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Home My WebLink About03-0768IN RE: GUARDIANSHIP OF MARY E. SHANK : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. PETITION FOR ADJUDICATION OF INCAPACITY AND APPOINTMENT OF AN EMERGENCY GUARDIAN AND NOW, comes JOSEPH J. SHANK, by and through his counsel, Bradley L. Griffie, Esquire, and petitions the Court as follows: 1. Your Petitioner is JOSEPH J. SHANK of 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania. 2. The alleged incapacitated person is MARY E. SHANK, born November 1, 1927, who is 76 years of age, is married, and is temporarily residing at the Chapel Pointe at Carlisle, 70 South Hanover Street, Carlisle, Cumberland County, Pennsylvania, where she has resided since September 17, 2003. 3. The following person is, to the best of Petitioner's knowledge, information and belief, the next-of-kin of the alleged incapacitated person: JOSEPH J. SHANK (husband) of 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania. 4. To the extent known by Petitioner, the assets of the alleged incapacitated person include: (1) personal property located at 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania (the alleged incapacitated person's permanent residence); (2) social security benefits. 5. Petitioner estimates the alleged incapacitated person's gross M~l~hly i _r~ me to be $360.00 from the Social Security Administration. 6. The alleged incapacitated person is not a member of the armed services of the United States and is not receiving benefits from the United States Veterans' Administration. 7. The alleged incapacitated person is incapacitated due to a significant cerebral vascular accident which occurred on September 13, 2003, as well as a history of cerebral vascular accidents, type II diabetes mellitus, hypercholesterolemia, osteoporosis, osteoarthritis, hypertension, gastro-esophageal reflex disease, cholelithiasis, osteomyelitis of the left foot with cellulitis, diffuse degenerative disc disease with spinal stenosis, anxiety and chronic muscular pain, as per correspondence from the alleged incapacitated person's treating physician which is attached hereto and incorporated herein by reference as Exhibit "A". 8. Because of MARY E. SHANK's present medical condition, she suffers from impaired ability to reason and physically care for herself. 9. Because of her mental/physical condition, the alleged incapacitated person is totally unable to manage her financial affairs and property, and to make and communicate responsible decisions relating thereto, including the ability to communicate her need for assistance in these areas. 10. The severity of the alleged incapacitated person's mental and physical condition and the lack of viable, less restrictive alternatives necessitate that a Emergency Temporary Guardian of her estate be appointed to manage and handle all aspects of the alleged incapacitated person's estate, specifically including, but not limited to: all decisions relative to hospital, nursing home and related medical care; the maintenance of her life and other insurance of which she is an owner or beneficiary; her entitlement to any governmental or non-governmental benefit plans; preparation and filing of federal, state, and local taxes; claims made or to be made on behalf of her or against her; the execution of documents, entry into contracts affecting her and the payment of reasonable compensation or costs to provide services for her, including medical services. 11. The severity of the alleged incapacitated person's mental and physical condition and the lack of viable, less restrictive alternatives necessitate that a Emergency Temporary Guardian of his person be appointed to handle all issues relating to the person of the alleged incapacitated person, specifically including, but not limited to: her living arrangements, her medical and psychiatric care, the administration of medication to her, and the employment and discharge of physicians, psychiatrist, dentists, nurses, therapists, and other professionals for her physical and mental treatment and care. 12. Petitioner is not aware that the alleged incapacitated person signed any power of attorney or advance health care directives or in any other way designated anyone to serve as her agent over any of her personal or financial affairs or as her surrogate over her medical care, nor that she designated in writing her wishes with regard to health care, including the use or refusal of life-sustaining treatment. 13. The alleged incapacitated person has no independent recollection of her assets, property, debts or liabilities, nor any independent recollection of all of her family members. 14. The alleged incapacitated person is married and has one child, namely, STEVEN L. SHANK and these are the alleged incapacitated person's only next of kin; therefore, the proposed Emergency Temporary Guardians of the person and estate of the alleged incapacitated person is JOSEPH J. SHANK. 15. The proposed Emergency Temporary Guardian has no interest adverse to the alleged incapacitated person. 16. The consent of the proposed Emergency Temporary Guardian is attached as Exhibit 17. As indicated in the treating physician's report, the alleged incapacitated person has been unable to communicate since approximately September 13, 2003 and, due to the fact that her incapacity is as a result of a stroke, there is no means to determine when and if the alleged incapacitated person may be in a position to handle her own affairs. 18. It is the position of your Petitioner, the proposed Emergency Temporary Guardian, to have the within guardianship appointment approved on an emergency basis, to be extended as permitted by law by further Petition, if necessary, and ultimately, to be entered as a plenary guardianship following hearing. 19. The need to make medical decisions and decisions on the day-to-day care of the alleged incapacitated person necessitates the entry of an Order providing for an Emergency Temporary Guardian, particularly because the alleged incapacitated person has already been admitted to a nursing home for rehabilitative care, but has not been able to provide the necessary authorization for such care or admission. 20. The appointment of an Emergency Temporary Guardian is the least restrictive alternative available in this case, particularly in light of the inability for the medical care providers to give an exact prognosis relative to the alleged incapacitated person's ability to manage her affairs in the future. WHEREFORE, Petitioners request your Honorable Court to enter an Order adjudging MARY E. SHANK to be incapacitated and appointing JOSEPH J. SHANK as Emergency Temporary Guardian of the person and estate of the said MARY E. SHANK for a period of 72 hours, to be extended as permitted by law. Respectfully submitted, OCIATES //~~6'~ffi~, Esquire ~ for Petitioner 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 I verify that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. DATE: ~-x ~i:, .... SEP-ig-2003 FBI 03:09 PM M~SL~ND FA× NO. 7172499332 P, 02/02 M ASLAND ASSOCIATES ] NC. INTERNAL MEDICINE Mt~mca~. A~n's BmlmNC~ 220 WZLSO~ $'rRe~T, CAm.~SLU, PA 17013 (71"0 249-1.929 Fax (717) 249-9332 Jsk,~n4 F. B~, M.D. T~v A. Roat.,~, D.O. T. At~x B~,N^gov, M,D. D~aa~ D. T~,¥~z~, M.D. PI~IIIp A. ~%~F. IDl~ai:.t~ Cmu~r~.~c~a J, B~.~o, M.D.. P,~m~. D. Lv~n:u L. H~m~t~a~,~ M,D. Dotn;L~.,~ J. Bowie, M.D. M~ctll:n ~.~ M. H,~r~ M.S.N., C.R.N.P. September 19, 2003 Bradley I.. Griffic, Esq. 200 N Hanover Street Carlisle, PA 17013 RE: Mary E. Shank(DOB 11/0t/27) Dear Atlomey Griffie: I am writing in response m your tclaphone request of September 18, 2003 regarding MaW Shank's medical condition~. As you know Ma~ is an extremely pleasant 75 year old woman who untonunatcly experienced a significant cerebral vascular accident on September 13, 2003. Her other medical conditions include.,~ prcv~us history of cev'bral va~nsba accidents, type 11 diabetes meilims, hypercholcaerolt:mia, osttoporosis, os~coanhritls, hypcnen.qion, ga.stro-esophageal reflex disease, cholelithiasis, osteomyelitis of the left foot with cellulitis, diffuse degenerative disc disease with spinal signnsia, anxicty and chmmc muscular pain. In thc past she experienced a d§ht hcmisphcdc CVA wilh icQ lower pmesia. She has a~* had a ic~t hemlsphcdc stroke in thc past with residual dght hcmlparcais. On Septcrnher 13, 2003, her hu~dmnd nogc~d that she had garbled and confu,,~d speech. She was unaware el thc~ findings. Subsequently they presented to thc ER and she was admitted to Carlislc Regional Medical C, cnt~r with thc working diagnosi.,~ al' new c~robral ~vascula~ accident. Shc was sccn i~$ consultation by Ds. Mohammad lsmail, oaumlogist who confimamJ thc diagnosis and also documented oxptessivc and receptive aphasia. Site wa~ al.