 12:13 23:25 secondly m 30:9 spccificdtsl 34:12 Fangcs[i] 10:21 25:2 spinalpll 3:19 10:Il SeC [t4l 8:2 8:9 10:13 10:15 11:6 rathCF pi 33:3 rcspcctivc [n] 3:3 9:18 Il:Il 14:3 12:8 13:19 27:17 reading [213:3 6:24 restore [il 15:2 20:2 20:6 20:20 27:20 27:21 27:25 rcasonablc [il 16:11 icst~icts 111 25:19 21:3 21:5 21:9 rcccivcltl 32:15 result[21 8:24 30:11 23:4 23:7 23:8 spine[n31 10:17 11:1 11:2 11:4 11:5 record[31 19:7 19:8 rcvicw[31 10:3 18:22 sccil~[4] 13:25 14:13 13:22 13:23 15:24 34:17 27:6 22:16 29:7 17:3 17:18 17:22 fccoFd$ [9120:16 20:19 rcvicwcd [~1 10:5 seem it] 19:12 25:2 25:18 20:23 20:25 21:3 18:8 18:16 19:15 sc~ntal it] 10:t9 Spirit fi] 7:21 21:5 21:9 23:7 28:10 8f~olllCllte f21 3:20 squcczing [21 9:16 24:5 rcvicwil~ Ill 17:16 23:i8 10:1 I [~(~ROSS [!1 18:2 RI(~I-L~RI) itl 17:19 sensation [21 8:22 SSiii 34:3 R~DIR~CT [21 18:2 fi~t [1 il 7:6 8:25 9:20 stabilJt3r [21 13:21 31:25 9:3 16:19 18:4 8Cllsatio~s [i] 9:9 13:22 l*cdllccd [11 34:10 20:4 22:24 25:6 scnsitivity ill 8:19 stab]© ill 17:1 1~[21 32:11 33:4 25:11 26:4 29:4 S~ptemb~r 121 17:8 standpoint[il 32:9 referable ill 28:6 Rombcl~*S iii 9:7 17:9 staffing [11 12:23 rcl'm~..CC [!1 20:14 rotation [21 25:9 sequelae pi 30:22 state ill 3:12 iL. fcrral p 132:16 25:10 sct [01 9:18 13:10 stenographically[il referred [41 7:11 routiu~ pi 14:16 14:19 14:24 18:13 34:9 32:23 33:6 33:7 ROVNER ill 17:18 34:19 stenosis [31 10:8 iI.-fcrrillg it i 20:24 RPR 121 17:10 34:21 sc~Cll inl 4:7 10:]0 27:10 r~f©rs[nl 17:8 rtlbbcf[tl 31:9 shc~tu] 34:13 still[il 33:13 reflex iii 9:1 rulc [t ] 9:22 sheridan 1~] 21:11 stimulate[il 13:15 reft©xes ill 8:18 shouldl~r [2] 25:11 stimttlatory it i 13:18 regarding[t] 33:10 =S= 25:12 stipulated[ti 3:2 8houldci~ 13] 8:4 rcgulaF [21 31:7 33:8 SADLO(~.K [121 17:19 8:5 15:23 STIPULATION [t13:1 w, habilitatiou [11 13:19 18:4 3:11 5:12 strength [21 8:20 t~labilitativc pi 23:17 6:23 17:7 17:14 show 15] 17:10 28:12 18:3 19:il 32:1 28:14 28:16 28:18 9:19 related [21 16:13 28:1 32:21 33:16 side [il 9:8 si~ungths [21 9:11 rclativc 121 34:14 saw [l~] 7:5 14:7 significance [4] 9:14 26:25 34:15 15:5 16:4 19:14 t1:20 12:1 27:19 sUcsscd[*] 11:17 relatively [ii 27:10 19:22 20:19 21:19 significant [ti 11:24 ~trctchablc itl 31:7 relaxation tn] 16:1 21:22 22:4 22:11 signing [ti 3:4 strong pi 9:12 16:25 releaSe[l] 20:19 28:21 33:6 signsf2] 9:5 9:5 27:1 rclcascd[21 22:19 scanpl 18:23 similaF[2] 9:17 13:25 studies[4] 10:3 28:10 22:19 scans[3j 6:13 6:15 28:20 28:25 rclicf[3] 23:21 23:23 6:25 simple[21 13:14 13:18 study[31 10:17 18:14 24:1 scapular [21 9:3 simply 131 14:24 22:12 18:15 rcmalncd [11 13:2 20:4 22:21 SturdiCF [11 10:25 rcmcmbm'[tl 32:5 scal'12Ol 16:23 17:23 sizcSltl 10:13 stuFdy[tl ll:l 23:18 28:7 28:12 skull [21 8:3 8:23 subluxation [3] 12:9 rcndcr[2] 32:10 33:3 28:22 29:1 29:5 slight[t] 8:25 12:11 12:12 rcndcrcd [nj 32:17 29:7 29:12 29:14 slightly[ti 9:1 subluxations [11 18:1 repeat [21 17:12 24:13 29:16 29:23 29:25 l*cplacc~i it ] 31:9 30:5 30:8 30:10 small ti! 27:11 such [31 8:18 1o:4 3o:17 30:22 31:3 smallcr[2l IO:14 11:5 34:15 l~cplacing 111 17:23 31:4 31:6 31:11 :smasl~dp] 7:20 suffered [il 5:7 rcpoFt[6l 19:2 19:3 31:14 31:15 31:16 Som~im~s[ij 25:20 SuFau[21 31:9 31:9 19:13 20:2 24:18 31:20 33:10 33:14 27:5 scaFr~d [il 16:25 soon iii 15:1 s~n [4] 32:5 rOpoFt~d [il 33:13 scheduled [21 i5:12 SOFty [4] 9:3 17:12 32:16 32:23 33:4 Re-pol'teF [il 34:11 15:14 22:5 24:12 SUlgcry {4] 6:7 28:25 spasm [41 8:5 19:24 32:19 32:20 HUGHES, ALBRI(IHT, FOLTZ & NATALE Index Page 5 ? 17-540-0220x717-393-5101 summ-ptibl~ - your~lf Multi-Pag~TM CHRIS TURNPAUGH D.C. m~so~.p~b]O Ill 1l:6 i ;:tm"°- [~,] 16:23 16:24 25:8 26:5 31:14 iuspcct U] 10:20 17:1 17:23 17:23 31:15 31:16 31:18 _i. suspicion [1] 11:16 23:19 28:7 28:12 IlppOF [4] 8:17 9:11 28:22 29:2 29:5 9:12 27:1 Yoar U21 3:24 3:25 sustained [31 7:23 29:7 29:12 29:14 4:2 5:19 14:10 17:2 17:17 29:16 29:23 29:25 1lnod [2] 19:24 22:25 15:11 16:3 21:20 sustaining[ti 11:7 30:5 30:8 30:11 usually [3] 3:19 25:18 21:23 21:25 22:2 8worfl [2] 3:8 34:9 30:17 30:22 31:3 26:16 23:10 8ylnptomatoIog]r [4l 31:4 31:6 31:8 [/OUFSO]f [I j 25:25 14:25 24:3 30:25 31:11 31:14 31:15 -V- 33:13 31;16 31:19 31:20 33:1! 33:14 VI1] 17:3 symptoms[si 23:22 today ui 16:13 variable [u 30:14 23:24 23:24 27:21 28:1 tOOir Ill 11:10 vnriatian ti! 10:12 system ['/i 3:20 4:24 topui 25:2 va~ ill 30:1 4:25 11:19 12:8 tough[Il 8:19 vehi¢lo [51 5:3 5:7 13:15 13:20 training [si 4:5 7:18 16:14 16:18 4:8 6:24 23:17 vorna~ ui 32:5 -T- 29:9 vibration uI 8:19 ta~ing [21 11:15 34:8 Ullp/lovatol' U l 20:13 Vibratory [U 9:9 tapered [2122:15 22:20 tfapoziu~ [11 8:10 visiblo [21 20:4 20:7 teghnicallytl! 22:17 trallma[u 30:6 'visiblyf~j 8:8 20:10 ~hnique [nj 15:21 t~t [2] 5:3 12:19 visit 141 15:16 15:17 ~olovision [11 9:18 tnmtod ui 23:4 20:12 33:1 t=llingui 30:3 ~ating[4] 3:18 visits[3! 15:13 32:4 5:14 7:13 33:8 32:5 tclls[l] 31:1 trcatn~nt U21 13:8 visua]iz~ [21 28:21 temporm~ [~] 31:21 13:11 13:12 15:15 29:1 tolld~ ui 32:25 16:20 22:18 22:21 f~rm8 [31 9:13 9:15 23:14 23:20 23:25 -W- 33:10 32:12 33:3 test [2l 9:4 9:7 tl~cllE~dous [5! 8:4 waived [113:5 t¢stif'lCd 121 3:8 19:23 20:6 20:9 ways [~] 29:23 19:21 20:14 WOnlrnons [2l 27:3 t~stimony [~l 18:8 TRIAL 11] 17:5 27:4 34:7 34:17 tl'a~ [2] 32:22 34:17 w~olr [~] 13:ll 14:4 testing[3] 8:20 8:20 Uying[2] 22:25 25:24 32:12 17:16 tuIn [31 26:9 26:14 weoIrly 11] 4:7 ~'~18 [31 8:18 9:13 26:16 W~]tS [21 13:11 22:11 25:14 tllr~illg 12126:4 26:4 whaUlot [21 17:17 Thai~ [41 6:20 18:3 Tu/~pallgh [61 17:8 33:11 31:23 33:16 18:3 3:7 3:13 iwhntsoovol' [I] 6:10 therapy 14132:12 32:18 5:13 34:7 ~llorone [1l 33:2 32:24 32:25 twico U I 14:11 v~r~l EI~,OF [!] 34:19 Ih~roby [1] 13:21 tv/oH] 14:18 22:10 wholo It i 7:23 thent~Ol~ [21 26:12 22:10 29:23 within[si 4:20 10:12 33:8 twofold [u 31:12 16:10 17:7 34:6 Thirty-thi~ [il 5:18 typo[si 4:15 9:22 without [2] 16:1 THOMAS [2l 17:21 13:17 14:19 17:17 29:12 17:21 ~[2] 13:16 15:3 wi~osS [?1 3:7 throo [6] 4:2 4:6 t~powtiting [11 34:10 17:12 19:9 32:15 9:1 13:11 14:4 typically 141 15:23 34:9 34:18 34:19 32:12 23:7 26:13 32:16 WIT]M'~SSES ill 18:1 through [61 13:3 woI~[ 141 19:23 20:6 14:9 26:9 26:9 20:14 22:24 26:22 31:13 -U- words ill 30:23 throughout [i i 14:4 ultimatoly iU 12:22 Wrap [2] 31:9 31:9 tight IH ]5:22 nndor [5] 12:22 13:2 tightness pi 15:18 21:18 24:2l 34:10 tilting [21 25:6 25:7 undoratand [21 18:7 -X- 30:2 X-ray [u 18:19 tim~16l 13:11 14:4 Univorsityt~l 3:25 X-raystsl 6:25 10:4 14:18 22:4 23:9 32:12 tip f~u 9:8 13:10 10:6 18:8 28:11 TIMMONS i~l 17:4 14:19 14:24 15:24 Index Pnge 6 HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220~7 i 7=393-51 ORI61NAL HELEN P. FULTZ, : IN THE COURT OF COMMON PLEAS PLAINTIFF : CUMBERLAND COUNTY, PENNSYLVANIA : V : CIVIL ACTION - LAW NO. 2001-2979 JOYCE M. TIMMONS, : DEFENDANT : JURY TRIAL DEMANDED VIDEO DEPOSITION OF: LEE S. SEGAL, M.D. TAKEN BY: PLAINTIFF BEFORE: BOBBI JO HAHN, RPR NOTARY PUBLIC DATE: APRIL 17, 2002 9:15 A.M. PLACE: HERSHEY MEDICAL CENTER HERSHEY, PENNSYLVANIA APPEARANCES: ANGINO & ROVNER, P.C. BY: RICHARD A. SADLOCK, ESQUIRE FOR - PLAINTIFF THOMAS, THOMAS & HAFER, LLP BY: C. KENT PRICE, ESQUIRE FOR - DEFENDANT ALSO PRESENT: ARKIE SIMMERS, VIDEOGRAPHER 2080 kinglestown Road · St, ite 103 · Harrisburg, PA 17110 717.540.02.70 · Fax 717.540.0221 "Lancaster 717.393.5101 WITNESSES NAME DIRECT CROSS REDIRECT RECROSS SEE S. SEGAL, M.D. BY: MR. SADLOCK 4 -- 25 -- BY: MR. PRICE -- 15 -- 28 3 1 STIPULATION 2 It is hereby stipulated by and between 3 ~ounsel for the respective parties that reading, 4 signing, sealing, certification and filing are hereby 5 Naived. 6 7 THE VIDEOGRAPHER: My name is Arkie Simmers. 8 I'm a paralegal with Angino & Rovner. Our offices are 9 located at 4503 North Front Street in Harrisburg, and 10 I'm operating the video and audio equipment for today's 11 deposition. The date is April 17th, 2002; and it is 12 9:15 a.m.. 13 We're here on behalf of the Plaintiff to take 14 the deposition of Lee S. Segal, M.D., at Hershey 15 Medical Center, Hershey, PA. Dr. Segal will be 16 testifying in this case, Helen P. Fultz versus Joyce M. 17 Timmons in the Court of Common Pleas of Cumberland 18 County, Pennsylvania, No. 2001 dash 2979. Will the 19 attorneys please introduce themselves and who they 20 represent? 21 MR. SADLOCK: Richard Sadlock, attorney for 22 Miss Fultz. 23 MR. PRICE: Kent Price for Joyce Timmons. 24 THE VIDEOGRAPHER: Will the court reporter 25 )lease swear in the witness? 4 1 2 LEE S. SEGAL, M.D., called as a witness, 3 being duly sworn, testified as follows: 4 5 DIRECT EXAMINATION 6 BY MR. SADLOCK: 7 Q Would you state your full name, sir? 8 A Lee Steven Segal. 9 Q And what is your occupation? 10 A I'm an orthopedic surgeon. 11 Q Can you briefly explain for the jury what is 12 involved in being an orthopedic surgeon? 13 A It -- it's a surgical subspecialty that 14 involves taking care of the musculoskeletal system in 15 eneral terms. 16 Q Can you highlight for us, Doctor, your 17 ducational background that led to you becoming an 18 Drthopedic surgeon? 19 A Starting from where? I mean how far back? 20 Q College. 21 A College. I did my undergraduate work at 22 ~enyon College in Ohio, went to medical school at 23 Femple University School of Medicine in Philadelphia, 24 ~id my orthopedic training and residency at the 25 Southern Illinois University in Springfield, Illinois, 1 did a pediatric orthopedic fellowship at Children's 2 ~ospital in Philadelphia; and I've been here since 3 then. 4 Q You're obviously then licensed in the 5 Commonwealth of Pennsylvania? 6 A Correct. 7 Q Do you hold any certifications or board 8 ~ertifications I should say? 9 A Yeah, with the American Board of Orthopedic 10 gurgery. 11 Q And when was that obtained and what's 12 involved in being Board Certified? 13 A It was obtained in 1993. It entails two 14.garts. One is a written part -- and it's completed 15 ~fter your residency training -- and then an oral part 16 two to three years after that so -- 17 Q Within the practice of orthopedics, do you 18 have any subspecialties? 19 A Pediatric orthopedic surgery. 20 Q And that would be dealing with children? 21 A Correct. 22 Q And do you also hold any teaching positions 23 here at the Hershey Medical Center? 24 A Yes, I do. 25 Q And what is that? 6 1 A I'm an associate professor of orthopedic 2 surgery and pediatrics. 3 Q Now, Doctor, as part of your practice, do you 4 treat patients who have been injured in motor vehicle 5 accidents? 6 A Yes. 7 Q Does that include patients who have had neck 8 injuries in motor vehicle accidents? 9 A At times, yes. 10 Q Have you previously provided testimony, 11 Doctor, as a treating physician and as an expert in 12 ~rthopedic surgery? 13 A Yes. 14 Q And Doctor, has Helen Fultz been a patient of 15 ,ours? 16 A Yes. 17 MR. SADLOCK: At this time, I'd like to offer 18 )r. Segal as an expert in orthopedic surgery and as 19 Helen Fultz's treating orthopedic surgeon. 20 MR. PRICE: I have no questions regarding Dr. 21 Segal's qualifications. 22 BY MR. SADLOCK: 23 Q Doctor, can you please explain for the jury 24 when you first saw Miss Fultz? 25 A Yeah. Can I just refer to -- 7 1 Q Sure. 2 A -- just to -- it's a letter actually just 3 reviewing my involvement with -- with Helen. I first 4 saw her on July 6, 2000. 5 Q Did she provide you with a history or the 6 reason she was in for evaluation with you? 7 A She did. 8 Q And what was that? 9 A She reported to me that she was involved in a 10 motor vehicle accident six months earlier. She was in ll the front seat, restrained passenger; and what she 12 reported to me was that she was -- her car was hit on 13 the side or T-boned by another car going at a high 14 speed. High speed -- the exact speed was not known. 15 She stated she had several injuries including 16 sternal fracture as well as a whiplash or 17 hyperextension injury to her -- to her neck that was 18 treated with a cervical collar; and she had come to me 19 with continued complaints of neck pain and -- 20 predominantly neck pain. . 21 Q And at that point, Doctor, dad you then 22 conduct a full orthopedic examination of Miss Fultz? 23 A I did. 24 Q And can you explain for us, Doctor, your 25 findings from that examination? 8 1 A She was particularly tender and complained of 2 nore pain right in her posterior neck in the midline on 3 examination and had more pain when I asked her to 4 extend her neck and move from side to side her neck. 5 Otherwise, I thought her motion was very good. She had 6 full flexion, extension of her neck, full rotation and 7 full bending. 8 Her neurologic examination was entirely 9 within normal limits. So she had normal reflexes, 10 normal strength, normal sensation; and so her exam 11 besides being point tender and having some pain with 12 certain motions of her neck was otherwise normal. 13 Q You mentioned that she was tender posterior 14 at the midline. What does that mean? 15 A Well, when you run your hands along the back 16 9f her neck, you can feel the -- the tips of the 17 spinous processes of the vertebra; and in that area, 18 she was tender as opposed to the sides which are the 19 nuscles running back or the paraspinal muscles. And 20 they were less tender. 21 Q Did you order any diagnostic studies, Doctor? 22 A I did. I got -- I obtained radiographs of 23 her cervical spine including flexion/extension to see 24 if there's any abnormal motion. She -- she had a few 25 abnormal findings on the radiographs. It would be nice 9 1 ~o have the radiographs here to show you which I don't 2 Rave. The first thing that you -- I noticed was she 3 had a loss of her normal lordosis of her neck. 4 Typically, the neck will be in a certain 5 ~urvature if we'd look at the neck from the side where 6 it -- it has more of an extension pattern, what we call 7 the lordosis. She lost that normal lordosis. That can 8 be due to a number of reasons. In some children, it's 9 normal, in about l0 to 15 percent of patients; but 10 otherwise, it can be in response to a -- some type -- 11 something is irritating her and holding her back, 12 holding her out of its normal lordosis. So she's 13 almost in like a protective spasm. That can be a 14 reason. So when you see that, that's -- that's of a 15 concern. 16 The other thing I noticed at the -- on -- on 17 -- from my notes here, at the C4-C5 level which is the 18 fourth and fifth cervical vertebra, she had some 19 ~ranslation of the one vertebra on the other that I 20 ~easured at about 3 millimeters; and then I thought she 21 had some increased angulation at the C4-C5 interval 22 5hat I measured at 15 degrees. 23 Posteriorly, we look at something called the 24 spinal laminae which was intact, and all the facet 25 oints looked like they were intact as well. So she 10 1 ~idn't meet the criteria that we use for frank 2 instability of her neck; but clearly, there were some 3 radiographic abnormalities on her radiographs. 4 Q You mentioned translation and angulation at 5 ~4-5. In lay terms, can you just break that down for 6 us? 7 A Yeah, I'm sorry. Translation is where my -- 8 my hands will represent the vertebra; and translation 9 is if they're shifted one way or the other either 10 forward or backward. And she was shifted forward about 11 millimeters; and then angulation is just as you see 12 ,n -- on flexion/extension films when you have somebody 13 move the neck up and back. But there's -- there's a 14 certain amount of angulation that one will see at 15 various levels of the spine, and she had a little 16 excessive motion at C4-5. But again, not to the degree 17 that would cause her frank instability. 18 Q The -- the loss of lordosis, the translation 19 ~nd angulation, can that have any relation to a 20 ~yperextension or hyperflexion injury and whiplash 21 injury in a motor vehicle accident? 22 A It can. It can, and that's only from her 23 history that I could relate to these findings. 24 Q Did you formulate then a -- a diagnostic 25 impression, Doctor, based on the history, your exam and 11 1 ~he X-ray findings? 2 A Based on the history and on her exam and less 3 so on the radiographs, I thought she had a diagnosis 4 consistent with a whiplash injury or cervical 5 hyperextension injury or cervical sprain or whatever 6 you want to call it; and -- and I sat down with the 7 family and told them this can be a very troubling 8 problem. . 9 In some cases, it can take up to a year to -- 10 to get better. Some cases, it doesn't. I did want to 11 obtain an MRI to further evaluate the -- the discs and 12 the ligaments and the spinal cord itself just to be 13 sure that we weren't missing anything. 14 Q You indicated in some cases this type of 15 injury does not get better? 16 A There -- yes, in some cases, it does not get 17 Detter. I -- I don't know where I'm crossing on terms 18 ~f being a treating or expert physician because I 19 ~on't -- I don't pretend to be an expert in -- with 20 ~hese injuries; but my understanding is that some 21 9atients even after all of the other issues, secondary 22 jains, litigation is completed -- so those are out of 23 .he picture -- about 45 percent will still have 24 symptoms even -- two years even after -- after the 25 fact. So clearly, there are people who do not get 12 1 oetter. 2 Q You mentioned that you suggested to the 3 Eamily -- Helen and her mom -- to have an MRI. Did you 4 recommend any other treatment at that first visit in 5 terms of whether therapy, exercise, medication, 6 anything of that nature? 7 A I did recommend some physical therapy to try 8 to improve her muscle strength and support or dynamic 9 support as I call it of her neck in addition to some 10 antiinflammatory medication to see if that would help 11 while we're getting the MRI scan and to see how she was 12 doing then, and I asked to see her back in three 13 months. 14 Q I believe you then did see Miss Fultz again 15 ~n October 12 of 2000, Doctor. 16 A That's correct. 17 Q And what was her -- her status at that time? 18 A She was now nine months from her injury. She 19 ~tated that her pain was better but still pain was 20.gresent. She completed her dynamic stabilization 21 ~herapy program. She had an MRI which was entirely 22 normal, still performing a home exercise program and 23 still going to schooling, working as well. 24 Q Your note indicates she was taking Naprosyn? 25 A Yes. I'm sorry. 13 1 Q was there any change in your diagnostic 2 impression, Doctor? 3 A No, there wasn't; and overall, I thought her 4 ~xam was about the same. 5 Q And then did you see her again, Doctor, on 6 February 1 of 20017 7 A February 1, yes, I did. 8 Q Was that your last evaluation or -- or time 9 ~eeing Miss Fultz? 10 A It was. It had now been almost over a year 11 from her injury. She really wasn't getting better. 12 She did report to me having two episodes of seizures 13 since September of 2000, that she had EEGs times two 14 that were normal and CT Scans that also were normal; 15 but essentially, I think the exam was normal. 16 She still had, you know, on radiographs the 17 same subtle or, you know, abnormalities in terms of 18 translation and angulation; but again, not meeting any 19 of the criteria for frank instability. And I actually 20 then sent her for another opinion to see my colleague, 21 Dr. Ludwig, for his opinion just because it had been 22 ~oing on for so long and I wanted to be sure I wasn't 23 ~issing anything. 24 Q Was Miss Fultz still complaining of pain at 25 ~hat -- in her neck on that February visit? 14 1 A Yes, she was. 2 Q You mentioned you referred her to Dr. 3 budwig. He's also an orthopedic surgeon here at 4 ~ershey Medical Center? 5 A Yes, he is. 6 Q Did you at least receive I believe at least 7 Dne report from Dr. Ludwig? 8 A Yes, I did. That report was from two weeks 9 later, February 15th; and in summary, he -- he also 10 thought that neck pain was secondary to a whiplash type 11 injury. He did notice the subtle changes on 12 radiographs as well. He had reviewed the MRI scan 13 which was normal. 14 His exam showed again a fairly unremarkable 15 examination with relatively -- with a relative lack of 16 objective findings on exam; and again, that's what you 17 do tend to find with these type injuries. So I think 18 his recommendation at that time was, again, there's no 19 evidence of instability of the spine and had 20 recommended consultation with -- with pain management 21 service. 22 Q From your review of Miss Fultz's chart here 23 at the medical center, was it your understanding that 24 she did follow-up and obtain treatment with the pain 25 management program? 15 1 A She did. When I reviewed the chart last -- 2 last evening, she did, subsequently was seen by the 3 pain management service here. 4 Q Doctor, do you have an opinion within a 5 reasonable degree of medical certainty based on the 6 history Miss Fultz provided, your examinations and 7 treatment whether the injury that you've diagnosed and 8 discussed with us today are directly, causally related 9 to her January 23, 2000 motor vehicle accident? 10 A As best I can determine without any other 11 history given by the patient except for this injury or 12 accident six months earlier, that I would assume that 13 ~he two are related causally. 14 MR. SADLOCK: Thank you, Doctor. I have no 15 further questions right now. 16 CROSS EXAMINATION 17 BY MR. PRICE: 18 Q Doctor, let me go back to the first time that 19 ,ou saw Miss Fultz which was July the 6th of 2000. 20 ~hink you indicated that's approximately three months 21 after the accident. 22 A Six months. 23 Q Six months. You're correct. 24 A Yeah. 25 Q And in your physical examination of her, you 16 1 indicate among other things that she had excellent 2 ~ange of motion of her cervical spine. For the benefit 3 Df the jury, what do you mean when you're talking about 4 range of motion? 5 A It's just the -- the degree of motion that 6 ,the neck will move in different directions. So 7 flexion/extension would be in the sagittal plane, side 8 to side in the coronal plane and then rotation in the 9 transverse planes. So there's six planes of motion -- 10 Q Okay. 11 A -- of the cervical spine. 12 Q Perhaps to do it in laymen's terms, the 13 extension would be moving your head backwards so you'd 14 be looking at the ceiling? 15 A Yes. 16 Q Flexion would be dropping your chin to your 17 chest? 18 A Correct. 19 Q And then you indicate turning your head to -- 20 A You want chin to your shoulder and then the 21 opposite way as well. 22 Q And then dropping your ear to your shoulder 23 on both sides? 24 A Right. 25 Q Okay. And at the time of your examination on 17 1 the first occasion -- in fact, all of your subsequent 2 examinations -- you noted an excellent range of motion 3 of the cervical spine? 4 A Yeah. 5 Q What -- 6 A I should have quantitated that, but I didn't 7 in my notes. 8 Q Okay. You're familiar obviously with the 9 concept of guarding? 10 A Yes. 11 Q If someone has pain because of a motion, they 12 tend to guard against it and they tend to avoid trying 13 to -- to move the joint, if you will, in that 14 )articular direction; is that correct? 15 A That's correct. 16 Q And in this case, you didn't see any evidence 17 ,f guarding? 18 A That's correct. 19 Q On the occasion of your first contact with 20 Miss Fultz in July of 2000, did you have the benefit of 21 reviewing any of the prior X-ray films? 22 A I don't believe so. Again, just looking at 23 my note, there's no -- there's nothing in the note that 24 suggests that; and my note does use we got films 25 today. So I don't think I saw earlier films. 18 1 Q Let me take you to the occasion of your next 2 visit which would be October, the Year 2000. 3 A Okay. 4 Q And there under radiographs, you indicate on 5 ~eview of her previous films. Do you know if that's 6 ~eferring to previous films that were taken here at the 7 nedical center? 8 A Most likely from July 6th, yeah. 9 Q Okay. So you did not have the benefit of any 10 K-ray films that were taken either at Holy Spirit 11 Eospital or by the chiropractors who had treated her? 12 A I don't recall. I don't believe so. 13 Q Would having prior X-ray films be of some 14 benefit to compare what you were seeing on your X-ray 15 films with what was seen on earlier films? 16 A They may be a benefit if one sees progression 17 of -- of instability or -- you know, or the radiologic 18 findings; but that's a matter of conjecture to how much 19 benefit. 20 Q Did you make any inquiry as to whether or not 21 there were films of her neck that had been taken before 22 the motor vehicle accident that you could use as a 23 baseline? 24 A I did not, and that would be surprising to 25 have those available. 19 1 Q Do you know whether or not -- strike that. 2 Did you at any time review or have the benefit of any 3 medical records generated by health care providers 4 mutside of the Hershey Medical Center? 5 A I don't believe so. I mean usually I'll make 6 documentation of that in my note that there were 7 ecords that I reviewed, but I believe that Miss Fultz 8 just presented to me with complaints of neck pain. 9 Q Do you know whether or not any of her prior 10 health care providers had ever indicated or expressed 11 an opinion that the situation -- if that's the right 12 word -- that you saw with her neck were congenital? 13 A No, not -- not -- well, there's no -- I had 14 no information from previous health care providers nor 15 was there anything on the radiographs that suggested a 16 congenital basis for this. 17 Q The MRI that you recommended, in fact, that 18 was taken some time after your first occasion of seeing 19 her? 20 A That's correct. 21 Q And the findings on the MRI were normal? 22 A That's correct. 23 Q As between X-rays and MRI, which is the more 24 sophisticated? 25 A They -- they actually -- well, the technology 20 i is clearly more sophisticated with MRI; but they look 2 at different things. MRI is much -- the X-rays are 3 nuch more valuable for looking at bony abnormalities. 4 the MRI is much more valuable looking at more soft 5 5issue, cartilage aspects of the -- of the -- of the -- 6 Df the -- of the skeleton so to speak. 