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Home My WebLink About11-5712OWENS, BARCAVAGE AND MCINROY, LLC BY: Bart W. Holmes, Esquire Attorney I.D. No. 85071 2595 Interstate Drive i II ED-OFFICE C, ' }E PROTHONOTARY J 11 J`?? 18 AM I0: 4 4 UMBERLAND COUNTY Harrisburg, PA 17110 PENNSYLVANIA (717) 909-2500 (717) 909-2504 (fax) Attorney for Plaintiff Luke Lingle IN RE: LUKE LINGLE, a Minor, by and COURT OF COMMON PLEAS through his parent and natural guardian CUMBERLAND COUNTY, LISA LINGLE PENNSYLVANIA 6-0 PETITION TO APPROVE SETTLEMENT OF MINOR'S CLAIM AND NOW COMES, Petitioner, Luke Lingle, by and through his parent and natural guardian Lisa Lingle, and Owens Barcavage & McInroy, LLC and aver as follows: 1. The Respondent, K & K Insurance Company (hereafter "K & K"), is the Claims Administrator for Great American Insurance Company, an Ohio Corporation authorized to do business in Pennsylvania, and which maintains an office at 1712 Magnavox Way, P.O. Box 2338, Fort Wayne, Indiana, 46897. 2. Respondent, American Youth Football, Inc., is a Great American Insurance Company insured, which owned or controlled the premises where Petitioner minor Luke Lingle was injured. 3. Petitioner minor Luke Lingle, and his mother and natural guardian, Lisa Lingle, who is an adult individual, live at 8880 Mountain Road, Grantville, PA 17028. 4. This Petition was prepared on behalf of Luke Lingle, a minor, by and through his mother and natural guardian Lisa Lingle, at their expense. U? m9a?Pda a s ?9L 3 etaCQlgi3 5. On October 6, 2007, Minor Petitioner Luke Lingle was injured when bleachers upon which he was standing gave way, injuring his leg. This accident occurred in New Cumberland Borough, Cumberland County, Pennsylvania. 6. As a result of the accident, Petitioner Minor Luke Lingle received treatment for a left midshaft tibial stress fracture, as set forth in the medical records attached hereto at Exhibit "A.19 7. Petitioner Luke Lingle has discontinued treating and the injury has resolved, as set forth in the medical records attached hereto at Exhibit "B." 8. In order to resolve the claim of the Minor Petitioner Luke Lingle, Kathy Osborn, of K & K, on behalf of Great American Insurance Company, has agreed to pay Petitioner $5,000.00 dollars. 9. The parties are not aware of any outstanding medical bills related to this incident. 10. As of the date of the filing of this Petition, the parties believe that there are no other unpaid claims, liens or debts associated with the incident. 11. Petitioner Minor Luke Lingle, by and through his parent and natural guardian Lisa Lingle, believe that settlement as set forth above is in the best interest of Minor Petitioner, and request authorization from the Court to execute and sign the proposed Release, which is attached hereto as Exhibit "C". 12. The parties request that the settlement sum of $5,000.00, less $500.00 in attorney fees, and $92.00 in filing fees (which were advanced by undersigned counsel), for a total of $4408.00, to be placed in a savings account restricted from the minor Petitioner Luke Lingle until he reaches the age of 18 years old. 13. Petitioners and Respondents, believing that the settlement described herein is fair, reasonable, and in the best interest of the minor Petitioner Luke Lingle, request approval of the same, and permission to sign the release set forth as Exhibit "C." WHEREFORE, the parties respectfully request this Honorable Court approve the settlement and authorize Petitioners to execute all documents related to the settlement of the aforementioned claim. Date: 7-1J_11 Date: 7-/5-// -7 l? :16 11 Respectfully submitted, Petitioner Minor Luke Lingle OWENS BARACAVE & McINROY, LLC ??)UAFC? h, -ei Bart . Holme , Esq re I.D. No. 85071 2595 Interstate Drive Harrisburg, PA 17110 (717) 909-2500 (717) 909-2504 (fax) John Lingle, parent and natural guardian of EXHIBIT A PESW . Cod of hiedid7t Patient Narne: LINGLE, LUKE J PSUHMC MRN: 0853321 O u t p a t i e n t L e t t e r D o c u m e n t Final Document Electronically Signed by: Grady, Betsy E 5/2/2008 8:26:31 AM April 29, 2008 Name: LINGLE, LUKE J HMC Number: 0853321 DOB: 06/1611995 Date of Service: 04/29/2008 Thomas J. Weida, M.D. Penn State Milton S. Hershey Medical Center PO Box 850 Hershey, PA 17033 Dear Dr. Weida: He is a 12-year-and-1 l -month-old male here for