~ perc, cvcmting and had difficulty undcmtanding simple commands. She was cared for in thc hospital by Dr. Alex B~shnakov. I did have thc opportunity to visit her on Monday evening September 15. At that time she was resting comfortably in bed and I thought site recognized 9~lto I was. Unfonunalcly .,~h6 was not able to follow simple commands nr communicare adequately. Hot family w-aa not ptcsem at that time. Given the axiom of her cercl~al event, I don't believe that she has thc capacity to make decisions rcgarding her hcalth cam or other treatment options. While at Chapel Pninl Nursing Home, shc will bc cared [or by Dr. Ken Guis~wite, who would ['~ sbic to provide you with thc lntest events in hgr care. I[you should haw: any olhcr quostion~, please do not hc.~italc Io c-onlact mc directly. CJ U/bw T: 9/19/03 Sincerely, Christopher J. Bt:to, M.D. EXHIBIT . CONSENT OF GUARDIAN OF THE PERSON AND ESTATE I, JOSEPH J. SHANK, hereby consent to act as the Guardian of the Person and Estate of MARY E. SHANK I reside at 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania. I am a citizen of the United States of America and can speak, read, and write the English language. I have no interest adverse to MARY E. SHANK, the alleged incapacitated person. J(J~I~PH J! ~AN~ COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : On this the I b~ ~ day of ~ ~qL{ ~)4 ~003, before me, the undersigned officer, personally appeared JOSEPH J. SHANK, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. EXHIBIT IN RE: GUARDIANSHIP OF MARY E. SHANK : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION g /-03- 70 DECREE AND NOW, this ay of September, 2003, upon consideration of the attached Petition, filed pursuant to 20 Pa.C.S. {}5513, it is hereby ORDERED AND DECREED that, based on a finding that MARY E. SHANK suffers from impaired ability to reason and physically care for herself as a result of a significant cerebral vascular accident which occurred on September 13, 2003, as well as a history of cerebral vascular accidents, type II diabetes mellitus, hypercholesterolemia, osteoporosis, osteoarthritis, hypertension, gastro-esophageal reflex disease, cholelithiasis, osteomyelitis of the left foot with cellulitis, diffuse degenerative disc disease with spinal stenosis, anxiety and chronic muscular pain, and is so severely mentally and physically impaired that she is unable to make, communicate or participate in any decisions relating to her estate or person, MARY E. SHANK, is adjudged totally incapacitated. JOSEPH J. SHANK is appointed Emergency Temporary Guardian of the person and estate of MARY E. SHANK, and is appointed to manage and handle all aspects of the alleged incapacitated person's estate, specifically including, but not limited to: all issues relating to payment of routine bills and other banking and savings account needs; the maintenance of her life and other insurance of which she is an owner or beneficiary; her entitlement to any governmental or non-governmental benefit plans; preparation and filing of federal, state, and local taxes; claims made or to be made on behalf of her or against her; the execution of documents, entry into contracts affecting her and the payment of reasonable compensation or costs to provide services for her, including 2003 medical services. In addition, the Emergency Temporary Guardian is appointed to handle all issues relating to the person of the alleged incapacitated person, specifically including, but not limited to: her living arrangements, her medical and psychiatric care, the administration of medication to her, and the employment and discharge of physicians, psychiatrist, dentists, nurses, therapists, and other professionals for her physical and mental treatment and care. This Order shall expire 72 hours from today's date unless extended pursuant to the provisions of 20 Pa.C.S. {}5513. ~__~ ., Esquire, is appointed as counsel for the incapacitated person, MARY E. SHANK, and shall be given notice of all future proceedings in this matter. Jo IN RE: GUARDIANSHIP OF MARY E. SHANK : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. STATEMENT OF RIGHTS AN ORDER HAS BEEN ENTERED WHEREBY YOU HAVE BEEN ADJUDICATED A TOTALLY INCAPACITATED PERSON AND UNABLE TO CARE FOR YOURSELF AND/OR MANAGE YOUR PERSONAL AND FINANCIAL AFFAIRS. YOU HAVE THE RIGHT TO FILE EXCEPTIONS TO THE COURT'S DECISION WITHIN TWENTY (20) DAYS OF THE DATE OF THE COURT'S ORDER. IF YOU FAIL TO FILE EXCEPTIONS, THE ORDER WILL BECOME FINAL. IN THE EVENT THAT YOU FILE EXCEPTIONS, THE ORDER WILL BECOME FINAL. IN THE EVENT THAT YOU FILE EXCEPTIONS AND THEY ARE DENIED, YOU HAVE A RIGHT TO FILE AN APPEAL TO THE SUPERIOR COURT WITHIN THIRTY (30) DAYS OF THE DATE OF THE DENIAL OF THE EXCEPTIONS. IN ADDITION, YOU MAY PETITION THE COURT AT ANY FUTURE TIME TO MODIFY OR TO TERMINATE THE PLENARY GUARDIANSHIP IF THERE IS A SIGNIFICANT CHANGE IN YOUR CAPACITY OR IF YOUR PLENARY GUARDIAN FAILS TO PERFORM HIS DUTIES IN ACCORDANCE WITH THE COURT'S ORDER. IF YOU WISH TO FILE EXCEPTIONS TO OR FURTHER APPEAL THE ORDER OR TO PETITION THE COURT TO MODIFY OR TERMINATE THE PLENARY GUARDIANSHIP, YOU MAY BE REPRESENTED BY AN ATTORNEY. IF YOU DO NOT HAVE AN ATTORNEY, YOU MAY REQUEST THAT THE COURT APPOINT ONE TO REPRESENT YOU. IF YOU CANNOT AFFORD AN ATTORNEY, THE SERVICES OF AN ATTORNEY WHOM THE COURT MAY APPOINT WILL BE PROVIDED AT NO COST TO YOU. IN RE: GUARDANSHIP OF MARY E. SHANK : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. 21-03-768 PETITION FOR ADJUDICATION OF INCAPACITY AND APPOINTMENT OF A PLENARY GUARDIAN AND NOW, comes Joseph J. Shank, by and through his counsel of record, Bradley L. Griffie, Esquire, and Petitions the Court as follows: Your Petitioner is Joseph J. Shank, and adult individual currently residing at 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania. The alleged incapacitated person, Mary E. Shank, was born on November 1, 1927 and is 76 years of age, is married and temporarily residing at Chapel Point at Carlisle, 770 South Hanover Street, Carlisle, Cumberland County, Pennsylvania. The following person is to the best of Petitioner's knowledge, information and belief, the next-of-kin of the alleged incapacitated person: Joseph J. Shank of 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania (husband). o An Emergency Temporary Order was entered on September 19, 2003, a copy of the said Decree and Petition being attached hereto and incorporated herein by reference as Exhibit "A." o The alleged incapacitated person has been a temporary resident of the Chapel Point at Carlisle, 770 South Hanover Street, Carlisle, Cumberland County, Pennsylvania since September 17, 2003 and has been incapacitated since that time, being unable to provide for her basic needs. o The report of Christopher J. Bero, M.D., dated September 19, 2003, was provided to support Petitioner's prior Petition to secure an emergency temporary guardianship Decree, a copy of said report being attached hereto and incorporated herein by reference as Exhibit "B." o Pursuant to 21 Pa.C.S. §5513, an extension of the 72-hour emergency Order is necessary for an additional 20-day period in order to allow for the Emergency Temporary Guardian to maintain the personal and financial needs of the alleged incapacitated person. o Based upon the medical recommendation, Petitioner requests that a permanent guardian be named and that a hearing be scheduled for purposes of taking testimony, if necessary, in order to allow for the naming of a permanent or plenary guardian. o The Court has appointed Michael A. Scherer, Esquire, as counsel for the alleged incapacitated person, Mary E. Shank. 