7 The other problem -- so in terms of 8 sophistication, clearly, the technology is -- is 9 greater with MRI. However, we tend to -- MRI is a much 10 newer modality of imaging; and we tend to -- it tends 11 to be much more sensitive in terms of what we're 12 seeing. And what we see may not in reality relate to 13 what the problem is. 14 So for instance, we see lots of patients 15 who -- who are otherwise asymptomatic; and you get an 16 MRI of their neck and they have many, many 17 abnormalities even though they have no symptoms. So 18 it's really hard to often relate what you're seeing on 19 an MRI, if you see an abnormal finding saying is this 20 truly what's relating to the symptoms. 21 So it clearly is a very, very sensitive tool; 22 but in being a new modality, we haven't fully realized 23 what it all means yet. It's kind of a long-winded 24 statement so -- 25 Q Insofar as the MRI was concerned, that was 21 1 normal? 2 A Yes. 3 Q And insofar as the X-rays were concerned, 4 there were no -- there's no evidence of fracture? 5 A There was no evidence of fracture of the 6 bones, that's correct. 7 Q And you indicated that although you did see 8 some evidence of angulation and translation that the 9 amount of angulation and translation that you saw did 10 not qualify to meet the criteria of cervical 11 instability; is that correct? 12 A That's correct. 13 Q Okay. You further indicate that there was a 14 relative lack of objective findings; is that correct? 15 A Correct. 16 Q Objective meaning something that you as the 17 examiner or the treating physician can -- can see or 18 can feel, if you will, by manipulating the patient? 19 A Yeah, looking for things like if there's 20 weakness of muscles, if the reflexes are diminished, if 21 there's decrease in sensation, something objectively 22 that you can -- you can hang your hat on so to speak. 23 Q And objective would be as compared to 24 subjective and subjective would be what the patient is 25 telling you? 22 1 A Correct. 2 Q I think at the occasion of your first visit 3 ~ou also recommended that she discontinue chiropractic 4 reatments; is that correct? 5 A I did. I did do that. 6 Q Okay. Why did you do that? 7 A I don't know. 8 Q Okay. 9 A Honestly, I don't know why. I -- I guess I 10 wasn't thinking they were helping her. I think she had 11 been receiving them before; and it -- it -- it had not 12 seemed to be helping. So I had -- helping long term. 13 She would get some short-term relief and then the pain 14 would come back. So I thought for the present time 15 ust to hold off on that and try these other 16 odalities. 17 Q All right. You also recommended physical 18 ~herapy for dynamic stabilization. And dynamic 19 stabilization refers to what? 20 A It's nothing more than just strengthening of 21 her neck muscles so she can -- so it's much more of an 22 active program. I found that passive programs, i.e. 23 ~hiropractic, where you lay there and they manipulate 24 do help but not long term whereas if you can do more of 25 an active program where you're an active participant in 23 1 ,our therapy and really work on strengthening your 2 ~scles, dynamically stabilizing per se the neck that 3 it may be more long-term benefit. 4 Q In reviewing the patient's chart last evening 5 or any time before your deposition this morning, did 6 ,ou, in fact, note that she had gone through physical 7 .herapy here at Hershey? 8 A Yes. 9 Q Do you happen to have a copy of the physical 10 therapy report? 11 A I did happen to see that; and that was 12 somewhere back -- in the back of the chart. Yeah, it's 13 dated July 11, 2001. 14 Q Okay. Now, I note -- and perhaps it's behind 15 the letter in the chart, Doctor -- that there, in fact, 16 are progress report notes from the physical therapy 17 ~epartment that start July the 18th -- 18 A Yes. 19 Q -- of the Year 2000 -- 20 A Yeah. 21 Q -- and continue through September it looks 22 like the 5th of the Year 2000. 23 A It looks like they continue through September 24 5th, 2000. 25 Q Right. I think that's what I said. 24 1 A I'm sorry. 2 Q And it looks as if between July 18 of 2000 3 and September 5 of 2000 that there were eight visits or 4 eight sessions. 5 A Seven. One was canceled. 6 Q Okay. Now, the letter from the physical 7 ~herapy department that's dated July the llth of 2001 8 indicates that she was seen for a total of eight 9 ~essions. 10 A That's what it says. 11 Q Okay. 12 A Yes, I agree. 13 Q And that she demonstrated good resolution of 14 her symptoms as a result of the therapy; is that 15 correct? 16 A That's what it says, yes. 17 Q Okay. Under the assessment, it says that the 18 )atient has been actively discharged from therapy given 19 ood resolution of symptoms and being able to resume 20 11 activities of daily living as well as work demands 21 Nithout problems. Did I read that correctly? 22 A That's correct. 23 Q Okay. 24 A I was pleased when I saw that. 25 MR. PRICE: Thank you, Doctor. That's all I 25 1 have. 2 REDIRECT EXAMINATION 3 BY MR. SADLOCK: 4 Q Doctor, just a few questions in follow-up. 5 In terms of your initial visit when you discussed 6 discontinuing chiropractic care, was that also based on 7 your referral of Miss Fultz to physical therapy here at 8 the med center? 9 A I -- I -- I think so, again, for the -- 10 the -- the fact that I wanted her to get an active 11 program. 12 Q It was not out of any concern of -- of 13 causing -- that chiropractic was causing her any 14 further harm or injury? 15 A I just didn't think it was helping her long 16 term, not giving her any long-term benefit, just seemed 17 to help her short term. So I wanted to try a different 18 modality to see if that would help. 19 Q And while therapy appears to have helped Miss 20 Fultz, is it unusual for a patient when they leave 21 therapy and try to resume activities to then have the 22 )roblem or the pain resume? 23 M~. P~CE: -~ '-- 24 25 .. : It's in direct response t~ 6ne 26 2 ~-~--WT~W~R: Should T ~=,..t~? 3 BY MR. SkDLOCK: 5 A I don't know if I can answer that. You know, 6 wasn't there on July llth to know -- I've not seen 7 er from that report for six months to really know how 8 ~he was doing honestly; but in -- in -- in general, 9 some patients, you know, can have persistent pain 10 afterwards. Whether or not Helen is having those 11 problems, I just -- I'm not -- I'm -- I don't have the 12 luxury of telling you that. 13 Q Well, let me ask it this way, Doctor. 14 A Okay. 15 Q The therapy -- if I can find my copy of the 16 notes -- was from seven visits starting July 18 of 2000 17 and the last one was September 18 of 2000. 18 A Yeah, and then the notes in 2001. I'm not 19 sure where the discrepancy is coming from. I don't 20 know. Yeah, I -- because that was a period of time ~1 that I was seeing her was from July of 2000 through 22 September. 23 Q Right. And you would have seen her again in 24 October of 2000 -- 25 A Correct. 27 1 Q -- after that September; and I believe you 2 indicated at that time she was still complaining of 3 ~ain. And my question -- 4 A Correct. 5 Q -- I guess is asking then is that unusual to 6 Lave a patient who completes therapy and reports to the 7 therapist that there was a good result but then tries 8 to resume normal activities and has a recurrence of the 9 )ain related to the original injury. 10 A Well, it's -- it's hard -- what I'm saying is 11 'm not -- this report that's typed out from July, 2001 12 s six months later or nine months later, ten months 13 later. So it's hard for me to gauge this report. I'm 14 not sure because there's no other handwritten notes 15 here; and it says it was typed as well on that same -- 16 9n 2001. So it's not -- I don't think that he dictated 17 ~he date wrong. 18 I can't answer specifically for Helen; but in 19 eneral, I think I would have to say that, sure, there 20 are some people who may have return of symptoms but 21 that's -- that's a general -- generality. 22 Q In terms of that -- that typed note as well 23 from July of 2001, is it possible that that was 24 referring to other therapy that Miss Fultz received 25 after she was -- because you indicated that she went 28 1 from Dr. Ludwig's care to a referral to pain management 2 Nhich, I believe, did continue as the chart will reveal 3 ~ntil 20017 4 A Yeah, I think I read somewhere in the chart 5 ~hat they had requested additional therapy for her 6 through -- through pain clinic and some other 7 modalities like biofeedback, consideration for facet 8 blocks, medications, etc., that are standard ways of 9 managing non-operatively this type of injury. 10 MR. SADLOCK: Thank you, Doctor. I have 11 nothing further. 12 RECROSS EXAMINATION 13 BY MR. PRICE: 14 Q Just one further thing, Doctor. Typically 15 Nhen physical therapy would see a patient and they 16 Nould issue a report, they would typically send that to 17 Zhe referring physician, would they not? 18 A I would hope so. 19 Q The letter from the physical therapy 20 ~epartment dated July 11, 2001, I note that a carbon 21 copy was sent to you as opposed to somebody at the pain 22 clinic. 23 A Okay. 24 Q Would that suggest that -- that that was sent 25 to you as a physician who had referred the patient to 29 1 ~hysical therapy? 2 A I don't know. 3 Q Okay. 4 A I -- I know the therapist. I don't know 5 whether or not he's referring it to me just because my 6 name was in the chart and maybe -- I really don't know. 7 Q A little bit of a mystery? 8 A Yeah, well -- 9 MR. PRICE: All right. Thanks, Doctor. 10 THE WITNESS: You're welcome. 11 THE VIDEOGRAPHER: This concludes the 12 ~eposition. The time is 9:47 a.m.. 13 (Whereupon, the deposition concluded at 9:47 14 ~.m..) 15 16 17 18 19 20 21 22 23 24 25 30 1 2 3 TOUNTY OF JUNIATA : SS 4 TOMMONWEALTH OF PENNSYLVANIA : 5 6 I, Bobbi Hahn, a Notary Public, authorized to administer oaths within and for the Commonwealth of 7 Pennsylvania, do hereby certify that the foregoing is ~he testimony of LEE S. SEGAL, M.D.. 8 I further certify that before the taking of 9 ~aid deposition, the witness was duly sworn; that the questions and answers were taken down stenographically 10 by the said Reporter-Notary Public, and afterwards reduced to typewriting under the direction of the said 11 Reporter. 12 I further certify that the said deposition was taken at the time and place specified in the 13 caption sheet hereof. 14 I further certify that I am not a relative or employee or attorney or counsel to any of the parties, 15 or a relative or employee of such attorney or counsel, or financially interested directly or indirectly in 16 this action. 17 I further certify that the said deposition constitutes a true record of the testimony given by the 18 said witness. 19 IN WITNESS WHEREOF, I have hereunto set my hand this 18th day of April, 2002. 20 I -" I Bo~l~H~m,~Pulx~ Bobbi Jo Hah~, RPR 22 ~Oomm~mmonEXlX~ml~r. lO, M~X~ Notary Public 23 24 25 WORD INDEX Malti-Ps~c~ I ~ cousistcat ~-~-~ ~. S~AL, M.D. 29:12 29:14 10:14 -l= able[il 24:19 -B- ~'rtainty [u 15:5 i 121 13:6 13:7 abnormal [31 8:24 background[ti 4:17 ccrtification m 3:4 10Ill 9:9 8:25 20:19 backward u i I0:10 certifications 121 5:7 I ] [2l 23:13 28:20 abnormalities [41 10:3 backwards ui 16:13 5:8 13:17 20:3 20:17 l lth[al 24:7 26:6 accident [~1 7:10 based 141 10:25 11:2 Ct-"rti fled u i 5:12 12IU 12:15 10:21 15:9 15:12 15:5 25:6 certify tsi 30:7 30:8 15Iai 2:5 9:9 15:21 18:22 baseline ru 18:23 30:12 30:14 30:17 9:22 accidents 121 6:5 basis ui 19:16 cervical tgi 7:18 8:23 9:18 11:4 IS[hill 14:9 6:8 I)cc~)ming ltl 4:17 11:5 16:2 16:11 171U l:ll actionial 1:2 30:16 behaifui 3:13 17:3 21:10 17thlu 3:11 active[41 22:22 22:25 behindui 23:14 changeltl 13:1 18[al 24:2 26:16 22:25 25:10 bending[Il 8:7 Challis [U 14:11 26:17 actively Ui 24:18 benefit[gl 16:2 17:20 ~SJ't [si 14:22 15:1 18thlal 23:17 30:19 activities 131 24:20 18:9 18:14 18:16 23:4 23:12 23:15 1993 UI 5:13 25:21 27:8 18:19 19:2 23:3 28:2 28:4 29:6 addition iu 12:9 25:16 cheat iii 16:17 -2- additionnl uI 28:5 best ui 15:10 childn~n 1al 5:20 2000[161 7:4 12:15 admi~ist~r[u 30:6 better[61 I1:10 11:15 9:8 13:13 15:9 15:19 [ft~rwards [21 26:10 11:17 12:1 12:19 ChJldtcII's iii 5:1 17:20 18:2 23:19 30:10 13:11 23:22 23:24 24:2 agalll UOl 10:16 12:14 b¢twccn [31 3:2 chin 131 16:16 16:20 24:3 26:16 26:17 13:5 13:18 14:14 19:23 24:2 chiropractic [41 22:3 26:21 26:24 14:16 14:18 17:22 Beyolld Itl 25:23 22:23 25:6 25:13 200] [tol 3:18 13:6 25:9 26:23 biofccdbackltl 28:7 chiropr~ctor8[ll 18:11 23:13 24:7 26:18 agalnstlU 17:12 bitui 29:7 CIVIL[u 1:2 27:11 27:16 27:23 ¢l©mrly [51 10:2 11:25 28:3 28:20 8grcc III 24:12 blocks Ul 28:8 20:1 20:8 20:21 almoat[al 9:13 13:10 board[al 5:7 5:9 ¢iini¢[21 28:6 28:22 2001-2979 ui 1:3 along[si 8:15 5:12 2002131 I:11 3:11 collar UI 7:18 30:19 Amcrig811 III 5:9 Bobbi [31 1:9 30:6 23UI 15:9 a.ll~llg III 16:1 30:21 CO]]CI~glI~ Ill 13:20 25[U 2:4 amount [2110:14 21:9 bones Ul 21:6 Col]cgc [31 4:20 2gui 2:5 Angino [211:17 3:8 holly [u 20:3 4:21 4:22 2979 Ui 3:18 angulation [81 9:21 brcak uI 10:5 c°mil!g [1126:19 10:4 10:Il 10:14 briefly ltl 4:11 ~A~nmon tal 1:1 10:19 13:18 21:8 3:17 Commonwealth la! 5:5 -3- 21:9 -(~' 30:4 30:6 3 Iai 9:20 I 0:11 anSWCF [si 26:2 26:5 27:18 CUI 1:20 ~ompar~ itl 18:14 · '4- answers itl 30:9 C4-5 Iai 10:5 10:16 compared tit 21:23 4UI 2:4 antiinflammatofy it i C4=C5 Iai 9:17 9:21 complained iu 8:1 12:10 g~ll¢clcd ill 24:5 complaining 121 13:24 45UI 11:23 APPEARANCES tu caption ui30:13 27:2 4503 ul 3:9 1:16 cml'iai 7:12 7:13 complaints t~l 7:19 AprilI31 1:11 3:11 carbollUi 28:20 19:8 completed t31 5:14 -,~- 30:19 C~'C [61 4:14 19:3 11:22 12:20 S[U 24:3 ai'C~ UI 8:17 19:10 19:14 25:6 $th [~1 23:22 23:24 Arlric iai 1:23 3:7 28:1 compictcs ill 27:6 asp~:t~ Ill 20:5 cartilage Itl 20:5 ~onccpt Itl 17:9 =6- as~88m~t Ui 24:17 CaSe [2] 3:16 17:16 gOD4~I~ iai 9:15 6Ul 7:4 associatc ltl 6:1 ca~s [41 11:9 ll:10 25:12 aSsun~ Ill 15:12 11:14 11:16 concerned [21 20:25 6th [21 15:19 18:8 a~ymptomatic [u 20:15 causally [2] 15:8 21:3 15:13 concluded [u 29:13 -9- attorilcy Iai 3:2 I 30:14 30:15 causinglal 25:13 concltldcs [11 29:11 9:15[al l:ll 3:12 attoTnt~y8 it i 3:19 25:13 COndll~t itl 7:22 9:47t21 29:12 29:13 audioui 3:10 c~ilingui ]6:14 congenital[21 19:12 authorized u I 30:6 c~ntcr [8l 1:12 3:15 19:16 5:23 14:4 14:23 conj~ctlll~ ill 18:18 -A- available ui 18:25 18:7 ]9:4 25:8 consideration [11 28:7 &mini I:ll 3:12 avoidui 17:12 certaint31 8:12 9:4 mmsiatentui 11:4 HU~HS~.~ ALRRi~'.MT la't~ T7 ,e. Man-aw,E ?17-540-0220W17-393-5101 Index Page I coastitut~s - hat Multi'Pa~c~ I.P.I~ S. SI~OAL, M:~-~. constJtl~to8 iii 30:17 10:24 13:i evaluation [~1 7:6 ~!~os~ [~1 8:6 16:16 c~ti~ t)] 14:20 dim~ ol 27:16 13:8 ~xio~cx~sion O] ~[ll 17:19 diffmt pi 16:6 ~ing [~] 15:2 8:23 10:12 16:7 ~fl~ [3) 23:21 20:2 25:17 2~:4 foll~-up [~l 14:24 23:23 28:2 di~nis~d O] 21:20 ~i~ [si 14:19 25:4 17:16 21:4 21:5 ,follows I~] 4:3 m~nmd Itl 7:19 ~[~1 2:2 4:5 21:8 forgoing o] 30:7 ~y[~l 23:9 26:15 25:25 ~x~t []1 7:14 fo~la~ [11 10:24 28:21 di~ti~ [~1 17:t4 cxm [71 8:10 10:25 fo~d [zl 10:10 ~rd[tl 11:12 30:10 11:2 13:4 13:15 10:10 ~n~ iq 16:8 ~tion8 iq 16:6 4:14 14:16 fo~d [~1 22:22 ~mt[ltl 5:6 ~tly [Zl 15:8 c~nmlnation p q 4:5 5:2l 12:16 15:23 30:15 7:22 7:25 8:3 f~tl] 16:18 17:14 17:15 ~sch~cd[]l 24:18 8:8 14:15 15:]6 fm~ol 7:16 17:18 19:20 19:22 ~mtinm [~1 22:3 15:25 16:25 25:2 21:4 21:5 21:6 21:11 21:12 dim~n~[]l 25:6 28:12 f~nkol 10:1 10:17 21:14 21:15 22:1 ex.nations [~l 15:6 13:19 22:4 24:15 24:22 ~sc~p~cy [Il 26:19 17:2 front [Zl 3:9 7:11 26:25 27:4 ~8 [11 I1:11 cx~ltl 21:17 f~ll [~1 4:7 7:22 ~y Ill 24:21 ~d[2l 15:8 :x~ll~t [21 16:1 8:6 8:6 8:7 ~un~l OI 3:3 25:~ 17:2 F~ly itl 20:22 30:14 30:1~ ~MF[~J 4:16 ~un~[311:l 3:18 ~:3 6:11 6:14 ~x~t[q 1~:11 ~l~p6] 1:1 3:16 6:23 7:2] 7:24 cx~sivc Ol ~0:16 3:22 6:14 6:24 30:3 8:21 10:2~ ]2:is ~i~ [21 12:5 7:22 12:~4 13:9 13:24 1~:6 IS:19 ~[31 I:l 3:17 13:2 13:~ 15:4 2:22 7:20 3:24 15:14 ~:18 23:~ ~fl [41 6:]1 6:18 25:20 27:24 Off.fiR [31 10:l 13:19 24:2S 25:4 26:13 11:18 11:19 21:10 28:10 28:14 29:9 Ful~'s [21 6:19 14:22 CROSS [2] 2:2 ~tation o] 19:6 explain ol 4:11 6:23 ~:24 A~:16 d~sn't pj 11:10 cx~s~d pi ~9:10 :mssin~m 11:17 ~[~1 10:~ 11:6 cx~nd[q 8:4 ~ns[~] ~1:22 ~[l] 13:14 30:9 cx~si~ [31 8:6 ~au~ Iq 27:~3 ~lnd o] l:l Dr[v] 3:1S 6:18 9:6 16:13 ~al [414:1~ 26:8 3:17 6:20 13:21 14:2 27:19 27:21 c~a~ [11 ~:5 14:7 28:1 -F- ~i~ Iii 27:21 ~ppin~ ~1 16:~6 -D- ~6:22 f~t 12] 9:24 28:7 ~m~d [q d~[Jl 9:8 f~t [61 11:25 17:1 ~1~ [3] I~:lt 24:18 d~ly [q 24:20 duly [2] 4:3 30:9 19:17 23:6 23:15 30:17 ~hol 3:~8 d~smlc [41 12:8 2~:10 ~lvi~ lq da~ [31 1:11 3:11 12:20 22:1S 22:1~ f~rly [t I 14:14 ~[q 23:6 27:17 d~c~ly [q 23:2 fnmili~p] 17:8 ~[4] 8:5 24:13 da~dol 23:13 24:7 ~*m~ly[2] 11:7 12:3 24:1~ 27:7 2S:20 -H- f~[tl 4:19 ~(]] 20:9 ~alin~[q 5:2o PC~ 14] 13:6 ~[11 17:12 ~mmo] 21:21 c~o] 16:22 13:7 t3:2~ 14:9 ~in8121 17:9 D~A~ [2] 1:4 ~ucafi~ it ] 4:17 Fcllows~p [It ~:1 17:17 t:2i ~[11 ]3:13 [~l 8:24 25:4 ~8121 22:9 27:~ ~[31 10:16 I~:~ ~t[31 24:3 24:4 fif~itl 9:18 16:5 24:8 -H- ~[q9:22 ci~[21 10:9 18:10 filing[ll 3:4 D~D~DIII 1:4 ~lo~t21 30:14 film[l~l 10:12 17:21 HAiR[ti 1:19 17:24 1~:25 18:5 ~[31 1:9 30:6 ~Rn~ [~1 24:20 30:15 18:6 18:10 18:13 30:21 ~ns~d Iq 24:13 ~t~ls Ol 5:13 18:15 18:15 18:21 hndpl 30:19 ~nt [3j 23:17 ~timly [21 8:8 finan~nily pi 30:15 ~ds [21 8:15 10:8 24:~ 28:20 12:21 fin~ iq 20:19 hnd~ Iii 27:14 3:11 3:14 23:5 ~uipmt pi 3:10 8:25 10:23 II:I bg[ll 21:22 29:12 29:13 30:9 ~S~ [21 I:17 14:16 18:18 19:21 b~[31 20:18 27:10 30:12 30:17 1:20 21:14 27:13 ~m[ll t$:lO ~s~ally []1 13:15 fi~t [~1 6:24 7:3 h~[il 25:14 ~d[Jl 15:7 c~[11 28:8 9:2 12:4 1~:18 H~sb~ Itl 3:9 ~agn~i8 [0 11:3 cva]uaM [11 11:11 17:1 17:19 19:18 hat [11 21:22 ~is~flqtic [~1 8:21 22:2 Index P~e 2 ~GH~, ~ uD~:~'r ~fll_~ & NATAI.~ 717-5~2~717-393-5 Multi-Page TM he, ad = neck ~-~- ~--~ Iai 16:13 16:19 inj~ [41 6:8 3:14 4:2 4:8 i2:10 ~al~ [si 19:3 19:10 7:15 11:20 14:17 30:7 ~dicati~a [ti 28:8 19:14 IBj~ H41 7:17 10:20 less iai 8:20 11:2 Me~ci~ [il 4:23 HoI~[si I:l 3:16 10:21 11:4 11:5 1~4] 7:2 23:15 ~[al 10:1 21:10 6:14 6:19 7:3 11:15 12:18 13:11 24:6 28:19 12:3 26:10 27:18 14:11 15:7 15:11 le~! [~l 9:17 ~ing [~1 13:18 ~lpt4l 12:10 22:24 25:14 27:9 28:9 ~tio~dl41 8:13 25:17 25:18 inq~ itl 18:20 le~ls [ti 10:15 10:4 12:2 14:2 ~l~d[~l 25:19 ina~la] 20:25 21:3 li~dt~l 5:4 ~i~tal 8:2 ~lping [4122:10 22:12 in~bili~ t~l 10:2 lig~ [~l 11:12 8:14 22:12 25:15 10:17 13:19 14:19 likely tsl 18:8 ~lli~ iai 9:20 ~mbylzl 3:2 3:4 18:17 21:11 li~[H 8:9 10:11 30:7 ina~n~ itl 20:14 litigati~ [~l 11:22 Misn [~4l 3:22 6:24 ~f[~l 30:13 in~[~l 9:24 9:25 livingl~l 24:20 7:22 12:14 13:9 13:24 14:22 15:6 ~un~l~l 30:19 in~ms2d[tl 30:15 LLP[ll 1:19 15:19 17:20 19:7 Hcm~y[sl 1:12 in~ [~l 9:21 I~a~d i~] 3:9 25:7 25:19 27:24 1:13 3:14 3:15 in~du~ i~] 3:19 i~g-2~ iai 23:3 ~ssing iai 11:13 5:23 14:4 19:4 invol~tzt 4:12 25:16 23:7 13:23 5:12 7:9 Io~-~n~d iii 20:23 modaliti~ iai 22:16 ~[al 7:13 7:14 invol~nt ill 7:3 I~k[al 9:5 9:23 28:7 hig~i~[~l 4:16 invol~s [~l 4:14 20:1 ~i~ Iai 20:10 hiam~[al 7:5 10:23 ~tatingttl 9:11 l~ked[~l 9:25 20:22 25:18 10:25 11:2 15:6 15:11 ias~ttl 28:16 I~king lsl 16:14 m~[H 12:3 hittH 7:12 isa~s [~1 Il:21 17:22 20:3 20:4 mn~a [~l 7:10 ~ld Iz] 5:7 5:22 i~lf[~l 11:12 21:19 12:13 12:18 15:12 22:15 I~ka OI 23:21 23:23 15:20 15:22 15:23 24:2 26:7 27:12 27:12 holing Iai 9:11 -J- lordosis [si 9:3 27:12 9:12 Ja~U~ [ s I 15:9 9:7 9:7 9:12 mo~i~ HI 23:5 Holy tH 18:10 Jo[al 1:9 30:21 10:18 M~t[H 18:8 ~[H 12:22 joint[ti 17:13 l~Slal 9:3 10:18 mti~l~l 8:5 8:24 ~tly la] 22:9 ]oin~ Ill 9:25 I~t iii 9:7 10:16 16:2 1~:4 26:8 Joy~ [si 1:3 3:16 lots Ill 20:14 16:5 16:9 17:2 ~[ll 28:18 3:23 Ludwig[si 13:21 17:11 Hoapi~ iai 5:2 14:3 14:7 moti~s i~l 8:12 18:11 J~y H41 7:4 15:19 17:20 18:8 23:13 LMd~g~s HI 28:1 m~or iai 6:4 6:8 ~x~sionlal 7:17 23:17 24:2 24:7 iux~[]l 26:12 7:10 10:21 15:9 10:20 11:5 26:6 26:16 26:21 18:22 h~oxi~ [~1 10:20 27:11 27:23 28:20 moro [41 8:4 10:13 ~IATA [~l 30:3 -M- 16:6 17:13 -l- 1~[41 1:4 4:11 Mtal 1:3 3:16 ~vi~ I1] 16:13 i.o t~l 22:22 6:23 16:3 M.D [si 1:7 2:3 M~ Iisi 11:11 12:3 3:14 4:2 30:7 12:11 12:21 14:12 Illinois iai 4:25 4:25 -K- manhunt [41 14:20 19:17 19:21 19:23 imagi~ IH 20:10 14:25 15:3 28:1 20:1 20:2 20:4 20:9 20:9 20:16 Imp~asi~ [al 10:25 ~tlal 1:20 3:23 ~nagi~[~l 28:9 20:19 20:25 13:2 ~Y~[H 4:22 ~ip~a2 t~l 22:23 musclo [~l 12:8 smpm~ttl 12:8 ~nd[t] 20:23 manip~afing isl 21:18 m~clea [si inclu~ itl 6:7 ~o~ Iii 7:14 8:19 ~r[H 18:18 8:19 21:20 22:21 inclu~ng iai 7:15 8:23 -L- may [41 18:16 20:12 23:2 23:3 27:20 m~kol~ai incma~ itl 9:21 I~k la] 14:15 21:14 ~[4] 4:19 8:14 4:14 in~ca~ [41 16:1 lamln~ [~l 9:24 16:3 19:5 ~S~ Ill 29:7 16:19 18:4 21:13 i~t [si 13:8 15:1 ~aning[~l 21:16 indica~ t,i 11:14 15:2 23:4 26:17 ~S[H 20:2~ 15:20 19:10 21:7 -N- 27:2 27:25 LAW Ill ]:2 ~ Iai 9:20 indica2s [~l 12:24 lay [al 10:5 22:23 9:22 n~f41 2:2 3:7 4:7 29:6 24:8 la ~'si~l 16:12 ~[H 25:8 ~aP~ Itl 12:24 indi~ly [~l 30:15 ie~t t~l 14:6 14:6 ~dicM i~ol 1:12 na~ [~l 12:6 3:15 4:22 5:23 info~ation [~1 19:14 loa~ [~1 25:20 14:4 14:23 15:5 ~[~] 6:7 7:17 initial [~1 25:5 led[~l 4:17 18:7 19:3 19:4 7:19 7:20 8:2 8:4 8:4 8:6 injmd [~l 6:4 ~ [~l 1:7 2:~ ~cation Iai 12:5 8:12 8:16 9:3 71 7-54~022~71 7-393-5101 Ind~ Page 3 ncurologic - minted Multi-Pagc'~ !-g-~ S. SHGAL, 9:4 9:5 10:2 O~ [101 5:14 9:19 )CF[I] 23:2 19:10 19:14 10:13 12:9 13:25 10:9 10:14 14:7 ~l~qlt [219:9 11:23 P~tbli¢ [41 I:10 30:6 14:10 16:6 18:21 18:16 24:5 25:25 ~rformillg ill 12:22 30:10 30:22 ..~ 19:8 19:12 20:16 26:17 28:14 p~rhaps [21 16:12 22:21 23:2 opc0ratillg [11 3:10 23:14 -Q- ncurologicpl 8:8 opinion[,q 13:20 period[ll 26:20 qualificationspl 6:21 new[ti 20:22 13:21 15:4 19:11 pcrsistmlt [il 26:9 qualify [11 21:10 ~CWCl' [11 20:10 opposed [2] 8:18 Philadelphia [21 4:23 quantitatcd pi 17:6 28:21 ocxt [11 18:1 5:2 questions [si 6:20 fllCC pi 8:25 oppoaits ill 16:21 physicai [!11 12:7 15:15 25:4 26:1 nine [2l 12:18 27:12 oral pi 5:15 15:25 22:17 23:6 30:9 oi'dcF [11 8:21 23:9 23:16 24:6 non-operatively pi 28:9 nor[il 19:14 miginal pi 27:9 25:7 28:15 28:19 -R- 29:1 normal [l~j 8:9 orthopedic p31 4:10 8:9 8:10 8:10 4:12 4:18 4:24 )hyaician [si 6:11 radiographic pi 10:3 8:12 9:3 9:7 5:1 5:9 5:19 1:18 21:17 28:17 radiographs[o] 8:22 9:9 9:12 12:22 6:1 6:12 6:18 28:25 8:25 9:1 10:3 13:14 13:14 13:15 6:19 7:22 14:3 pi¢tum [il 11:23 11:3 13:16 14:12 14:13 19:21 21:1 orthopedics pi 5:17 place [21 1:12 30:12 18:4 19:15 27:8 othcrwis~ [41 8:5 Plaintiff [41 1:1 radiologic Il! 18:17 Iqorth[tl 3:9 8:12 9:10 20:15 1:8 1:18 3:13 fango13] 16:2 16:4 Notltry[~l I:10 30:6 outside[il 19:4 plan©j21 16:7 16:8 17:2 30:22 ovcraiip] 13:3 plallcs[21 16:9 16:9 read[21 24:21 28:4 note [Ol 12:24 17:23 Picas [21 1:1 3:17 l'~adilig itl 3:3 17:23 17:24 19:6 -P- II©ascd pi 24:24 reality pi 20:12 23:6 23:14 27:22 rcaiiz~d [11 20:22 28:20 PI21 I:1 3:16 )oillt [21 7:21 8:11 notcdpl 17:2 P.(2[ll 1:17 )usitious[ll 5:22 r~ally[51 13:11 20:18 23: I 26:7 29:6 ~Ot~S[Sl 9:17 17:7 pain[nj 7:19 7:20 )ossiblcp] 27:23 reason[21 7:6 9:14 23:16 26:16 26:18 8:2 8:3 8:11 post~rior [21 8:2 l~ftSOllablo pi 15:5 27:14 12:19 12:]9 13:24 8:13 nothing [21 17:23 14:10 14:20 14:24 pus~riorly pi 9:23 reasons [1l 9:8 -- 12:20 28:11 15:3 17:11 19:8 j~ccivc itl 14:6 12:13 25:22 26:9 pFagticc [21 5:17 notice pi 14:11 27:3 27:9 28:1 6:3 received pi 27:24 noticed [219:2 9:16 28:6 28:21 predominantly pi 7:20 rccciving pi 22:11 now 16] 6:3 12:18 laralagai [11 3:8 p~sent [31 1:22 12:20 rcennmmnd 12] 12:4 13:10 15:15 23:14 jaruspinai [il 8:19 22:14 12:7 24:6 }art [~1 5:14 5:15 plgscntgd [11 19:8 rccOmlll~datio~ p I 14:18 lmmbcr [t19:8 6:3 jrctsnd [1111:19 rccommf~dcd [41 14:20 paflicipant pi 22:25 ~vious [3] 18:5 -O- particular[i] 17:14 18:6 19:14 19:17 22:3 22:17 oaths[i] 30:6 particularlyp] 8:1 pmviouslyp! 6:10 reenrdpl 30:17 Obicction 11] 25:23 parties [21 3:3 30:14 Pricc [101 1:20 2:5 records [21 19:3 19:7 3:23 3:23 6:20 ~ECROSS t21 2:2 ~)bjcgtiv~ [41 14:16 parts[il 5:14 15:17 24:25 25:23 28:12 21:14 21:16 21:23 passenger ill 7:11 28:13 29:9 rccItFrCllCC ill 27:8 objectively ill 21:21 tasaivc itl 22:22 problc~! [41 11:8 R~DIKI~{2T [21 2:2 obtain[2] 11:11 14:24 taticnt[ol 6:14 15:11 20:7 20:13 25:22 25:2 obtained 13] 5:11 21:18 21:24 24:18 troblcms [21 24:21 reduced pi 30:10 5:13 8:22 25:20 27:6 28:15 26:11 r~fof[ll 6:25 obviously 121 5:4 28:25 t i-0~.'~8os pi 8:17 f~folTai 12125:7 28:1 17:8 )atient's Ill 23:4 pFofcssor pi 6:1 mf~,~d [21 14:2 occasion ts] 17: i patients 161 6:4 )FOgl'O~! [6] 12:21 28:25 17:19 18:1 19:18 6:7 9:9 11:21 12:22 14:25 22:22 ICfClTillg [4] 18:6 22:2 20:14 26:9 22:25 25:11 27:24 28:17 29:5 D~up8tienPl 4:9 pn~rD[ll 9:6 programs[il 22:22 rcfcl'SPl 22:19 OgtObCF [21 12:15 pediatric [21 5:1 progress [il 23:16 Ft~flCX©S [2l 8:9 18:2 26:24 5:19 prOg/cssioI! Ill 18:16 21:20 off pi 22:15 lg~dia~ics [il 6:2 prot~ctiv~ [ti 9:13 rcgaFdil~ [1l 6:20 offcJ'll] 6:17 Pennsylvania 161 1:1 officCSpl 3:8 1:13 3:18 5:5 providcpl 7:5 rclatCpl t0:23 20:12 ofmnp] 20:18 30:4 30:7 trovidcd [21 6:10 20:18 Ohio[Il 4:22 ~opl~[21 11:25 27:20 15:6 related[31 15:8 15:13 ,rovidcrs [31 19:3 27:9 Index Page 4 ' 717=54~=0220~717=393=5101 Multi-Pngcea relating - therapy Ll~.