initial evaluation for chronic left mid shin pain. He identifies it in September of 2007. He was walking on football bleachers and fell through and hit his left shin. Since that time, he has had chronic pain with that area when he is standing for long periods or when he puts pressure on the area. He was seen by his family doctor one week after the incident occurred and x-rays were within normal limits. Mom identifies no other concerns. Luke identifies no other injury and/or trauma occurred with this incident. He identifies that he is active with baseball and when he slides or it is hit by object the left shin does have pain. It does not awake him at night. Mom does not note any asymmetry or limp with his gait. He currently is on no medications and has no known allergies. No other concerns were identified. Clinically, the patient was alert and oriented with no acute signs of distress. It was noted that he did have some edematous area in the mid shaft of the left tibia and noted some pain with palpation over this area. Noted he could fully flex and extend his knee as well as ankle with his left lower extremity without difficulty. Noted he had +2 dorsalis pedal pulses with the foot with excellent sensation as well too. He complained of no pain on evaluation of the right midshaft of the tibia. He had no asymmetry or limp with his gait. Radiologically AP, lateral views of the left tibia, mid shaft, as well as the fibula identified some signs of periosteal reaction with the left midshaft of the tibia. Noted no sign of an obvious fracture in the area. Growth plates were intact with the proximal and distal tibia, as well as the fibula. Impression is left midshaft stress fracture versus a scar reaction. Plan: At this time I identified to Luke and his mom that there is some concern of a periosteal reaction with the x-ray today. I did recommend a bone scan to be done of the area due to the chronicity of this problem. I recommended that we also guard this area with Shing Guard from further being injured. He will follow up with Dr. Fortuna after the bone scan is done. He may participate in activity as tolerated at this point. Date Printed: 61252009 Time Printed: 11: 53 PM ------------------- ----- - -... - -- - :Q......... . Patient Name: LINGLE, LUKE J PSUHMC MRN: 0853321 O u t p a t i e n t L e t t e r D o c u m e n t Final Document Electronically Signed by: Grady, Betsy E 512/2008 8:26:31 AM Thank you for allowing me to participate in his care. 430089 CC: Weida, Thomas J, MD DepartTncnt of Family and Community Medicine Penn State Milton S. Hershey Medical Center PO Box 850 Hershey, PA 17033-0850 Sincerely, Grady, Betsy E, CRNP BEG /CO DD: 04/29/08 DT: 05/01/08 05:28 Date Printed: 61252009 Time Printed: 11:53 PM EXHIBIT B Patient Name: LINGLE, LUKEJ PSUHMC MRN: 0853321 Patient Sex: Male Date of Birth: 6/16/1995 Patient Location: NUC, , Visit Number: 09805065 Visit Type: Clinic M u s c u l o s k e l e t a l - S t u d Final ZNMZ BONE SCAN, 3 PHASE (WITH FLOW), ADULT PATIENT NAME: LINGLE, LUKE J PATIENT MRN:00853321 PATIENT DOB: 06/16/1995 -jEXAM DATE OF SERVICE: 05/13/2008 EXAM NUMBER: 2621306 ORDERING PHYSICIAN: GRADY, BETSY LIMITED TRIPHASIC BONE SCINTIGRAPHY CLINICAL HISTORY: This is a 12-year-old boy with chronic left midshaft pain, rule out stress fracture. RADIOPHARMACEUTICAL: Technetium-99m MDP, 20.23 millicuries, IV. DISCUSSION: Limited images of the pelvis to feet were obtained with blood flow, pool, and three hours after bone tracer injection. At the time of the delayed imaging both anterior, posterior as well as lateral images were obtained. Blood flow, pool and delayed images are normal without evidence of abnormal tracer accumulation. IMPRESSION: Normal triphasic limited bone scan without etiology identified to explain the patient's pain. There is no evidence for a stress fracture. DICTATED: TULCHINSKY, MARK REVIEWED AND SIGNED: TULCHINSKY, MARK DATE DRAFTED: 05/13/2008 04:26 PM DATE OF FINAL SIGNATURE: 05/13/2008 04:30 PM Date Printed: 612512009 Time Printed: 11: 50 PM EXHIBIT C PARENT-GUARDIAN RELEASE AND INDEMNITY AGREEMENT FOR AND IN CONSIDERATION of the payment to me/us of the sum of Five Thousand and 00/100 hundredths Dollars ($5,000.00), the receipt of which will be hereby acknowledged, I/we, the undersigned father, mother and/or guardian of Luke J. Lingle, a