10. The facts recited in Petitioner's initial Petition for Adjudication of Incapacity and Appointment of An Emergency Guardian remain as set forth in that Petition, which is attached hereto as Exhibit "A." WHEREFORE, Petitioner requests your Honorable Court to extend the 72-hour emergency temporary guardianship naming and appointment Joseph J. Shank as said guardian for an additional 20-day period and to schedule a hearing in this matter to determine the appropriateness of naming of a permanent guardian. Respectfully submitted, GRIFFIE & ASSOCIATES 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 I verify that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unswom falsification to authorities. fg~I~PH J./SI/IA~ ' 1N RE: GUARDIANSHIP OF MARY E. SHANK AND NOW, this Iq''~\ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. /Pt- DECREE day of September, 2003, upon consideration of the attached Petition, filed pursuant to 20 Pa.C.S. §5513, it is hereby ORDERED AND DECREED that, based on a finding that MARY E. SHANK suffers from impaired ability to reason and physically care for herself as a result of a significant cerebral vascular accident which occurred on September 13, 2003, as well as a history of cerebral vascular accidents, type II diabetes mellitus, hypercholesterolemia, osteoporosis, osteoartlu'itis, hypertension, gastro-esophageal reflex disease, cholelithiasis, osteomyelitis of the left foot with cellulitis, diffuse degenerative disc disease with spinal stenosis, anxiety and chronic muscular pain, and is so severely mentally and physically impaired that she is unable to make, communicate or participate in any decisions relating to her estate or person, MARY E. SHANK, is adjudged totally incapacitated. JOSEPH J. SHANK is appointed Emergency Temporary Guardian of the person and estate of MARY E. SHANK, and is appointed to manage and handle all aspects of the alleged incapacitated person's estate, specifically including, but not limited to: all issues relating to payment of routine bills and other banking and savings account needs; the maintenance of her life and other insurance of which she is an owner or beneficiary; her entitlement to any governmental or non-governmental benefit plans; preparation and filing of federal, state, and local taxes; claims made or to be made on behalf of her or against her; the execution of documents, entry into contracts affecting her and the payment of reasonable services for her, including compensation or costs t~) provide !~ EXHIBIT I '1 ! medical services. In addition, the Emergency Temporary Guardian is appointed to handle all issues relating to the person of the alleged incapacitated person, specifically including, but not limited to: her living arrangements, her medical and psychiatric care, the administration of medication to her, and the employment and discharge of physicians, psychiatrist, dentists, nurses, therapists, and other professionals for her physical and mental treatment and care. This Order shall expire 72 hours from today's date unless extended pursuant to the provisions of 20 Pa.C.S. §5513. 1~ \~[~.~.~.\ ~_~_~¥~'9.~3'"'¢(-'. , Esquire, is appointed as counsel for the incapacitated person, MARY E. SHANK, and shall be given notice of all future proceedings in this matter. BY THE COURT, 7 A TRUE COPY FROM RECORD In Testimony wherof, I hereunto set my hand and the seal of said Court~t Cadige, PA __ Cum~and ~u~ IN RE: GUARDIANSHIP OF MARY E. SHANK : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. STATEMENT OF RIGHTS AN ORDER HAS BEEN ENTERED WHEREBY YOU HAVE BEEN ADJUDICATED A TOTALLY INCAPACITATED PERSON AND UNABLE TO CARE FOR YOURSELF AND/OR MANAGE YOUR PERSONAL AND FINANCIAL AFFAIRS. YOU HAVE THE RIGHT TO FILE EXCEPTIONS TO THE COURT'S DECISION WITHiN TWENTY (20) DAYS OF THE DATE OF THE COURT'S ORDER. IF YOU FAIL TO FILE EXCEPTIONS, THE ORDER WILL BECOME FINAL. IN THE EVENT THAT YOU FILE EXCEPTIONS, THE ORDER WILL BECOME FINAL. iN THE EVENT THAT YOU FILE EXCEPTIONS AND THEY ARE DENIED, YOU HAVE A RIGHT TO FILE AN APPEAL TO THE SUPERIOR COURT WITHIN THIRTY (30) DAYS OF THE DATE OF THE DENIAL OF THE EXCEPTIONS. IN ADDITION, YOU MAY PETITION THE COURT AT ANY FUTURE TIME TO MODIFY OR TO TERMINATE THE PLENARY GUARDIANSHIP IF THERE IS A SIGNIFICANT CHANGE IN YOUR CAPACITY OR IF YOUR PLENARY GUARDIAN FAILS TO PERFORM HIS DUTIES IN ACCORDANCE WITH THE COURT'S ORDER. IF YOU WISH TO FILE EXCEPTIONS TO OR FURTHER APPEAL THE ORDER OR TO PETITION THE COURT TO MODIFY OR TERMINATE THE PLENARY GUARDIANSHIP, YOU MAY BE REPRESENTED BY AN ATTORNEY. IF YOU DO NOT HAVE AN ATTORNEY, YOU MAY REQUEST THAT THE COURT APPOINT ONE TO REPRESENT YOU. IF YOU CANNOT AFFORD AN ATTORNEY, THE SERVICES OF AN ATTORNEY WHOM THE COURT MAY APPOINT WILL BE PROVIDED AT NO COST TO YOU. 1N RE: GUARDIANSHIP OF MARY E. SHANK · IN THE cOURT OF COMMON PLEAS OF · CUMBERLAND COUNTY, PENNSYLVANIA · ORPHANS' COURT DIVISION · NO. PETITION FOR ADJUDICATION OF INCAPACITY AND APPOINTMENT OF AN EMERGENCY GUARDIAN AND NOW, comes JOSEPH J. SHANK, by and through his counsel, Bradley L. Griffie, Esquire, and petitions the Court as follows: 1. Your Petitioner is JOSEPH J. SHANK of 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania. 2. The alleged incapacitated person is MARY E. SHANK, born November 1, 1927, who is 76 years of age, is married, and is temporarily residing at the Chapel Pointe at Carlisle, 70 South Hanover Street, Carlisle, Cumberland County, Pennsylvania, where she has resided since September 17, 2003. 3. The following person is, to the best of Petitioner's knowledge, information and belief, the next-of-kin of the alleged incapacitated person: JOSEPH J. SHANK (husband) of 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania. 4. To the extent known by Petitioner, the assets of the alleged incapacitated person include: (1) personal property located at 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania (the alleged incapacitated person's permanent residence); (2) social security benefits. 5. Petitioner estimates the alleged incapacitated person's gross mo..,mhly income to be $360.00 from the Social Security Administration. 6. The alleged incapacitated person is not a melnber of the armed services of the United States and is not receiving benefits from the United States Veterans' Administration. 7. The alleged incapacitated person is incapacitated due to a significant cerebral vascular accident which occurred on September 13, 2003, as well as a history of cerebral vascular accidents, type II diabetes mellitus, hypercholesterolemia, osteoporosis, osteoartl~ritis, hypertension, gastro-esophageal reflex disease, cholelithiasis, osteomyelitis of the left foot with cellulitis, diffuse degenerative disc disease with spinal stenosis, anxiety and chronic muscular pain, as per correspondence from the alleged incapacitated person's treating physician which is attached hereto and incorporated herein by reference as Exhibit "A". 8. Because of MARY E. SHANK's present medical condition, she suffers from impaired ability to reason and physically care for herself. 9. Because of her mental/physical condition, the alleged incapacitated person is totally unable to manage her financial affairs and property, and to make and communicate responsible decisions relating thereto, including the ability to communicate her need for assistance in these areas. 10. The severity of the alleged incapacitated person's mental and physical condition and the lack of viable, less restrictive alternatives necessitate that a Emergency Temporary Guardian of her estate be appointed to manage and handle all aspects of the alleged incapacitated person's estate, specifically including, but not limited to: all decisions relative to hospital, nursing home and related medical care; the maintenance of her life and other insurance of which she is an owner or beneficiary; her entitlement to any governmental or non-governmental benefit plans; preparation and filing of federal, state, and local taxes; claims made or to be made on behalf of her or against her; the execution of documents, entry into contracts affecting her and the payment of reasonable compensation or costs to provide services for her, including medical services. 