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Home My WebLink About12-07300* 0 6. IN RE: BRIAN JOSEPH DYM, IN THE COURT OF COMMON PLEAS a Minor OF CUMBERLAND COUNTY, PENNSYLVANIA AARON and SHARI DYM, as parents and nataral guardians of C 0' BRIAN JOSEPH DYM, No. 730 -? I a minor, Petitioners PETITION FOR APPROVAL OF SETTLEMENT OF MINOR'S CLAIMS rjj- Co -q 1. Petitioners, Aaron and Shari Dym, are the parents and natural guardia% B , cnr` ? Vic' Joseph Dym, a minor (hereinafter referred to as "Minor-Petitioner"). 2. Petitioners are represented by Devon M. Jacob, Esquire. •_ -- - ; ; 3. Minor-Petitioner was born on November 18, 2003, and is currently eia,-yeaA old. 4. Cumberland Apothecary, Inc. is a corporation duly organized under the laws of Pennsylvania and authorized to do business in Pennsylvania, and currently does so at a business address of 3300 Market Street, Camp Hill, PA 17011, Cumberland County, Pennsylvania. 5. Cumberland Apothecary operates a pharmacy. 6. At the time if the incident described more Silly below, Cumberland Apothecary was insured by Pennsylvania National Mutual Casualty Insurance Company ("Penn National"). 7. On or about December 17, 2010, Petitioners filled a prescription for Minor Petitioner at Cumberland Apothecary. 8. Cumberland Apothecary mis-filled Minor-Petitioner's prescription, which lead to temporary adverse health consequences, from which Minor-Petitioner has recovered. .$103.'15 PQ A"'-/ ?? 1??38a1 9. More specifically, Minor-Plaintiff was prescribed a combination of Demerol Syrup 50 mg/5cc and Donnatal Elixir - a sedative - and was instructed to take 2 teaspoons 1 hour prior to dental surgery. The label on the prescription bottle subsequently read "take contents 1 hour prior to visit." This was equivalent to 3 times the prescribed dose. 10. Following the instructions printed on the medication bottle by the Apothecary, Minor-Petitioner took the contents of 'the prescription bottle. While in route to his dentist appointment, Minor-Petitioner .vomited several times and, upon .arrival, the dentist noted that Minor-Petitioner was suffering from an unanticipated and decreased level of consciousness, at which time the dentist noted the error on the label of the prescription bottle. 11. Minor-Petitioner's medical condition was such that emergency medical intervention and treatment was required by the dentist and paramedics, who ultimately transported him to Sinai Hospital at the recommendation of Minor-Petitioner's pediatrician for further emergency medical treatment. Minor-Petitioner was subsequently taken to the emergency room, where he was treated, admitted to the hospital, and then later discharged. 12. Minor-Petitioner does not appear to have suffered any permanent, lasting, or ongoing physical effects or physical injuries from the mis-filled prescription, and Petitioners have not been advised by any of Minor-Petitioner's medical treatment providers that any long term or permanent injury or effect has or will occur. See medical records attached hereto as Exhibit A. 13. Petitioners' insurance had paid for all medical costs associated with this event, and it is therefore averred that there are no outstanding medical liens or outstanding medical expenses. 14. On behalf of Cumberland Apothecary, Penn National has offered to settle this claim for Twenty-Five Thousand Dollars ($25,000.00), with 25% of the total settlement amount i (or $6,250.00) being paid to satisfy Petitioners' reasonable attorney's fees and costs. 15. Petitioners have accepted said settlement offer, which will be used for the benefit of Minor-Plaintiff. 16. Petitioner Parents, Aaion and Shari Dyrn, believe this offer is fair and in the best, interest of Brian Joseph Dym,_Minor-Petitioner. 17. Penn National has retained Corey J. Adamson, Esquire, to represent their insured, Cumberland Apothecary, in the acquisition of Court approval of the aforementioned settlement. 18. Petitioners therefore respectfully request this Honorable Court approve said settlement. 19. Additionally, Petitioners respectfully request that Petitioners be authorized to execute a full and final general release, releasing Cumberland Apothecary and Penn National,. The proposed Release is attached hereto as Exhibit B. 20. No Judge of this Honorable Court has ever ruled on any issue in this matter. 