~ S. SEGAL, M rs. rel~-'""g IH 20:20 15:19 17:25 19:12 SiX [7] 7:10 15:12 subtle f2l 13:17 14:11 relation IH 10:19 21:9 24:24 15:22 15:23 16:9 8uchlll 30:15 x~lativ~ [4l 14:15 says [4] 24:10 24:16 26:7 27:12 21:14 30:14 30:15 24:17 27:15 sircl~ton Iii 20:6 S~t Ill 28:24 r~latively ill 14:15 Sann [21 12:11 14:12 soft[il 20:4 sltgg~sted [21 12:2 19:15 roliof[ll 22:13 ScanSlll 13:14 som~ollC[ll 17:11 suggcstsHi 17:24 rcportpol 13:12 14:7 school[2] 4:22 4:23 somb"whcfc[2] 23:12 14:8 23:10 23:16 schooling pi 12:23 28:4 sllmmary HI 14:9 25:24 26:7 27:11 scope Hi 25:23 sophisticated [21 19:24 support 121 12:8 27:13 28:16 SCH! 23:2 20:1 12:9 reported [2l 7:9 sophistication iii 20:8 surgeon [si 4:10 7:12 scaling iH 3:4 4:12 4:18 6:19 tCpol'tcr 12l 3:24 Scat ill 7:11 8OFry [3l 10:7 12:25 14:3 30:11 ScColldmry [2] Il:21 24:1 81trgerY [si 5:10 5:19 Rcportc~Notal~ ill 14:10 Sollthcl'n ill 4:25 6:2 6:12 6:18 30:10 sec [191 8:23 9:14 spasm[il 9:13 surgical iii 4:13 r~port~[]] 27:6 lO:Il 10:14 12:10 sPCnIr[2] 20:6 21:22 stttprisinglt] 18:24 12:11 12:12 12:14 specifically pi 27:18 8wear [i] 3:25 t~"prcscnt [21 3:20 13:5 13:20 17:16 10:8 sp~ificd itl 30:12 SWOI~ [2] 4:3 20:12 20:14 20:19 30:9 requested [il 28:5 21:7 21:17 23:11 speed [2] 7:14 7:14 symptoms/6l 11:24 residency [21 4:24 25:18 28:15 7:14 20:17 20:20 24:14 5:15 seeing[61 13:9 18:14 spinal[21 9:24 11:12 24:19 27:20 r~solution[21 24:13 19:18 20:12 20:18 spinel61 8:23 10:15 systG'~I[ii 4:14 24:19 26:21 14:19 16:2 16:11 respective ill 3:3 SCCS [11 18:16 17:3 -T- response [21 9:10 Scgal [si 1:7 2:3 spinous ill 8:17 25:25 3:14 3:15 4:2 Spirit ill 18:10 T-boned ill 7:]3 tftking [~1 4:14 12:24 restrained ill 7:11 4:8 6:18 30:7 sprain iii 11:5 30:8 tCslllt [2l 24:14 27:7 Scga]'s iH 6:21 Springfield ill 4:25 teaching ill 5:22 rcsIm3~ [41 24:19 25:21 8cizIlrCS ill 13:12 SS[il 30:3 technology [21 19:25 25:22 27:8 scndlil 28:16 stabilization 1~1 12:20 20:8 rlfftlLFnHI 27:20 Sensation[21 8:10 22:18 22:19 tcl]i~lg[21 21:25 26:12 reveal Hi 28:2 21:21 stabilizing ill 23:2 l'Clllp]© H 14:23 review [si 14:22 18:5 sensitive [~1 20:11 standard[il 28:8 tell ill 27:12 19:2 20:21 start[il 23:17 reviewed [21 14:12 scut [~l 13:20 28:21 starting [2l 4:19 tend [si 14:17 17:12 15:1 19:7 28:24 17:12 20:9 20:10 26:16 tC~dCF [$1 8:1 8:11 f~vib"wing [31 7:3 Scptc~nbcr i?l 13:13 st~t~ [Il 4:7 8:13 8:18 17:2l 23:4 23:21 23:23 24:3 8:20 Richaxd [2l 1:17 26:17 26:22 27:1 statement ill 20:24 tends ltl 20:10 3:21 scrvicc[2l 14:21 15:3 statllsHi 12:17 tCl~l[41 22:12 22:24 right [si 8:2 15:15 SeSsiOns [21 24:4 stenographically ill 25:16 25:17 16:24 19:11 22:17 24:9 30:9 f~Fm8 [101 4:15 10:5 23:25 26:23 29:9 set Ill 30:19 stcrfla] HI 7:16 11:17 12:5 13:17 rotation[21 8:6 8cVCil[~l 24:5 26:16 StcvclI[H 4:8 16:12 20:7 20:11 16:8 SCVcTai [11 7:15 still[?! 11:23 12:19 25:5 27:22 12:22 12:23 13:16 testified 111 4:3 Rovner [21 1:17 3:8 sheet [H 30:13 13:24 27:2 testifying ti! 3:16 RPR 121 1:9 30:21 shifted [2l 10:9 10:10 stipldatcd [il 3:2 testimony [2l 6:10 runlll 8:15 ~lort [11 25:17 STIPULATION [113:1 30:7 30:17 running[il 8:19 short=ti~rm[ll 22:13 Strg~tlll 3:9 Thank[21 15:14 24:25 shoulder [21 16:20 strength [21 8:10 28:10 -S- 16:22 12:8 Th~8 ill 29:9 $[Sl 1:7 2:3 shoW[il 9:1 themselves ill 3:19 strengthening 121 22:20 3:14 4:2 30:7 showed ill 14:14 23:1 therapist [21 27:7 Sadlock H 21 1:17 side [6l 7:13 8:4 strilrc ill 19:1 29:4 2:4 3:21 3:21 8:4 9:5 16:7 studies pi 8:21 therapy [211 12:5 12:7 12:21 22:18 4:6 6:17 6:22 16:8 subjective [21 21:24 23:1 23:7 23:10 15:14 25:3 25:25 sides [2l 8:18 16:23 21:24 23:16 24:7 24:14 26:3 28:10 &iglling Ill 3:4 subsequent Hi 17:1 24:18 25:7 25:19 ~agitta] ill 16:7 'qi~ [21 1:23 mlbscqucllt]y IH 15:2 25:21 26:15 27:6 8atHi 11:6 3:7 subspccialtics ill 5:18 27:24 28:5 28:15 saw [?l 6:24 7:4 Sltuatioll ill 19:11 sllb-%n~inlty [Il 4:13 28:19 29:1 Z-]-I, JGI..I'I~.q AI.I;IIP. IG[.rr !~'0! '!~ ~, MA"S. AT u 7 ! 7-540=0220W ! 7-393='5101 Index Page 5 thinking = y~t Multi=Png~m LEE S. SIlGAL, M.D. ~ 22:10 25:20 THOMAS 121 1:19 27:5 thought [618:5 9:20 usually Ill 19:5 22:14 =V= thr~ [31 5:16 12:12 VIII 1:2 15:20 through [61 23:6 valuable [2] 20:3 23:21 23:23 26:21 20:4 28:6 28:6 VagiOUS Ill 10:15 times [31 6:9 13:13 vehicle [61 6:4 6:8 T~mmon8 [~1 1:3 7:10 10:21 15:9 3:17 3:23 18:22 tissIi~ Ill 20:5 vertebra [41 8:17 9:18 9:19 10:8 [oday[2l 15:8 17:25 video[21 1:7 3:10 today's ill 3:10 VIDEOGRAPHER tool[il 20:21 1:23 3:7 3:24 fOra[ill 24:8 29:11 training [21 4:24 visit fsi 12:4 13:25 5:15 18:2 22:2 25:5 translation 1Sl 9:19 visits 12] 24:3 26:16 10:4 10:7 10:8 21:9 t ~'~lISVOYSO Ill 16:9 waived [I 1 3:5 tlcat Itl 6:4 ways Il! 28:8 Uoatod [al 7:18 18:11 woll~ll~S Ill 21:20 t~cating [61 6:11 W~kS ltl 14:8 Ucatmcnt [31 12:4 whaleRS ti] 22:24 14:24 15:7 ~VHI~.RI~OF [il 30:19 treatments 111 22:4 whiplash 141 7:16 triOS Ill 27:7 within 141 5:17 8:9 troubling[il 11:7 15:4 30:6 truly ti I 20:20 24:2 I t~ [41 12:7 22:15 wiUl~SS [71 3:25 4:2 26:2 29:10 25:17 25:21 30:9 30:18 30:19 trying ill 17:12 ~rl'l~qJ~SSES [II 2:1 turning [il 16:19 wold[il 19:12 two [71 5:13 5:16 14:8 15:13 ~rl'oBg [11 27:17 typo [SI 9:10 11:14 typcdtal 27:11 27:15 X-ray[si 11:1 17:21 27:22 18:10 18:13 18:14 typewriting Ill 30:10 X=rays [~] 19:23 20:2 typically [31 9:4 21:3 28:14 28:16 ond~r [~1 18:4 24:17 18:2 23:19 23:22 uudcly, raduato itl 4:21 20:23 University [21 4:23 4:25 unrcmarkablc Ill 14:14 HUGtl~8, ALBRIGHT, FOLI'Z & NATALI~ Index Page 6 717=540=0220~717-393=5101 ORIGINAL. ~ I{ELEN P. FULTZ, : IN T~{E COURT O~ COMMON PLEAS OF PLAINTIFF : CUMBERLAND COUNTY, PENNSYLVANIA : V : CIVIL ACTION - LAW : NO. 2001-2979 JOYCE M. TIMMONS, : DEFENDANT : JTJRY TRIAL DEMANDED VIDEO DEPOSITION OF: MICHAEL H. INNES, D.C. TAKEN BY: PLAINTIFF BEFORE: PAMELA S. SULLIVAN, REPORTER-NOTARY PUBLIC DATE: APRIL 19, 2002, 10:25 A.M. PLACE: ANGINO & ROVNER, P.C. 4503 NORTH FRONT STREET IiARRISBURG, PENNSYLVANIA APPEARANCES: ANGINO & ROVNER, P.C. BY: RICHARD A. SADLOCK, ESQUIRE FOR - PLAINTIFF THOMAS, THOMAS & HAFER, LLP BY: C. KENT PRICE, ESQUIRE FOR - DEFENDANT ALSO PRESENT: ARKIE SIMMERS, VIDEOGRAPHER 2080 kinglestown Road · Suite 103 · Harrisburg, PA 17110 717.540.0220 · Fax 717.540.0221 · Lancaster 717.~93.5101 2 1 WITNESS 2 NAME EXAMINATION 3 MICF~%EL H. INNES, D.C. 4 BY: MR. SADLOCK 3, 8, 36 5 BY: MR. PRICE 5, 28 6 7 8 EXHIBITS 9 DEFENDANT'S EXHIBIT NO. PRODUCED & MARKED 10 1 - REPORT DATED 1-23-00, ONE PAGE 27 11 2 - REPORT DATED 1-23-00, ONE PAGE 27 12 3 - REPORT DATED 4-27-00, ONE PAGE 27 13 4 - REPORT DATED 7-6-00, ONE PAGE 27 14 5 - REPORT DATED 7-18-00, ONE PAGE 27 15 6 - REPORT DATED 2-1-01, ONE PAGE 27 16 7 - REPORT DATED 6-13-01, ONE PAGE 27 17 18 19 20 21 22 23 24 25 3 1 MR. SIMMERS: My name is Arkie Simmers. I am a 2 paralegal with Angino & Rovner located at 4503 North Front 3 Street in Harrisburg. I'm operating the video and audio 4 equipment for today's deposition. The date is April 19th, 5 2002. It is 10:25 a.m. 6 We're here on behalf of the Plaintiff to take the 7 deposition of Michael H. Innes, D.C., at the offices of 8 Angino & Rovner in Harrisburg, PA. 9 Dr. Innes will be testifying in this case of 10 Helen P. Fultz versus Joyce M. Timmons in the Court of ll Common Pleas of Cumberland County, Pennsylvania, 12 No. 2001-2979. 13 Will the attorneys please introduce themselves 14 and who they represent? 15 MR. SADLOCK: I'm Richard Sadlock on behalf of 16 Helen Fultz. 17 MR. PRICE: Kent Price on behalf of Joyce 18 Timmons. 19 MR. SIMMERS: And now will the court reporter 20 please swear in the witness? 21 22 MICHAEL H. INNES, D.C., called as a witness, 23 being duly sworn, testified as follows: 24 EXAMINATION 25 BY MR. SADLOCK: 4 1 Q Would you state your full name, sir? 2 A Michael Harold Innes. 3 Q And you are a doctor of chiropractic care? 4 A Yes. 5 Q Can you explain for the jury your educational 6 background? 7 A I did a portion of my undergraduate at Ohio 8 State. I did a portion at Toledo State. I completed my 9 education at Palmer College of Chiropractic. I graduated in 10 1977. 11 Q The education at Ohio State and Toledo State, did 12 that result in any type of degree or certificate? 13 A No. 14 Q Are you licensed as a chiropractor? 15 A I'm licensed in the State of Pennsylvania. 16 Q When was that obtained? 17 A I believe it was 1979. 18 Q Can you briefly explain for the jury some of the 19 education you've had at Palmer College of Chiropractic in 20 terms of dealing with injuries to the neck? 21 A We had a fair course of study in anatomy, 22 biomechanics, physiology of the cervical spine. 23 Q Did you also receive training in how to read, 24 review and interpret x-rays? 25 A Yes. 5 1 Q Doctor, have you previously provided testimony as 2 a treating chiropractor? 3 A Yes. 4 Q As part of your practice, Doctor, did you treat 5 patients who were injured in motor vehicle accidents? 6 A Yes. 7 Q Did that include patients who had sustained neck 8 injuries in motor vehicle accidents? 9 A Yes. 10 Q Doctor, was Helen Fultz a patient of yours? 11 A Yes. 12 MR. SADLOCK: At this time, I'd like to offer Dr. 13 Innes as an expert in chiropractic care and as one of Miss 14 Fultz's treating chiropractors. 15 MR. PRICE: A few questions. 16 EXAMINATION 17 BY MR. PRICE: 18 Q How many years did you attend Ohio State? 19 A Two and a half, I believe. 20 Q At the time that you were at Ohio State, were you 21 in any particular curriculum? 22 A I majored in biology. 23 Q How many years did you attend Toledo State? 24 A Approximately another six or eight months. 25 Q While you were at Toledo State, were you in any 6 1 type of a degree program? 2 A No. I was preparing the prerequisites to attend 3 Palmer College of Chiropractic. 4 Q What are the prerequisites to attend Palmer 5 College of Chiropractic insofar as your educational 6 background is concerned? 7 A There were prerequisites in physics -- it's been 8 a long time -- mathematics and certain science courses. 9 Q Did you have to have at least as a minimum a high 10 school degree? 11 A Yes. 12 Q But, apparently, it did not require a college 13 degree? 14 A No. At the time I went to school, it required 15 two years of college. 16 Q Did it require a minimum of an Associate's 17 degree? 18 A No necessary degree. You had to meet specific 19 requirements relative to the prerequisites of admission. 20 Q Now, with regard to Palmer College of 21 Chiropractic, how many years did you attend there? 22 A It's a four-year program. I completed it in 23 three years by going around the calendar. 24 Q How much of the -- strike that. Were your 25 courses rated in hours, credit hours or anything like that? 7 i A Yes. 2 Q Here's what I'm trying to get at: Could you give 3 me an idea as to the number of credit hours or course hours 4 you had in radiology? 5 A In radiology. It would just be my guess, but 6 there were several hundred. 7 Q Did that include your reading films? 8 A Yes. 9 Q CT films? 10 A CT? 11 Q CAT scans? 12 A Yes. 13 Q MRI films? 14 A Yes. 15 Q Plain films? 16 A Well, not the -- excuse me. The MRIs and CAT 17 scans I picked up in postgraduate. MRI was not being done 18 back during the time when I was in school. 19 Q So if I understand what you've just testified to, 20 your experience and training while you were at Palmer 21 College of Chiropractic was in reading what they call plain 22 films? 23 A Correct. 24 Q As opposed to CAT scans or MRIs? 25 A Correct. 8 1 MR. PRICE: Thank you, Doctor. 2 EXAMINATION 3 BY MR. SADLOCK: 4 Q Doctor, can you please tell the jury when you 5 first saw Miss Fultz in your office? 6 A The first date of service I have is 2-7-2000. 7 Q And did she provide you with a history at that 8 time as to why she was in to see you? 9 A Yes, she did. 10 Q And what was that history? A Helen presented herself in our office on February 12 7th, 2000. At which time, she filled out a history form 13 that related that she was involved in an automobile accident 14 on January 23rd, 2000, at 7 p.m. The driver of the vehicle 15 was Matthew Shindel. She was passenger in a 1980 E1 Camino. 16 She reports that the vehicle was driving -- in 17 which she was driving received front-end damage in a 18 broadside collision. She states that at the time of the 19 accident visibility was good, road conditions were clear and 20 they were hit by another car. 21 She describes the accident as follows; quote, I 22 flung forward, hit my chin on my sternum and flew back and 23 hit my head on the seat, unquote. She stated that she did 24 see the accident just before they hit. She did not have 25 enough time to brace herself. She states she was wearing a 9 1 seat belt with a shoulder harness. There was not a 2 functional headrest in the car. 3 At the time of the accident, the car was braking. 4 She estimated the speed at approximately 45 miles per hour. 5 She had no estimate of the other car's speed. She stated 6 that during the accident, she was seated with her head 7 straight forward, body in a straight sitting position. 8 At the time of the accident, she relates that my 9 head did not hit any part of the car, my head had impact on 10 my sternum. As a result of the accident, she was shaken but 11 could function. She could move all of her body parts and 12 was able to walk unaided. She reports no bleeding, cuts or 13 bruises. 14 Immediately after the accident, she stated she 15 felt dizzy, a lot of pain in the neck right after the 16 accident. Later that night, she had more marked pain, 17 quote/unquote. The next day, she states that the back and 18 sternal pain increased. 19 At the time of seeing her in the office, she 20 stated that since the accident she was having headaches, 21 neck pain and stiffness, mid-back pain, iow-back pain, 22 dizziness, fatigue, chest pain and nose bleed. 23 Q Were those also her complaints on her first 24 presentation to your office? 25 A Yes. 10 1 Q Before being seen by you, had Miss Fultz received 2 other treatment? 3 A Yes. 4 Q I believe at the emergency room, at her family 5 doctor? 6 A Correct. 7 Q And, Doctor, was it your understanding that Miss 8 Fultz did not have any prior history of any problem with her 9 neck before this motor vehicle accident? 10 A The specific questions were asked, Did you have 11 any physical complaints just before the accident? She 12 answered, No. Prior to the accident, have you ever had any 13 symptoms similar to what you're now experiencing? She 14 answered, No. 15 Q On February 7, 2000, Doctor, did you conduct an 16 examination? 17 A No, I did not. 18 Q Why not? 19 A She had told me that they were going to do a CT 20 scan, and we awaited the results of that before we proceeded 21 with any type of a physical examination. 22 Q And that was done, as I understand it, then on 23 February 9th of 2000? 24 a Correct, correct. 25 Q Can you explain for us and for the jury what you 11 1 did in the examination and what your relevant findings were? 2 A On 2-9-2000, Helen appeared in the office having 3 had the bone scan performed on February 9th, 2000, showing 4 no evidence of fractures. We did complete the examination. 5 I had called for an oral and then subsequently got a written 6 update, a fax, on the results of that which were negative. 7 In the standing examination, we checked her 8 cervical range of motion. Her left lateral flexion was 5 9 degrees, which is reduced. Right lateral flexion was 5 10 degrees with pain. Extension was 20 degrees with pain. 11 Left lateral flexion means you bend your head to the left. 12 Right lateral flexion she bends her head to the right. 13 Extension meaning she puts her head backwards. Flexion 14 meaning she puts her head forward. Again, flexion was 30 15 degrees with pain. 16 We did a foraminal compression test where you 17 push down on the top of the -- apply light pressure to the 18 top of the head. She complained of neck pain from the first 19 cervical to the seventh cervical, the top of the neck down 20 to the bottom of the neck. 21 We checked muscle strengths in the upper 22 extremities and found those to be good and equal 23 bilaterally. We checked the dermatomes using a light 24 pinprick on the arms and found those to be normal 25 bilaterally. The deep tendon reflexes of the upper arms, 12 1 the biceps, the triceps and brachial radialis were normal. 2 She did have -- on physical palpation, feeling 3 with the hands, she had tight and ropy fibers found in the 4 paravertebral muscles. That means the muscles around the 5 spine. She had interfacetal swelling. That means the 6 joints between the vertebrae in the neck were swollen. And 7 we found areas of what's called -- termed intersegmental 8 motion fixation meaning that the motion between the joints 9 was not performing correctly. And that was on the first 10 cervical on the right. 11 We also did a pelvic inclinometer which is a 12 device much like a carpenter's level, for the lack of a 13 better term. It goes over the hips and measures the 14 off-centering of whether the hips are level or not. we also 15 challenged that mechanism by having her step up on a 16 three-quarter inch piece of wood with one foot alternating 17 to the other side, and we found that to be unequal. 18 The lumbar ranges of motion, again, we checked 19 her in backward bending which was 15 degrees, forward 20 bending 30 degrees. Right and left lateral flexion were 15 21 degrees. Right and left rotation were 25 degrees on both. 22 Both of those were the same on both sides, and she 23 complained of pain in the thoracolumbar area which is the 24 place where the lower back and the mid back meets. 25 We also did a Kemp sign which involves bending to 13 1 the side and backwards, extending backwards, which gave her 2 pain in the same region of the spine. We watched her walk. 3 That was normal. Toe walk and heel walk was good. That's 4 where we have her walk on tiptoes and heels to test muscle 5 strength and balance. Romberg's test is another 6 neurological test, a finger to nose test. Those were both 7 normal indicating that there was no central nervous system 8 brain damage. 9 Supine examination, lying on her back, her legs 10 were equal. We were able to raise her legs up to 60 degrees 11 on both sides, and she did have tight hamstrings. We did a 12 figure-four test to test for any kind of hip pathology. And 13 then we had her do a double leg lift test which, again, 14 produced -- reproduced pain in the thoracolumbar junction. 15 To just give an idea, it's right in this area where that is 16 describing. 17 The prone examination, we had her do a Thompson 18 sacral leg lift to check the motion of the low back. That 19 was normal. Palpation of the sacroiliacs and the lumbar 20 spine was normal. She did have, again, tight and ropy 21 fibers within the paravertebral muscles and in across that 22 spine, again, was found at the upper neck, the first and 23 second cervical spine, in that position as well. 24 Q Thank you, Doctor. One term you used that I 25 believe needs some explanation that you mentioned a couple 14 1 of times is tight and roping fibers. What does that mean? 2 A When you feel the spine, feel the muscles around 3 the spine, you can't feel a muscle spasm. A muscle spasm is 4 more of a subjective finding. But what you feel is that the 5 fibers within the muscle themselves rather than having a 6 smooth texture to the muscles, you find fibers that are 7 taut, that when you touch on those, the patient will often 8 tell you that those are tender areas that you find. 9 So these are things that you can feel within a 10 normal -- within a muscle that indicate that there has been 11 muscle damage. 12 Q So that would be an objective finding? 13 A Yes. 14 Q The joint swelling that you mention as well, 15 would that be an objective finding? 16 A Yes, it is. You can feel where the joints come 17 together. And, obviously, like a swollen ankle or swollen 18 knee, you can tell that that joint has swollen. 19 Q Based on the history then, Doctor, and the 20 examination that you performed and your findings, did you 21 render a diagnostic impression for Miss Fultz? 22 A Yes, I did. I diagnosed that she had suffered a 23 flexion/extension injury to the cervical spine. She was 24 suffering from cervicalgia which is a technical term for 25 neck pain. She was having muscle spasms as diagnosed by the 15 1 tight and ropy fibers that I found. She was also having 2 thoracic vertebrae subluxation which has to do with the loss 3 of the normal juxtaposition of the vertebrae of the mid 4 back, and pain in the thoracic spine accompanying that 5 condition. 6 Q Did you establish then a treatment plan for Miss 7 Fultz? 8 A Yes, I did. I began a program which included 9 chiropractic adjustments to the cervical spine. We applied 10 electrical muscle stimulation to the area to help reduce the i1 swelling and muscle spasms and to help control the pain. We 12 also applied moist heat. These were in preparation to the 13 manipulations so that the area would be more supple when we 14 would work on her. 15 I originally said we would see her three times a 16 week for three weeks instead of seeing her for two weeks. I 17 instructed her in using home ice massage to help control the 18 swelling, and I instructed her in a home exercise program 19 which would include at this stage of the injury a pain-free 20 range of motion. 21 By that I mean that if it hurts to go this far, 22 you go just before the pain starts, but to try to establish 23 motion back into the injured parts of the spine in the same 24 directions that we had originally tested her. This is to 25 help establish normal healing patterns within the muscles 16 1 and joints. 2 Q You mentioned, Doctor, that you were going to 3 perform chiropractic adjustments as part of the treatment 4 program. First of all, to what part of the body were the 5 adjustments? 6 A I initially began working on the cervical spine. 7 Q And what is involved from your standpoint when 8 you were treating Miss Fultz with a chiropractic adjustment? 9 A A chiropractic adjustment -- chiropractic is an 10 art form which varies from doctor to doctor. Much as you 11 would have a different sculptor sculpt something in a 12 different way, you would have a chiropractor work in a 13 different way. 14 The way that I do a chiropractic manipulation -- 15 and I did perform one with her -- were low force techniques 16 involving more leverage, not the -- I did not do the long 17 lever-type maneuvers that are often associated with cervical 18 manipulation. 19 Q Did Miss Fultz follow your treatment program? 20 A Yes, she did. 21 Q Doctor, I believe from your chart it appears that 22 you sent Miss Fultz for some x-rays in April of 2000. Is 23 that correct? 24 A Correct. 25 Q Did you have an opportunity to receive not only a 17 1 report regarding those x-rays but to review them yourself? 2 A Yes, I did. 3 Q Do you have them with you today? 4 A I do. 5 Q Can you please show us or put them on the view 6 box so that I may ask you some questions about it? 7 A I'll start with these three. I'm sorry. These 8 are the 2001 films. We'll come to those later. 9 Q These are the April 2000 x-rays? 10 A Yes. You can see the marker right here that indicates the date that they were taken. 12 Q Can you explain for us, Doctor, any significant 13 findings from the x-rays? 14 A Yeah. These are x-rays taken of the side of the 15 neck. It would be taken directly over the shoulder, the 16 face of the patient straight ahead. 17 This middle one is called the neutral lateral 18 view. It's the position that she would assume in a relaxed, 19 head-forward position. The normal cervical lordosis is in a 20 forward curve like that. In her case, we have a 21 straightening with actually a reversing of that curvature in 22 that part of the spine. 23 On this film, the patient is asked to rotate the 24 head as far backward as she is able to look and then again 25 asked to put her head as far forward as possible onto the 18 1 chin. 2 Q And, Doctor, what is the relationship of, first 3 of all, the loss of the and reversal of the curve given Miss 4 Fultz's history of her head whipping forward chin to sternum 5 and then back again? 6 A The dynamics of the type of an accident that Miss 7 Fultz described involved her chin going forcibly to her 8 sternum to the point that they wanted to check and see if 9 she'd broken her sternum. Well, of course, that was 10 probably involved with the seatbelt. 11 But she put her head so forcibly forward that she 12 had a recollection of having hit herself. Then her head 13 went forcibly backwards. Both of these movements are going 14 to exceed the normal restraining function of the ligaments 15 in the spine. 16 The ligaments are designed to allow a certain 17 range of movement between each one of the vertebrae. When 18 the vertebrae exceed that distance that they're supposed to 19 move, they stretch and tear. In this case and as we've 20 described in our x-ray report, there's an actual loosening 21 all along the back here which allows these vertebrae to slip 22 out of their normal position. 23 That lack of normal alignment, sitting properly 24 on each other, is also reflected in this view here where 25 instead of stacking up normally, they're stacked up as you 19 1 can imagine a child's toy not being properly set on top of 2 itself. The weight of the head has still got to be 3 balanced. And so with these vertebrae out of their normal 4 juxtaposition, the head frame has to -- I mean, the 5 alignment of the cervical spine is changed to make up for 6 that balancing of the head. 7 Down here on this view, instead of having this 8 smooth continuum of the posterior joints on the forward 9 flexion, you can also see that these have been stretched l0 allowing forward slippage of the vertebrae. You should see a smooth arc in here. Instead, you see what I've described 12 as a stair-stepping where the vertebrae kind of drop off 13 subsequently on each one. That's evidence that the 14 ligaments have been stretched beyond their normal capacity. 15 Q Based on the x-ray findings then, Doctor, would 16 there be -- or was there any change then in the treatment 17 that was being provided to Miss Fultz? 18 A Well, going to my report of that date -- based on 19 what I saw here, what I was saying was that it was my 20 opinion that we had permanent laxity of these ligaments. 21 The original time that I had seen her was in February. This 22 was some two months later. We were still seeing this level 23 of ligament instability. 24 And I also have another very important view 25 relative to this, this one right here. This one shows a 20 1 distortion of this opening where the nerves come out 2 indicating that not only the front-to-back instability but a 3 sideways instability in that joint. Rather than being a 4 nice oval, it's kind of a peanut shape in this area. It's a 5 little hard to see here. But if we could blow it up, it 6 would be visible for us. But that indicates some 7 instability. 