11. The severity of the alleged incapacitated person's mental and physical condition and the lack of viable, less restrictive alternatives necessitate that a Emergency Temporary Guardian of his person be appointed to handle all issues relating to the person of the alleged incapacitated person, specifically including, but not limited to: her living arrangements, her medical and psychiatric care, the administration of medication to her, and the employment and discharge of physicians, psychiatrist, dentists, nurses, therapists, and other professionals for her physical and mental treatment and care. 12. Petitioner is not aware that the alleged incapacitated person signed any power of attorney or advance health care directives or in any other way designated anyone to serve as her agent over any of her personal or financial affairs or as her surrogate over her medical care, nor that she designated in writing her wishes with regard to health care, including the use or refusal of life-sustaining treatment. 13. The alleged incapacitated person has no independent recollection of her assets, property, debts or liabilities, nor any independent recollection of all of her family members. 14. The alleged incapacitated person is married and has one child, namely, STEVEN L. SHANK and these are the alleged incapacitated person's only next of kin; therefore, the proposed Emergency Temporary Guardians of the person and estate of the alleged incapacitated person is JOSEPH J. SHANK. 15. The proposed Emergency Temporary Guardian has no interest adverse to the alleged incapacitated person. 16. The consent of the proposed Emergency Temporary Guardian is attached as Exhibit 17. As indicated in the treating physician's report, the alleged incapacitated person has been unable to communicate since approximately September 13, 2003 and, due to the fact that her incapacity is as a result of a stroke, there is no means to determine when and if the alleged incapacitated person may be in a position to handle her own affairs. 18. It is the position of your Petitioner, the proposed Emergency Temporary Guardian, to have the within guardianship appointment approved on an emergency basis, to be extended as permitted by law by further Petition, if necessary, and ultimately, to be entered as a plenary guardianship following hearing. 19. The need to make medical decisions and decisions alleged incapacitated person necessitates the entry on the day-to-day care of the of an Order providing for an Emergency Temporary Guardian, particularly because the alleged incapacitated person has already been admitted to a nursing home for rehabilitative care, but has not been able to provide the necessary authorization for such care or admission. 20. The appointment of an Emergency Temporary Guardian is the least restrictive alternative available in this case, particularly in light of the inability for the medical care providers to give an exact prognosis relative to the alleged incapacitated person's ability to manage her affairs in the future. WHEREFORE, Petitioners request your Honorable Court to enter an Order adjudging MARY E. SHANK to be incapacitated and appointing JOSEPH J. SHANK as Emergency Temporary Guardian of the person and estate of the said MARY E. SHANK for a period of 72 hours, to be extended as permitted by law. Respectfully submitted, & ASSOCIATES ,/ ,t~"~L,~G'~iffid, Esquire ~l:~y for Petitioner 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 I verify that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. DATE: t/~l [~D ~ '*< ,' ' F~× NO. 7172499332 M ASLAND ASSOCIATES ! NC. ]'NTE. RNAL ME.DIClNE MFDICAL AR'Ir.'; BUll.DING 2,20 WILSON S~'REE'r, C^etJSLU, PA 17013 f'/]7) 249-1929 Fax (717) 249-9332 02/02 Ja)s~,H F. Bmt~,z£~. M,D. T. AtJ~'x B~z;nn^~:t)v, M.D. September 19, 20(13 Bradley I.. Griffic, Esq. 200 N I. la~ovcr Street Carlisle, PA 17013 RE: Mary E, Shank(Dl:)B 11f0t/27) Dear Atlorney Griffie: I am writing in response ~o your telephone r~que~t of Sepmmber 18, 2003 regarding Mary Shank'a medi,'.al condi~o~. ~ you ~ow MaW ~ ~ extremol~ pl~nt 75 y~r old wom~ w~ unfo~unalely experienced a signifi~nt cerebral v~cular accident on September 13, ~3. Her other medical ~ndi~om~ includes prcviou~ h~tory of cerebral va~mla[ ~iden~, type I1 diab,tcs mellitus, hypercholcsterolumia, {)smo~roais, ostcoarthritls. h~e~qian, ~str~op~g~al reDex d~*m, choiolithiaMh ~qt~myalitis of Ihe left foot with cotlulitis, diffuse degenerative d~ di~se ~th spin~ s~nt)s~, anxiety and chrome m~ul~ ~in. In the p~t abe ¢x~rionced a right he.spheric CVA with l~ft lower ~re~. She has ais~) had a left bc~phcric stro~ in thc past with ~¢sidual right hcmiparcsia. On Sep~mbcr 13, ~3. her hu~a~ ~i~d that she had ~rbled and maraud ~ech. She w~ unuwarc of thc~ findings. SubsequenUy t~ pr~entod to lhe ER and she ~s ad~ttod to ~rlislc Re~onal Medi~l Cantor ~th thc working dia~o~ al' new ~rebral ~a~ular a~ident. She was sccn ill conmlmtion by Dr. Mt~hammad lamail, ~uurol~at who mnfirm~ ~e dia~i$ and aim d~um,nt~ exptemivc ~d receptive ~l~:mia. She w~ al~ ~rscverating and ~d diffi~lty undammnding simple ~mmnds. She w~ ~r~ for in ~e ~spital by Dr. Alex gashn~ov. 1 did have the op~tmnity to ~sit hot on Monday evening September i5. At t~t time she was r~ting comll}rtably in b~ a~ l ~ought she tg~gn~ed ~o I w~. Unfonunalely ~ was ~t able to follow simple commnds ~r communicate adcquate~. H~t [a~ly ~ not presan~ at that time. Given the a~ent of her ~m~al evenL I don't ~lkvc ~at ~ ~ the ca~ci~ m make deeision~ reg~ding her health cart: or o~er treatment opfiom. While at Chapel Pninl Naming Home, she MIl ~ m~d for by Dr. Krn Guis[wite, who w~,uld be able ~ provide you with the ~te~t events in her ~m. It' you should have any olhct quostiona, plo~ do not hesitate lo con,ct me directly. Sincerely, Christopher J. Bore, M.D. CJ B/bw '1': 9/19/03 EXHIBIT CONSENT OF GUARDIAN OF THE PERSON AND ESTATE I, JOSEPH J. SHANK, hereby consent to act as the Guardian of the Person and Estate of MARY E. SHANK I reside at 4303 Carlisle Road, Gardners, Cumberland County, Pennsylvania. I am a citizen of the United States of America and can speak, read, and write the English language. I have no interest adverse to MARY E. SHANK, the alleged incapacitated person. COMMONWEALTH OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : On this the I q '~ day o'f 5~f e'~ I/$1 q~f~2003, before me, the undersigned officer, personally appeared JOSEPH J. SHANK, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. MY C,.,.,.,~$$10# EXPIRES AUG. 25,200? · EXHIBIT MASLAND ASSOCIATES INC. INTERNAL MEDICINE MEDICAL ARTS BUILDING 220 WILSON STREET, CARLISLE, PA (717) 249-1929 Fax (717) 249-9332 17013 JOSEPH F. BRAZEL, M.D. TERRY A. ROmSON, D.O. T. ALEX BOSHNAKOV, M.D. DEBRA D. TAYLOR, M.D. PHILIP A. NEIDERER, D.O. CHRISTOPHER J. BERO, M.D., PHARM. D. LESTER L. HIMMELREICH, M.D. DOUGLAS J. BOWER, M.D. MICHELLE M. HALE, M.S.N., C.R.N.P. September 19, 2003 Bradley L. Griffie, Esq. 200 N Hanover Street Carlisle, PA 17013 RE: Mary E. Shank(DOB 11/01/27) Dear Attorney Griffie: I am writing in response to your telephone request of September 18, 2003 regarding Mary Shank's medical conditions. As you know Mary is an extremely pleasant 75 year old woman who unfortunately experienced a significant cerebral vascular accident on September 13, 2003. Her other medical conditions includes previous history of cerebral vascular accidents, type II diabetes mellitus, hypercholesterolemia, osteoporosis, osteoarthritis, hypertension, gastro-esophageal reflex disease, cholelithiasis, osteomyelitis of the left foot with cellulitis, diffuse degenerative disc disease with spinal stenosis, anxiety and chronic muscular pain. In the past she experienced a right hemispheric CVA with left lower paresis. She has also had a left hemispheric stroke in the past with residual right hemiparesis. On September 13, 2003, her husband noticed that she had garbled and confused speech. She was unaware of these findings. Subsequently they presented to the ER and she was admitted to Carlisle Regional Medical Center with the working diagnosis of new cerebral vascular accident. She was seen in consultation by Dr. Mohammad Ismail, neurologist who confirmed the diagnosis and also documented expressive and receptive aphasia. She was also perseverating and had difficulty understanding simple commands. She was cared for in the hospital by Dr. Alex Boshnakov. I did have the opportunity to visit her on Monday evening September 15. At that time she was resting comfortably in bed and I thought she recognized who I was. Unfortunately she was not able to follow simple commands or communicate adequately. Her family was not present at that time. Given the extent of her cerebral event, I don't believe that she has the capacity to make decisions regarding her health care or other treatment options. While at Chapel Point Nursing Home, she will be cared tbr by Dr. Ken Guistwite, who would be able to provide you with the latest events in her care. If you should have any other questions, please do not hesitate to contact me directly. CJB/bw T: 9/19/03 Sincerely, Christopher J. Bero, M.D. IN RE: GUARDANSHIP OF MARY E. SHANK IN THE COURT OF COMMON PLEAS OF'''P~[' CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-03-768 24 2003 ORDER OF COURT AND NOW, this ~ q' day of ,.