21. All interested parties referenced herein concur in this Petition. WHEREFORE, Petitioners respectfully request this Honorable Court enter an Order in I the form proposed, approving the..settlement of Minor-Petitioner's cljaims, and authorizing and directing Petitioners to execute a full and final release, and authorizing the payment for the same to be made, as outlined in the proposed Order. I ri Date: 1019315.1 Devon M. Jaco? sq. Lavery Fahertatterson 225 Market St. POB 1245 Harrisburg, PA 17108 717-233-6633 VERIFICATION We, Aaron and Shari Dym, as Parents and Natural Guardians of Brian Joseph Dym, a Minor, do hereby verify that we are the Petitioners in the above-captioned action and further verify that we have read the foregoing document and that it is true and correct to the best of our knowledge, information and belief. We understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904, relating to unworn falsification to authorities. Date: ?2? Lv 1 o I? Date: t Z ZD 21 0-a '7 Aaron Dym, as Par and Natural Guardian of Brian oseph Dym, a Minor 2 Shari Dym, as Parent and Natural Guardian of Brian Joseph Dym, a Minor CERTEU4CAIE QF U VICE The undersigned hereby certifies that on this day of , 201 . , copies of the foregoing document were served via United States First Class Mail, postage prepaid, upon: Corey J. Adamson, Esq. Thomas, Thomas and Hafer, LLP 305 N. Front St. POB 999 Harrisburg, PA 17108 ?? r? ?? uzfuZf11 11:12 Ati aeDeet via V51-PAX Paxe (/1/)-8Uv-32Uq Page z at 15 sltitib3 ML 81/311811 1403 41ML8975 3IW1I11m PAGE 03/16 I R mim 4` ? 10 i ? UMIME I I 7rao Ap 7ymn Di w .12I MWt amm- 211 ftlo t 11a.% P r Umaska : N 0 PKAS.• OW fl 2"J AIYO? w.-Mw8RdAwv M?afty i7YY TNM Hd*mx% w U215 i GIN4eeM1 ?ewe dwad Dr. mdd 3 mD., 017111D1d 13-Am. P ad Nl i»ra,tva? 12/14/LOIQ 134 o wdoee t.Mebeid0A NOM Ayeeem Poo . W14 wum 3 i+R915?1101d1 is A4W, T"w$ I= "ft am W3210 NMI 111407MI' DDAMINOMMEM Th0 ? 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Ciippll AIMISn11101? ; 90% fiff; 3) Ur3eM Orr011r1 P = : Pegs d?pMr NO l4n1hr191 No T" M M% AUM -19! iTt2 S i3:12 14 of 14 L"ca6dm w Suva DlaslOm ?ftUato JTfm 1f3l/XI I MAI Sinai Hospital of Baltimore Patient Discharge Instructions Name: DYM, BRIAN J Current Date: 12117/201019:03:55 America/New York DOB: 11/18/200312:00 AM MRN: S#0016407852 Address: 1611 MITCHELL RD HARRISBURG PA 17110 Phone: 7172219986 Allergies: NKA Medication List Sinai Hospital of Baltimore would like to thank you for allowing us to assist you with your healthcare needs. The following Is a list of your medications to take after discharge. It contains some or all of the medications you were taking at home, and any new medications that we recommend you take now. Keep an accurate list of your medications with you at all times. This list replaces any other list of medications you may have. Please contact your Primary Care Physician if you have any questions about this list. Home Medication Comments: Prescription Comments: Name: DYM, BRIAN J 1 of 3 12117!2010 19:03:56 MRN: S#0016407852 Discharge Instructions: Discharge Instructions Form 12/17/10 04:51 pm Performed by Gjikopulli MD, Aarieda Entered on 12/17/10 04:55 pm Undated on 12/17/10 04.58 pm by Gjikopulli MD, Arieda Discharge Instructions Condition on Discharge: Improved Discharge Disposition: HOME Discharge Instructions Being Provided?: The following Discharge Instructions are being provided to the Patient General Discharge Instructions: General Instructions General Instructions Follow Up Appointment: Please notify pediatrician or visit ER in case of worrying symptoms of lethargy, change in mental status or any seizure activity. (modified) Notify Physician: Other: change in mental status, seizure activity Diet: Regular Activities Restricted: No restrictions Activities Encouraged: Activity as tolerated Discharge Instruction Comments: Name: DYM, BRIAN J 2 of 3 12/1712010 19:03:56 MRN: SOM S407852 ?? ??? ??? ?? GENERAL RELEASE KNOW ALL MEN BY THESE PRESENTS, THAT FOR AND IN CONSIDERATION OF Twenty-Five Thousand Dollars ($25,000.00), payable to Aaron and Shari Dym, the receipt and sufficiency of which is hereby acknowledged, Aaron and Shari Dym, individually and as parents and/or natural guardians of Brian Dym, a minor (collectively, "Releasors"), for themselves and each of their respective heirs, executors, administrators, assigns, and representatives, if any, do hereby release and forever discharge Cumberland Apothecary, Inc., Pennsylvania National Mutual Casualty Insurance Company, and all affiliated or related predecessors, successors, assigns, present and former parents and subsidiaries (whether or not wholly-owned and whether or not directly owned), former, present, and