8 Based on the fact that we had these instabilities 9 two months into the program, I determined that it was my 10 opinion that the patient had achieved the maximum 11 improvement. The healing phase on an injury like this is 12 about six to eight weeks. So we had gone past the initial 13 healing phase. It had healed as much as it was going to. 14 What we found at this stage of the process I believe to be 15 the result of the stretching of the ligaments. 16 Now, let me explain a little bit about the 17 cervical spine. The spine ligaments are unique in that they 18 contain yellow elastic fibers. That elasticity allows them 19 to be stretched and come back and stretch and come back and 20 maintain a nice alignment of the vertebrae. When they're 21 stretched beyond that, those yellow elastic fibers rupture. 22 A_nd when they're replaced, they're replaced with a white 23 fibrous tissue that lacks the elasticity of the other 24 ligaments. 25 So when I saw these findings at this point of the 21 1 treatment, it was my opinion that she had received the 2 maximum improvement that she was going to have and that 3 these injuries were thus permanent. I then put her on what 4 I call a supportive care program rather than an active 5 treatment care program in which we're going to try to 6 ameliorate her symptoms as they arrive. 7 So I didn't anticipate that we were going to see 8 any significant improvement. The protocol of her plan of 9 treatment at this point was designed to ameliorate her 10 symptoms and to try to prevent further degeneration by 11 maintaining as much proper body mechanics as we could 12 possibly do. 13 Q The findings you had on the x-rays and what you 14 described for us, that being the instability and the 15 stretching of ligaments, would that produce pain? 16 A Yes. All these tissues are very pain sensitive. 17 Q At that point, Doctor, what was the treatment 18 frequency for Miss Fultz? 19 A Well, as I say here in my notes, we began to 20 reduce her frequency based on her symptomatology. It was 21 irregular in that if she had a flare-up, I would tell her to 22 come back on a specific date. When we seemed to have 23 quieted that flare-up, I'd tell her to come back the next 24 time she had some problems. 25 So it was a very erratic, irregular schedule at 22 1 that point. We weren't trying to keep her on a regular 2 schedule as we had in the beginning. 3 Q And, Doctor, from your notes, it appears you last 4 saw Miss Fultz on February 28, 20017 5 A Correct. 6 Q And after that point in time, she was referred to 7 Dr. Turnpaugh, I believe, for continuing treatment? 8 A Correct. 9 Q How was Miss Fultz, what was her status on your 10 last examination? 11 A Well, going to the one before on 1-8, I had on 12 that one suggested that she see Dr. Turnpaugh. She had been 13 having seizures. And at that point, I felt that I wanted to 14 have her go see Dr. Turnpaugh because of his extra training 15 as a chiropractic neurologist. I thought he might be able 16 to manage her care more effectively. And as I said, I 17 thought we had gone as far as we could in our office. 18 The 2-28 visit, she came in. I believe that was 19 -- I'm not sure when she started with Dr. Turnpaugh. But I 20 had asked her to see Dr. Turnpaugh on 1-8. 21 The last day that I saw her on 2-28, to answer 22 your question, she was complaining of neck pain, hip and 23 iow-back and upper back pain. 24 Q Throughout your course of treatment with Miss 25 Fultz, Doctor, from the first visit in February of 2000 23 1 through the last visit in February 2001, was there ever any 2 change in your diagnosis? 3 A On 2-28 -- on 4-28, excuse me, we changed the 4 diagnosis, continuing the flexion and extension injury. We 5 added the acquired kyphosis, that backward bending in the 6 neck that I talked about, the spinal enthesopathy indicating 7 the abnormality of the ligaments and also added the fact 8 that she was complaining of more headaches at that stage. 9 Q Doctor, based on your examinations and your 10 review of the x-rays that you've shown us and discussed, did 11 you have a prognosis for Miss Fultz? 12 A Yes. The prognosis was that we were going to see 13 continuing degeneration. When these ligaments are stretched 14 and torn and when the discs are moving abnormally, the body 15 deteriorates over time with the abnormal stresses that are 16 placed on those areas. 17 Q Did Miss Fultz sustain a permanent injury to her 18 cervical spine? 19 A In my opinion, yes. 20 Q And what is that? 21 A The damage that is done to the ligament 22 structures of the spine resulting in lack of normal 23 motoricity to the spinal segments. 24 Q Doctor, I believe you had with you some x-rays 25 that were taken in June of 2001, I believe, at the Hershey 24 1 Medical Center. 2 A These are those films. 3 Q First of all, Doctor, how did those films compare 4 to the ones taken fourteen months earlier? 5 A We're seeing -- on this neutral lateral view 6 again, we're seeing that this kyphosis continues, that 7 reversal of the curve. The most important feature here, 8 however, is this view where she's going into extension. 9 Again, they're asking her to put her head back as far as it 10 is, and the operator makes certain that that is taking place. 12 On the first view that we had shown you, the head 13 came way over to here. It was a very pronounced extension 14 of the cervical spine. Fourteen months later, that 15 extension has been almost lost, almost totally lost. 16 This would actually make a good example of the 17 way this picture should look. That's the normal curve that 18 I would anticipate to see on a normal individual. This one, 19 you can see what I'm talking about when I'm talking about 20 the reversal rather than this smooth forward arcing. 21 However, this is when she was attempting to put her head all 22 the way backward. 23 This is resulted from what I had already 24 discussed, the exchange of tissue types in the spine. Where 25 instead of having the normal yellow elastic fiber, it has 25 1 been replaced with a more fibrous material which lacks the 2 normal motility, the movability. 3 And one of the features of that is that these 4 discs in here -- several things take place. Where these 5 have been damaged, there is a tendency to deposit calcium 6 from the original injury. But because of the altered 7 biomechanics that are taking place in the middle of the 8 disc, this disc is not getting the normal nutrition. 9 The nutritive flow of a disc is by a process we 10 call imbibition. It comes from the word imbibe or to drink. 11 The blood supply to there is lacking. So the nutrition 12 comes into the vertebral body and then moves from the top 13 and the bottom into the disc. 14 Without the normal movement in here, that pumping 15 action doesn't take place. That will allow these discs to 16 deteriorate due to a lack of the proper nutritive, the 17 nutritional flow in and out of the disc. 18 Also, we see on the forward flexion view an 19 increasing in that stair-stepping that I had talked about 20 before. You can see how we're getting a little rounding 21 taking place on the front of these vertebral bodies, the 22 superior portion of these vertebral bodies in the two years 23 since the accident -- well, fourteen months, as I said. 24 We're already starting to see what -- the seeds 25 of what is going to end up to be, in my opinion, osteophytes 26 1 or bony overgrowths along with my anticipated decay and 2 degeneration of the cervical discs themselves. 3 Q Doctor, I believe I may have misspoke when I said 4 these x-rays were taken at the Hershey Medical Center. I 5 believe they were taken at Dr. Turnpaugh's request. 6 A These are from Quantum Imaging on Trindle Road in 7 Camp Hill. 8 Q Doctor, do these x-rays support the statements 9 you made in terms of your prognosis and opinion regarding 10 the permanence of Miss Fultz's injury? 11 A Yes, I believe they do. 12 Q And lastly, Doctor, do you have an opinion within 13 a reasonable degree of chiropractic certainty whether the 14 injuries that you diagnosed for Miss Fultz and treated and 15 discussed with us today including your prognosis and 16 statement regarding permanence are directly causally related 17 to the January 23, 2000, motor vehicle accident? 18 A I do. 19 Q And what is your opinion? 20 A My opinion is that based on the history that she 21 gave me, the mechanism of injury that she described to me, 22 the findings that I had on physical examination and on x-ray 23 combined with my experience tell me that these injuries were 24 the result of the accident as described to me. 25 MR. SADLOCK: Thank you, Doctor. I have nothing 27 1 further right now. 2 MR. PRICE: Let's go off the record. 3 MR. SI~ERS: Off the video record. The time is 4 11:03 a.m. 5 (Discussion held off the record.) 6 (Report dated 1-23-00, one page, produced and 7 marked Defendant's E~ibit No. 1.) 8 (Report dated 1-23-00, one page, produced and 9 marked Defendant's Exhibit No. 2.) 10 (Report dated 4-27-00, one page, produced and 11 marked Defendant's Exhibit No. 3.) 12 (Report dated 7-6-00, one page, produced and 13 marked Defendant's Exhibit No. 4.) 14 (Report dated 7-18-00, one page, produced and 15 marked Defendant's Exhibit No. 5.) 16 (Report dated 2-1-01, one page, produced and 17 marked Defendant's Exhibit No. 6.) 18 (Report dated 6-13-01, one page, produced and 19 marked Defendant's Exhibit No. 7.) 2~ ~ MR. PRICE: Befo~we go bac~ 21 record, I'd like to o~ve to s~rike the docto~ opinzon~ ! .// / 22 ~ t~ p~g~si? ~ P .~ V with regard the prognosi /and his r ections as to ~er 23 futu~/~rse because I behove the~ren,t rendered/to a 24 p/~x~er degree of certainty%,~, f~,.I don't think ~e said 25 that they were to any degree of certaznty. So I wo~ld move 2 .~PR'~m~--M~m~' B=~k on th~ ¥i~to r~nr_ch_The time 4 BY MR. SADLOCK: 5 Q Doctor, in discussing your prognosis with us and 6 the statements you made, was that based on a reasonable 7 degree of chiropractic certainty? 8 A Yes, it was. 9 MR. SADLOCK: Thank you. 10 EXAMINATION 11 BY MR. PRICE: 12 Q Doctor, the opinions that you've just expressed 13 during your testimony this morning are set forth in a letter 14 dated April 2, 2002, addressed to Mr. Sadlock. Is that 15 correct? 16 A Correct. 17 Q And those opinions are, I believe, found in the 18 last paragraph. Is that correct? 19 A Yes. -- ~ l~k-~. '. i1~ uugh c?ac paragraph,~e--e--~ 2 t~a~,_~ny of ~~s are i~asonable degree 22 ofchlropra~ico~~c~ 23 . 1 object. ~port, there 24 is no ca e the 25 ogy that is 1 required.~t just indicates what his opinion is. 3 Q _ ~ I co .~at the words to ~onable 4 degas of ~i~p~ ~y t~e of ~ai~y ~ not 5 app~r 1~ t~~y~r o~i~s 8 what~r~ ~ t~ wo~nt~ipate 9 consi~eg~e ~ ~i~p~ct~ 10certainty/ 12 c ' opractic certainty in my mind. I may have not stated it ". 13.' ' inology, but th~w~= ..~y intcn~. ~" 14 Q Do you have a definition for the phrase, To a 15 reasonable degree of chiropractic certainty? 16 ~LOCK: ~Obj~cti~n~ The c.hiropractor 17 d~ ]:ncr *~e le~&l dcfi-~t~9-.- 18 BY MR. PRICE: 19 Q Well, if you're going to be issuing opinions, 20 Doctor, based upon a reasonable degree of medical certainty, 21 I assume that you have some understanding of what a 22 reasonable degree of chiropractic certainty is. Otherwise, 23 that phrase is meaningless. So do you have an understanding 24 of what a reasonable degree of chiropractic certainty means? 25 A My understanding is that these sequela that I 30 have described -- it's been my experience in the past and in 2 the training that I've had that these will be the proper, 3 what will be the actual results from an accident like this 4 and that my prognosticating or foretelling of what can be 5 seen based on what we see today using a logical step, if we 6 have this today, we'll have this tomorrow, and based on my 7 anticipated findings based on what I've seen in the past and 8 seen in the literature. 9 Q In your experience, does every patient -- let's 10 take a patient -- or a series. Let's get a group of patients who have the same injury. And let's say in the six 12 months following the initial injury, their courses are the 13 same as well. Okay? Would you project that in the future, 14 every one of those patients in that group will have the same 15 progress and the same prognosis? 16 A Given the findings that I have with the level of 17 instability that I see based on the history that I was 18 given, yes. 19 Q By the way, have you seen any of the medical 20 records from the Hershey Medical Center? 21 A No, I did not. When were they done? 22 Q I don't know. We've discussed them at some 23 length when we've taken the deposition of Dr. Segal. 24 Are you aware that the doctors at the Hershey 25 Medical Center, I believe Dr. Segal, who's an orthopedic 1 doctor, and Dr. Ludwig, who's an orthopedic doctor, disagree 2 with your opinion as to cervical instability of this 3 patient? 4~ ~ MR. S . , 1 ~bject because what 5 dgctor~-~cated is it'~~cal instability .... Their 7 rec~z=d for ~uz~ery. 8 BY MR. PRICE: 9 Q Do you agree -- are you aware of the fact that 10 they have an opinion that is different from yours with 11 regard to the issue of cervical instability? 12 A I have learned that today. 13 Q How did you learn that today? 14 A On a preinterview -- a predeposition conversation 15 with Mr. Sadlock, he told me that there was a disagreement 16 as to my opinion. 17 Q Doctor, where is your office located? 18 A Currently, I have no office. It was located at 19 3327 Market Street in Camp Hill. 20 Q Are you currently practicing? 21 A I'm retired. 22 Q You're retired. Were you aware that Miss Fultz 23 had a course of physical therapy at the Hershey Medical 24 Center for stabilization? 25 A The last record that I have was the record that I 32 1 gave you on February of 2000 or whatever that date was. Was 2 that 2000? 3 MR. SADLOCK: 2001. 4 THE WITNESS: February 28, 2001, was the last 5 time that I had seen her. 6 BY MR. PRICE: 7 Q So you have not seen the physical therapy report 8 that's dated July 1, 2001, from the Hershey Medical Center? 9 A No, sir. My contact with the patient ended on 10 that date when I referred her to Dr. Turnpaugh. 11 Q Were you aware that at the conclusion of that 12 physical therapy program, her complaints of pain referable 13 to the cervical spine had been eliminated? 14 A I was not aware of that. 15 Q Now, I realize that you're not a radiologist, 16 although you did take some studies that were related to 17 radiology. Do you have an understanding of what a medical 18 doctor or an osteopathic doctor who is a radiologist, what 19 they do in their normal practice? 20 A I believe I do. 21 Q What do they do as you understand it? 22 A They read x-rays. 23 Q Do they see patients? 24 A I don't believe they do. 25 Q Do they perform surgeries on patients? 33 1 A We're talking about a radiologist? 2 Q Yes. 3 A No, I don't believe they do. 4 Q So their practice is -- a hundred percent of 5 their practice, as you understand it, would be reading plain 6 films, x-rays, reading CT scans, MRI scans, bone scans and 7 other types of diagnostic tests like that? 8 A Correct. 9 Q In your report of April 2, 2002, you're talking 10 on the second page about the x-ray films that were taken on 11 April 27, 2000. And you indicate in there that there was an 12 uncovertebral compression fracture? 13 A Right. 14 Q Was that based upon your reading of the films? 15 A Yes, it was. 16 Q Doctor, I'm going to show you a series of seven 17 radiology reports having to do with the cervical spine that 18 were taken of Miss Fultz over a period of time. If you will 19 bear with me, I'll get those out. And the first one -- I'll 20 give you this stack. These have been identified as 21 Defendant's Exhibits 1 through 7, and they are seven 22 individual radiology reports of the cervical spine of Miss 23 Fultz. 24 The first one is dated January 23rd of the year 25 2000 and was taken at the Holy Spirit Hospital. Do you have 34 I that in front of you? 2 A Yes, I do. 3 Q And the conclusion there is, No fracture or 4 misalignment. Is that correct? 5 A Correct. 6 Q The next one, Exhibit 2, is also of the cervical 7 spine, the same date, January 23 of the year 2000 at Holy 8 Spirit Hospital. It looks like a different radiologist than 9 the one who read the first report. And his conclusion, 10 Dr. Bronfman, I believe, indicates, AP and lateral images of 11 the cervical spine show no fractures. Is that correct? 12 A Correct. 13 Q Exhibit 3 is a radiology report dated April the 14 27th of the year 2000, and this is the one that you were 15 referring to in your report. Is that correct? 16 A Correct. 17 Q And that was read by a Bertrand Giulian. And his 18 conclusion was, Negative examination of the cervical spine. 19 Is that correct? 20 A Correct. 21 Q The next one is an x-ray report from the Hershey 22 Medical Center dated July 6th of the year 2000. And the 23 indication there is or the impression is, Reversal of the 24 cervical spine lordosis with limited flexion. And that is 25 what you had talked about. Is that correct? 35 1 A Correct. 2 Q There's no indication in that report that there's 3 any evidence of a fracture? 4 A Correct. 5 Q The next report is dated July the 18th of the 6 year 2000, also from the Hershey Medical Center. This is an 7 MRI now of the cervical spine rather than just a plain film 8 x-ray. The impression by this particular radiologist was, 9 Normal MRI of the cervical spine. Is that correct? 10 A Correct. 11 Q The next report was dated February the 1st of the 12 year 2001. These are films of the cervical spine. And the 13 indication is, A limited flexion and extension with 14 extension better than in July of the year 2000. On the 15 extension, the patient has only one millimeter of 16 retrolisthesis of C-2 on C-3. No evidence of 17 anterolisthesis, and there's no other abnormality. 18 So that report doesn't indicate that there is any 19 fracture? 20 A Correct. 21 Q And the final report, June 13th of the year 2001, 22 seven views of the cervical spine by Dr. Kunkel indicates, 23 Reversal of the normal lordotic curvature of the cervical 24 spine which corrects on the extension view, no fracture or 25 significant degenerative changes. Is that correct? 1 A Correct. 2 Q So none of these various radiologists who read 3 these seven reports and wrote these seven reports of the 4 various studies of the ce~ical spine made any reference to 5 a compression fracture? 6 A Correct. 7 Q Is a fracture a significant finding? 8 A I believe it is, yes. 9 Q Would you expect a radiologist reading films to 10 note the presence of a fracture? 11 A I would expect that. 12 MR. PRICE: That's all I have. Thank you. 13 EXAMINATION 14 BY MR. SADLOCK: 15 ~ ~ Miss Fultz was examined by a Dr. Dahmus 16 at th~quest of Mr. Price. We took his dep--~on 17 yesterday.~ . 18 /e s~_her.or examined her on April 10th, I 19 believe~ ~, ~f.~, '.~ar. He indicated that at that 20 examin, a.tion sE. ~ill ~n in her neck. And in his 21 depos,i.o~ .t.e.st~ony ~t~da~ rendered the o~inion that 22 that ~~s~l, ns ~p~encing was still from 23 the a~i~nt~d .inj ru y.th. at he h~iagnosed, I 24 believe~ai~ram~ t~e~ injury. 25 A Who was this again, please? ~, 1 Q Dr. Dahmus, an orthopedic surgeon. 2 A Ail right. 3 Q And as I said, he rendered an opinion in his 4 deposition that that pain was still related to Miss Fultz's 5 accident. And, again as I said, he saw her April 10th of 6 this year. Would that fin~g and that opinion by the 7 orthopedic surgeon su~6rt your opinion as to the prognosis 8 -that Miss Fultz._/_w~'have continuing problems? 9 ~/~RICE: Objection. Beyond the scope of his / 10 report a~/beyond the scope of recross. / BY ~ADLOCK: 12 /Q You may answer, Doctor. / 1~ ~ ~-- i b~l~.~ i~. 14 ,~ ~d, bocnoz, wl~ ycu ~-r~providing your opinion 15 on prognosis, was it your estimation that those problems you 16 were discussing for Miss Fultz were more likely than not to 1~ o~ur fcr h~ in th~ 18 A - 19 -MR. ~RiCE: Objoctio~a_Jding. 20 MR. SADLOCK: I have nothing further. Thank you, 21 Doctor. 22 ~~. ~RICE: Doctor, if I may, could-~yo just hand 23 me your cha~ second? 25 THE WITNESS: I did want to talk about that one 1 finding, if we can get back to that. 2 BY MR. SADLOCK: 3 Q Doctor, while he's looking at the chart, you had 4 indicated there was an extension finding from the films? 5 A Yes. It wasn't from the films. 6 Q Oh, from your examination. 7 A It was when I did the physical examination on 8 her. The most definitive finding that I had when I examined 9 Miss Fultz on the initial examination was during the 10 extension. And I described it as a cogwheel-type movement ll on extension in my report, and I didn't much touch on that 12 when I was discussing things. 13 When her head -- when I brought her head into 14 extension, there was a very significant feeling that she had 15 lost control of the -- that the weight of the head was 16 actually out of control. The head as she brought it back, 17 there was a feeling that the head was dropping into my hand. 18 That's a very unusual finding. And, again, it 19 was the basis for a lot of my opinions that there was 20 significant ligamentous instability. That is a finding that 21 I do not find on a regular basis at all. It was very 22 unstable when I first examined her. 23 M~. F~ZCE: I wou£~ odiouS. 24 ~at is beyond the~-~u-u~= ~f rcdiract. 25 MR.~__~: Well, u~ked him in 39 1 cross-e~ion about instability, ked him 2 abuuo~C~6~her doctors and what the~~ 3 instability. So thiu ~- directly in regpo~_~__to that. 4 Thank you, Doctor. I have nothing further. 5 MR. PRICE: Nothing further. 6 MR. SIMMERS: This concludes the deposition. The 7 time is 11:22 a.m. 8 (Whereupon, the deposition was concluded at 11:22 9 a.m.) 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 40 1 COUNTY OF DAUPHIN SS 2 COMMONWF2%LTH OF PENNSYLVANIA : 3 4 I, Pamela S. Sullivan, a Notary Public, authorized to 5 administer oaths within and for the Commonwealth of 6 Pennsylvania, do hereby certify that the foregoing is the 7 testimony of Michael H. Innes, D.C. 8 I further certify that before the taking of said 9 deposition, the witness was duly sworn; that the questions 10 and answers were taken down stenographically by the said 11 Reporter-Notary Public, and afterwards reduced to 12 typewriting under the direction of the said Reporter. 13 I further certify that the said deposition was taken 14 at the time and place specified in the caption sheet hereof. 15 I further certify that I am not a relative or employee 16 or attorney or counsel to any of the parties, or a relative 17 or employee of such attorney of counsel, or financially 18 interested directly or indirectly in this action. 19 I further certify that the said deposition 20 constitutes a true record of the testimony given by the said 21 witness. 22 IN WITNESS WHEREOF, I have hereunto set my hand this 23 19th day of April, 2002.~'/"~/L~/~ '~ ~../. · NOTARI~SEAL 24 PAME~ S.~WV~.N~a~Pm~cI · ~ ~-~ 8wammT~.,Daap~Coumy I P~mela S: SulIiv~n ~ - 25 ~Comm~nEx~Jan. 31,20051 Reporter-Notary Public WORD INDEX Multi-PageTM ! - bit MICHAEL H. INNES, D.C. 36111 2:4 action[31 1:4 25:15 Arkie[2] 1:25 3:1 =1= 40:18 ~'~ [2] 11:24 11:25 I [41 2:10 27:7 =4= active[ti 21:4 ~=l'JV~[ll 21:6 32:8 33:21 4121 2:13 27:13 ~ctunl F2] 18:20 30:3 ntt itl 16:10 1-23-00 [41 2:10 4-27-00 [21 2:12 added [2] 23:5 23:7 Associate's Ill 6:16 2:11 27:6 27:8 27:10 add~ssed itl 28:14 associated pi 16:17 ]=8121 22:11 22:20 4=28 pi 23:3 ndiustn~nt [21 16:8 ~SlI~ [2] 17:18 29:21 10:25 12] 1:13 3:5 45HI 9:4 15:9 attempting pi 24:21 10th [21 36:18 37:5 4503 [21 1:15 3:2 adjustments pi 15:9 attend[si 5:18 5:23 16:3 16:5 6:2 6:4 6:21 1 1:03PI 27:4 ndmlnister pi 40:5 attorney [21 40:16 1 1:06Pl 28:3 -5- admission iii 6:19 40:17 11:22[2l 39:7 39:8 5[si 2:5 2:14 afterward~ pi 40:11 nttoI~y$ pi 3:13 13thpl 35:21 11:8 11:9 27:15 15121 12:19 12:20 againH21 11:14 12:18 audio[il 3:3 13:13 13:20 13:22 authori~d pi 40:4 18thHi 35:5 -6- 17:24 18:5 24:6 19pi 1:13 6121 2:15 27:17 24:9 36:25 37:5 automobile pi 8:13 1977 pi 4:10 6-13-0] [21 2:16 38:18 awaitml pi 10:20 1979pl 4:17 27:18 ~gr~pl 31:9 aw~r~[Sl 30:24 31:9 ]980Pl 8:15 60PI 13:10 ~adpl 17:16 31:22 32:11 32:14 19th [2l 3:4 40:23 6thpl 34:22 alignment [21 18:23 Istpl 35:11 19:5 20:20 -B- -7- allow pi 18:16 25:15 background pi 4:6 =2= allowing [~ l 19:10 6:6 7[Sl 2:16 8:14 allows [21 18:21 20:18 b~lrwnrd [4] 12:19 215] 2:11 27:9 10:15 27:19 33:21 almost [2l 24:15 24:15 17:24 23:5 24:22 28:14 33:9 34:6 7= 1 8=00 [21 2:14 along 12l 18:21 26:1 backwards 14] 11:13 Z-l-01 PI 2:15 27:16 27:14 2-28131 22:18 22:21 7-6-00121 2:13 27:12 a]tercdpl 25:6 13:1 13:1 18:13 23:3 7[h[H 8:12 alternating pi 12:16 balan~ pi 13:5 2-7-2000 pi 8:6 nmeliorate [21 21:6 balnn~x.'d pi 19:3 21:9 balancing [ I I 19:6 2-9-2000 pi 11:2 -g- nnatomy pi 4:21 ba~d psi 14:19 19:15 20[~1 I1:10 8[11 2:4 Angino [411:14 1:18 19:18 20:8 21:20 2000 pSl 8:12 8:14 23:9 26:20 28:6 10:15 10:23 11:3 3:2 3:8 29:11 29:20 30:5 16:22 17:9 22:25 -~- ankle pi 14:17 30:6 30:7 30:17 26:17 32:1 32:2 9th [21 10:23 11:3 nnsw~f [21 22:21 37:12 33:14 33:11 33:25 34:7 answ¢~d [21 10:12 basis[21 38:19 38:21 34:14 34:22 35:6 35:14 -A- 10:14 b~tf pi 33:19 answors [i] 40:10 hogan [31 15:8 16:6 2001191 17:8 22:4 a.m[~l 1:13 3:5 anterolisfl~sispl 35:17 21:19 23:1 23:25 32:3 27:4 28:3 39:7 32:4 32:8 35:12 39:9 anticipate [41 21:7 beginning 111 22:2 35:21 abl~ [41 9:12 13:10 24:18 29:8 29:8 behalf pi 3:6 3:15 2001=2979 [~1 1:5 17:24 22:15 anticipated [21 26:1 3:17 3:12 ad}normal [i] 23:15 30:7 b~lt pi 9:1 2002151 1:13 3:5 abnormality pi 23:7 AP[ii 34:10 bcDd pi 11:11 28:14 33:9 40:23 35:17 appear[il 29:5 bending [41 12:19 2312! 26:17 34:7 abnornl~lly pi 23:14 APPEARANCES pi 12:20 12:25 23:5 23rd [21 8:14 33:24 aocident [2Ol 8:13 1:17 bends pi 11:12 25HI 12:21 8:19 8:21 8:24 app~l~d il i 11:2 i~'fttnnd [1l 34:17 27[Sl 2:10 2:11 9:3 9:6 9:8 applied [2115:9 15:12 bctter [~1 12:13 35:14 2:12 2:13 2:14 9:10 9:14 9:16 apply pl 11:17 b¢tW~.'