~/~~ 2003, upon consideration of the within Petition for Adjudication of Incapacity and presentation and Appointment of Permanent Guardian, it is ORDERED AND DECREED that a hearing on this matter shall be held on ~/;24 , the ~ day of ~J ,2003, at /-'3(3 o'clock, __~.m., in Courtroom No. _~ , of the Cumberland County Courthouse, Carlisle, Pennsylvania. AND that a citation be issued to Mary E. Shank commanding her to show cause why she cannot appear at the aforementioned hearing and why a plenary guardian should not be appointed for her person and estate. PENDING the hearing in this matter, our Order of September 19, 2003, naming JOSEPH J. SHANK as Emergency Temporary Guardian is extended for an additional twenty (20) days pursuant to 20 Pa.C.S. {}5513. By the Court, Cc: Bradley L. Griffie, Esquire ~:-' ~ Attorney for Petitioner Michael A. Scherer, Esquire Attorney for Mary E. Shank P.J. 1N RE: GUARDANSHIP OF MARY E. SHANK : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. 21-03-768 IMPORTANT NOTICE TO: Mary E. Shank c/o Michael A. Scherer, Esquire A petition has been filed with this Court to have you declared an Incapacitated Person. If the Court finds you to be an Incapacitated Person, your rights will be affected, including your right to manage money and property and to make decisions. A copy of the Petition which has been filed by Joseph J. Shank is attached. You are hereby ordered to appear at a hearing to be held in Courtroom # , of the Cumberland County Courthouse, Carlisle, Pennsylvania, on , the ~ day of ,2003, at o'clock, __.m., to tell the Court why it should not find you to be an Incapacitated Person and appoint a Guardian to act on your behalf. To be an Incapacitated Person means that you are not able to receive and effectively evaluate information and communicate decisions and that you are unable to manage your money and/or other property, or to make necessary decisions about where you will live, what medical care you will get, or how your money will be spent. At the hearing, you have the right to appear, to be represented by an attomey, and to request a jury trial. If you do not have an attorney, you have the right to request the Court to appoint an attorney to represent you and to have the attorney's fees paid for you if you cannot afford to pay them yourself. You also have the right to request that the Court order than an independent evaluation be conducted as to your alleged incapacity. If the Court decides that you are an Incapacitated Person, the Court may appoint a guardian for you, based on the nature of any condition or disability of your capacity to make and communicate decisions. The Guardian will be of your person and/or your money and other property and will have either limited or full powers to act for you. If the Court finds you are totally incapacitated, your legal rights will be affected and you will not be able to make a contract or gift of your money or other property. If the Court finds that you are partially incapacitated, your legal rights will also be limited as directed by the Court. If you do not appear at the hearing (either in person or by an attorney representing you), the Court will still hold the heating in your absence and may appoint the Guardian requested. By the Court, Date: Clerk, Orphans' Court IN RE: GUARDIANSHIP OF MARY E. SHANK IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-2003-0768 IMPORTANT NOTICE CITATION WITH NOTICE A petition has been filed with the Court to have you declared an Incapacitated Person. If the Court finds you to be an Incapacitated Person, your rights will be affected, including our right to manage money and property and to make decisions. A copy of the petition which has been filed by Joseph J. Shank is attached. You are hereby ordered to appear at a heating to be held in Court Room No. 3, Cumberland County Courthouse, Carlisle, Pennsylvania, on Monday, October 6th ,2003, at 1:30 P.M. to tell the Court why is should not find you to be an incapacitated Person and appoint a Guardian to act on your behalf. To be an incapacitated Person means that you are not able to receive and effectively evaluate information and communicate decisions and that you are unable to manage your money and/or other property, or to make necessary decisions about where you will live, what medical care you will get, or how your money will be spent. At the heating, you have the right to appear, to be represented by an attorney, and to request a jury trial. If you do not have an attorney, you have the fight to request the Court to appoint an attorney to represent you and to have the attorney's fees paid for you if you cannot afford to pay them yourself. You also have the right to request that the Court order that an independent evaluation as to your alleged incapacity. If the Court decides that you are an Incapacitated person, the Court may appoint a Guardian for you, based on the nature of any condition or disability and your capacity to make and communicate decisions. The Guardian will be of your person and/or your money and other property and will have either limited of full powers to act for you. If the court finds you are totally incapacitated, your legal rights will be affected and you will not be able to make a contract or gift of your money to other property. If the court finds that you are partially incapacitated, your legal rights will also be limited as directed by the Court. If you do not appear at the hearing (either in person or by an attomey representing you) the court will still hold the hearing in your absence and may appoint the Guardian requested. Clerk, Orphans' ~mrt Division Cumberland County, Carlisle, PA My Commission Expires 1st MondaY, January, 2006 Durable Power of Attorney for Health Care (Pennsylv~'~'"Statutes Annotated title 20, §§ 5601 to 5607) ,._ ' -- ~" Print your full name ' am of sound mind and I voluntarily mal('e this Durable Power of Attorney for'Health Care. There are two parts to this document: Part 1 sets forth my health-care ins.tructions; Part 2 appoints a person to make health-care decisions for me on matters not covered in my instructions. This document shall take effect upon my incapacity. PART 1 Health-Care Instructions (2) I am one of Jehovah's Witnesses. On'the basis of my firmly held religious convictions, see Acts 15:28, 29, and on the basis of my desire to avoid the numerous hazards and Complications of blood, I absolutely, unequivocally and reso- lutely refuse homologous blood (another person's blood) and stored autologous blood (my own stored blood) under any and all circumstances, no matter what my medical condition. This means no whole blood, no red cells, ho.white cells, no platelets, and no blood plasma no matter what the consequences. Even if health-care providers (doGtors, nurses, etc.) believe that only blood transfusion therapy will preserve my life or health, I do not want it. Family, rela- tives' or friends may disagree with my. religious beliefs and with my wishes as expressed herein. However, their disa- greement is legally and ethically irrelevant because it is my subjective choice that controls. Any such disagreement should in no way be construed as creating rmbigu!ty'orldoubt about the strength or substance of my wishes. Also, because many health-care providers view Jehovah's' wi~esses, refus'al of blood With disapproval and eviin . -. hostility, I am concerned that someone may claim that I orally consented to a blood transfusion. Thus, I hereby state ~--.. that it is my conscious de':is;on that my' absol~te-refusal of blood ffan'sfusi0n'shall not be i-e~,o~:able by me orally.