subsequent partners, shareholders, officers, directors, attorneys, agents, representatives, insurers, and employees and any and all other persons, firms, corporations, and entities, their heirs, executors, administrators, successors, assigns, and employees) (hereinafter collectively referred to as "Releasees"), and all other persons and firms, from any and all actions, claims for contribution and/or indemnification and/or subrogation, causes of action, demands, claims, damages, liens, judgments, suits, costs, fees, consequential damages, punitive damages, or any other thing whatsoever on account of all known and unknown losses, interest, attorney fees, costs, personal injuries, death, property damage, damages, debts, or loss of any nature which Aaron and Shari Dym, individually and as parents and/or natural guardians of Brian Dym, a minor, now have or may hereafter have, including all matters which were raised or which could have been raised in or in connection with, or anything whatever on account of, related to, or in any way growing out of, or incident to, be it directly or indirectly: the mis-filling of a prescription that occurred on or about December 17, 2010, involving Brian Dym. Aaron and Shari Dym, individually and as parents and/or natural guardians of Brian Dym, a Minor, and Releasees understand that this settlement is the compromise of doubtful and disputed claims and represents a full accord and satisfaction of such claim or claims and that the payment is not to be construed as an admission of liability on the part of anyone, including Releasees, by whom liability is expressly denied. Aaron and Shari Dym, individually and as parents and/or natural guardians of Brian Dym, a Minor, hereby acknowledge and assume all risk, chance, or hazard that the said injuries or damages may be greater or more extensive than is now known, anticipated, or expected. No promise or inducement which is not herein expressed has been made to Aaron and Shari Dym, individually and as parents and/or natural guardians of Brian Dym, a Minor, in executing this Release. The undersigned do not rely upon any statement or representation made by any person, firm, or corporation, or other entity hereby released or any agent or any other person representing them or any of them concerning the nature, extent, or duration of said damages or losses or the legal liability therefor. 1 In consideration of the payment stated above, Aaron and Shari Dym, individually and as parents and/or natural guardians of Brian Dym, a Minor, agree to hold Releasees harmless, and to defend and indemnify them against any suits, claims, actions, cross claims, judgments, liability, costs, demands and suits for damages, contribution, indemnity, subrogation, loss of service, attorney fees, expenses, or compensation which anyone or any entity may have on account of or in any way growing out of the damages and injuries which Aaron and Shari Dym, individually and as parents and/or natural guardians of Brian Dym, a Minor, now have or may hereafter have, all matters which were raised or which could have been raised in or in connection with, or any other thing whatever on account of, related to, or in any way growing out of, or incident to, be it directly or indirectly, the mis-filling of a prescription that occurred on or about December 17, 2010, involving Brian Dym. Since freedom from costs of future litigation represents an important item of consideration bargained for in this agreement, it is agreed that damages recoverable for breach of this GENERAL RELEASE shall include reasonable attorney's fees and other costs incurred as a consequence of such breach. As a condition of this Release, the parties hereto agree that in the event of a dispute resulting from the Release, the appropriate venue for adjudicating said dispute will be Cumberland County, Pennsylvania. As a further condition of this Release, the terms hereof are and shall remain confidential and shall not be disclosed to anyone other than the parties hereto and their counsel, except to the extent necessary to comply with the law. The parties hereto recognize that this confidentiality provision is a material condition of the settlement. Aaron and Shari Dym, individually and as parents and/or natural guardians of Brian Dym, a Minor, further declare that they have a full understanding of the terms of this settlement and GENERAL RELEASE, and that they had the benefit of legal counsel, Devon M. Jacob, Esquire, who has explained the terms of this