minor, do forever release, acquit, discharge and covenant to hold harmless American Youth Football, Inc., Great American Assurance Co. and K & K Insurance Group, Inc. and his, her, their, or its heirs, executors, successors, assigns, administrators, officers, partners, managers, employees, volunteer workers, agents, servants and all other affiliated corporations, associations and partnerships (the "Releasees") of and from any and all claims, actions, causes of action, demands, rights, damages, costs, loss of service, expenses and compensation whatsoever, on account of, or in any way growing out of, any and all known and unknown, foreseen and unforeseen, bodily and personal injuries and property damage, and the consequences thereof, which I/we may now or hereafter have for myself/ourselves and as the parent/s and/or guardian of said minor, and also all claims, actions, causes of action, demands, rights, damages, costs, expenses and compensation whatsoever which said minor now has or may hereafter have, either before or after said minor has reached the age of majority, resulting or to result from a certain accident and/or offense which occurred on or about October 6, 2007 at or near New Cumberland, PA. I/we promise to bind myself/ourselves jointly and severally, my/our heirs, executors and administrators, to repay to the Releasees any and all additional sums of money in excess of the sum paid above that the Releasees may hereafter be induced or compelled to pay to, or on behalf of, said minor or any other person or third party because of said accident and/or offense. It is further understood and agreed that this settlement is the compromise of a doubtful and disputed claim, and that the payment made is not to be construed as an admission of liability on the part of the Releasees, by whom liability is expressly denied. THE TERMS AND CONDITIONS OF THIS SETTLEMENT ARE CONFIDENTIAL. The Undersigned, his/her attorney or anyone acting on his/her behalf may not disclose the terms of this agreement except to his/her spouse, accountant and/or financial advisor, tax authorities, in response to a valid subpoena or as required by law. It is understood that violations of this provision may result in a claim for damages including attorney fees, costs and expenses in enforcing this confidentiality provision. I/we further state that I/we have carefully read the foregoing RELEASE and INDEMNITY AGREEMENT, that I/we know the contents thereof, and that I/we sign the same as my/our own free act. Signed, sealed and delivered this day of , 20 STATE OF COUNTY OF CAUTION: READ BEFORE SIGNING BELOW On this -_ day of , 20 , before me appeared to me personally known, and who acknowledged the execution of the foregoing instrument as free act and deed, for the consideration set forth herein. My term expires Notary Public: CERTIFICATE OF SERVICE I, Bart W. Holmes, Esquire, certify under penalty of unsworn falsification to governing authorities, that I have served a true and correct copy of the foreoing, by United States Mail, pre- paid, as follows: Luke Lingle, by and through his parent and natural guardian Lisa Lingle 8880 Mountain Road Grantville, PA 17028. K & K Insurance Company Attn: Kathy Osborne 1712 Magnavox Way, P.O. Box 2338 Fort Wayne, Indiana, 46897 Date: ? (I _ Bart W. Ho mes, squire 11:19 I IN RE: LUKE LINGLE, a Minor, by and through his parent and natural guardian LISA LINGLE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO.: )S71-,-i llt/l,? ?.^2 ORDER AND NOW, this ea / _?_ y of 2011, upon consideration of Petitioner Luke Lingle, by and through his parent and natural guardian Lisa Lingle's Petition to Approve Minor's Claim, it is hereby ordered and decreed that said Petition is approved. Lisa Lingle is authorized to sign the within release. The settlement sum of $5,000.00, less $500.00 in attorney fees, and $92.00 in tiling fees (which were advanced by Petitioner's counsel), for a total of $4408.00, shall be placed in a savings account restricted from the minor Petitioner Luke Lingle until he reaches the age of 18 years old. By the Court, `T j -< a > o =i Distribution: C _r f Owens Barcavage & McInroy, LLC, 2595 Interstate Drive, Harrisburg, PA 17110 _j c:1 K & K Insurance Company, Attn: Kathy Osborne, 1712 Magnavox Way, P.O. Box 2338, Fort Wayne, Indiana, 46897 0opq I/V/I( TOTAL P.02 J