-If ' . anyone.claims that i hav~ 'orally conseflted ~'a'blood tra~sfu~i~r~:,'i der~an'ci th';~t such claim be ignbred finles~ confU'med' i. ........ in writing sigfi~d 6y-ine'fi~/d s~bscribed b~; ht least twO ~ii~i'ntet:~t~d ,bi'tnes'ses.:~J- - '- -- ' :(i ¢'. :~.. :':'!:-" .'?j7 ~5 ..-4 .-.:'::'-:g--"4',.',.:.:-(.:::':.-: .' :-::-' '"-~5-'-'.:':':5"~/'--:::: :'.::.:~5~'.4':.=:.':.5::'~':,:,~':5.:..:. ~- ~: -'...'-- -...-": :: -:i:_(3) '..Wi!h 'respect to m-ifi6P bl60d fractions*-0f products c'0~itain[n'~'/fiin&:bl;&i fractions;' ac~0t:ding to my conscien'-c~' -:. ,: ACCEPT:' [initi'~il ~bh~'~f'~h'~ t~ree ch6ic~-b~loi,~,]. '.-'. ....... -:' _ .- :. ":. ;?/ri i-: . ::--.' :'i.' :': 4: :'...':"-". -:: " ~, ' "-~'.L ---f ' :: '.' '" : -'"'C ';5 ,. ':..~.:.'. :-,_-.,, ..'....'..: ..L .~::~'.._::~_:. - 'T: :.-. '_ .: ...:'::.., ..---::. -.'._': _f ... _' .. - '(C) SOME. That iS, I ACC'EPTi [initial ch0{c~0)'bel0~]:-..~::.:~':::i!-~t· --~:. :-"-::::!.' ':.' ~,}:.::-~":-"Q ..':. ::.'.::. - '. -' __~ Products l[hat may hav.e.been processed with or contain small amounts of albumin (e.~., streptokin'a~e, and some recombinant products [such as_ eryth:r, opoietin ~EPO) and synthesized clotting factors],'-and ..... ' some radionuclide, scan preparations may'conta!ffa!bdmin) ..... _. . ..... . Immunoglobulins (e:g.;'Rh immune globulin,' gamrfiaglobuliri, hc~rse'serum, snake bite'antivehins). Clotting factors (e.g., fibrinogen, Factors-y!I, viii, IX~ xII). ' ' -' -: Other: ' ' ::: (4) (5) I accept and request alternative nonblood medical management to build up or conserve my own blood, to avoid or minirn!ze blood loss, to replace lost-circulatory volume, or to stop bleeding. For example, volume expanders Such as ' dextran, saline or Ringer's solution,'0r hetastarch would be a6'6'eptable 'to me. . . ~:.~...- _ With respec.,i to non-stored autologous blood* (my own non-stored blood), according'to my conscience I ACCEPT: [initial choide(s) below] ' '. .'~ .... ' --; ....... -...: .... --' '-- .. ,~ tON(; EQ N(' (divei-si6r~' my lo-0d w ~iii an extrii~:,0rP0 ' :'. DIALYSIS OR HE T-L uIPME of b i real CirCuit that does not irn~olve storage or more than.brief interruptio.n 0fblpod' fl0-W_ and that is constaiitly linked to my circulato~ system, provided any equipment used is not P'~:imed with s~'6red bi0~>d). -i. HEMoDmtrr~ON (dilution of m9' blood Wit~inan ~trac;rP0i-ei~l"ckcuii that c~'not'irrvolv~ ihan brief interruption of blood flow"an-d that'iS' constantly lini<ed tS my' cirCUlat~i-y System; provided any equipment used is-not primed with stored bloo~l).":-- :-. -' ' ..'--'.._: :':':- .": ': INTRAOPERATIVE OR POSTOPERATIVE BLOOD SALVAGE (contemporaneous reiovery and reinfusion of blood lost during or after surgery that does not involve storage or more than brief interruption of blood flow, pro- vided any equipment used is not primed with stored blood). NONE. (d) *Warning: Consult your doctor regarding potential health risks. Page t of 4 (6) With respect to providing, withholding, or withdrawing life-sustaining treatment at the end of life, and consistent with Pennsylvania Statutes Annotated title 20, § 5404, my declaration, which in no way alters my absolute refusal of blood as directed above, is: [initial one of the three choices below] '~ (a) NOT TO PROLONG LIFE.' That is', if to a reasonable degree of medical certain(y my condition is hopeless (for . example, if to a reasonable degre~ of medical certainty I have an incurable and irreversible condition that will result in my death within a relatively short time, or if I am unconscious and to a reasonable d~gree of medical certainty will not regain consciousness, or if I have brain damage or a brain disease that makes me · unable to recognize people (ir communicate and to a reasonable degree of medical certainty my condition will not improve), I do not want my life to be prolonged. Thus, in such situations, I do not want mechanical respiration (ventilation), cardiopulmonary resuscitation (CPR), tube feeding (artificial nutrition or hydra- tion), etc. However, I do want palliative care treatment for comfort. (b) TO PROLONG LIFE. That is, I want my life to be prolonged as long as possible within the limits of generally accepted health-care standards, although I realize this means that I might be kept alive on machines for years in a hopeless condition. (c) OTHEP.. Jif you do not completely agree with either (a) or (b) above, you can initial here and write 3;our own end-of-life instructions in the space provided.--NOTE: Unless your agent knows your wishes about artificial nutrition and hydration, your agent may not be able to make decisions about these matters.] .': (7) Other"health-car ..Q' :.'. :/i. problems; etc.): '. (8) I am primarily C'onc~'rned that my refusal of blood-and choi'ce of alternative 'nenblo0d maniigemeh-t b~ i:e'ipeet'ed '.' regardless of my aiedical condition. My right~ under the federal and state constitu'ti0r~s and state common iaw require - · heatth:qare p?oitiders to respect and .comply with my treatment decisions.-- My rights are net dependent on, and do not vary wi~'-my medical condition. Thus, ,my decision to refuse blood and choose'-'nonblood management must be re- spected even if my life or health is deemed to be threatened by my refusal. Stamford Hosp. v. Vega; 674 A.2d 821 (Conn. ! 996) (Witness patient's refusal of blood protected by state common law right of bodily self-determination); In re Dub;cull, 629 So. 2d 819 (Fla. 1993) (Witness patient's'refusal of blood protected by state constitutional rightslof_ personal privacy and religious freedom); NorWoodHosp. V. Munoz, 564 N.E.2d 1017 (Mas~. 1991) (W!tness patient's refusa! of bl~3d proteeted'by stati cbmmon law right of bodily self-determiiiation and federal constitutional right:of . personal privacy); Fosrnire v. Nicoleaul-551 N.E.2d ,?;/' (N.Y. 1990) (Witness patient's re~'sal of blood protected by state common law right of bodily self-determination); In re E.G., 549 N.E.2d 322 (Ill. 19895 (Witnesspatient's refusal of blood protected by state common law right of bodily self-determination); PutQic Health Trust v. Worts, 541 So. 2d 96 ' · -- (Fla. 1989)~{:~,vi~ess pa{lc;it's i'efusal Of blood protected by state constitutional 'i'ights' of pefs0nal privacy and religious'- ;i. freedom); In'~e ~Milton; ~505 N.E.2d 255 (Ohio" 1987)' (n~n-Witness p;,tientWr~ligion-based i~efusal of treatment pro- :, ,:, :-:~ :' tected by 1st Amgndmef~"~ii'arint~&'bf'frie.e-~i. CiS~-:bf religiofi); [r~ re Brown; 478 S~ ..... ...... ':' atient% 'r~fui": ....... '~" '- ~':'" ..... "' :'-; ......... :"· .... :~....:... ....... .~: .......: ..... . . .: '2d .1033 CM.!s.s. 1985) (witness .. ,-~ :: p .... : .... ~1. 9fb.l.o.o~ pro.te, cted by state c.9nst~tuttona_l nghB of personal pi-iyaey' and '~-eli~i0ui"freedom)} 'in '/:~ Os£:j A::..:.:. borne, ·294 A}2d:~72"(D~c::'1972)-(Wftng~s¥~ii~'~rit,~ r~usal:0f ble0d piYtect~d by l st"Xm~ndment'g~a~i~te~ ~0~' f~ee' · :.: ;'/exercise ~0f religibn);' ~rr/~e'F..iti~tdjDfBrD'3kS;':2OS.i-~}Ei2~ 435 (I1[ 19i55)~ (WitneSs:~atier~t's i-~fusal-0f bloed' ~i-oiecied-by-~ · [This footnote applies only to pregnant women.] If I am pregnant and there is a reasonable chance my fetus could survive, I want my life to be prolonged for the sake of my fetus, notwithstanding my instructions in Paragraph (6)(a). However, in no way does this change my wishes about nonblood treatment for both myself and my fetus. After any efforts to save my fetus, my instructions in Paragraph (6)(a) shall again control. The United States Supreme Court has said that "[i]t is settled now ... that the Constitution places limits on a State's right to interfere with a person's most basic decisions about ... bodily integrity." Planned Parenthood v. Casey, 505 U.S. 833,849 (1992). In Cruzan v. Missouri Depar'tment of Health, 497 U.S. 261 (1990), the Supreme Court stated: "It cannot be disputed that the Due Process Clause [of the Fourteenth Amendment to the United States Constitution] pro- tects an interest in life as well as an interest in refusing life-sustaining medical treatment." Id. at 281. The Court also said: "The principle that a competent person has a constitutionally protected liberty interest in refusing unwanted medi- cal treatment may be