~l [21 12:6 2:15 2:16 33:11 9:20 10:9 10:11 271h pi 34:14 10:12 18:6 25:23 April p~l 1:13 3:4 12:8 18:17 26:17 26:24 30:3 16:22 17:9 28:14 b~Jond [51 19:14 20:21 28[~1 2:5 22:4 37:5 33:9 33:11 34:13 37:9 37:10 38:24 32:4 a~ident-related pi 36:18 37:5 40:23 biceps pi 12:1 36:23 ~Y~HI 19:11 bilaterally [21 11:23 =3- accidents [2l 5:5 arcing HI 24:20 11:25 3141 2:4 2:12 5:8 ~l~n13] 12:23 13:15 biology ill 5:22 27:11 34:13 ~gompanyingHi 15:4 15:10 15:13 20:4 biomechanics[2] 4:22 30121 11:14 12:20 achieved pi 20:10 n"'~ [3] 12:7 14:8 25:7 23:16 3327pl 31:19 a~quimd pi 23:5 bitpl 20:16 HUGHES, ALBRIGHT, FOL-I-Z~ & NATALE Index Page 7 ! 7=540-0220W ! 7=393-5101 bleed - diagnosed Multi-PageTM MICHAEL H. INNES, D.C. bleed[il 9:22 ~ig~l [3~1 4:22 ~oll~lud~d [1] 39:8 d~n~ [4] 8:17 13:8 bleeding [ti 9:12 11:8 11:19 11:19 concludes pi 39:6 14:11 23:21 12:10 13:23 14:23 COllCJilaio~ [4] 32:11 damaged [11 25:5 blood pi 25:11 15:9 16:6 16:17 blow pi 20:5 17:19 19:5 20:17 34:3 34:9 34:18 date 1o] 1:13 3:4 bodies [2] 25:21 25:22 23:18 24:14 26:2 condition o! 15:5 8:6 17:11 19:18 21:22 32:1 32:10 body [6] 9:7 9:11 31:2 31:11 32:13 conditions o] 8:19 34:7 16:4 21:11 23:14 33:17 33:22 34:6 ¢ondugt [i] 10:15 dated [211 2:10 2:11 25:12 34:11 34:18 34:24 consistent Ol 29:9 2:12 2:13 2:14 boi~ F21 11:3 33:6 35:7 35:9 35:12 35:22 35:23 36:4 constitutes O] 40:20 2:15 2:16 27:6 bony [11 26:1 ccrvicalgia [1] 14:24 contact u] 32:9 27:8 27:10 27:12 27:14 27:16 27:18 bottom [21 11:20 25:13 chsllcnf~d ui 12:15 conL~in [1] 20:18 28:14 32:8 33:24 box [Zl 17:6 chnn~c~ [21 19:16 23:2 continues[ti 24:6 34:13 34:22 35:5 brmIc is] 8:25 cheF21 19:5 continuing [41 22:7 35:11 brachial pi 12:1 23:3 23:4 23:13 37:8 DAUPI-IIN pi 40:1 brain [i] 13:8 chmlg~s [~] 35:25 continuum pi 19:8 dealing [1] 4:20 bFaking[i) 9:3 chart[3] 16:21 37:23 control[4l 15:11 15:17 dccayo] 26:1 bFicfly O! 4:18 38:3 38:15 38:16 deep pi 11:25 broadsidco] 8:18 chcc]tl2] 13:18 18:8 convcrsationol 31:14 DEFENDANT[2] 1:7 bFok~ll [il 18:9 chc~c~d [41 ! ! :7 coi'r~ [33] 7:23 1:23 BFonfman vi 34:10 11:21 11:23 12:18 7:25 10:6 10:24 Defendant's 19] 2:9 10:24 16:23 16:24 27:7 27:9 27:11 brought [2] 38:13 chest [~ ] 9:22 22:5 22:8 28:15 27:13 27:15 27:17 38:16 child's [11 19:1 28:16 28:18 28:22 27:19 33:21 bl~tisc8 [~1 9:13 chin 14] 8:22 18:1 29:3 29:6 33:8 bu~pl 28:25 18:4 18:7 34:4 34:5 34:11 definition 121 29:14 chiropractic 1241 4:3 34:12 34:15 34:16 29:17 4:9 4:19 5:13 34:19 34:20 34:25 definitive I11 38:8 =C- 6:3 6:5 6:21 35:1 35:4 35:9 d~f~o~ [si 21:10 C[ll 1:22 7:2I 15:9 16:3 35:10 35:20 35:25 23:13 26:2 C-2 1~1 35:16 16:8 16:9 16:9 36:1 36:6 dogonorativo p i 35:25 16:14 22:15 26:13 correctly o] 12:9 dogfco [1914:12 6:1 C-3 itl 35:16 28:7 28:22 29:4 corrects [~1 35:24 6:10 6:13 6:17 calciumttl 25:5 29:9 29:12 29:15 counscl [21 40:16 6:18 26:13 27:24 calendar [11 6:23 29:22 29:24 40:17 27:25 28:7 28:21 Cnmino ltl 8:15 chiropractor [41 4:14 County [si 1:2 3:11 29:4 29:9 29:11 Cnmp [2l 26:7 31:19 5:2 16:12 29:16 40:1 29:15 29:20 29:22 ©apacity pi 19:14 chifoprat~Ol~ [~ ] 5:14 coup]~ o] 13:25 29:24 31:6 dcgl~CS [~] 11:9 11:10 captiono]40:14 CIVILnI 1:4 COUlSC[6] 4:21 7:3 11:10 11:15 12:19 CaF[4] 8:20 9:2 clear ill 8:19 18:9 22:24 27:23 12:20 12:21 12:21 9:3 9:9 cogwheel-type Ol 38:10 31:23 13:10 cnr'$pl 9:5 collage[al 4:9 4:19 cours¢~[Sl6:8 6:25 DI~.MANDItDitl 1:7 Cftl~ [si 4:3 5:13 6:3 6:5 6:12 30:12 deposit pi 25:5 2l:4 21:5 22:16 6:15 6:20 7:21 cottrt [~1 1:1 3:10 oalpontc~'t ~ 1~1 12:12 collision pi 8:18 3:19 deposition p ~1 1:9 3:4 3:7 30:23 g[[SO [4] 3:9 17:20 combined pi 26:23 cl~dJt [~1 6:25 7:3 36:16 36:21 37:4 18:19 28:24 Common [~1 1:1 cros~-oxnmlaation p! 39:6 39:8 40:9 CAT[si 7:11 7:16 3:11 39:1 40:13 40:19 7:24 Commonwealth [21 40:2 CT [4l 7:9 7:10 dcl311Rton~s [i] I 1:23 Causnlly pi 26:16 40:5 10:19 33:6 described [si 18:7 Ccn~l' iSl 24:1 26:4 compal~ iii 24:3 Cnml~Tland [21 1:2 18:20 19:11 21:14 30:20 30:25 31:24 complained [21 11: I 8 3:11 26:21 26:24 30:1 32:8 34:22 35:6 12:23 CU/TJclthtm [11 5:21 38:10 central[t] 13:7 complaining [2] 22:22 CUl'vatltfc [2] 17:21 describes 01 8:21 cortain [si 6:8 18:16 23:8 35:23 doscribing Ol 13:16 24:10 complaints Oi 9:23 ©ul~c [41 17:20 18:3 clcsignod [21 18:16 oort8iaty [121 26:13 10:11 32:12 24:7 24:17 21:9 27:24 27:25 28:7 complotc 01 11:4 ©uts[il 9:12 dotcriorato u i 25:16 28:22 29:4 29:10 completed [21 4:8 dcto~arates p! 23:15 29:12 29:15 29:20 6:22 -D- d~im,..lnod [~1 20:9 29:22 29:24 complios u1 37:24 D.C [Sl 1:9 2:3 dovicc [il 12:12 CCFtificatc [ti 4:12 compression Oi 11:16 3:7 3:22 40:7 diagnosed [4] 14:22 certify[si 40:6 40:8 33:12 36:5 Dalnnus [21 36:15 14:25 26:14 36:23 40:13 40:15 40:19 concerned pi 6:6 37:1 Index Page 2 HUGHES, ALBRIGHT, FOLTZ & NATALR 7 ! 7=540-0220~717-393=5 Multi=Pagcra diagnosis = Fultz MICHAI~-I. H. INNES, ~,.~,. di&~osJS[2l 23:2 ~]u~iug[4! 7:18 9:6 tcxpcrioncing[2! 10:13 first[ts1 8:5 8:6 23:4 28:13 38:9 36:22 9:23 11:18 12:9 diagnostic [2] 14:21 dyllnmlgs Ill 18:6 ~pcrt [H 5:13 13:22 16:4 18:2 33:7 oxplnin [514:5 4:18 22:25 24:3 24:12 diffei~nt fsi 16:11 -E- 10:25 17:12 20:16 33:19 33:24 34:9 16:12 16:13 31:10 ©xplanntion [ij 13:25 38:22 34:8 education [31 4:9 fixation ilI 12:8 direction ill 40:12 4:11 4:19 cxp~cssod [t ] 28:12 flare-up [21 21:21 directions pi 15:24 ©ducational [21 4:5 extending [il 13:1 21:23 dixcctly [41 17:15 6:5 extension[i,] I1:10 flew [il 8:22 effectively [ti 22:16 1]:13 23:4 24:s flexion p21 11:8 26:16 39:3 40:18 eight [21 5:24 20:12 24:13 24:15 35:13 disagree ill 31:1 35:14 35:15 35:24 11:9 11:11 11:12 (lisngll~ll~nt ill 31:15 Iai [11 8:15 38:4 38:10 38:11 11:13 11:14 12:20 disc 15] 25:8 25:8 ©laatic 131 20:18 20:21 38:14 19:9 23:4 25:18 25:9 25:13 25:17 24:25 extra[il 22:14 34:24 35:13 tliscs [,i 23:14 25:4 elasticity [21 20:18 cxtrcmiti©8 iH 11:22 flexion/extension[il 25:15 26:2 20:23 14:23 flow [2l 25:9 25:17 discussed 14i 23:10 clectricnl ill 15:10 =F- flung HI 8:22 24:24 26:15 30:22 elimiuntcd ill 32:13 discussing [~1 28:5 ~lX~t~lcy [ i i 10:4 fmix~ [ti 17:16 follow[il 16:19 37:16 38:12 ~mploy~c f21 40:15 ['a~t [51 20:8 23:7 fo]lowing Hi 30:12 Discussion pi 27:5 40:17 27:24 29:7 31:9 follows [21 3:23 distance pi 18:18 ~nd[ll 25:25 fair[il 4:21 8:21 distortion[l! 20:1 ~ndedpl 32:9 fnmilyHi 10:4 foot[il 12:16 dizziness Itl 9:22 ~nthesopathy ill 23:6 far[si 15:21 17:24 forami~la] ill 11:16 17:25 22:17 24:9 fo~ [11 16:15 dizzy[il 9:15 :qnal[21 11:22 13:10 fatigue[il 9:22 for~ibly[~l 18:7 do~tor [441 4:3 5:1 equipment [11 3:4 fnxHl 11:6 18:11 18:13 5:4 5:10 8:1 cFratic ti] 21:25 8:4 10:5 10:7 ESQUIRE 121 1:19 f©atuto [H 24:7 foregoing [ti 40:6 10:15 13:24 14:19 1:22 features pi 25:3 foretelling i~1 30:4 16:2 16:10 16:10 establish [31 15:6 FcbFuary p ~1 8:11 foFm[2] 8:12 16:10 16:21 17:12 18:2 19:15 21:17 22:3 15:22 15:25 10:15 10:23 11:3 forth[il 28:13 19:21 22:4 22:25 22:25 23:9 23:24 cstimnt~ Hi 9:5 23:1 32:1 32:4 forward [121 8:22 24:3 26:3 26:8 estimated fl] 9:4 35:11 9:7 11:14 12:19 26:]2 26:25 28:5 estimation[il 37:15 feeling [3! 12:2 38:14 17:20 17:25 18:4 28:12 29:20 31:1 18:11 19:8 19:10 31:1 31:17 32:18 cvidcn(x~ [,i 11:4 38:17 24:20 25:18 32:18 33:16 36:15 19:13 35:3 35:16 fei[ [21 9:15 22:13 fonnd [Ol 11:22 11:24 37:12 37:14 37:21 examination [2j] 2:2 low [11 5:15 12:3 12:7 12:17 37:22 38:3 39:4 3:24 5:16 8:2 ,fiber [1! 24:25 13:22 15:1 20:14 doctor's[il 27:21 10:16 10:21 11:1 fibci~ [~1 12:3 13:21 28:17 11:4 11:7 13:9 dogtol~ [3130:24 31:5 13:17 14:20 22:10 14:1 14:5 14:6 fout-y~at [11 6:22 39:2 26:22 28:10 34:18 15:1 20:18 20:21 fous"tcc~ [31 24:4 docsn*t [3125:15 29:17 36:13 36:20 38:6 fibrous [2120:23 25:1 24:14 25:23 35:18 38:7 38:9 figtlrc-foltr ill 13:12 fl'a~tllI~ fsi 33:12 don~ 14] 7:17 10:22 oxamiontions Ill 23:9 fil]©d [11 8:12 34:3 35:3 35:19 35:24 36:5 36:7 23:21 30:21 ¢I~min~l [,i 36:15 film [Zl 17:23 35:7 36:10 doubleltl 13:13 36:18 38:8 38:22 fil~[tSl 7:7 7:9 fl'~tm~s[~l 11:4 dowll [,i 11:17 11:19 ©xnmpl¢ [~1 24:16 7:13 7:15 7:22 34:11 19:7 40:10 29:7 17:8 24:2 24:3 Dr[l~l 3:9 5:12 exceed[21 18:14 18:18 33:6 33:10 33:14 ffn~a~[l] 19:4 22:7 22:12 22:14 cxchang~ [H 24:24 35:12 36:9 38:4 freqtm'ncy 121 21:18 22:19 22:20 26:5 38:5 21:20 30:23 30:25 31:1 eXCUSe [~1 7:16 23:3 finnl Ill 35:21 front[,[ 1:15 3:2 32:10 34:10 35:22 exercise pl 15:18 financially pi 40:17 25:21 34:1 36:15 37:1 Exhibit i1~1 2:9 finding lml 14:4 front-~'nd ill 8:17 dl'inlr Ill 25:10 27:7 27:9 27:11 drivel' Il I 8:14 27:13 27:15 27:17 14:12 14:15 36:7 ftout-to-bn¢lr H I 20:2 27:19 34:6 34:13 37:6 38:1 38:4 full [iI 4:1 driving [~18:16 8:17 ExhibitS[al 2:8 38:8 38:18 38:20 Flllt~ [~91 1:1 3:10 drop[il 19:12 33:21 findings [lOl I1:1 3:16 5:10 8:5 14:20 17:13 19:15 10:1 10:8 14:21 dropping iii 38:17 uxpcct 12] 36:9 36:1l 20:25 21:13 26:22 15:7 16:8 16:19 du©HI 25:16 gxPcri~l°c [,I 7:20 30:7 30:16 39:2 16:22 18:7 19:17 duly [31 3:23 40:9 26:23 30:1 30:9 fingcl' H i 13:6 21:18 22:4 22:9 HUGHES, ALBRIGIfI', FOL'rZ & NATALE Index Page 717=540=0220~7 ! 7=393-510 ! Fuitz's - limited Mulfi-Pa~Ilt~ MICHABL H. INNI~_ _g~ D.C. 22:25 23:11 23:17 15:17 15:25 iDd~eat~i i~l 17:11 = u~.~ion [1l 13:14 26:14 31:22 33:18 ht~oby it ] 40:6 20:6 29:1 34:10 Ju~c [21 23:25 35:21 35:22 ~ [5l 1:7 4:5 .--~ 33:23 36:15 36:22 hclcof ill 40:14 indicatil~ [21 13:7 4:18 8:4 10:25 37:8 37:16 38:9 [l~rcqlnto iii 40:22 F~iltzt s [41 5:14 18:4 20:2 23:6 juxtnposition [2] 15:3 26:10 37:4 hcraclf t3] 8:11 8:25 indication [21 34:23 19:4 function [2] 9:11 18:12 35:2 35:13 18=14 Hoi~h~y is! 23:25 indin:ctly ill 40:18 =K= 26:4 30:20 30:24 functional iii 9:2 31:23 32:8 34:21 individual [21 24:18 fttturo [41 27:23 29:8 35:6 33:22 kcop ill 22:1 30:13 37:17 highit] 6:9 initial[31 20:12 30:12 Kemp[ii 12:25 38:9 Kent [2] 1:22 3:17 Hill [21 26:7 31:19 injured [21 5:5 15:23 kind [3] 13:12 19:12 'Ct= hip [21 13:12 22:22 injuries 1~] 4:20 20:4 Giulian ltl 34:17 hips [21 12:13 12:14 5:8 21:3 26:14 ]tl~c [1] 14:18 given[41 18:3 30:16 history[2l 8:7 8:10 26:23 Kun]mllt135:22 30:18 40:20 8:12 10:8 14:19 ii,jury [12l 14:23 15:19 kyphosis [21 23:5 goos ill 12:13 18:4 26:20 30:17 20:11 23:4 23:17 24:6 gone [21 20:12 22:17 hit 161 8:20 8:22 25:6 26:10 26:21 good [4] 8:19 11:22 8:23 8:24 9:9 30:11 30:12 36:23 =L= 13:3 24:16 18:12 36:24 grnduatcd [11 4:9 Holy [2] 33:25 34:7 ]nn~ is] 1:9 2:3 ln~k [41 12:12 18:23 ,~oup [2] 30:10 30:14 ~om~ [2l 15:17 15:18 3:7 3:9 3:22 23:22 25:16 guess [11 7:5 Hospital [21 33:25 4:2 5:13 40:7 laclring ill 25:11 34:8 ,insofar[ti 6:5 lacks[21 20:23 25:1 -H- hour itl 9:4 instabilities [~1 20:8 last [si 22:3 22:10 hottrs [41 6:25 6:25 instability [1~1 19:23 22:21 23:1 28:18 H [si 1:9 2:3 7:3 7:3 20:2 20:3 20:7 29:5 31:25 32:4 3:7 3:22 40:7 bundled [21 7:6 21:14 30:17 31:2 lastly it i 26:12 [-IAF]~R. [11 1:21 33:4 31:5 31:6 31:11 [[t~rnl [21 11:8 11:9 38:20 39:1 39:3 I1:11 11:12 12:20 half ill 5:19 h~ts ill 15:21 instead [~1 15:16 18:25 17:17 24:5 34:10 ~ hnm~ttings [il 13:11 19:7 19:11 24:25 law[21 1:4 28:24 hand [~1 37:22 38:17 -1- instnlctcd [21 15:17 laxity itl 19:20 40:22 ic¢ itl 15:17 15:18 leading [1137:19 hands[il 12:3 ides[21 7:3 13:15 intent[il 29:13 lcarn[~j 31:13 hard[mi 20:5 idsntificd [ti 33:20 interested ill 40:18 learned 11131:12 harl~cs$ [i]9:1 il~l~cs [~1 34:10 interfacctal [~1 12:5 Harold [mi 4:2 least [Il 6:9 imagine it] 19:1 interpret 111 4:24 Hftrrisburg [31 1:16 left [5l 11:8 11:11 3:3 3:8 Imaging t~] 26:6 intcrscgmcntal it] 12:7 1]:11 12:20 12:21 hcad[25] 8:23 9:6 imbibc[~] 25:10 introducc[ll 3:13 lag[21 13:13 13:18 9:9 9:9 11:11 imbibition [11 25:10 involved [4] 8:13 legal 111 29:17 11:12 11:13 11:14 Immediately itl 9:14 16:7 18:7 18:10 lags [21 13:9 13:10 11:18 17:24 17:25 im.nact[ij 9:9 involves[il 12:25 length[il 30:23 18:4 18:11 18:12 involving [1l 16:16 J9:2 19:4 19:6 ilnpoftant [21 19:24 I~'T ii i 28:13 24:9 24:12 24:21 24:7 · il~gttlar [21 21:21 38:13 38:13 38:15 ilnprcssion [31 14:21 21:25 level [41 19:22 30:16 12:12 12:14 38:16 38:17 34:23 35:8 iasoc itl 31:11 Icv~-typc [11 16:17 head-forward [11 17:19 improvtr/nclit [31 20:11 issued ill 28:21 l~cragc ill 16:16 h~ad~h~ [21 9:20 21:2 21:8 n$suing [il 29:19 licensed [2] 4:14 23:8 inch [11 12:16 ' itself [21 19:2 28:24 4:15 headiest itl 9:2 inclinometer [11 12:11 ~lift [21 13:13 13:18 h~alcd It I 20:13 includ~ 1~15:7 7:7 -J' ligament [2] 19:23 healing [21 15:25 20:11 15:19 January [4l 8:14 23:21 20:13 included [mi 15:8 26:17 33:24 34:7 liganmntous itl 38:20 ]mat[il 15:12 including vi 26:15 oint t~1 14:14 14:18 ligaments [io] 18:14 hccl [il 13:3 incrcascd.] 9:18 20:3 18:16 19:14 19:20 heels 1i] 13:4 increasing 111 25:19 oints [51 12:6 12:8 20:15 20:17 20:24 h~ld[tl 27:5 indicate [~1 14:10 14:16 16:1 19:8 21:1~ 23:7 23:13 .-- Helen[si I:1 3:10 29:7 31:6 33:11 Joyed[21 1:6 3:10 light[21 11:17 11:23 3:16 5:10 8:11 35:18 3:17 likely itl 37:16 11:2 indicated [21 31:5 July 141 32:8 34:22 limited [21 34:24 35:13 l~]p [4] 15:10 15:11 36:19 38:4 35:5 35:14 Index Page 4 HUGHES, ALBRIGHT, FOLTZ & NATALE 7 ! 7=540=0220W ! 7=393=5 ! 0 ! Multi=Pngo TM literature - P MICHARI. H. INNES, D.C. lif~amlm~ [11 30:8 26:21 musclos [61 12:4 37:9 37:19 LLPuI 1:21 medical[ii] 24:1 12:4 13:21 14:2 objective [21 14:12 lecat~d fsi 3:2 31:17 26:4 29:20 30:19 14:6 15:25 14:15 31:18 30:20 30:25 31:23 ohtained ui 4:16 Iogicalill 30:5 35:632:8 32:17 34:22 -N- obviously [u 14:17 IOOlr [21 17:24 24:17 [n~t ill 6:18 nam~ [si 2:2 3:1 OCf'IIF U] 37:17 Ioolring Ill 28:20 4:1 off[41 19:12 27:2 38:3 mccts Ui 12:24 ~SS~]"y Ill 6:18 27:3 27:5 Ioolrs[u 34:8 mcntionul 14:14 BCck[lSl 4:20 5:7 off-contcringul 12:14 loosening[il 18:20 n~ntioncd [21 13:25 9:15 9:21 10:9 offer Ui 5:12 16:2 11:18 11:19 11:20 office [si 8:5 8:11 lordosis 121 17:19 Michac1161 1:9 12:6 13:22 14:25 34:24 2:3 3:7 3:22 17:15 22:22 23:6 9:19 9:24 11:2 lordotic Ul 35:23 4:2 40:7 36:20 22:17 31:17 31:18 1o~$[11 15:2 18:3 mld[N 12:24 15:3 nc~dsui 13:25 offic~sui 3:7 lost[si 24:15 24:15 mid-back Ui 9:21 negative [2l 11:6 oftcll [2l 14:7 16:17 38:15 middle [21 17:17 25:7 34:18 Ohio [41 4:7 4:11 Iow[il 13:18 16:15 mightuI 22:15 ncrvcsu] 20:1 5:18 5:20 [ow-back Ill 9:21 mila8 UI 9:4 I~FVOUS Ill 13:7 ona [ssi 2:10 2:11 22:23 2:12 2:13 2:14 lower Ui 12:24 millimeter ui 35:15 neurnhtgical iu 13:6 2:15 2:16 5:13 Ludwig ui 31:1 mind [u 29:12 ncurnlogist iii 22:15 12:16 13:24 16:15 htmbar[~l 12:18 13:19 minimum[~l 6:9 n~utral[21 17:17 24:5 17:17 18:17 19:13 6:16 n~xt [61 9:17 21:23 19:25 19:25 22: I 1 lying [U 13:9 misaliRnme~t Ui 34:4 34:6 34:21 35:5 22:12 24:18 25:3 Miss [~] 5:13 8:5 35:11 27:6 27:8 27:10 27:12 27:14 27:16 -M- 10:1 10:7 14:21 nice [21 20:4 20:20 27:18 29:7 30:14 M[N 1:6 3:10 15:6 16:8 16:19 night [U 9:16 33:19 33:24 34:6 msgia [U 28:25 16:22 18:3 18:6 IIOD~ [11 36:2 34:9 34:14 34:21 19:17 21:18 22:4 35:15 37:23 37:25 maintain UI 20:20 22:9 22:24 23:11 nonsurgical Ill 31:5 maintaining uI 2 I: l I 23:17 26:I0 26:14 normal [23] l 1:24 Oll~S [il 24:4 mnjolr~d U] 5:22 31:22 33:18 33:22 12:] 13:3 13:7 ontoui 17:25 mnlros UI 24:10 36:15 36:22 37:4 13:19 13:20 14:10 op~nillg Ui 20:1 37:8 37:16 38:9 15:3 15:25 17:19 operating Ui 3:3 managa Ui22:16 misspoka Ui 26:3 18:14 18:22 18:23 19:3 19:14 23:22 opcrntor Ul 24:10 DIRn~llv~rB li] 16:17 , moist[u 15:12 24:17 24:18 24:25 opinion U~I 19:20 manipulation i2l 16:14 months [?l 5:24 19:22 25:2 25:8 25:14 20:10 21:1 23:19 16:18 20:9 24:4 24:14 32:19 35:9 35:23 25:25 26:9 26:12 manipulations Ui 15:13 25:23 30:12 normally Ui 18:25 26:19 26:20 29:1 nlatlrad [912:9 9:16 morning[il 28:13 ]qorth [2l 1:15 3:2 31:2 31:10 31:16 27:7 27:9 27: I I 36:21 37:3 37:6 27:13 27:15 27:17 most [21 24:7 38:8 nOS~ Ill 9:22 13:6 37:7 37:14 27:19 motility[il 25:2 Notary[il 40:4 opinions is1 27:21 m~FlraFUI 17:10 motion[?l 11:8 12:8 note[ii 36:10 28:1 28:12 28:17 M&F]tOt [ii 31:19 12:8 12:18 13:18 28:21 29:5 29:19 15:20 15:23 notes [si 21:19 22:3 massage Ui 15:17 31:6 38:19 motor [4l 5:5 5:8 opportunity iq 16:25 material[il 25:1 10:9 26:17 nothing [41 26:25 37:20 39:4 39:5 opposedtu 7:24 tnnthcmatics Ui 6:8 mototicity U I 23:23 now [71 3:19 6:20 oral Ui 11:5 Matthew ui 8:15 movability ui 25:2 10:13 20:16 27:1 original [2] 19:21 m~xil]flll~! [;I 20:10 mov~ [~1 9:11 18:19 32:15 35:7 25:6 21:2 27:21 27:25 38:23 number [u7:3 originally [~] 15:15 may[~l 17:6 26:3 movement is] 18:17 nutrition i~l 25:8 15:24 29:12 37:12 37:22 25:14 38:10 25:11 ofthopedi,' [41 30:25 ll~nn [~] 19:4 14:1 15:21 movements Ui 18:13 nutritional iU 25:17 31:1 37:1 37:7 moves ill 25:12 nutritive [21 25:9 OSteopathic U I 32:18 meaning [~l 11:13 moving U] 23:14 25:16 ostcophytc8 [ti 11:14 12:8 25:25 mcnningloss [U 29:23 MRI [si 7:13 7:17 Otherwise itl 29:22 nEans [41 11:11 12:4 33:6 35:7 35:9 -O- oval [u 20:4 12:5 29:24 MRIs[21 7:16 7:24 osths[ll 40:5 OV~l'gFowths[ll 26:1 maaslll~S ill 12:13 muacla [iOl 11:21 13:4 14:3 14:3 object[si 28:23 31:4 tncchanics ill 21:I1 14:5 14:10 14:ll 38:23 -p- mechanism [21 12:15 14:25 15:10 15:11 Objection[si 29:16 !)[21 1:1 3:10 HUGHES, ALBRIGHT, FOLTZ & NATALE Index Page 5 717=540-0220~717=393=5101 P.C - report Multi-P~TM MICHAel[- H. INNES, D.C. D.C [2] 1:14 1:18 i~rmanc~t [3] 19:20 37:8 37:15 xnh~d 11] 6:25 ).nl [i] 8:14 21:3 23:17 .proctorial [1] 10:20 mth~r [~j 14:5 20:3 Day, iisi 2:10 2:Il phas~[2] 20:11 20:13 irocc8812120:14 25:9 21:4 24:20 35:7 .-~. 2:12 2:13 2:14 phrase [2l 29:14 29:23 ll~dllc~ [11 21:15 road[s] 4:23 32:22 2:15 2:16 27:6 physical iq lO:Il irodnced i91 2:9 34:9 34:17 36:2 27:8 27:10 27:12 10:21 12:2 26:22 13:14 27:6 27:8 reading [6l 7:7 7:21 27:14 27:16 27:18 31:23 32:7 32:12 27:10 27:12 27:14 33:5 33:6 33:14 33:10 38:7 27:16 27:18 36:9 ~ain[26] 9:15 9:16 physics[q 6:7 pmgnosis[g] 23:11 roslizc[ll 32:15 9:18 9:21 9:21 ~hysiologytq 4:22 23:12 26:9 26:15 mmonable [~o] 26:13 9:21 9:22 Il:lO 27:22 28:5 30:15 28:6 28:21 29:3 I1:10 11:15 11:18 ticked [11 7:17 37:7 37:15 29:9 29:11 29:15 12:23 13:2 13:14 )ictul~ Ill 24:17 jrognosticating[ll 30:4 29:20 29:22 29:24 14:25 15:4 15:11 )iecc ill 12:16 receive [2) 4:23 16:25 15:22 21:15 21:16 pinprick pi 11:24 ~rogrm [iOl 6:1 22:22 22:23 32:12 6:22 15:8 15:18 received [al 8:17 36:20 36:22 37:4 )lace [81 1:14 12:24 16:4 16:19 20:9 I0:1 21:1 24:11 25:4 25:7 21:4 21:5 32:12 recollection pi 18:12 pain-frae pi 15:19 25:15 25:21 40:14 )rogl~8s [i] 30:15 m~ord [si 27:2 27:3 P~mgl'[61 4:9 4:19 flaCedlq 23:16 ~rojcct[~] 30:13 27:5 27:21 28:2 6:3 6:4 6:20 7:20 )lain [4] 7:15 7:21 projections pi 27:22 31:25 31:25 40:20 )alpation [21 12:2 33:5 35:7 prol~ iq 13:17 lg~ords [1130:20 13:19 Plaintiff [41 ] :2 Pamela[al 1:11 40:4 I:10 1:20 3:6 }renounced pi 24:13 rc~ro~s [11 37:10 40:24 plnn [21 15:6 21:8 proper [41 21:11 25:16 redirect [il 38:24 27:24 30:2 ll~dl~c~ [21 15:10 21:20 paragraph [21 28:18 Pleas [2l 1:1 3: I 1 28:20 point[vi 18:8 20:25 properly [2] 18:23 mduc~d 12] 11:9 19:1 40:1 I pal-Ilgraphs [11 29:5 21:9 21:17 22:1 22:6 22:13 protocol iq 21:8 l~f¢l~ble ill 32:12 p~rnl~gltl Iq 3:2 portion Iai 4:7 4:8 provide Ill 8:7 l~'l'~x~,,c~ ill 36:4 paravc~lcbral t21 12:4 25:22 provided [21 5:1 referred [21 22:6 13:21 position [~1 9:7 19:17 32:I0 part is] 5:4 9:9 13:23 17:18 17:19 providing lq 37:14 ~¢ferli~l~ [1 ] 34:15 ~ 16:3 16:4 17:22 18:22 Pllblic [41 1:12 40:4 refl~ iq 18:24 particular [al 5:21 possiblc[q 17:25 40:11 40:25 l~flex~$ ill 11:25 35:8 possibly Ill 21:12 pumping[ti 25:14 regard [31 6:20 27:22 pa[tics it i 40:16 post~ior Iq 19:8 push [11 11:17 31:11 ~art8 [21 9:11 15:23 postgrlidtlatc [] i 7:17 put [6] 17:5 17:25 regarding iai 17:1 taSSClIgf~F [il 8:15 18:11 21:3 24:9 26:9 26:16 pr~-tico [,Z 5:4 last [~1 20:]2 30:1 32:19 33:4 33:5 24:21 l~gion iq ]3:2 30:7 pl'actJoillg [i ! 31:20 puls ia[ 11:13 11:14 l'cplar i~] 22:1 38:21 latho]ogylq 13:12 predcpositionttl 31:14 rclatod[4! 8:13 26:16 laticnt po[ 5:10 -(~- 32:16 37:4 14:7 17:16 17:23 Dmint~rvicw [q 31:14 20:10 30:9 30:10 preparation [t] 15:12 Quantum [11 26:6 relates pi 9:8 31:3 32:9 35:15 pmparing[q 6:2 qtlcstioos [41 5:15 relationship iq 18:2 Jaticnts [6] 5:5 rmmquisit~s [41 6:2 10:10 17:6 40:9 ,relative [4] 6:19 5:7 30:11 30:14 6:4 6:7 6:19 quic~l []] 21:23 19:25 40:15 40:16 32:23 32:25 )rcscnos[tj 36:10 quote[il 8:21 mlaxcd[q 17:18 re[terns iq 15:25 PRESENT iq 1:24 quotedunquotc p[ 9:17 relevant iq 11:1 )canutlq 20:4 jrcscntation[lj 9:24 rcnd~rpl 14:21 Jclvic tq 12:11 )resented [11 8:11 -R- rendered [al 27:23 Pennsylvania [61 1:2 )rossurc rtl 11:17 radialis p[ 12:1 36:21 37:3 1:16 3:11 4:15 mplmmd p[ 20:22 40:2 40:6 ~l~v~nt [q 21:10 radiologist [61 32:15 20:22 25:1 lei' [~ 1 9:4 ncviously iq 5:1 32:18 33:1 34:8 I~pO~t [321 2:10 2:11 p~rc~lt iq 33:4 ~'ic~ [211 1:22 2:5 35:8 36:9 2:12 2:13 2:14 3:17 3:17 5:15 radiologists pi 36:2 2:15 2:16 17:1 pf.,'rfoFm la] 16:3 5:17 8:1 27:2 radiology [~l 7:4 18:20 19:18 27:6 16:15 32:25 27:20 28:11 29:2 7:5 32:17 33:17 27:8 27:10 27:12 peFform~d [21 J 1:3 29:18 31:8 32:6 33:22 34:13 27:14 27:16 27:18 14:20 36:12 36:16 37:9 raise lq 13:10 28:23 28:24 32:7 '--% pc[lorraine ill 12:9 37:19 37:22 38:23 33:9 34:9 34:13 period[~l 33:18 39:5 r~llg~[a118:17 11:8 15:20 34:15 34:21 35:2 p~smaO~lC~ [2! 26:10 problcl~ [11 10:8 35:5 35:11 35:18 26:16 problcmu [3] 21:24 Fang, s ill 12:18 35:21 37:10 38:11 Index Page 6 HUGHES, ALBRIGHT, FOLTZ & NATALE 717=540=0220W i 7=393=$101 Multi-PageTM mpoFt~r - sworn MICHAEL H. INNES, D.C. reporter [21 3:19 36:14 37:11 37:20 sideways ill 20:3 status[il 22:9 40:12 38:2 38:25 sigl~ ti] 12:25 stenographically ti] Rcportcr-NotaFy [31 saw[?] 8:5 19:19 significant [61 17:12 40:10 1:12 40:11 40:25 20:25 22:4 22:21 21:8 35:25 36:7 step iai 12:15 30:5 I~3OFtS[~I 8:16 9:12 36:18 37:5 38:14 38:20 $t~toallll 9:18 33:17 33:22 36:3 sean t21 10:20 11:3 similaF Itl 10:13 $t~l'nltm itl 8:22 36:3 seall$ [01 7:11 7:17 $imn~FS [?1 1:25 9:10 18:4 18:8 represent pi 3:14 7:24 33:6 33:6 3:1 3:1 3:19 18:9 reproduced pi 13:14 33:6 27:3 28:2 39:6 stiffness [11 9:21 request iai 26:5 36:16 sehcdulc [21 21:25 sitting iai 9:7 18:23 still itl 19:2 19:22 22:2 require[al 6:12 6:16 six [~] 5:24 20:12 36:20 36:22 37:4 required [~1 6:14 sehool i~l 6:10 6:14 30:11 stimulation[il 15:10 29:1 31:7 7:18 slip pi 18:21 straight 1~1 9:7 requirements p i 6:19 science pi 6:8 slippage pi 19:10 9:7 17:16 requireSpl 28:24 seopC[~l 37:9 37:10 smooth[41 14:6 19:8 straightcningpl 17:21 38:24 19:11 24:20 Street i3l 1:15 3:3 response[il 39:3 sculpt[il 16:11 restraining[il 18:14 scu]pto£ Ill 16:11 SOITy pi 17:7 31:19 res~llt[41 4:12 9:10 'spasm[~l 14:3 14:3 s~,uagth[ll 13:5 20:15 26:24 seat[al 8:23 9:1 spasms[al 14:25 15:11 strengths[ti 11:21 resulted pi 24:23 seatbelt 111 18:10 specific [~1 6:18 stresses ill 23:15 resulting[il 23:22 seated[si 9:6 10:10 21:22 st~tchlal 18:19 20:19 second 1~1 13:23 33:10 specified pi 40:14 $t~'tcIEd [51 19:9 results 131 10:20 11:6 37:23 30:3 speed[al 9:4 9:5 19:14 20:19 20:21 sec [a~l 8:8 8:24 spinal 1al 23:6 23:23 23:13 rctil~ iai 31:21 31:22 15:15 17:10 18:8 retrolisthesis ill 35:16 19:9 19:10 19:11 spine 1a51 4:22 12:5 stretching [21 20:15 reVCFsal itl 18:3 20:5 21:7 22:12 13:2 13:20 13:22 21:15 24:7 24:20 34:23 22:14 22:20 23:12 13:23 14:2 14:3 $tr~k~ 14l 6:24 27:21 35:23 24:18 24:19 25:18 14:23 15:4 15:9 28:1 38:23 reversing[il 17:21 25:20 25:24 28:20 15:23 16:6 17:22 $tl'u©ture$ p i 23:22 revicw[~l 4:24 17:1 30:5 30:17 32:23 18:15 19:5 20:17 studies [21 32:16 36:4 23:10 seeds[il 25:24 20:17 23:18 23:22 24:14 24:24 32:13 study pi 4:21 Richard iai 1:19 seeing fsi 9:19 15:16 33:17 33:22 34:7 $ubj¢cti¥c ill 14:4 3:15 19:22 24:5 24:6 34:11 34:18 34:24 subluxation pi 15:2 rightp31 9:15 11:9 Segal[21 30:23 30:25 35:7 35:9 35:12 subsequently[al 11:5 11:12 11:12 12:10 seglncnt$ i~l 23:23 35:22 35:24 36:4 19:13 12:20 12:21 13:15 seizures[il 22:13 Spirit[al 33:25 34:8 such itl 40:17 17:10 19:25 27:1 sensitiv© pi 21:16 sprain/streJn pi 36:24 33:13 37:2 tuff©red pi 14:22 toad[al 8:19 26:6 sent[il 16:22 SS[~I 40:1 tuff-cling [ ii 14:24 Rombctg's ill 13:5 sequela pi 29:25 stabilization pi 31:24 $uggcstgd pi 22:12 i'oom[tl 10:4 series[l] 30:10 33:16 staclr[tl 33:20 Sullivan[~l 1:11 roping[il 14:1 sel'vic¢[l] 8:6 stack©dpllS:25 40:4 40:24 toPY I~1 12:3 13:20 set [4] 19:1 28:13 'stacJting pi 18:25 sllp~ol' [ii 25:22 15:1 28:25 40:22 $18~c [~1 15:19 20:14 SMpinc ill 13:9 se¥cn[Sl 33:16 33:21 23:8 supplcpl 15:13 rota~epl 17:23 35:22 36:3 36:3 stair-s~-'pping[al 19:12 rotation pl 12:21 seventh itl 11:19 25:19 supply 111 25:11 rounding Itl 25:20 seVcFal Iai 7:6 25:4 standing [il 11:7 support [~1 26:8 37:7 ROVIICF[41 1:14 1:18 sha]tg~ ill 9:10 standpoint pl 16:7 3:2 3:8 supportive pi 21:4 shalx: pi 20:4 start pi 17:7 supposed pl 18:18 rupture[il20:21 shcctpl 40:14 $taFtcdPl 22:19 SUrgeon Iai 37:1 =S= Shin(Jcl[il 8:15 starting[il 25:24 37:7 shoulder iai 9:1 starls [11 15:22 sul~¢ri©$ ill 32:25 S[~I 1:11 40:4 17:15 state it01 4:1 4:8 SUfRCry pi 31:7 40:24 show [~1 17:5 33:16 4:8 4:11 4:11 sustain [~1 23:17 SBCFal It I 13:18 34:11 4:15 5:18 5:20 5:23 5:25 sustained pi 5:7 sacroiliacs pi 13:19 showing pl 11:3 Sadlock[atl 1:19 shown[21 23:10 24:12 stalL'nx.'ntpl 26:16 SWCaFpl 3:20 2:4 3:15 3:15 shows ltl 19:25 statL'mcnt$ iai 26:8 swelling [41 12:5 3:25 5:12 8:3 28:6 14:14 15:11 15:18 26:25 28:4 28:9 side 131 12:17 13:1 states I~l 8:18 8:25 swollen [41 12:6 28:14 28:23 29:16 17:14 9:17 14:17 14:17 14:18 31:4 31:15 32:3 sides [21 12:22 13:11 SWOFfl [21 3:23 40:9 HUGHES, ALBRIGHT, FOLTZ & NATALE Index Page 7 7 ! 7-540-0220~7 ! 7-393=5101 symptomatology - yourself Multi-PsgeTM MICHABL H. INNI~, D.C. symptomatolog~[i] tissue[2] 20:23 24:24 up[si 7:17 12:15 writ~li[l] 11:5 21:20 tissilO~[i] 21:16 13:10 18:25 18:25 w~fo~[ll 36:3 ~]mptom~ [~l 10:13 today [6] 17:3 26:15 19:5 20:5 25:25 21:6 21:10 30:5 30:6 31:12 update 11[ 11:6 =X_ system[l! 13:7 31:13 ul~3~'[4l 11:21 11:25 [od~y*s Ill 3:4 13:22 22:23 x-ray [6] 18:20 19:15 -T- TOCpl 13:3 used[ti 13:24 26:22 33:10 34:21 35:8 t~ting[41 24:10 25:7 Iogolh~[ll 14:17 using[~l 11:23 15:17 X-FayS[is]4:24 16:22 25:21 40:8 Tolodo [41 4:8 4:11 30:5 17:1 17:9 17:13 taut[il 14:7 5:23 5:25 17:14 21:13 23:10 I~r[]l 18:19 tomorrow [i i 30:6 -V- 23:24 26:4 26:8 I~micnl (11 14:24 took[Il 36:16 Vlll 1:4 32:22 33:6 t~chniqucs ill 16:15 top [51 11:17 11:18 YaFiCS [I ] 16:10 11:19 19:1 25:12 vatimm [2] 36:2 36:4 -Y- t~cl~cy [Il 25:5 tender [Il 14:8 torn [1l 23:14 vchicle [6] 5:5 5:8 ~[l~] 33:24 34:7 I~lldon[ll ll:25 tO~l]ly[l] 24:15 8:14 8:16 10:9 34:14 34:22 35:6 I~l~l[~l 12:13 13:24 tou~h[21 14:7 38:11 26:17 36:1935:12 37:635:14 35:21 14:24 . toy []1 19:1 v~'~u~ []I 3:10 ~1~ [61 5:18 5:23 im..