inferred front our prior decisions." Id. at 278. In addition, in B/ashington v. Harper, 494 U.S. 2 I0 (1990), the Supreme Court said that pti{on inmates suffering fi'om mental disorders possess "a significant liberty inter- est in avoiding the unwanted administration of antipsychotic drugs under the Due Process Clause of the Fourteenth Amendment." Id. at 221-22. The Court also observed that "it]he forcible injection of medication into a nonconsenting person's body represents a substantial interference with that person's liberty." Id. at 229. There is no indication in these Supreme Court cases that a person must be in a terminal, irreversible, incurable or untreatable condition, or in a permanently unconscious or vegetative state in order to exercise his fundamental Four- teenth Amendment right to refuse treatment or otherwise control what is done to his body. Indeed, Nancy Cruzan her- self was not terminally ill. See 497 U.S. at 266, n.I. Moreover, implicit throughout the majority opinion in Cruzan and expressly stated in Justice ~,,onnor s concurrence and all the dissents (except Justice Scalia's) is the acceptance of advance written directives as clear and convincing evidence of a formerly competent patient's wishes. Therefore, be- cause I have prepared this advance directive while competent, if I become incompetent, my wishes as expressed herein must be respected as if I were competent. · (9) [This paragraph applies only to pregnaht women.] In Planned parenthood v. Case),, 505 U.S. 833,860 (1992), the Su- preme Court confirmed that "viability mm-ks the earliest point at which the State's interest in fetal life is constitutionally adequate to justify, a legislative ban 0_n therapeutic aborfions."..Thus, since I have the right to abort: my pregnanc before :.- - viability I necessarily have'the lesser right to refuse blood transfusions before vtabdtty. In addition, even if m}5~tus is ':?:-:5 .- -viable, the Supreme Cou'rt has said that m'othei-s Cannot Se ek~0sed to increased m · . .-: - '- - · ....... v ...... ~ m~ orme terns is lnsumc~ent to override the mother's intel:eSt'in prek-:z :~_ · .- servtng her own health.: Tho)nburgh v.~:American'iCollege'of Obstetridians & Gynecologists, :476 U~S. 747, 768-71 ¢? ~-.< '(i986); see Planned Parenthood v. CasZ, y~-505~'U.~.'~33,846 (1~92). Als0, in the cases of In ~ A.C., ·573 A.2d ;. :~ ' b'Y worsen W/th-viabl~"fetus&---~.-e~-&, ilph'~id.':..Alth~ugh· both"'6:f th4se crees in,,oiled cae}ar~an S~c~i0~n~}'a~ a majtidf'~)'f: +, i::...-."-, principl~ and logic they Sho,,~ th·at. itis the P~-~n'ari{ wom~-'~h0 sh0iild decide what is tO be done~i'0 hei'self a~rid ~.}-:.;((-- fetus..Therefore, I demand that 'my t~fusai of blood and chh'ice df alternative 'n0nbi0od managemen't be folloWed --'.'(10)In sum; based on federal and state Const'itutional law and stat~ Common law, I d~mand that the instmctioh~ se~ forth in '. this doiument be followed regardless'of my medical condition ' Any attempt to administer blo - :- instructions will be a violation ^r ~'_ ,-,:..L,.- -_, _ -~. .... '- ... Od to me'contrarY'to my :.. ..... · . ~,, my rouneenm Amenament liberty interest in bodily self-determination, :my First' i~. .-.-' ..... ' - ' Amehdment-right of reIigiou~ free exeicise,'.mY'st~ie congiitutional rights Of p~'s0nal liberty or ~i~rig'a~:~'and i'eligi0us'i; '. : : freedom, and my state common law rights 0fb0dily self-determ ination and personal autonomy. '.. ': :-.i ~: ~i' "' PART 2~Appointment Of Health-Care Agent (1 l) I hereby appoint the following person as my health-care agent: [Notice: You may choose any adult to be your agent, ' . . ~ . but it is recomm,-nded 'that' you not chon'se your doctor, any of your doctor's employees, or any emp'loy~e of a hospital or n.ursing home where you might be a Patient, unless the individuaI is related to you by blood, marriage;'0r adoption..].:}-:....:~;~ -.. '. n - WorkTelephone:(~.) ~..~,27Lc~--.~.~(~?~omeTelephone:(7/.7) /-~7~--,~,-'j /'/D Other:( ) ' : Page 3 of 4 . "..(19) PA (13) To the extent this document sets forth my health-care instructions, there is no need or reason to look to my agent for a decision. However, I grant my agent full power and authority to ensure that the wishes expressed in this document are followed by health-care providers. Further, I grant my agent full power and authority to make health-care decisions for me on matters not covered by this document. My agent's authority is effective as long as I am incapable of making my own health-care decisions. (14) In harmony with the limitations in the preceding paragraph, my agent's authority shall include but not be limited to the (a) To consent to, refuse, or withdraw consent to any or all types of medical care treatment, surgical procedures, diag- nostic procedures, medication, and the use of other mechanical or other procedures related to health care. This authorization includes the power to consent to pain-relieving medication for relief of severe and intractable pain. (b) To request, review, and receive any information, oral or written, regarding my physical or mental health, including, but not limited to, medical and hospital records, and to consent to the disclosure of this information. (c) To employ or discharge my health-care providers; to authorize my admission to or discharge from any hospital, nursing home, mental health or other medical care facility; and to take any lawful actions that may be necessary to carry out my wishes, including the granting of releases from liability to health-care providers. (I 5) A copy of this document shall be as valid as the original. I ask that a copy of this document be made part of my perma- nent medical record. I have provided copies of this document to ray health-care agent and alternste agent. It is my intention that this document be honored in any jurisdiction in which it is presented and tha~t'it be construed liberally to give my agent the fullest discretion in making health-care decisions in my behalf consistent with my instructions. (16) If my health-care providers cannot respeci: my wishes as expressed in this dbcum~nt or as 6therw[se known to my'agent and a transfer of care is necessary to effectuate 'my wishes, I direct my health-care providers to cooperate With and assist ' --' my .agent in promptly transferring me t0"aiiother heal~ii2care'pro~,id~r that Will respect'my Wish6sT.: Iff such'circum:.~'~: .: stances, I direct my hehlth-care pmc-idei~s-ic;-transfer p-r0h/ptly all my medical records, i'ndlt~ding a 6opy Of this do~fi-"k- I declare that the person Who si~ed this d0cum~nt (the principal) or the person who ~igned on behalf of and at the direction of the principal knowingly and voluntarily.,signed this writing by signature or mark in my presence. Also, I am not the p~rson appointed as agent alternate agent by this document. - . .. Address - . _ - (21) A Professional Corporation 522 South. Pitt street. Carlisle. PA 17013 Phone: 243-1516 KENNETH R GUIS'TWlTE. M.D.- CURRI VITAE Bachelor"of Science Degree, Urslnus College Doctorate of Mecllclne, Tern ~e University Residency in Family Practi~ Board Certified, American Practice American Academy of Family Practice recertificatlon Family 1968 1972 1973 1976 1989-1996 Carlisle Hospital Medical Chairman, Family Practice Carlisle Medical Staff Member, PennsYlvania Medi, Member,"American Medical A Member, American Academy Practice limited to Family Professional Corporation LIATIONS ,ff t, Society ~oclation ~f Family Practice 1973 ". ," ,,. 