~-d Ill 12:7 'ti'~illillg [41 4:23 ~bF~ [1ol 12:6 6:15 6:21 6:23 t~i~nOlog~ [21 28:25 7:20 22:14 30:2 15:2 ]5:3 18:17 25:22 18:18 18:21 19:3 29:13 treat Ill 5:4 19:10 19:12 20:20 ~llow [~j 20:18 20:21 t~Tn~[21 4:20 26:9 II,at,dill 26:14 vl~l~bral[]l 25:12 24:25 t~st [61 11:16 13:4 tiaa[lng [~1 5:2 25:21 25:22 ~lcrday []1 36:17 13:5 13:6 13:6 5:14 16:8 video [si 1:8 3:3 36:21 13:12 13:12 13:13 ll~atm~lt [i 11 10:2 27:3 27:20 28:2 you~elf[]] 17:1 toat~d [1] 15:24 15:6 16:3 16:19 VIDEOGRAPHER [11 19:16 21:1 21:5 testified [2! 3:23 21:9 21:17 22:7 1:25 7:19 22:24 viow Il01 17:5 17:18 ~'~tifying Iii 3:9 TRIAL[ii 1:7 18:24 19:7 19:24 24:5 24:8 24:12 tcstimolly is] 5:1 fl'iCL'pS[II 12:1 25:18 35:24 28:13 36:21 40:7 40:20 Ttindl© ill 26:6 views[ii 35:22 Icsts [11 33:7 I~u~ [11 40:20 visibility[il 8:19 ~xtltl~[l114:6 tfy[~l 15:22 21:5 visibl~[l120:6 Thnnlt [718:1 13:24 21:10 visit [~[ 22:18 22:25 26:25 28:9 36:12 tl~ing [217:2 22:1 23:1 37:20 39:4 Tttmpangh [6l 22:7 ~lv~s [si 3:13 22:12 22:14 22:19 =W- 14:5 26:2 22:20 32:10 tht,'Tapy ISI 31:23 32:7 Tumpangh's ill 26:5 walk[si 9:12 13:2 32:12 tWO [61 5:19 6:15 13:3 13:3 13:4 THOMAS [21 1:21 15:16 19:22 20:9 wa~l~d [~l 13:2 l:21 25:22 w~l"illg Ii ] 8:25 Thompson ill 13:17 1~[61 4:12 6:1 w~ir Ill 15:16 10:21 18:6 29:4 w~¢ir$ [si 15:16 15:16 t[~tacic [2] 15:2 15:4 36:24 20:12 thorscolumbsr[2] 12:23 typ~s[2] 24:24 33:7 w~ig~t[2] 19:2 38:15 13:14 type-writing[il 40:12 W/HEREOF pi 40:22 fllought [~122:15 22:17 whipln~h [~1 36:24 tlm~ [41 6:23 15:15 -U- whipping [~1 18:4 15:16 17:7 unnided 1,1 9:12 whi+~ ill 20:22 thr~o=qun~'F[~l 12:16 uncov~r~bral[ll 33:12 within[?l 13:21 14:5 t[h-ough [~l 23:l ulldof ill 40:12 14:9 14:10 15:25 28:20 33:21 und~rgraduat~ ill 4:7 26:12 40:5 Throughout[il 22:24 under~tand [41 7:19 Without [il 25:14 tight i~1 12:3 13:11 10:22 32:21 33:5 wi~/le~s [9l 2:1 13:20 14:1 15:1 un,qua] is] 12:17 3:20 3:22 32:4 37:24 37:25 40:9 tim~s [2! 14:1 15:15 unique [I] 20:17 40:21 40:22 T~mmons [31 1:6 3:10 3:18 unquote [11 8:23 wood ti! 12:]6 tip[ocs [1] 13:4 unstabic [11 38:22 woFd [2] 25:10 29:8 unusual [ti 38:18 woFds [2] 28:25 29:3 Index Page 8 HUGHES, ALBRIGHT, FOLTZ & NATALE 71 ?=540=0220W 17=393=5 · ~ Holy Spirit Hospital Depai th,ent of Radiology and Diagnostic Imaging Camp Hill, Pennsylvania 17011 (717) 763-2600 tTIENT: FULTZ, HELEN DICTATION DATE: Jan 23 2CX3O 9:14P R~ 157630 TRANSCRIPTION DATE: Jan 24 20::)0 7:48A :)C SEC: 199-68-10'/4 :~D DR: ED GROUP M.D. r TYPE: E )M DATE: 01/23/2000 ARRIVAL DATE: )CATION: ;=RI- HOSP SERVICE: ***Final Report"' (AMINATION: C-SPINE LIMITED PORTABLE (IV) CROSS TABLE LATERAL 2040 HOURS 72020 - Jan 23 2000 COMMENTS: INDICATION: MVA. Postador neck pain. Spinal alignment is normal. 'rhere is a slight reversal of the usual cervicaJ lordosis although the patient's neck is in a collar. I see no obvious fracture. Vertebral body height is well maintained. The discs are probably normal. CONCLUSION: No fracture or malalignment. DICTATED BY: RICHARD STEVVART M.D. I LAH DATE OF EXAM: Jan 23 2000 SIGNED BY: DONALD BUXTON M.D. DATE/TIME: Jan 24 2000 7:07'P Imaging Services Consultation Page I Holy Spirit Hospital Depa,b.ent of Radiology and Diagnostic Imaging Camp Hill, Pennsylvania 1;'011 (717) 763-2600 ~,'nENT: FUI_TZ, HELEN DICTATION DATE: Jan 24 2QQD 6:06A ~ 157~30 TRANECRIPTION DATE: Jan 24 2Q:)O 8:53A :)C SEC: 199-68-1074 ~D DR: THOMAS ALDOUS M.D. ~' TYPE: E )M DATE: 01/23/2(~0 ARRNAL DATE: )CATION: ER1- HOSP SERVICE: ER1 *'*Final Report"* (ANENATION: CERVICAL SPINE (2v) 72062 - Jan 23 2000 COMMENTS: Histo;y: MVA, neck and sternai pain. Initially, portable cross-table lateral image of the cervical spine was carded out at 2040 ours. C1 through C7 are normally aiigned. Them are no fractures. Them are no jumped fecets. Subsequently AP and lateral images of the cervi=ai spine were carried out. There i~ s~me straightening of the cervical lordosis which may be positional, but no fractures, precewical soft tissue swailing or loss of alignment. There are no jumped facets. CONCLUSION: AP and lateral Images of the cervical spine show no ~actures. DICTATED BY: HOVVARD BRONFMAN M.D. I JAS DATE OF EXAM: Jan 23 2000 SIGNED BY: HOVVARD BRONFMAN M.D. DATE/TIME: Jan 24 2000 1ZQSP Imaging Services Coneulta(]on ~ Page I ~ A Z RITZMAN DIViSiOr; ~ Imaging a Therapeutic 3508 Trln0m. ar. an Camo H,II PA , ?m'..' ' ~SOC:a~ ~5, Inc (717) 761-7470 Fax: (717) 761-6291 GENERAL DIAGNC~';C.. ., ~AD~OLOGY _ _ULTRASOUND MAMMOGRAPHY FLUOROSCOP~ W1074 April 27, 2000 Michael Ira]es DC 3327 Market Sa'ee~ Camp Hill. PA 170Il RE: HELEN P FULTZ 199681074 Dear Dr. lin]es' CERVICAL SPINE (TV includin,__, flexion and extension): History: trauma Spinal alignment is normal. There ts excellent range of motion on the dynamic views. Tl~c mtervertebr:d disc spaces and vertebral bodies are normal. Thc neural toramina :ac p:ltcllt bilaterally. The odontoid process is intact. There is no prevertebr:~l sob tissue swelling. CONCLUSION Negative examination of the cer'.tcal spine. Thank you for referring this paucnt. Sincerely, BBG/TYdmh Bertrand B Giulian, MD C-spine XR (4-5 views) FULTZ, HELEN P - 433156 * Final Report * DX C-SPINE 4-5 VIEWS-LT,LAT, ERCT, FLEX, EXTNS, AP, PATIENT NAME: FULTZ,HELEN P PATIENT M~N: 00433156 PATIENT DOB: 22-Dec-1982 EXAM NUMBER: 548A-070600 EXAM: DX C-SPINE 4-5 VIEWS - LT LAT, ERCT, FLEX, EXTNS, AP , ORDERING PHYSICIAN: LEE SEGAL Exam: DX C-SPINE 4-5 VIEWS - LT , LAT, ERCT, FLEX, EXTNS, AP , CERVICAL SPINE AP, LAT NEUTRAL, EXTENSION AND FLEXION VIEWS CLINICAL HISTORY: Neck pain. DISCUSSION: There are no comparison films. On neutral view of the cervical spine, there is reversal of the cervical spine lordosis centered at C4-5 level. This slightly improves with extention. The flexion angle centered at C4-5 level is limited. The alignment of the vertebral bodies is anatomic and maintained with flexion extension. There is no loss of vertebral body height or disc space narrowing. The precervical soft tissues are unremarkable. IMPRESSION: Reversal of the cervical spine lordosis with limited flexion. Dr. Hulse reviewed the images and discussed the interpretation with Dr. Eidlin. DICTATED: 15767 REVIEWED AND SIGNED: NATALYA EIDLIN, M.D./MICHAEL HULSE, D.O. 1/psc Printed by:. Men, Chanthan Page 1 of 1 Printed on: 10/01/2001 11:01 AM (End of Report) C-spine MR (enenhanced) FULTZ, HELEN P -433156 * Final Report * MR C SPINE UNENHANCED - ADULT PATIEZ',,"T ~: FULTZ, HELEN P PATI~'T MiO..N: 00433156 PATIENT DOB: 22-Dec-1982 EXAM NUMBER: 542A-071800 EXAM: MR C SPINE UNENHANCED - ADULT ORDERING PHYSICIAN: LEE SEGAL Exam: MR C SPINE UNENHANCED - ADULT MRI OF CERVICAL SPINE, UNENHANCED CLINICAL HISTORY: 17-year-old female with c-spine injury status poet MVA. TECHNIQUE: Standard unenhanced MRI of the cervical spine protocol was adhered. DISCUSSION: There are no comparison MRis. Alignment is anatomic. There is no evidence of abnormal bony signal. The parasl~inal soft tissues are normal. There is normal cord signal. The discs appear normal. There is no central canal or foraminal stenosis. The cerabellar tonsils are properly positioned. IMPRESSION: Normal MRI of the cervical spine. Dr. McNamara reviewed the images and discussed the interpretation with Dr. Gibson. DICTATED: 16260 REVIEWED AND SIGNED: RUSSELL GIBSON, M.D./KEVIN P. MCNAMARA, M.D. 1/smc Printed by:. Men, Chanthan Page I of 1 Printed on: 10/01/2001 11:02 AM (End of Report) C-spine XR (2-3 views) FULTZ, HELEN P - 433156 * Final Report * DX C-SPINE ~3 VIEWS-FLEX, EXTNS, PATIENT NAME: FULTZ,HELEN P PATIENT MRN: 00433156 PATIENT DOB: 22-Dec-1982 EXAM NUMBER: 556A-020101 EXAM: DX C-SPINE 2-3 VIEWS - FLEX, EXTNS, ORDERING PHYSICIAN: LEE SEGAL Exam: DX C-SPINE 2-3 VIEWS - FLEX, EXTNS, FLEXION EXTENSION C~RVICAL SPINE FILMS CLINICAL INFORMATION: This patient sustained a whiplash injury. DISCUSSION: Comparison is made with the previous examination of 6 July 2000. In the interval since thac examination, the patient has developed better extension of the neck which is still however limited somewhat. On extension, there is approximately i em of retrolisthesis of C2 on C3. There is normal alignment in the flexion between C2 and C3. Flexion seems to occur primarily at the C4-5 disc space but for an 18 year old, flexion remains somewhat limited. Once.again, I can detect no fracture and there is no abnormal soft tissue swelling seen. IMPRESSION: 1. Limited flexion and extension with extension better than in July of 2000. On the extension, the patient has only i rmn of retrolisthesis of C2 on C3. There is no evidence of an~erolisthesis. There is no other abnormality. DICTATED: 4191 REVIEWED AND SIGNED: KATHLEEND. EGGLI, M.D./ 4/psc Printed by: Men, Chanthan Page 1 of 1 Printed on: 10/01/2001 11:02 AM (End of Report) ~ 3508 Trindle Road Camp Hill, PA 17011 (717) 761-7470 A~odates, lnc. F~ (7'17) 761-6291 W1074 June 13, 2001 Chris Turnpaugh DC 6103 Carlisle Pike Mechanicsburg, Pa 17055 RE: HELEN P FULTZ 199681074 Dear Dr. Turnpangh: CERVICAL SPINE (7 views) INCLUDING FLEXION AND EXTENSION: History: MVA one year ago, persistent neck pain. There is reversal of the curvature of the cervical spine which corrects on the extension view. This finding may be due to a muscle spasm. The vertebral bodies and intervertebral disc spaces are well maintained. The neural foramina are patent. There is no evidence of prevertebral sof~ tissue swelling. The odontoid is intact. CONCLUSION: Reversal of the normal lordotic curvature of the cervical spine which corrects on the extension view. No fracture or significant degenerative changes. Thank you for referring this patient. Sincerely, . / ,) 'Barbar~ K Kunkel, MD BKK/EB/sr ORIGINAL HELEN P. FULTZ, : IN THE COURT OF COMMON PLEAS OF PLAINTIFF : CUMBERLAND COUNTY, PENNSYLVANIA : V : CIVIL ACTION - LAW : NO. 2001-2979 JOYCE M. TIMMONS, : DEFENDANT : JURY TRIAL DEMANDED VIDEO DEPOSITION OF: ROBERT R. DAHMUS, M.D. TAKEN BY: DEFENDANT BEFORE: PAMELA S. SULLIVAN, REPORTER-NOTARY PUBLIC DATE: APRIL 18, 2002, 8:20 A.M. '~ PLACE: ORTHOPEDIC INSTITUTE % .! OF PENNSYLVANIA 450 POWERS AVENUE HARRISBURG, PENNSYLVANIA APPEARANCES: THOMAS, THOMAS & HAFER, LLP BY: C. KENT PRICE, ESQUIRE FOR - DEFENDANT ANGINO & ROVNER, P.C. BY: RICHARD A. SADLOCK, ESQUIRE FOR - PLAINTIFF ALSO PRESENT: CRAIG ASHWAY, VIDEOGRAPHER 2080 Linglestown Road · Suite 103 · Harrisburg, PA 171 I0 717.540.0220 · Fax 717.540.0221 · Lancaster 717.393.5101 2 1 WITNESS 2 NAME EXAMINATION 3 ROBERT R. DAHMUS, M.D. 4 BY: MR. PRICE 3, 10, 34 5 BY: MR. SADLOCK 8, 26, 36 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 3 1 MR. ASHWAY: My name is Craig Ashway. I 2 represent Video Images, 155 Windshire Drive, Red Lion, 3 Pennsylvania. Today's date is April 18th, 2002. The time 4 of day is 8:22 a.m. This deposition was videotaped at 450 5 Powers Avenue, Harrisburg, Pennsylvania. 6 The caption of the case is Helen P. Fultz versus 7 Joyce M. Timmons. The name of the witness is Robert R. 8 Dahmus. This deposition is being videotaped on behalf of 9 Defendant. 10 will counsel introduce themselves? 11 MR. SADLOCK: I'm Richard Sadlock, counsel for 12 Miss Fultz. 13 MR. PRICE: Kent Price for Joyce Timmons. 14 MR. ASHWAY: Will the court reporter identify 15 herself and swear in the witness? 16 MS. SULLIVAN: My name is Pam Sullivan from 17 ~ughes, Albright, Foltz & Natale Reporting. 18 19 ROBERT R. DANMUS, M.D., called as a witness, 20 being duly sworn, testified as follows: 21 EXAMINATION 22 BY MR. PRICE: 23 Q Would you state your name, please? 24 A Robert Dahmus. 25 Q What is your profession? 4 1 A I'm an orthopedic surgeon. 2 Q Would you explain briefly to the jury what an 3 orthopedic surgeon does? 4 A An orthopedic surgeon is that discipline of 5 medicine that takes care of the musculoskeletal system. 6 What that means is anything that involves the muscles, the 7 tendons, the ligaments, the joints, anything that helps us 8 get around, anything from basically the bottom of the head, 9 which is the beginning of the cervical spine, down to your 10 toes. 11 We take care of traumatic injuries such as 12 sprains, fractures, things like that. We take care of 13 congenital problems such as scoliosis, club feet. We take 14 care of degenerative problems such as arthritis, basically 15 anything that affects the part of your body that helps you 16 get from here to there. 17 We don't deal with the kidneys or the liver or 18 the lungs or the heart. We deal with the arms and the legs 19 and the spine and the back and things like that. 20 Q Doctor, are you currently involved in active 21 practice? 22 A Yes, I am. 23 Q Do you practice on your own or with a group? 24 A I'm in a group, Orthopedic Institute of 25 Pennsylvania. 5 1 Q What's your date of birth? 2 A I was born on September 14th of 1953. 3 Q Can you briefly provide the jury with your 4 educational background? 5 A I got my degree in general arts and science from 6 Penn State in 1975. I got my Master's degree in exercise 7 physiology in 1976. I got my M.D. degree in 1980 from 8 Hershey Med Center. 9 I did a one-year general surgery internship 10 followed by a four-year orthopedic surgery residency 11 finishing in June of 1985. I became board certified by the 12 American Board of Orthopedic Surgeons in 1987, and I 13 recertified in orthopedic surgery in 1995. 14 I've been on active staff in the hospitals in the 15 Harrisburg area since July 1st of 1985. 16 Q And you're licensed to practice medicine in 17 Pennsylvania? 18 A Yes. 19 Q Could you briefly tell the jury what it means in 20 your profession to be board certified? What's the 21 significance of that? 22 A In order to be board certified in orthopedic 23 surgery, you have to first have completed an accredited 24 orthopedic residency program. You then have to pass a 25 written exam which is basically a test of what you should 6 1 have learned during that residency program. 2 After you pass that, then you have to practice in 3 the same area for two years. You can't just move here and 4 there and everywhere, but you have to stay in the same place 5 for at least two years so that the doctors in that area can 6 comment on whether they think you know what you're doing or 7 not. 8 ~J~d once you pass that, then you have to take an 9 oral exam at which time you go before at least four or five 10 different orthopedic surgeons with your cases and explain 11 why you did what you did. And if you pass that, then you're 12 board certified. 13 Q Are all orthopedic surgeons board certified? 14 A No. You don't have to be board certified to 15 practice. 16 Q And then you indicated that in 1995 you were 17 recertified. What does that involve? 18 A In order to maintain your board certification -- 19 everybody from I think the year before me who graduated from 20 now on in order to maintain your certification, you have to 21 recertify every ten years. 22 People that were a couple years older than me, if 23 you just got board certified, that was it. You never had to 24 recertify. You could basically not keep up anymore. You 25 wouldn't have to go to conferences. You don't have to get 1 any further education. 2 But from the year before me and from now on in 3 order to maintain that certificate of certification, 4 basically saying that you know what you're doing, you have 5 to be recertified every ten years. And that means education 6 and passing another exam. 7 Q Doctor, do you currently hold any teaching 8 positions? 9 A I'm on active staff with Pinnacle, and Pinnacle 10 has an orthopedic residency program. I train and work with 11 them almost every day of the week. We're on associate staff 12 with the medical center. But that's very, very loose at 13 this point. Once they get their new chairman, it's supposed 14 to get more regimented again. Although, obviously, we don't 15 know that until they have a chairman and find out exactly 16 what's going to happen. 17 Q Which medical center were you referring to? 18 A Hershey. 19 Q Are you a member of any professional societies or 20 organizations? 21 A I'm a member of Pennsylvania Orthopedics Society, 22 Pennsylvania Medical Society, Dauphin County Medical 23 Society. I'm sure there's a couple others. I used to be a 24 member of the American Medical Association. But a couple of 25 their political views I didn't agree with, and I dropped 8 1 out. 2 Q In the course of your practice, do you perform 3 surgeries? 4 A Yes. 5 Q And do you perform surgical procedures involving 6 the spinal column? 7 A Yes. 8 Q Do you treat people who have been involved in 9 motor vehicle accidents? 10 A Yes. 11 Q Do you treat people in your profession who have 12 medical problems involving the neck, the back, including the 13 muscles, ligaments, tendons and the spine? 14 A Yes. 15 MR. PRICE: I would submit the doctor as an 16 expert qualified to practice orthopedic surgery. 17 EXAMINATION 18 BY MR. SADLOCK: 19 Q Doctor, you mentioned a teaching relationship 20 with Hershey Medical Center. Is that something you've done 21 in the past as well as you're anticipating doing in the 22 future? 23 A We -- basically, in the past, there was a very, 24 very strong Hershey Med Center/town physician association 25 since when you're at the Med Center you see a lot of very 9 1 interesting cases, very strange cases, congenital anomalies 2 and things like that. But you don't get a lot of the 3 bread-and-butter type of orthopedics like the knee injuries 4 and the herniated discs and things like that. 5 So before the residents and even the med students 6 would come out to the community and be trained by us. I'm 7 assuming that's going to happen again. But, again, until 8 they have a chairman, I don't know. But, yeah, I've done 9 that from basically day one. 10 Q Do you know Dr. Segal from Hershey? 11 A I know Dr. Segal very well, yes. 12 Q And do you know Dr. Ludwig? 13 A Actually, no, I don't know Dr. Ludwig. He came a 14 couple years ago, and he does just spines. And I don't 15 really have an association, so to speak, with him since we 16 have two people in our practice that do just spines. And, 17 basically, I would send them all my stuff. 18 Q But you are familiar with Dr. Segal? 19 A Right. Dr. Segal is a pediatric orthopedist. 20 And when we have pediatric cases like strange club feet or 21 things like that, then, yeah, we would send things to 22 Dr. Segal all the time. 23 Q And he's a good doctor? 24 A Oh, yeah. 25 MR. SADLOCK: Nothing further. 10 1 EXAMINATION 2 BY MR. PRICE: 3 Q Dr. Dahmus, at my request, did you have an 4 opportunity recently to examine Helen Fultz, the Plaintiff 5 in this case? 6 A Yes, I did. I saw her on April the 10th. 7 Q Had she ever been a patient of yours before that? 8 A No. 9 Q And just so the jury is clear on this, you saw 10 her for the purpose of performing a medical examination at 11 my request as opposed to being a treating physician for her? 12 A Correct. 13 Q Now, did I also provide you with medical records 14 regarding her past medical history? 15 A Yes, you did. 16 Q And you are aware that this legal case arises out 17 of an automobile accident in which she was involved several 18 years ago? 19 A Yes. 20 Q And the records that I provided you were, I 21 think, from the day of the accident up to approximately the 22 present time. Is that correct? 23 A Yes. 24 Q Could you briefly describe for the jury what you 25 did in the case of performing an independent medical 11 1 evaluation of Miss Fultz? 2 A Basically in her case just like any case that I 3 would do, I read the records before I see the patient. I 4 then see the patient, talk with the patient, get their 5 story, examine the patient just like I would examine any 6 other person who would come to my office. 7 Then I usually read the records again. And in 8 her case, I read them again since there were a couple 9 discrepancies. ~_nd then I dictate a report and send it out 10 to you. 11 Q The first part of the process that you just 12 talked about when she came and presented herself at your 13 office was to perform a physical examination? 14 A Well, it was to perform a physical exam. But it 15 was also to take her history. I wanted to hear from her 16 what happened, what kind of problems she was having, what 17 she had done to try to get better, that sort of thing. 18 Q What were the relevant findings upon the physical 19 examination? 20 A Basically, on my examination, she definitely had 21 some tenderness in the mid-portion of her cervical spine 22 when I palpated the spine itself. Meaning if you would put 23 your fingers up and down the back of her spine and feel the 24 little nubbins in the back, which are the bones, she was 25 tender over the mid-portion down to the bottom of her 12 1 cervical spine, basically the middle of her neck to the 2 bottom of her neck on the bones. She really wasn't tender 3 in the muscles on each side of the bones, but she was tender 4 on the bones themselves. 5 She didn't have any significant tenderness in 6 either trapezius muscle. That's the big muscle that goes 7 from your neck down to your shoulder on both sides. She 8 didn't have significant tenderness in the rhomboids. Those 9 are the muscles right below the trapezii. 10 Her arms were basically nontender to palpation. Her legs were nontender to palpation. She had normal 12 strength throughout her legs and her feet. She had normal 13 sensation throughout her legs and her feet. She had normal 14 sensation and normal strength in her left arm. I thought 15 her right arm showed some weakness, and I thought her right 16 arm showed a little bit of numbness compared to her left 17 arm. 18 The numbness is something I can't put a real 19 gauge on because I have to take the patient's word for it. 20 If they tell me it's different, then I have to assume it's 21 different since there's really, you know, no test I can do. 22 The weakness I thought was definitely different one side to 23 the other. 24 She had a full range of motion of her neck 25 meaning that she could bring her head all the way down, 13 1 bring her head all the way back, turn it side to side, tip 2 it side to side. And she had no trouble doing that. It 3 didn't hurt her. She didn't go slowly. 4 I was surprised by reading through the records 5 that she would have such a nice neck exam except for the 6 tenderness when I palpated the spinous processes, the lumps 7 in the back of your neck. 8 Q What was the relevance for this particular 9 patient in finding that she had a full range of motion of 10 the cervical spine? 11 A Well, basically, when somebody has a whiplash 12 injury like she had -- I mean, she told me and the records 13 pretty much agreed that she was sitting as a passenger in 14 the front seat and they got hit and she got her head whipped 15 back and forth. 16 People like that tend to have a fair amount of 17 pain in their neck. And because of pain -- if anybody has 18 ever had a neck pain, they kind of move like this because 19 they don't do this because it hurts. But they move slowly 20 side to side, and you can feel their muscles getting really 21 tight when they move side to side. 22 Well, she didn't. She could move all around, and 23 it didn't bother her. It bothered her for me to push on the 24 back, but it didn't bother her to move it. 25 And most people with a problem with instability, 14 1 for lack of a better word, or mild instability or a strain 2 of the ligaments that hold the vertebral bodies or the bones 3 in your neck together, they hurt and they tend not to want 4 to let you move. And then, like I said, they move very 5 carefully. They do what we call guarding. They don't let 6 you move quickly. 7 And she didn't do that. She had great motion 8 without pain, and I was surprised it was that good. 9 Q I'm sorry, Doctor. Can you continue then with 10 your examination? 11 A Basically, she had a little bit of tenderness to 12 palpation at what we call the L5-S1 facet area. That's at 13 the very bottom of the spine, right at the pelvis. 14 But as I said, she was neurologically intact in 15 her legs. She had a negative straight leg raising test, 16 which means there wasn't any nerve stretch, nerve pinching 17 going on in her spine or lower than her spine. She had full 18 strength. She had full sensation in her lower extremities. 19 So, basically, the only abnormalities that I 20 found were the tenderness at the bottom of her neck and the 21 numbness that she complained of in her arm and the weakness 22 that I thought was there in her right arm compared to her 23 left arm. 24 She could still move her arm well. I mean, it 25 wasn't that she couldn't move it. It just wasn't as good as 15 1 the other side, but there wasn't any swelling. There wasn't 2 any atrophy. There wasn't any other outward sign of any 3 problem. Basically, that's it. 4 Q What's the relevance of no atrophy? And maybe 5 you ought to explain, first of all, what you refer to or 6 what you mean by atrophy. 7 A Atrophy means like a wasting away of a muscle. 8 If you've known anybody that was injured and had to lay in 9 bed for a while or was in a cast for a while, when the cast 10 comes off or they get out of bed, they're very small. 11 Especially in a cast you can see that. If you had a cast on 12 your arm and you take the cast off and you look at this arm 13 compared to this arm, the muscles are very small. That's 14 what atrophy means. 15 Atrophy means that you haven't used that muscle 16 for a while, and the muscle gets small. And that can either 17 be you haven't used it because it hurts or you haven't used 18 it because you were unable because you had an operation done 19 and had to keep it immobile. But you could also have 20 atrophy because the nerves don't work, and the muscles just 21 tend to waste away because the nerves aren't working right. 22 It's basically a smaller muscle one side to the other. 23 Q And, therefore, the absence of atrophy would 24 indicate what to you as a physician? 25 A Basically, that means that you've been using the 16 1 muscles the same one side to the other. Otherwise, there 2 would be a difference in the size one side to the other. 3 Q Following the completion of your physical 4 examination, did you obtain a history from Miss Fultz? 