1985-86 ~.: 1973 thru present thru present 1976 thru present MASLAND ASSOCIATES INC. INTERNAL MEDICINE MEDICAL ARTS BUILDING 220 WILSON STREET, CARLISLE, PA (717) 249-1929 Fax (717) 249-9332 17013 JOSEPH F. BRAZEL, M.D. TERRY A. ROBrSO~, D.O. T. Pa. EX BOSHNAKOV, M.D. DEBRA D. TAYLOR, M.D. PHILIP A. NEIDERER, D.O. CHRISTOPHER J. BERO, M.D., P~AR~. D. LESTER L. HIMMELREICH, M.D. DOVGLAS J. BOWER, M.D. MICHELLE M. HALE, M.S.N., C.R.N.P. September 19, 2003 Bradley L. Griffie, Esq. 200 N Hanover Street Carlisle, PA 17013 RE: Mary E. Shank(DOB 11/01/27) Dear Attorney Griffie: I am writing in response to your telephone request of September 18, 2003 regarding Mary Shank's medical conditions. As you know Mary is an extremely pleasant 75 year old woman who unfortunately experienced a significant cerebral vascular accident on September 13, 2003. Her other medical conditions includes previous history of cerebral vascular accidents, type II diabetes mellitus, hypercholesterolemia, osteoporosis, osteoarthritis, hypertension, gastro-esophageal reflex disease, cholelithiasis, osteomyelitis of the left foot with cellulitis, diffuse degenerative disc disease with spinal stenosis, anxiety and chronic muscular pain. In the past she experienced a right hemispheric CVA with left lower paresis. She has also had a left hemispheric stroke in the past with residual right hemiparesis. On September 13, 2003, her husband noticed that she had garbled and confused speech. She was unaware of these findings. Subsequently they presented to the ER and she was admitted to Carlisle Regional Medical Center with the working diagnosis of new cerebral vascular accident. She was seen in consultation by Dr. Mohammad lsmail, neurologist who confirmed the diagnosis and also documented expressive and receptive aphasia. She was also perseverating and had difficulty understanding simple commands. She was cared for in the hospital by Dr. Alex Boshnakov. I did have the opportunity to visit her on Monday evening September 15. At that time she was resting comfortably in bed and I thought she recognized who I was. Unfortunately she was not able to follow simple commands or communicate adequately. Her family was not present at that time. Given the extent of her cerebral event, 1 don't believe that she has the capacity to make decisions regarding her health care or other treatment options. While at Chapel Point Nursing Home, she will be cared for by Dr. Ken Guistwite, who would be able to provide you with the latest events in her care. If you should have any other questions, please do not hesitate to contact me directly. CJB/bw T: 9/19/03 Sincerely, Christopher J. Bero, M.D. IN RE: GUARDIANSHIP OF · IN THE COURT OF COMMON PLEAS OF MARY E. SHANK · CUMBERLAND COUNTY, PENNSYLVANIA · ORPHANS' COURT DIVISION~ · NO. 21-03-768 DECREE ,.' AND NOW, this 6th day of October, 2003, upon consideration of ~e Petition filed, and hearing held in this matter, it is hereby ORDERED AND DECREED that, based on a finding that Mary E. Shank suffers from impaired ability to reason and physically care for herself as a result of a significant cerebral vascular accident which occurred on September 13, 2003, as well as a history of ccrebrai vascular accidents, type II diabetes mellitus, hypercholesterolemia, osteoporosis, osteoarthritis, hypertension, gastro-csophageal reflex disease, cholelithiasis, ostcomyelifis of thc left foot with cellulites, diffuse degenerative disc and spinal stenosis, anxiety and chronic muscular paid, and is so severely mentally and physically impaired that she is unable to make, communicate or participate in any decisions relating to her estate or person, Mary E. Shank, is adjudged totally incapacitated and in need of plenary guardianship services for her persona and estate. Further, there being no advance directives in existence issued by Mrs. Shank, Joseph J. Shank, is appointed plenary Guardian of thc person and estate of Mary E. Shank and is appointed to manage and handle all aspects of Mary E. Shank's estate, specifically including, but not limited to: all issues relating to payment of routine bills and other banking and savings account needs; the maintenance of her life, and other insurance of which she is an owner or beneficiary; her entitlement to any governmental or non-governmental benefit plans; preparation and filing of federal, state, and local taxes; claims made or to bc made on behalf of her or against her; the execution of documents, entry into contracts affecting her and the payment of reasonable compensation or costs to provide services for her, including medical services; and all other powers, duties, and liabilities set forth in 20 P.C.S. Section 5521. In addition, the Guardian is appointed to handle all issues relating to the person of Mary E. Shank, specifically including, but not limited to: her living arrangements, her medical and psychiatric care, the administration of medication to her, and the employment and discharge of physicians, psychiatrist, dentists, nurses, therapists, nursing care facilities, and other professionals for her physical and mental treatment and care. No bond shall be required to be filed by the Guardian in this case. Cc: Bradley L. Griffie, Esquire Michael A. Scherer, Esquire By the Court, ~esident Judge AUTHORITY TO PAY COURT APPOINTED COUNSEL DEC 1 8 2003 1. COURT --6405 [] District Justice I~ Common Pleas [] Appellate [] Other 3. FOR (D.J., C.P., APPELLATE) 4. AT (CITY/STATE) 5. BUDGET qODE Court of Common Pleas Carlisle, Pennsylvania 6. IN THE CASE OF 7. CHARGE/OFFENSE (PURDON CITATION) 8. O PI= I~ I ¥ OFFENSE Mary Shank Guardianship ~ FELONY D MISDEMEANOR 9. PROCEEDINGS (Describe briefly) 1 I. PERSON REPRESENTED 12. CIVIL DOCKET NO. , ~ o.,..~..,- ^~, 21 - 03- 768 Guardianship ~ [3 3 [2 Appellant 4 [::] Aooellee 13. CRIMINAL DOCKET NO. 5 D Habeas Petitioner 6 [2 Material W~lness ? O Parolee Charged Wilh Violation 10. PERSON REPRESENTED (Full Name) 8 [2 Probationer Charged Wil~h Violation 14. APPEALS DOCKET NO. Mary Shank ~ s o,~e~ 18. NAME OF ATTORNI=¥/PAYF:E AND ApOt Date MAILING ADDRESS Michael A. Scherer, Esquire Honorable George E. Hoffer, P.J. O'Brien, Baric & Scherer NAME OF COMMON PLEAS JUDGE ASSIGNED TO CASE 17 West South Street Carlisle, Pennsylvania 17013 17. TELEPHONE No. I 18. SOCIAL SECURITY NO OR E IN NO (717) 249-6873I 25-1708515 CLAIM FOR SERVICES OR EXPENSES 19. ~ SERVICE HOURS DATES AMOUNTS CLAIMED a. Arraignment and/Dc Plea Multiply rate Der hour times total b. Preliminary Hearing hours to oblain "In Court" core- c. Motions and Re~auest$ Densation. Enter total below. ~n- cl. Bail Hearings ~(~ e. Sentence Hearings Z f. Trial g. Revocation Hearings h. Juvenile Hearings i. Appeals Court 9A. TOTAL IN COURT COMP. j- Other (Specify on additional sheets) Guard i ansh i p 1 . 00 SEE ATTACHED TOTAL HOURS= i .00 SZ~' 0~ERHOUR =$ z~5' O0 20. a. Inter~iews and confer,,,~.,a 1. 2 5 SE E ATTACHED Multiply rate per hour times total b. Obtaining and reviewing records hours. Enter total "Out of Court" ~) ~ c. Legal research and brief writing compensation below. I- 8 ~O d. InveslJgative and other work (Specify on addilJonaJ sheets) 20A. TOTAL OUT OF COURT CPM P. TOTAL HOURS = 1. 2 5 $ 4 5 · 0 0 X PER HOUR = $ 56.25 21. ITEMIZATION OF REIMBURSABLE EXPENSES AMT. PER ITEM Mileage $.25 per m~e x uJ 3: l- O 21A. TOTAL ITEMIZED EXP. 22. CERTIFICATION OF ATtORNEY/PAYEE [~'[i chae '1 A. Scherer ~ Esquire 23. GRAND TOT&L CLAIMED Has compensalion and/or reimbursement fa' wo~ in this case previously been applied for? I-I YES ~ NO Ifyes. were you paid? ri YES ~[~ NO Ifyes,bywhomwereyoul3alcr? Howmuch? Has the person represented paid any money to you, or to your knowledge anyone else, in connection with the matter for i24. DEDUCT. PRIOR PYMTS. which you were al3oointed 1o provide reDresenta~,~?/; ,C] ~E~jf~/L,.,~ NO If yes, give details on additional sheets I swear or affirm the truth or correctness /,4,",~,¢,,f..,4 lT., }! T/o~' 25. NET AMOUNT CLAIMED of the above statements Signature of Attorney/Payee Date = S 1 0 P&YMEN[ I Signature o! 27. AMT. APPROVED F(~,, Juclge ~ F D,te: ' / '0 = $ Co to Court ,~ ministrator at completion of service Robert L. O'Brien David A. Baric Michael A. Scherer Law Offices O'BRIEN, BARIC & $CHERER 17 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 FAX: (717) 249-5755 E-mail obs@obslaw, com Mary Shank Court Appointed Guardianship 1 Courthouse Square Carlisle, PA 17013 November 25, 2003 File #: 3162 Inv #: 11022 Guardianship: court appointed DATE DESCRIPTION HOURS AMOUNT LAWYER Sep-26-03 Oct-02-03 Oct-06-03 Receive and review letter from Brad Griffie, emergency guardianship petition and petition for plenary guardian. Meet with Mary Shank at Chapel Pointe Nursing Home. Represent Mary at guardianship hearing. 0.50 $22.50 MAS 0.75 $33.75 MAS 1.00 $45.00 MAS Totals 2.25 $101.25 Invoice #: 11022 Page 2 Total Fees & Disbursements Previous Balance Previous Payments Interest Due November 25, 2003 $101.25 $0.00 $0.00 $0.00 Balance Due Now Administrative charge of l % per month (12% per annum) will be added to any outstanding balance over 30 days. Payment due within 20 days of invoice date. $101.25