5 A Yes, I did. 6 Q And what were the findings on your taking of the 7 history? 8 A Well, a lot of it was the same as what I had read 9 through the records that you had sent to me in that she had 10 been in an auto accident and that she was a passenger and 11 she was belted in and she got her head whacked around. 12 She said that she didn't hit her head on anything 13 as far as the windshield, but her chin came down and hit her 14 in the sternum, your breastbone. She said that she was 15 taken to Holy Spirit Hospital and she had neck pain right 16 away and she had back pain right away. 17 The reason I went back and looked at the records 18 again, as I said at the beginning of my testimony, was I had 19 thought by reading through the records that she didn't have 20 any back pain when she went to the ER and that she didn't 21 have any back pain when she saw her family doctor. But she 22 told me that she had back pain right away. 23 So I did go back to the records again, and the 24 records did state that she did not have back pain at the ER 25 and that she did not have back pain with her family doctor. 17 1 But it's been a couple years. So it's very possible that 2 she just forgot that. 3 Basically, she told me also with her course of 4 treatment in that she had first been seen in the ER, then 5 she went to her family doctor, then she had went to a 6 chiropractor, Dr. Innes, and she had seen Dr. Segal, she had 7 seen Dr. Ludwig and that now she was being treated by 8 another chiropractor, Dr. Turnpaugh. 9 And, basically, all that agreed with what I had 10 seen in the records prior to seeing her. 11 Q Did she also give you any information about what 12 she was doing by way of either employment or education? 13 A Yes. She told me that she was working full-time 14 as a cashier and she was going to school full-time at 15 Thompson Institute. 16 She told me that she basically wasn't really 17 taking any medicine. She would take some medicine every now 18 and then. She was not in any physical therapy program. She 19 was not in any rehab program. The only treatments that she 20 was getting when I saw her were chiropractic manipulations 21 by Dr. Turnpaugh, and she said that she would have them 22 probably two to three times a month. 23 Q After you obtained a history, you talked about 24 going through the records before the examination and then 25 re-reading the records on a second occasion. What findings, 18 1 if any, of relevance to this case did you find in the 2 records? 3 A As far as what I found in the records what I 4 thought was important and by talking with her what I thought 5 was important was the fact that she did get her head whipped 6 around and everybody that had seen her along the way thought 7 that she did have a neck injury, a whiplash-type injury, a 8 flexion/extension-type injury. 9 I thought it was important that she now 10 remembered that she had back pain at the beginning. But 11 according to the records, it's very clear that she didn't. 12 But that's very common for patients to confuse that. 13 I thought it was very important in that Dr. Segal 14 and Dr. Ludwig had seen her, evaluated her, looked over her 15 x-rays and her MRI scan and didn't find anything 16 significantly wrong with her neck except the strain pattern 17 in her neck, the hyperextension strain pattern in her neck 18 for which she had been sent to physical therapy for and had 19 gotten all better, but now was being manipulated again and 20 now having pain again. I thought that was important. 21 I thought it was important that she had been seen 22 by the ER physician, her family physician, two different 23 chiropractors and two different orthopedic surgeons prior to 24 seeing me and she had no weakness in her arm, but now she 25 had some weakness in her arm. And seeing all them before, 19 1 she also had no numbness in her arm. And now she had some 2 mild numbness in her arm. I thought that was important. 3 The fact that she had a perfect range of motion 4 of her neck was very important to me. But looking through 5 the records, she almost always had a perfect range of motion 6 as far as Dr. Segal and Dr. Ludwig were concerned. And she 7 had basically been discharged by her family physician 8 because her neck had gotten back to normal also. 9 But most importantly was that she had gone 10 through physical therapy for her neck, for neck 11 stabilization exercises, meaning learning how to use your 12 muscles to move your neck properly like that, and that she 13 had gotten completely better. The therapist had released 14 her with what he said was a full resolution of her pain. 15 And to me, that's what I would expect too. Because most 16 people that get whiplash-type problems, those are the 17 equivalent of strains, sprains of the joints in your neck. 18 Now, an older person, you know, someone over 40, 19 50, 60 with arthritis, they might not get better just 20 because, I mean, they may have some damage to the joints 21 now. But a young person like she was when she got hurt -- 22 she was 17 when she was hurt -- if she is taught properly 23 how to cake care of this, can do great. 24 And that's what I expected to see with that PT 25 report. And that is what I saw in the PT report is that 20 1 stabilization procedures, not manipulation, but 2 stabilization made her better. And, basically, that's what 3 Dr. Segal had put in his notes too that she shouldn't 4 continue with her chiropractic treatments because he thought 5 that might make it worse. I thought it might make it worse. 6 The stabilization procedures made it better, and 7 now she's getting manipulated again. And I think that may 8 be causing some of her pain. I think she needs to stabilize 9 her neck, not to manipulate her neck. She's already got a 10 normal range of motion. She doesn't need more motion. 11 She's got normal motion. She needs to keep the muscles 12 strong. 13 Q Is there some conflict, if you will, between 14 stabilization and manipulation? 15 A Absolutely. 16 Q Could you explain that to the jury? 17 A Stabilization is keeping something from moving. 18 Manipulation is moving it. If you had a person, in my case, 19 come in with a broken arm, I'm not going to keep moving it 20 around and hope that it's going to heal. What I'm going to 21 do is I'm going to put it in a cast and keep it from moving. 22 In the case of a person who has their neck whipped around, 23 I'm not going to keep moving it around. I'm going to try to 24 keep it stable until it's had a chance to heal. 25 This is a perfect example of that. She had 21 I physical therapy for neck stabilization, and she got better. 2 She got better because she had a problem of being whipped 3 around that made the joints in her neck get sprained, for 4 lack of a better word. And she was treated properly with 5 the therapy, and she got better. 6 Now, she's having some aches and pains again and 7 getting manipulated again. And I don't think that's the 8 right thing to do. 9 Q If I recall correctly, Doctor, I believe that 10 there were eight physical therapy sessions at the Hershey Medical Center for the stabilization program. Does that 12 coincide? Is that consistent with your recollection of the 13 records? 14 A I don't remember how many there were, but that 15 sounds about right. 16 Q Do you recall what the records say with regard to 17 her progress and her condition at the completion of that 18 physical therapy program? 19 A Yes. At the completion, it definitely states 20 that her pain had resolved and that she was doing very well. 21 Q Doctor, having seen the patient, having reviewed 22 the medical records, having taken a history from the patient 23 and performed a physical examination, do you have an opinion 24 to a reasonable degree of medical certainty as to whether or 25 not Helen Fultz requires surgical intervention? 22 I A No. That's been pretty well stated by Dr. Ludwig 2 that she does not have instability that is clinically risky, 3 for lack of a better word, that should be treated with a 4 surgical intervention. But, rather, it was treated with 5 physical therapy intervention, and she did excellently. 6 There's no reason that she needs an operation done. 7 Q To the extent that she presently has expressions 8 of pain referable to the neck -- and you described some of 9 that upon palpation -- what would be the course of treatment 10 that would be recommended for such a patient? 11 A If she was my patient, I would use therapy every 12 now and then if necessary. But what I would do and what it 13 sounds like was done is that I would have hooked her up with 14 a therapy place to teach her how to take care of it herself. 15 Because I think if she truly learned how to do the 16 stabilization exercises and would do them every now and then 17 or just get in the habit of doing them every day, I think 18 she would be able to control her problem without any 19 difficulty. 20 Q Doctor, there is some reference in the medical 21 records and I believe that Dr. Segal when we took his 22 deposition recently made a brief reference to the fact that 23 this patient had a seizure or had a couple seizures. Do you 24 recall seeing those references in the medical records? 25 A Yes. 23 1 Q And do you have an opinion to a reasonable degree 2 of medical certainty as to whether or not any of the seizure 3 activity that you noted in the records have any relationship 4 to the motor vehicle accident involved in this case? 5 A I would say there is no relationship at all. The 6 first seizure that she had was when she had a needle stuck 7 in her toe in her family physician's office. I know for a 8 fact myself and by talking with almost every doctor that I 9 know, all of us have seen patients do that. 10 For some reason, some patients when they get 11 stuck with a needle either because of the pain or because of 12 the medicine that is put in will actually pass out, and some 13 of them actually do seize. They actually move. Their eyes 14 roll back, and you actually worry that they might swallow 15 their tongue and stop breathing. 16 That happens. It didn't happen at the accident. 17 It didn't happen at therapy. It happened when she got stuck 18 with a needle. I believe that she had a normal reaction 19 that a lot of people get that is very scary, but it's not 20 related to her accident. 21 Q If I recall correctly, there was a reference in 22 the medical records to a vaso -- can you help me out here? 23 A Vasovagal. 24 Q -- reaction to the injection that you just 25 referenced. 24 I A Right. 2 Q Could you explain what that is to the jury? 3 A Vasovagal means basically your body shuts down. 4 Your vagus nerve is one of the nerves that comes out of your 5 head that goes to your heart and several organs and can 6 actually basically stop things from working. And for some 7 reason that we're not exactly sure why when a stimulus hits 8 the patient, like a needle, like a fall down and break my 9 arm, patients pass out and they can literally seize. 10 And this is what happened in this case. It's a 11 response that your brain can't control. It's not a thinking 12 response. It's an innate response that your body controls 13 somehow, and it happens somehow. But, fortunately, it tends 14 to pass pretty quickly. You just have to make sure the 15 patient is okay when it happens. 16 Q Doctor, in reviewing the medical records, did you 17 see any reference to or documentation of any type of a 18 fracture to the cervical spine? 19 A Yeah. I saw in, I think it was Dr. Innes's 20 notes, that he said that there was a fracture of the 21 uncovertebral joint area. Now, I did not see the x-rays 22 myself. So I can't say. I did not see it, but I read the 23 official radiology reports of those x-rays. I saw 24 Dr. Segal's notes. I saw Dr. Ludwig's notes. They saw the 25 x-rays. They saw the MRI scan, and they said there was no 25 1 fracture. I would have to say there was no fracture. 2 Q In fact, the MRI scan was read as negative. 3 Correct? 4 A Correct. 5 Q Negative means what? 6 A It means normal. 7 Q Perhaps it might help to explain to the jury what 8 an MRI is and how sophisticated it is in its ability to pick 9 up or detect the presence of fractures. 10 A An MRI scan is literally that, a scan of whatever 11 body part you want to do, in this case, a neck. It's not 12 x-rays. It's a magnetic field that orients the electrical 13 charges in each of your cells. Your body is made up of 14 cells. Ail these cells have an electrical field, a positive 15 and a negative. 16 What the MRI scanner does is puts energy in, 17 aligns the electrical field in such a way. And then when 18 the energy is turned off, that energy is given off. And the 19 computer reads the energy given off. And it can make an 20 almost perfect picture of whatever you're looking at, a 21 nerve, a disc, a muscle, a ligament, a tendon. Anything you 22 want, it can do. 23 When it comes to bones, it can't get bony detail 24 as well as a CAT scan because a CAT scan is made of x-rays 25 and x-rays go through bone better. But what an MRI scan is 26 1 better than a CAT scan at as far as bone is concerned is it 2 can tell if there is a fracture that the x-rays can't see. 3 Because what the MRI scan will show is edema or bleeding in 4 the bone that the CAT scan cannot pick up. 5 So if the MRI scan looks at a bone and there's no 6 edema and there's no blood and there's nothing abnormal in 7 the marrow itself, then the bone is okay. And the scan 8 looked at this, and there wasn't anything there. So between 9 the x-rays and between the scan, you can say that there was 10 no fracture. 11 MR. PRICE: Thank you, Doctor. Cross-examine. 12 EXAMINATION 13 BY MR. SADLOCK: 14 Q Doctor, I think twice during your direct 15 examination, you commented upon Miss Fultz'$ telling you 16 about her complaint of pain in terms of her low back. And I 17 believe your referencing -- your statement was that it's 18 common for patients to confuse or forget. Was that correct? 19 A Yeah. Patients do that all the time. 20 Q Doctors do that all the time as well? 21 A They can. But in this case, the ER doctor -- 22 Q Doctor, that was only a simple yes or no 23 question. Do doctors do that as well, yes or no? 24 A As far as -- 25 Q Confuse, sometimes misdocument or not remember 27 1 correctly what may have been told to them. Doctors do that 2 as well. Correct? 3 A I can't comment on other doctors that -- if 4 you're talking about -- 5 Q But you're commenting on whether or not Miss 6 Fultz said something two years ago. 7 A Right. 8 Q But you're saying that you can never comment as 9 to whether a doctor misdiagnoses or mischarts. I guess you 11 A Oh, yeah. Sure, anybody could mischart. But the 12 fact that two different people on several different 13 occasions didn't, I would say, no, it didn't happen. 14 Q Did you review all of Dr. Innes's records? 15 A I reviewed the records that were sent to me. I'm 16 assuming they were all there. 17 Q So you're aware then that when Miss Fultz first 18 saw Dr. Innes on February 7 about two weeks after the 19 accident, she filled out a patient questionnaire and at that 20 time indicated low-back pain. 21 A Right, she did. But the first two that she saw, 22 she didn't. The ER physician and Dr. Sheridan, she didn't. 23 And she saw Dr. Sheridan three times. In none of those 24 appointments was there any mention of any back pain. That 25 is what I testified to. 28 1 Q In your practice, Doctor, have you experienced 2 patients who after a motor vehicle accident have some 3 immediate symptoms and as time wears on and other aches and 4 pains do surface, they report them to you, whether it's a 5 week or ten days after an accident? You've had that happen, 6 I would imagine? 7 A Yes. But not if it -- no. 8 Q Doctor -- 9 A I'm ~oin~ to finish the question. You asked a 10 question, and I'm ~oin~ to finish it. 11 Q I asked a simple yes or no question, if that's 12 happened to you or not. 13 A But it's not a simple yes or no. It's not a 14 simple yes or no. If you want a yes or no, then you ask a 15 yes or no question. 16 Q I did ask you a yes or no question. Doctor, in 17 your practice, yes or no -- 18 A No, no. 19 Q -- have you had patients -- 20 A Yes or no, for a day or two. Ten days later, no. 21 Q Doctor, have you ever been sued before? 22 A Have I been sued? Sure. Everybody -- as far as 23 I know, I don't know any doctor that hasn't been sued. 24 MR. PRICE: Objection. Move to strike. 25 BY MR. SADLOCK: 29 1 Q Have you been sued by my office, Doctor? 2 A By your office? I think I have been sued by your 3 office. I don't -- no. Yeah, I think I probably have. 4 Does that make a difference? No. Have you been treated by 5 my office? 6 Q Doctor, in all cases -- would it be true that not 7 in all cases with a whiplash injury the patient would have 8 guarding? 9 A If they truly had bad pain at least at first, 10 yes, they'd have guarding because they don't want to move 11 their neck around. 12 Q Two years later if they still have some pain, 13 there wouldn't be guarding necessarily? 14 A Not necessarily. If they didn't have pain, they 15 wouldn't have guarding. That's exactly right. No pain; no 16 guarding. 17 Q I didn't say no pain. Decreased pain? 18 A No. You said if they didn't have pain. You can 19 read that back to him if he wants you to. 20 Q The tenderness that you found in physical 21 examination on Miss Fultz, is that associated with a 22 whiplash injury? 23 A I think it probably is, yes. 24 Q And that whiplash injury was directly causally 25 related to the January 23, 2000, motor vehicle accident? 30 1 A Yes. There's nothing in the records of anything 2 else. 3 Q So that pain that you found on examination on 4 April 10th, I believe it was, of 2002 is still related to 5 the automobile accident? 6 A I would have to say yes because she doesn't know 7 of anything else and I can't find anything else. So I would 8 have to say yes. 9 Q And you weren't provided with any records from 10 before January 23 of 2000 to suggest that Miss Fultz had any problem with her neck before the accident. Would that be 12 correct? 13 A Correct. 14 Q Doctor, you did not, as I understand it, attend 15 any chiropractic college? 16 A No. 17 Q You've never been educated or trained in 18 chiropractic care or the treatment that a chiropractor 19 provides to a patient? 20 A Absolutely not. Just like they've never made it 21 to med school. 22 Q Doctor, I believe you -- in referencing 23 Dr. Segal's suggestion to Miss Fultz to go to physical 24 therapy and discontinue chiropractic care, I believe your 25 statement was that you felt that Dr. Segal had indicated 31 1 that he told her that that would make it worse? 2 A No. I said I would assume that's what makes it 3 worse. He did say she should not go to chiropractor care. 4 Q But you don't know why then he -- 5 A No. 6 Q -- suggested that? 7 A I don't know except -- no, I don't know why. 8 You're right. 9 Q When you treat patients, Doctor, do you assume? 10 MR. PRICE: Objection. I1 THE WITNESS: I assume by what patients tell me. 12 Ail of us assume. You assume. We all assume at times. And 13 then I ask the patient if my assumption is correct. So I 14 follow up on my assumptions. 15 BY MR. SADLOCK: 16 Q And you didn't follow up on Dr. Segal? 17 A How was I supposed to follow up on that? 18 Q Well, you know Dr. Segal. Correct? 19 A But that's his records, and I'm not allowed to 20 ask him something unless the patient says it's okay. And 21 I'm sure you probably told your patient never to sign a 22 release to let us sign anything. Did you? 23 Q Doctor, you didn't speak with -- yes or no, did 24 you speak with Dr. Sheridan? 25 A No, I did not speak with -- 32 1 Q Yes or no, did you speak with Dr. Innes? 2 A If you will let me answer everything, I will. 3 Q Yes or no, did you speak with Dr. Turnpaugh? 4 A No, I didn't. 5 Q Yes or no, did you speak with Dr. Segal? 6 A No. 7 Q Did you speak with Dr. Ludwig? 8 A No. 9 Q Did you speak with the emergency room doctor? 10 A No. 11 Q Did you speak with -- 12 A Am I allowed to speak with them? No. 13 Q Did you speak -- 14 A So, no, I did not break the law. Thank you. 15 Q Did you speak with Mrs. Fultz -- Miss Fultz's 16 mother, Mrs. Fultz? 17 A Mrs. Fultz's mother? No. If she had been in the 18 office, I would have spoke to her. But she wasn't there. 19 Q And you did not review any x-ray films? 20 A Correct. I had said that before. 21 Q In discussing the discrepancy between Dr. Innes's 22 finding on x-ray versus other interpretations, if Miss Fultz 23 were a patient of yours and there was that discrepancy 24 between findings and reports, would you yourself want to see 25 the film then to make your own independent judgment of that 33 1 film? 2 A I would, but I would also want to see the other 3 ones too. Because if the other x-rays were normal and the 4 MRI scan was normal, then that would be enough for me if she 5 was my own patient. 6 She was Dr. Segal's patient, and she was Dr. 7 Ludwig's patient. And they did check, and they said there 8 was no fracture. So I would assume that there is no 9 fracture. 10 Q Doctor, you mentioned that Miss Fultz told you 11 she was working as a cashier and going to Thompson 12 Institute. Did you discuss with her what her educational 13 goals were or what her employment goals were at any -- 14 A No. 15 Q Doctor, is it possible for seizures to develop 16 from a cervical hyperextension/hyperflexion injury? 17 A In this case, no. 18 Q I didn't say in this case. I said, Is it 19 possible, yes or no, in the medical field? 20 A If you would have something like a syrinx form, 21 damage to the cord that could cause swelling, yes. But her 22 MRI scan is very clear that there is no damage. So in this 23 case, no. 24 Q You did not take any x-rays, as I understand. Is 25 that correct? 34 1 A NO. You've asked me that before that I've not 2 seen any x-rays. 3 Q No. I asked if you took any. 4 A If I had taken them, I would have seen them. I 5 did not see any x-rays. 6 Q Doctor, when you were -- you mentioned that you 7 thought Miss Fultz should undergo some physical therapy now 8 and learn some exercises now, is that still for her need 9 because of her accident-related injury? 10 A Yeah. I think if she would learn how to do it, 11 then she could take care of herself and not need to be 12 treated by anybody anymore. 13 Q And did you review Dr. Turnpaugh's deposition? 14 A I've not seen anyone's deposition. 15 MR. SADLOCK: Thank you, Doctor. I have nothing 16 further. 17 EXAMINATION 18 BY MR. PRICE: 19 Q Doctor, let me just follow up on one thing. You 20 were asked a series of questions about whether you had 21 spoken with any of the healthcare providers that had had 22 contact with Miss Fultz before you conducted your IME. 23 Is there some reason in the law as you understand 24 as to why you -- strike that -- as to when you are able and 25 under what circumstances you would be able to contact a 35 1 patient's other healthcare providers? 2 MR. SADLOCK: I'll object that the doctor is not 3 offered as a legal expert. 4 THE WITNESS: In the law -- and I know this very 5 well because we're told this in medical school -- patients 6 have rights to keep their records confidential. Unless the 7 patient signs a waiver for me to ask a doctor, then I can't. 8 I'm not allowed to do that, and a doctor is not allowed to 9 tell me. 10 Now, if you send me records, I'm allowed to look 11 at the records because obviously the patient would have 12 already signed for them or you wouldn't have been able to 13 get them to give to me. But the records are one thing. 14 Askin9 a doctor his opinion or what the patient 15 looked like to him, I can't do that because that is truly 16 confidential to the patient. And unless the patient tells 17 me directly and writes -- 9ives me something directly, then 18 I'm not allowed to do that. I wouldn't do that to one of my 19 patients to someone else, and no other physician is ~oin~ to 20 do that either because that is confidential for the patient. 21 BY MR. PRICE: 22 Q The relationships that you have with your various 23 patients, that's a confidential relationship. Is it not? 24 A Yes. 25 Q If I want to ~et records of one of your patients, 36 1 I would have to send you either a subpoena or a signed 2 authorization by the patient to release those records to me? 3 A Absolutely. 4 MR. PRICE: That's all I have. Thank you. 5 EXAMINATION 6 BY MR. SADLOCK: 7 Q Doctor, when Miss Fultz was being examined by you 8 on April 10, 2002, did you ever present her with an 9 authorization for you to have contact with any of her 10 physicians? 11 A No. 12 MR. SADLOCK: Thank you. 13 MR. ASHWAY: This videotape deposition is now 14 concluded. The time of day is 9:02 a.m. 15 (Whereupon, the deposition was concluded at 9:02 16 a.m.) 17 18 19 2O 21 22 23 24 25 37 1 COUNTY OF DAUPHIN : SS 2 COMMONWEALTH OF PENNSYLV~uNIA : 3 4 I, Pamela S. Sullivan, a Notary Public, authorized to 5 administer oaths within and for the Commonwealth of 6 Pennsylvania, do hereby certify that the foregoing is the 7 testimony of Robert R. Dahmus, M.D. 8 I further certify that before the taking of said 9 deposition, the witness was duly sworn; that the questions 10 and answers were taken down stenographically by the said 11 Reporter-Notary Public, and afterwards reduced to 12 typewriting under the direction of the said Reporter. 13 I further certify that the said deposition was taken 14 at the time and place specified in the caption sheet hereof. 15 I further certify that I am not a relative or employee 16 or attorney or counsel to any of the parties, or a relative 17 or employee of such attorney of counsel, or financially 18 interested directly or indirectly in this action. 19 I further certify that the said deposition 20 constitutes a true record of the testimony given by the said 21 witness. 22 IN WITNESS WHEREOF, I have hereunto set my hand this 23 18th day of April, 2002. ~.,...~ ~ ) . , 24 PAME~ S. SU~V~.No~'yP~ SwsmmT~.,O~nCeu~ ~amela S. Sullivan 25 M~O0mmim~Jan. 31,~15 Reporter-Notary Public WORD INDEX Multi-PagoTM 10 - coils ROBERT R. DAHMUS, M.D. able [4] 22:18 34:24 12:16 12:17 14:21 bit[al 12:16 14:11 -I- 34:25 35:12 14:22 14:23 14:24 blccding pi 26:3 10[al 2:4 36:8 abaotmnl all 26:6 15:12 15:12 15:13 blood m 26:6 18:24 18:25 19:1 1 0th lal 10:6 30:4 abnormalities HI 14:19 19:2 20:19 24:9 board [91 5:I 1 5:I 2 5:20 5:22 6:12 14thHI 5:2 abg~nc~ aH 15:23 n."m8 iai 4:18 12:10 6:13 6:14 6:18 155pi 3:2 Absolutely [31 20:15 aflhl'iti$ [21 4:14 6:23 30:20 36:3 19:19 17[il 19:22 accident [lal 10:17 bodieS[il 14:2 181q 1:13 10:21 16:10 23:4 ~'ts IH 5:5 body[si 4:15 24:3 18th [al 3:3 37:23 23:16 23:20 27:19 Ashway as1 1:26 24:12 25:11 25:13 1953 all 5:2 28:2 28:5 29:25 3:1 3:1 3:14 bono[si 25:25 26:1 1975 pi 5:6 30:5 30:11 36:13 26:4 26:5 26:7 accident-related [ti aasociatc [q 7:11 bones [61 11:24 12:2 197611] 5:7 ~ 34:9 asscciatedp] 29:21 12:3 12:4 14:2 1980 all 5:7 'accidents [11 8:9 association aH 7:24 25:23 1985 [2] 5:11 5:15 according pi 18:11 8:24 9:15 bony pi 25:23 1987pl 5:]2 accredited ail 5:23 aasulnc [8112:20 31:2 borfl ail 5:2 31:9 31:11 31:12 bothcF [21 13:23 13:24 1995121 5:13 6:16 ach~ [21 21:6 28:3 31:12 31:12 33:8 Ist [11 5:15 action[al 1:4 37:18 assnmi~lg [21 9:7 bothered pi 13:23 active[s] 4:20 5:14 27:16 bottom[si 4:8 11:25 -2- 7:9 ass-mption pi 31:13 12:2 14:13 14:20 2000 12l 29:25 30:10 activity [q 23:3 assnmptions [q 31:14 brain[il 24:11 2001=2979 pi 1:5 sdmi~listor iH 37:5 atrophy[si 15:2 bmad-and-butt~r p] 200215] 1:13 3:3 affects pl 4:15 15:4 15:6 15:7 - 9:3 30:4 36:8 37:23 afterwards pi 37:11 15:14 15:15 15:20 break [2l 24:8 32:14 23[21 29:25 30:10 again [12] 7:14 9:7 15:23 breastbone pi 16:14 26pl 2:5 9:7 11:7 11:8 attend pi 30:14 breathing [11 23:15 16:18 16:23 18:19 attorney [21 37:16 brief Hi 22:22 -3- 18:20 20:7 21:6 37:17 briefly [4] 4:2 5:3 21:7 authorization [2l 36:2 5:19 10:24 3pi 2:4 IIgo [31 9:14 10:18 36:9 bring [21 12:25 13:1 34UI 2:4 27:6 authorized [11 37:4 bfokg/I aH 20:19 36[11 2:5 agree pi 7:25 auto[il 16:10 agFccd 12] 13:13 17:9 automobile [21 10:17 -C- -4= Albright [11 3:17 30:5 4011J 19:18 aligns[ti 25:17 Avenue [21 1:16 C[q 1:20 450[2] hi6 3:4 allowed [6l 31:19 3:5 cal~ all 19:23 32:12 35:8 35:8 awaro[a] 10:16 27:17 cannot[il 26:4 35:10 35:18 away[si 15:7 15:21 captien [213:6 37:14 =5= almost [41 7:11 19:5 16:16 16:16 16:22 cato Ho] 4:5 4:11 50111 19:19 23:8 25:20 4:12 4:14 19:23 along [11 18:6 -B- 22:14 30:18 30:24 -6- always HI 19:5 31:3 34:11 60[11 19:19 Am~icen [21 5:12 background all 5:4 ca.fully [11 14:5 7:24 bad ill 29:9 o88o[171 3:6 10:5 -7- amount ltl 13:16 became IH 5:11 10:16 10:25 11:2 AN(~IIqO all 1:22 bcd [21 15:9 15:10 11:2 11:8 18:1 20:18 20:22 23:4 7pi 27:18 anolnalics [1] 9:1 beginning [31 4:9 24:10 25:11 26:21 16:18 18:lO -8- answer [1l 32:2 33:17 33:18 33:23 answoFS[ll 37:10 behalf[il 3:8 cases[6] 6:10 9:1 8[11 2:5 anticipating[il 8:2] below pi 12:9 9:1 9:20 29:6 8:20 pl 1:13 anyone's [11 34:14 b~ltgd all 16:11 29:7 8:22[1l 3:4 APPEARANCESpl bcttOF[14] 11:17 14:1 cashier[21 17:14 33:11 1:18 18:19 19:13 19:19 cast [61 15:9 15:9 20:2 20:6 21:1 15:11 15:11 15:12 -9- appointments at i 27:24 21:2 21:4 21:5 20:21 9:02 ral 36:14 36:15 April 161 I:13 3:3 22:3 25:25 26:1 CAT [4] 25:24 25:24 10:6 30:4 36:8 botw~.'ll Is] 20:13 26:1 26:4 37:23 26:8 26:9 32:21 cansnlly Hi 29:24 -A- al~a [si 5:15 6:3 32:24 a.m [41 1:13 3:4 6:5 14:12 24:21 big[il 12:6 call$ing pi 20:8 36:14 36:16 Ilti~8 [11 10:16 birth[il 5:1 cc]Is[al 25:13 25:14 ability[il 25:8 arm [l?l 12:14 12:15 25:14 HUOHES, ALBRIOHT, FOLTZ & NATALE Index Page I 71 7=540=0220~7 i 7=393=51 01 center = exm'~ises Muiti=Pag~ TM ROBERT R. DAHMUS, M.D. center [si 5:8 7:12 conferences pi 6:25 34:13 34:14 36:13 31:16 31:18 31:24 7:17 8:20 8:25 confidb'ntiai [41 35:6 36:15 37:9 37:13 32:1 32:3 32:5 21:11 35:16 35:20 35:23 37:19 32:7 32:21 33:6 Cc~tt~/towll Ill 8:24 conflict pi 20:13 dc~crib~ [11 10:24 33:6 34:13 certainty [21 21:24 confuse [~1 18:12 described p i 22:8 Drive pl 3:2 23:2 26:18 26:25 detail pi 25:23 dropped ill 7:25 certificate ill 7:3 congenital Iai 4:13 detect pl 25:9 duly[al 3:20 37:9 certification [~1 6:18 9:1 develop pi 33:15 during [21 6:1 26:14 6:20 7:3 consistent pi 21:12 dictate pi 11:9 certified pi 5:11 constitutes Pl 37:20 diffcm-ncc [al 16:2 -E- 5:20 5:22 6:12 6:13 6:14 6:23 contact[3134:22 34:25 29:4 odcl~a[2! 26:3 26:6 36:9 different Iai 6:10 ~dneat~d iii 30:17 certify [si 37:6 37:8 continue I~1 14:9 12:20 12:21 12:22 education pi 7:1 37:13 37:15 37:19 20:4 18:22 18:23 27:12 ~crvicnl [61 4:9 control Iai 22:18 24:11 27:12 7:5 17:12 11:21 12:1 13:10 educational [21 5:4 24:18 33:16 controls pi 24:12 difficulty pi 22:19 33:12 chairman[el 7:13 cord iH 33:21 dilcct pi 26:14 eight p i 21:10 7:15 9:8 correct pal 10:12 direction pi 37:12 ~idicr [*1 12:6 15:16 chance iii 20:24 10:22 25:3 25:4 directly 141 29:24 17:12 23:11 35:20 charges pi 25:13 26:18 27:2 30:12 35:17 35:17 37:18 36:1 30:13 31:13 31:18 disc[il 25:21 cltk.la~¢nl lei 25:12 ~lcclr [H 33:7 32:20 33:25 discharged[il 19:7 25:14 25:17 chin HI 16:13 ~ormctly [el 21:9 discipline[i] 4:4 ~llaCrgcncy [11 32:9 ~liropl~ctic [~] 17:20 23:21 27:1 20:4 30:15 30:18 ~ounscl [4] 3:10 discontinue p] 30:24 ~nlploycc 12j 37:15 30:24 3:11 37:16 37:17 ~[iscl~epancics ti i 11:9 37:17 ~hiropractor [41 17:6 Cotmty [311:2 7:22 discrepancy [21 32:21 ~mploym~t 12l 17:12 17:8 30:18 31:3 37:1 32:23 33:13 ~liropractorspl 18:23 couple[71 6:22 7:23 discs[il 9:4 cl~qgy[41 25:16 25:18 circumst~c~s [11 34:25 7:24 9:14 11:8 discliss IH 33:12 25:18 25:19 CIVIL pi 1:4 17:1 22:23 discussing[il 32:21 equivalent pi 19:17 clear[el 10:9 18:11 course [~1 8:2 17:3 doctor [4H 4:20 7:7 M-R [61 16:20 16:24 33:22 22:9 8:15 8:19 9:23 17:4 18:22 26:21 clinically pi 22:2 court[al 1:1 3:14 14:9 16:21 16:25 27:22 clubfal 4:13 9:20 Cntig [al 1:26 3:1 17:5 21:9 21:21 g-specially pi 15:11 22:20 23:8 24:16 I~SQUIRE iai 1:20 coincide pi 21:12 Cross-oxnmino [H 26:11 26:11 26:14 26:21 1:23 college pi 30:15 CUMBERLAND p] 26:22 27:9 28:1 cvaluatcd pi 18:14 column [I 18:6 1:2 28:8 28:16 28:21 evaluation pi 11:1 comment [el 6:6 28:23 29:1 29:6 27:3 27:8 -D- 30:14 30:22 31:9 everybody lei 6:19 31:23 32:9 33:10 18:6 28:22 commented [i i 26:15 Dnhmus [71 1:9 33:15 34:6 34:15 ~'ctywh~'~l~ [ i ] 6:4 ~tingPl 27:5 2:3 3:8 3:19 34:19 35:2 35:7 cxn~.tly [~17:15 24:7 common [~] 1:1 3:24 10:3 37:7 35:8 35:14 36:7 29:15 18:12 26:]8 d~lllSgC [~l 19:20 33:21 doctors [~l 6:5 26:20 exam [~l 5:25 6:9 Commonwoalth iai 37:2 33:22 26:23 27:1 27:3 7:6 11:14 13:5 37:5 dato lei 1:13 3:3 docul~tatio~ [i] 24:17 xami~lation [1~1 2:2 community IH 9:6 5:1 doesn't Iai 20:10 30:6 3:21 8:17 10:1 Dauphin [zi 7:22 done [~] 8:20 9:8 10:10 11:13 11:19 compared iai 12:16 37:1 11:20 14:10 16:4 14:22 15:13 11:17 15:18 22:6 complained[il 14:21 d~ys iai 28:5 28:20 22:13 17:24 21:23 26:12 26:15 29:21 30:3 complaint pi 26:16 d~al iai 4:17 4:18 down [9] 4:9 11:23 34:17 36:5 completed pi 5:23 l~ccrc~scd [i] 29:17 11:25 12:7 12:25 Defendant [41 1:7 16:13 24:3 24:8 Xnmine [el 10:4 completely pl 19:13 1:10 1:21 3:9 37:10 11:5 11:5 completion [31 16:3 definitely m 11:20 Dr14ol 9:10 9:11 cxnmi~lod [1] 36:7 21:17 21:19 12:22 21:19 9:12 9:13 9:18 Cxnmplc [11 20:25 computer p] 25:19 degenerative pi 4:14 9:19 9:22 10:3 ©xccllcntly pi 22:5 17:6 17:6 17:7 except lei 13:5 18:16 coocoFnod 12l 19:6 degree IS] 5:5 5:6 17:8 17:21 18:13 31:7 26:1 5:7 21:24 23:1 18:14 19:6 19:6 concluded iai 36:14 DEMANDED[ii 1:7 20:3 22:1 22:21 exercise pi 5:6 36:15 condition [ti 21:17 deposition psi 1:9 24:19 24:24 24:24 exorcises m 19:11 3:4 3:8 22:22 27:14 27:18 27:22 22:16 34:8 conducted pi 34:22 27:23 30:23 30:25 Index Page 2 HUGHES, ALBRIGHT, FOLTZ & NATALE 717-540-0220W 17-393-51 Multi=PageTM expect - least ROBERT R. DAHMUS, M.D. ~xpccttll 19:15 foundl4] 14:20 18:3 h~l~b~[l] 37:6 32=21 expected [11 19:24 29:20 30:3 I~l~of U ] 37:14 instability nl 13:25 ~xpcricnccd ill 28:1 fottl' ill 6:9 hereunto[il 37:22 14:1 22:2 cxpcl'[ [2] 8:16 35:3 fout=y~ar ill 5:10 herniated[il 9:4 Instituf~ [41 1:14 4:24 17:15 33:12 · xplain [414:2 6:10 fta~tttr~ [8] 24:18 ]IClY~lf [41 3:15 11:12 15:5 20:16 24:2 24:20 25:1 25:1 22:14 34:11 intact[ii 14:14 25:7 26:2 26:10 33:8 Herslmy [61 5:8 intcnmtcd [il 37:18 · xprcssions ill 22:7 33:9 7:18 8:20 8:24 interesting 111 9:1 fractures [2] 4:12 9:10 21:10 internship [ti 5:9 · xtcnt[ll 22:7 25:9 history[6] 10:14 11:15 in~rpr~tations[ll 32:22 ~-xt,~.,.~ti©s [il 14:18 Dont [11 13:14 16:4 16:7 17:23 intm'vention [31 21:25 . e~c8 ill 23:13 fllll [51 12:24 13:9 21:22 22:4 22:5 14:17 14:18 19:14 hit[31 13:14 16:]2 introduce[il 3:10 =F= full-tinE [21 17:13 16:13 involve ii 16:17 f~'t II] 14:12 17:14 hi~s ti1 24:7 involved [41 4:20 fact [6] 18:5 19:3 Fu]tz [191 1:1 3:6 hold [21 7:7 14:2 8:8 10:17 23:4 22:22 23:8 25:2 3:12 10:4 11:1 Holylli 16:15 27:12 16:4 21:25 27:6 involves ill 4:6 27:17 29:21 30:10 hooked [il 22:13 involving[al 8:5 fail [11 13:16 30:23 32:15 32:16 hope ill 20:20 8:12 fall[il 24:8 32:22 33:10 34:7 Hospital[il 16:15 itself iai 11:22 26:7 familiar Ill 9:18 34:22 36:7 hospitals[il 5:14 family[61 16:21 16:25 Fuitz's[31 26:15 32:15 [-luglx~[lla:17 -J- 17:5 18:22 19:7 32:17 hllrt [41 13:3 14:3 Janum¥ [21 29:25 23:7 fllturc [il 8:22 19:21 19:22 30:10 far [61 16:13 18:3 hurts [21 13:19 15:17 joint ill 24:21 19:6 26:1 26:24 28:22 hyporcxtcnsJon[ll 18:17 joints[41 4:7 19:17 F©brllnly ill 27:18 gaug© ill 12:19 hypcrcxtcusion/hylmrfl©xion 19:20 21:3 f~[4l 4:13 9:20 gcncFal [21 5:5 5:9 Ill 33:16 ]foycc DI 1:6 3:7 12:12 12:13 given iai 25:18 25:19 3:13 felt ill 30:25 37:20 -!= judgment ill 32:25 Field 141 25:12 25:14 goals [al 33:13 33:13 identify Ill 3:14 July Ill 5:15 25:17 33:19 goes [21 12:6 24:5 Ilnagcs [il 3:2 Jul~ Ill 5:11 ill]od[il 27:19 gone ill 19:9 mangin¢ 1ti 28:6 [Izry [91 1:7 4:2 film [al 32:25 33:1 good[al 9:23 14:8 IME[11 34:22 5:3 5:19 10:9 10:24 20:16 24:2 film[il 32:19 14:25 nnmtMiatc ill 28:3 25:7 financially ill 37:17 gniduatcd ill 6:19 immobile [il 15:19 finding [2j 13:9 32:22 ga:at [21 14:7 19:23 findings [4] 11:18 group [2l 4:23 4:24 important18:5 [8118:9 18:1318:4 -K- 16:6 17:25 32:24 gaaFding [6] 14:5 18:20 18:21 19:2 kc~p [si 6:24 15:19 fingers [il 11:23 29:8 29:10 29:13 19:4 20:11 20:19 20:21 finish [21 28:9 28:10 29:15 29:16 inlportnntly ill 19:9 20:23 20:24 35:6 finishing ill 5:11 guess [11 27:9 including[il 8:12 keeping ill 20:17 f'lrst [81 5:23 11:11 independent [21 10:25 Kent [21 1:20 3:13 15:5 17:4 23:6 -H- 32:25 Iridncys ill 4:17 27:17 27:21 29:9 habit[il 22:17 indicate [11 15:24 kind[al 11:16 13:18 five[il 6:9 HAFER[ll 1:19 indicated[al 6:16 k]lcc [11 9:3 fl©xion/cxtcnsion-typc[ll hand[il 37:22 27:20 30:25 know~[ll 15:8 18:8 Harrisburg[al 1:17 indil~'ctly [11 37:18 fo]Iow [41 31:14 31:16 3:5 5:15 information [~1 17:11 -L- 31:17 34:19 h~8d[61 4:8 12:25 injection[il 23:24 LS-SI ill 14:12 followed ill 5:10 13:1 13:14 16:11 injurod ill 15:8 lack[al 14:1 21:4 Following[il 16:3 16:12 18:5 24:5 injuri©s [21 4:11 22:3 follows[il 3:20 heal[al 20:20 20:24 9:3 law[41 1:4 32:14 Foltz[ll 3:17 Imalthcarc[21 34:21 injuryt~l 13:12 18:7 34:23 35:4 foregoing ill 37:6 35:1 18:7 18:8 29:7 lay[il 15:8 forg©t ill 26:18 hem' ill 11:15 29:22 29:24 33:16 forgot ill 17:2 heart [21 4:18 24:5 34:9 lcaFn [21 34:8 34:10 fOlln[ll 33:20 l-I©lcn[41 1:1 3:6 innat~[l] 24:12 I©amcd[216:l 22:15 forth[il 13:15 10:4 21:25 Inncs iai 17:6 27:18 I©arfling ill 19:11 fortunntcly ill 24:13 help [21 23:22 25:7 32:1 least[al 6:5 6:9 helps [21 4:7 4:15 lnnos's [al 24:19 27:14 29:9 HUGHES, ALBRIOHT FOL'FZ & NATALE Index Page 717=540=0220~717-393-5 i 01 left - pain Multi-PageT~ ROBERT R. DAHMUS, M.D. ~ft[M 12:14 12:16 m~dical [atl 7:12 oaths[il 37:5 14:23 7:17 7:22 7:22 =N- obj~'t iii 35:2 leg[ii 14:15 7:24 8:12 8:20 lO:lO 10:13 10:14 flank-- Iai 2:2 3:1 Objection Iai 28:24 iogal [2] 10:16 35:3 10:25 21:11 21:22 3:7 3:16 3:23 31:10 logs[si 4:18 12:11 21:24 22:20 22:24 Nsta]O[ll 3:17 obtain[t] 16:4 12:12 12:13 14:15 23:2 23:22 24:16 no¢oasurJly iai 29:13 obtainod 11 ] 17:23 lioen~od ill 5:16 33:19 35:5 29:14 obviously [21 7:14 ligament ill 25:21 medicine [si 4:5 necessary Ui 22:12 35:11 ligaments [Sl 4:7 5:16 17:17 17:17 nodt [Sll 8:12 12:1 occasion[il 17:25 8:13 14:2 23:12 12:2 12:7 12:24 acoasion$ ill 27:13 Lion ill 3:2 mmnber iai 7:19 13:5 13:7 13:17 off[f[ 15:10 15:12 literally[al 24:9 7:21 7:24 13:18 14:3 14:20 25:18 25:18 25:19 25:10 mention iH 27:24 16:15 18:7 18:16 liver ill 4:17 m~ntionod iai 8:19 18:17 18:17 19:4 offered[il 35:3 LLPui 1:19 33:10 34:6 19:8 19:10 19:10 office [~1 11:6 11:13 look iai 15:12 35:10 mid-portion iai 11:21 19:12 19:17 20:9 23:7 29:1 29:2 11:25 20:9 20:22 21:1 29:3 29:5 32:18 Iookodlnl 16:17 18:14 mlddleul 12:1 21:3 22:8 25:I1 offi¢iallll24:23 26:8 35:15 29:11 30:11 older iai 6:22 19:18 Ioolring [21 19:4 might[fl 19:19 20:5 need pi 20:10 34:8 on¢o iai 6:8 7:13 25:20 20:5 23:14 25:7 34:11 One[to] 9:9 12:22 [OO1rSUI 26:5 mildial 14:J 19:2 noodlo[41 23:6 23:11 15:22 16:1 16:2 loose [ti 7:12 misohafl [il 27:11 23:18 24:8 24:4 34:19 35:13 Iow 11[ 26:16 miga~ [i] 27:9 needs iai 20:8 20:11 35:18 35:25 low-back[Il 27:20 misdia~uo~s 111 27:9 22:6 on~-y~ar ill 5:9 lower iai 14:17 14:18 misdocumcnt ill 26:25 tmgativ~ [41 14:15 on~ ill 33:3 Llulwig [71 9:12 Miss IiSI 3:12 I1:1 25:2 25:5 25:15 operation[al 15:18 9:13 17:7 18:14 16:4 26:15 27:5 noTvo [4] 14:16 14:16 22:6 19:6 22:1 32:7 27:17 29:21 30:10 24:4 25:21 opinion[s] 21:23 30:23 32:15 32:22 I~I~S is] 15:20 15:21 23:1 35:14 Ludwig's [21 24:24 33:10 34:7 34:22 24:4 opportunity[l] 10:4 33:7 36:7 neurologically itI 14:14 opposed ill 10:11 lumps[il 13:6 month[il 17:22 n~v~r[Sl 6:23 27:8 lungs itl 4:18 most[si 13:25 19:9 30:17 30:20 31:21 oral ill 6:9 19:15 sow iii 7:13 Ol~r [4] 5:22 6:18 6:20 7:3 -M- mother [2] 32:16 32:17 nice 1][ 13:5 organizations pi 7:20 Mlal 1:6 3:7 motion 1si 12:24 13:9 none ill 27:23 14:7 19:3 19:5 nontender fsi 12:10 O~anS [Il 24:5 M.D Iai 1:9 2:3 20:[0 20:10 20:11 orients [11 25:12 3:19 5:7 37:7 12:11 magnb~ic [i] 25:12 motor [4l 8:9 23:4 normal [Ztl 12:11 orthopedic iisi 1:14 mnlntain iai 6:18 28:2 29:25 12:12 12:13 12:14 4:1 4:3 4:4 6:20 7:3 move[IS] 6:3 13:18 19:8 20:10 20:11 4:24 5:10 5:12 13:19 13:21 13:22 23:18 25:6 33:3 5:13 5:22 5:24 S~S [1] 31:2 13:24 14:4 14:4 33:4 6:10 6:13 7:10 manipulate[ti 20:9 14:6 14:24 14:25 ]~[otury it! 37:4 8:16 18:23 manipulated iai 18:19 19:12 23:13 28:24 oflhop~dics [2] 7:21 20:7 21:7 29:10 noted[il 23:3 9:3 manipulation ts] 20:1 moving iai 20:17 20:18 notes [41 20:3 24:20 orthopcdist [il 9:19 20:14 20:18 20:19 20:21 20:23 24:24 24:24 Oth~rwi~ iii 16:1 manipulations[il 17:20 MIL[[itl 18:15 24:25 nothing[n] 9:25 InalTOW Ill 26:7 25:2 25:8 25:10 26:6 30:1 34:15 ought[il 15:5 25:16 25:25 26:3 now[all 6:20 7:2 ontwatd ill 15:2 Master*s [1] 5:6 26:5 33:4 33:22 10:13 17:7 17:17 owu iai 4:23 32:25 naRy[si 19:20 20:7 Mrn la] 32:15 32:16 18:9 18:19 18:20 33:5 27:1 32:17 18:24 19:1 19:18 '~an [4] 13:12 14:24 MS[ii 3:16 19:21 20:7 21:6 -p- 22:12 22:16 24:21 15:6 19:20 most'JO[il 12:6 12:6 34:7 34:8 35:10 P[al 1:1 3:6 n~aning pi 11:22 15:7 15:15 15:16 36:13 P.C[ii 1:22 12:25 ]9:11 15:22 25:21 nubbins[u 11:24 )nih [291 13:17 13:17 means [ill 4:6 5:19 muscles [iOl 4:6 nulnbocss is] 12:16 13:18 14:8 16:15 7:5 14:16 15:7 8:13 12:3 12:9 15:14 15:15 15:25 13:20 15:13 15:20 12:18 14:21 19:1 16:16 16:20 16:21 24:3 25:5 25:6 16:1 19:12 20:11 19:2 16:22 16:24 16:25 18:10 18:20 19:14 ngd Iai 5:8 8:24 musculoskcictai [ti 20:8 21:20 22:8 8:25 9:5 30:21 4:5 -O- 23:11 26:16 27:20 Index Page 4 HUGHES, ALBRIGHT, FOLTZ & NATALE 7 ! 7=540=0220~717=393=5 ! Multi-PageTM pains - reviewed ROBERT R. DAHMUS, M.D. 27:24 29:9 29:12 19:21 20:18 20:22 prOgreSS [I] 21:17 13:4 13:12 16:9 29:14 29:15 29:17 physical [lsl 11:13 properly [si 19:12 16:17 16:19 16:23 29:17 29:18 30:3 11:14 11:18 16:3 19:22 21:4 16:24 17:10 17:24 17:25 18:2 18:3 )aiu$ [2] 21:6 28:4 17:18 18:18 19:10 provido [21 5:3 18:11 19:5 21:13 palpatod 121 11:22 21:1 21:10 21:18 10:13 21:16 21:22 22:21 13:6 21:23 22:5 29:20 provid~1121 10:20 22:24 23:3 23:22 30:23 34:7 palpation [41 12:10 30:9 24:16 27:14 27:15 12:11 14:12 22:9 physician fsi 8:24 provide~ [21 34:21 30:1 30:9 31:19 10:11 15:24 18:22 Pnm ill 3:16 18:22 19:7 27:22 35:1 35:6 35:10 35:11 Pnlnoln [~1 1:11 37:4 35:19 providog 111 30:19 35:13 35:25 36:2 37:24 physician's[il 23:7 PTI21 19:24 19:25 R~d Ill 3:2 )art[si 4:15 I1:11 physicians[il 36:10 Public[al 1:12 37:4 reduced[il 37:11 25:11 37:11 37:25 refOF Ill 15:5 particular[il 13:8 physiology[il 5:7 )ick [21 25:8 26:4 pul'po~o Ill 10:10 refutable H i 22:8 }aFticslll 37:16 JicturC[ll 25:20 push[il 13:23 reference[41 22:20 }sass[?] 5:24 6:2 put[si 11:22 12:18 22:22 23:21 24:17 6:8 6:11 23:12 )inching[il 14:16 20:3 20:21 23:12 rt:f©rcnced [11 23:25 24:9 24:14 Piullncl© [21 7:9 Juts ti] 25:16 I'Of~a~hce8 [11 22:24 passongcr 121 13:13 7:9 refcroncing [21 26:17 16:10 }lac~ 14] 1:14 6:4 passing [117:6 22:14 37:14 _~)- 30:22 pa~t [31 8:21 8:23 Plaintiff[si 1:2 qualified ill 8:16 referring[il 7:17 10:14 1:24 10:4 qanstionnaim ill 27:19 regard Ill 21:16 patient [sol 10:7 PLEAS IH 1:1 questions [21 34:20 regarding HI 10:14 11:3 11:4 11:4 ~oint ti] 7:13 37:9 reginmnted iq 7:14 11:5 13:9 21:21 ~olitical ill 7:25 quicldy [21 14:6 rehab iii 17:19 21:22 22:10 22:11 )o~itions Ill 7:8 24:14 related iii 23:20 29:25 22:23 24:8 24:15 30:4 27:19 29:7 30:19 po~itive ill 25:14 31:13 31:20 31:21 possible[si 17:1 =g= relationship [41 8:19 23:3 23:5 35:23 32:23 33:5 33:6 33:15 33:19 R[Sl 1:9 2:3 relationships[il 35:22 33:7 35:7 35:11 Powcr~ [21 1:16 3:5 3:7 3:19 37:7 relative 121 37:15 35:14 35:16 35:16 practice [iOl 4:21 nldiolog~ [H 24:23 37:16 35:20 36:2 4:23 5:16 6:2 raisingti] 14:15 r~lca~[21 31:22 36:2 mtiont's [21 12:19 6:15 8:2 8:16 35:1 9:16 28:1 28:17 tango iii 12:24 13:9 relca~,-d ill 19:13 19:3 19:5 20:10 ~aticntg [141 18:12 pre~nce [11 25:9 rath~r [il 22:4 relevance [~1 13:8 23:9 23:10 24:9 15:4 18:1 26:18 26:19 28:2 pre~ent [si 1:25 10:22 re-reading [q 17:25 36:8 relevant ill 11:18 28:19 31:9 31:11 maction [21 23:18 mmmnber [21 21:14 35:5 35:19 35:23 pm~-nted[H 11:12 23:24 26:25 35:25 presently [11 22:7 read [7] 11:3 11:7 remembered ill 18:10 }IR'tErn[21 18:16 18:17 pretty[3] 13:13 22:1 11:8 16:8 24:22 )ediatri¢ Fa1 9:19 24:14 25:2 29:19 l'~port [4] 11:9 19:25 9:20 Price [l~l 1:20 2:4 rendilag [2113:4 16:19 19:25 28:4 reportoF 12] 3:14 }~Ivis[II 14:13 3:13 3:13 3:22 readS[Il 25:19 8:15 10:2 26:11 37:12 Pennlll 5:6 28:24 31:10 34:18 real [1] 12:18 Rcportot-NoUu~ [~] Pennsylvania[iq 1:2 35:21 36:4 really[si 9:15 12:2 1:12 37:11 37:25 1:15 1:17 3:3 problem[si 13:25 12:21 13:20 17:16 ]~ortillg [il 3:17 3:5 4:25 5:17 15:3 21:2 22:18 reRSOU [$] 16:17 22:6 7:21 7:22 37:2 30:11 23:10 24:7 34:23 report~ [21 24:23 32:24 37:6 )robl~nm [si 4:13 renaonable [2] 21:24 represent [il 3:2 people[91 6:22 8:8 4:14 8:12 11:16 23:1 reqanst[21 10:3 10:11 8:11 9:16 13:16 19:16 recently [21 10:4 requires iq 21:25 13:25 19:16 23:19 27:12 )ruecdures [31 8:5 22:22 residency [41 5:10 pcrf~ct [41 19:3 19:5 20:1 20:6 recertificd [~1 5:13 5:24 6:1 7:10 20:25 25:20 iron.ss [il 11:11 6:17 7:5 msid~nta [il 9:5 p~l~or~] [4] 8:2 prOCeSSeS [H 13:6 receflify [21 6:21 resolution [il 19:14 8:5 11:13 11:14 ,rofcssion ts] 3:25 6:24 resolved[il 21:20 pcrfOFfl~d [il 21:23 5:20 8:11 recollection [11 21:12 respousc [~] 24:11 performing [2] 10:10 irofcssional [i] 7:19 l~'~ol~lllE~dcd [I ] 22:10 24:12 24:12 10:25 IrOgFnm[?] 5:24 recordtll 37:20 review[~l 27:14 32:19 P~l~U~pS Ill 25:7 6:1 7:10 17:18 records [iq 10:13 34:13 p~rsoR iii 11:6 19:18 17:19 21:11 21:18 10:20 11:3 11:7 reviewed [21 21:21 HUOI-IF~, ALBRIGI-rl FOLTZ & NATALE Index Page 5 7 ! 7-540-0220~717=393-5 ! 0 ! rcvims~ng = therapy Multi=PageTM ROBERT R. DAHMUS M.D. 27:15 23:6 spine [121 4:9 4:]9 37:24 reviewing pi 24:16 s~izures [2! 22:23 8:13 11:21 11:22 suppce~d [21 7:13 Fhomboids ill 12:8 33:15 11:23 12:1 13:10 31:17 Richard t2] 1:23 solid [si 9:17 9:2! 14:13 14:17 14:17 3:1] 11:9 35:10 36:1 24:18 8UFfaC~ [I 1 28:4 F~gh~H?l 9:19 12:9 senzation[~! 12:13 spinest2] 9:14 9:16 surgeon[~14:3 4:4 4:1 12:15 12:15 14:13 12:14 14:18 spJnous t~l 13:6 $~8 [4] 5:12 14:22 15:21 16:15 sent [3] 16:9 18:!8 Spirit[t] 16:15 6:10 6:13 18:23 16:16 16:22 21:8 27:15 apo]tO HI 32:18 8ttlgCriC8 [1] 8:3 21:15 24:1 27:7 Scpt~qllbcF [11 5:2 8po]~ll [11 34:21 SUl~gC~t [~15:9 5:10 27:21 29:15 31:8 scFics IH 34:20 spl'sincd H 1 21:3 5:13 5:23 8:16 rightS[il 35:6 sessions iH 21:10 sprains [21 4:12 19:17 sulgicnl DI 8:5 risky Hi 22:2 Sct[H 37:22 SS[H 37:1 21:25 22:4 Robcrt[sl 1:9 2:3 scvcl'lll[21 10:17 24:5 stabilization[o] 19:11 8llrpriscd[21 13:4 3:7 3:19 3:24 37:7 27:12 20:I 20:2 20:6 14:8 roi]Hi 23:14 sheet iH 37:14 20:14 20:17 21:1 SWOI]OW[H 23:14 room [H 32:9 Sheridan [2j 27:22 21:1l 22:16 swear Hi 3:15 27:23 31:24 stabilize[il 20:8 swelling [2] 15:1 ROVNER [~1 1:22 shoulder ill 12:7 stsblc p! 20:24 33:21 show[xl 26:3 gtaff[~] 5:14 7:9 6worn[2] 3:20 37:9 -S- showod [2l 12:15 12:16 7:11 symptolnm [1] 28:3 $[~1 1:11 37:4 shuts[il 24:3 stsl~[21 3:23 5:6 syrinx[H 33:20 37:24 side 1141 12:3 12:22 16:24 Syst~m [il 4:5 Sadlock p3l 1:23 13:1 13:1 13:2 stat~n~nt [21 26:17 2:5 3:11 3:11 13:2 13:20 13:20 30:25 8:18 9:25 26:13 13:21 13:21 15:1 States [I] 21:19 -T- 28:25 31:15 34:15 15:22 16:1 16:2 Stay [1l 6:4 fa]rcs ill 4:5 35:2 36:6 36:12 sides iH 12:7 stsnogrnphically [11 taking i31 16:6 17:17 saw H~] 10:6 10:9 sign[21 15:2 31:21 37:10 37:8 16:21 ]7:20 19:25 24:19 24:23 24:24 31:22 stcrnllm iH 16:14 taught[il 19:22 24:24 24:25 27:18 signcd[2] 35:12 36:1 8till[4l 14:24 29:12 tc~ch[H 22:14 27:21 27:23 significance[ti 5:21 30:4 34:8 tcnching [21 7:7 8By8 [l] 31:20 significant [21 12:5 stimulus[ti 24:7 8:19 scan HSl 18:15 24:25 12:8 stop [21 23:15 24:6 tc]llng itl 26:15 25:2 25:10 25:10 significantly[il 18:16 StOl'y [11 11:5 tells[l! 35:16 25:24 25:24 25:25 signs iH 35:7 stl~ight [ii 14:15 tc~ [41 6:21 7:5 26:1 26:3 26:4 simpic[4l 26:22 28:11 8tntin[31 14:1 18:16 28:5 28:20 26:5 26:7 26:9 33:4 33:22 28:13 28:14 18:17 tend [21 13:16 14:3 ~canncrHi 25:16 sitting[il 13:13 StFaillSHi 19:17 15:21 $csr~[H 23:19 ~izcHi 16:2 SttimgCI219:l 9:20 I~ndcr[~l 11:25 12:2 12:3 schooi[~l 17:14 30:21 ~lowlyl21 13:3 13:19 StrCllgthl~l 12:12 t~nd~ncs~[?l 11:21 35:5 smal! [~] 15:10 15:13 12:14 14:18 12:5 12:8 13:6 scicnce [~15:5 15:16 s~au' ~t~h ill 14:16 14:11 14:20 29:20 scoliosispl 4:13 smnllcrHilS:22 strilr~[2l 28:24 34:24 tc'ndon[ll 25:21 scat [11 13:14 societies pl 7:19 strong [21 8:24 20:12 tcndons [21 4:7 second[il 17:25 Society[217:21 7:22 stuclr[31 23:6 23:11 8:13 sec [~21 8:25 11:3 7:23 23:17 ~ends il i 24:13 11:4 15:11 19:24 someone [2l 19:18 stlldcnts H i 9:5 tDrms [11 26:16 24:17 24:21 24:22 35:19 stuff[Il 9:17 t~st iH 5:25 12:21 26:2 32:24 33:2 son~-timt~ [t i 26:25 submit[ii 8:15 14:15 34:5 sophisticatmJ [11 25:8 subpoena [~l 36:1 ~stifi©d [2l 3:20 seeing[4] 17:10 18:24 SOFty[il 14:9 such[7] 4:11 4:13 27:25 18:25 22:24 soft H] 11:17 4:14 13:5 22:10 tcstimony [3] 16:18 Sf~oi[l[14] 9:10 9:11 sounds[2l 21:15 22:13 25:17 37:17 37:7 37:20 9:18 9:19 9:22 spc~lr[z3] 9:15 31:23 s11~.dt5] 28:2] 28:22 Thank[~] 26:11 32:14 17:6 18:13 19:6 20:3 22:21 30:25 31:24 31:25 32:1 28:23 29:1 29:2 34:15 36:4 36:12 31:16 31:18 32:5 32:3 32:5 32:7 suggest HI 30:10 thtemscivcs [~1 3:10 32:9 32:11 32:12 Sil~gl~s~cd [1] 3l:6 12:4 Scgnl's [2124:24 30:23 32:13 32:15 sttggcstion [~1 30:23 therapist pi 19:13 33:6 specified[il 37:14 Sullivan[si I:ll therapy il31 17:18 seize [21 23:13 24:9 spinnl HI 8:6 3:16 3:16 37:4 18:18 19:10 21:1 seizure [21 22:23 23:2 21:5 21:10 21:18 Index Page 6 HUGIiF~, ALBRIGHT, FOLTZ & NATALE 7 ! 7-540-0220~7 ! 7-393-51 Multi-PageTMtl~[ufor~ = yourself ROBERT R. DAHMUS, M.D. 22:5 22:11 22:14 two ital 6:3 6:5 whiplash-typ~ [21 18:7 23:17 30:24 34:7 9:16 17:22 18:22 19:16 fltcFcfol~ It I 15:23 18:23 27:6 27:12 whipped [41 13:14 t]lCysvc Itl 30:20 27:18 27:21 28:20 18:5 20:22 21:2 29:12 windshield[ti 16:13 thinking[ti 24:11 typc [21 9:3 24:17 Windshirc I~] 3:2 THOMAS [2] 1:19 typewriting ill 37:12 1:19 within itl 37:5 without [21 14:8 Thompson [21 17:15 33:11 -U= 22:18 thoug]lt it si 12:14 tmnblc It I 15:18 witheS8 [91 2:1 12:15 12:22 14:22 tlllCOVcrt~brfil it i 24:21 3:7 3:15 3:19 31:11 35:4 37:9 16:19 18:4 18:4 undL'r [21 34:25 37:12 18:6 18:9 18:13 37:21 37:22 18:20 18:21 19:2 tludgTgo [t l 34:7 word [41 12:19 14:1 20:4 20:5 34:7 understand [3] 30:14 21:4 22:3 three [21 17:22 27:23 33:24 34:23 worry it i 23:14 through[TI 13:4 unlcss[3] 31:20 35:6 WOFSC[41 20:5 20:5 16:9 16:19 17:24 35:16 31:1 31:3 19:4 19:10 25:25 up itt] 6:24 10:21 WFitCS [~] 35:17 throughout [21 12:12 11:23 22:13 25:9 12:13 25:13 26:4 31:14 written [11 5:25 31:16 31:17 34:19 WlOIIg [11 18:16 tight Itl 13:21 times [21 17:22 27:23 used [41 7:23 15:15 15:17 15:17 -X- 31:12 useillg [~ i 15:25 ~jmmolls [21 1:6 x-ray [2] 32:19 32:22 3:7 3:13 usually itl I 1:7 x-rays [131 18:15 24:21 lipitl 13:1 24:23 24:25 25:12 Today's [ti 3:3 -V- 25:24 25:25 26:2 26:9 33:3 33:24 toe[ti 23:7 V[tl 1:4 34:2 34:5 toes Itl 4:10 vagus Itl 24:4 tog~'~lCf [11 14:3 vstious Itl 35:22 -y- tongue it i 23:15 vas~o it i 23:22 tOOl~l 19:15 20:3 V~soyngful [2] 23:23 yoRF[21 6:19 7:2 33:3 24:3 years [no] 6:3 6:5 6:21 6:22 7:5 took[al 22:21 34:3 vchicl© [41 8:9 23:4 9:14 10:18 17:1 train[ti 7:10 28:2 29:25 27:6 29:12 trained[21 9:6 30:17 Versus[a1 3:6 32:22 young[ti 19:21 ttapczii Itl 12:9 vertebral [ti 14:2 yourself rtl 32:24 trapczius [~ l 12:6 video 121 1:8 3:2 tronmntic It I 4:11 VIDEOORAPHER Itl 1:26 float [~l 8:8 8:11 31:9 videotape [I I 36:13 t~ca~od [61 17:7 21:4 videotaped [21 3:4 22:3 22:4 29:4 3:8 34:12 vim[ti 7:25 t~atting [ti 10:1 I lxoatmotlt [~] 17:4 -W- 22:9 30:18 W~vcr [11 35:7 ~catmcnts 12l 17:19 wsnt8 []1 29:19 20:4 TR.IAL[II 1:7 w~8t~[tI ]5:21 wasting 1~] 15:7 trouble [ti 13:2 weakness [si 12:15 truc [21 29:6 37:20 12:22 14:21 18:24 truly [~] 22:15 29:9 18:25 35:15 WCaFS [ti 28:3 [!~ [21 11:17 20:23 WCCIr [21 7: I 1 28:5 t31rll [11 13:1 W~Irs [ti 27:18 turned itl 25:18 whacked [I] 16:11 Turnpau~h [~1 17:8 WHEREOFi~] 37:22 17:21 32:3 whiplash [41 13:11 l*urnpaugh's it 1 34:13 29:7 29:22 29:24 [wicc [~ i 26:14 HUGHES, AX,BRIGHT, FOL'I-;- & NATALE Index Page 7 717=540=0220~717=393=5101