instrument to them and its legal consequences, that the amount stated herein is the sole consideration of this GENERAL RELEASE, and they voluntarily accept said sum and consideration for the purpose of making a full and final compromise, accord and satisfaction, adjustment, and settlement of all claims for injuries, losses, and damages resulting and relating to the aforementioned incident. This GENERAL RELEASE shall be construed and applied under the laws of the Commonwealth of Pennsylvania. This GENERAL RELEASE contains the entire agreement between the parties hereto and the terms of this GENERAL RELEASE are contractual and not a mere recital. It is further understood and agreed that there is no written or oral understanding or agreement directly or indirectly connected with the parties settlement agreement and/or this GENERAL RELEASE that is not incorporated herein. 2 The undersigned certify that they are eighteen (18) years of age or older, are of sound mind, and FURTHER STATE, AARON AND SHARI DYM, INDIVIDUALLY AND AS PARENTS AND/OR NATURAL GUARDIANS OF BRIAN DYM, A MINOR, THAT THEY HAVE CAREFULLY READ OR HAVE HAD READ TO THEM THE FOREGOING GENERAL RELEASE OF ALL CLAIMS AND KNOW THE CONTENTS THEREOF AND SIGN THE SAME AS THEIR OWN FREE ACT. WE, Aaron and Shari Dym, individually and as parents and/or natural guardians of Brian Dym, a Minor, have hereunto set our hands this day of , 2011. Signature of Aaron Dym Signature of Shari Dym Witness Witness Signature Representative of Cumberland Apothecary Witness Witness Signature 1019307.1 Date Date 3 CERTIFICATE OF SERVICE i The undersigned hereby certifies that on this t-°? day of 201'2-, copies of I the foregoing document were served via United. States First Class Mail, postage prepaid, upon: j Corey J. Adamson, Esq. Thomas, Thomas and Hafer, LLP 305 N. Front St. POB 999 Harrisburg, PA 17108 IN RE: BRIAN JOSEPH DYM, a Minor AARON and SHARI DYM, as parents and natural guardians of BRIAN JOSEPH DYM, a minor or& a" 0?ftj%t W11000000% IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL DISTRICT No. 12-730 CIVIL TERM IN RE: PETITION FOR APPROVAL OF SETTLEMENT OF MINOR'S CLAIM ORDER OF COURT AND NOW, this day of February, 2012, upon consideration of the "Petition for Approval of Settlement of Minor's Claim" and the "General Release," attached thereto as Exhibit B, filed by Petitioners, Aaron Dym and Shari Dym, as the natural parents and guardians of Brian Joseph Dym, a minor, the Petition is GRANTED to the extent as follows: 1. The Settlement between Petitioners and Cumberland Apothecary, Inc. is APPROVED, in the total settlement amount of $25,000.00, which sum is to be paid as follows: a. The sum of Twenty-Five Thousand dollars ($25,000.00), shall be payable to Aaron and Shari Dym, as natural parents and guardians of Brian Joseph Dym, by Pennsylvania National Mutual Casual Insurance Company, on behalf of Cumberland Apothecary, and for the benefit of Brian Joseph Dym, a minor; ?I b. Aaron and Shari Dym shall distribute twenty-five percent of the total settlement amount ($6,250.00) to Lavery Faherty Patterson to satisfy Petitioners' reasonable attorney's fees and costs; c. Petitioners, as natural parents and guardians of Brian Joseph Dym, are Ordered and Directed to deposit the balance of the settlement amount into an interest-bearing account with a federally insured savings and loan or banking institution of Petitioner's choosing, in the name of Brian Joseph Dym; d. The account created for Brian Joseph Dym pursuant to this order shall bear the Express Restriction that there shall be no withdrawals from the minor's account prior to the minor having obtained the age of majority, except (i) for payment of state or federal income taxes, or (ii) upon subsequent order of court. 2. Petitioners are authorized to execute (a) any documents related to the said deposit, and (b) a full and final Release. PETITIONERS shall file, or cause to be filed, with the court affidavits of compliance with this order within sixty (60) days of distribution of the Settlement. m Thom A. Placey -P.k.? Distribution List: Devon M. Jacob, Esq Lavery Faherty Patterson 225 Market Street P.O. Box 1245 Harrisburg, PA 17108 Corey J. Adamson, Esq. Thomas, Thomas and Hafer, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 4 '.. r{ 4 1 X012 FEB 21 PM 2' 0? IN RE: BRIAN JOSEPH DYM,,' a Minor 00 PENNS LVp A AARON and SHARI DYM, as parents and natural guardians of BRIAN JOSEPH DYM, a minor IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL DISTRICT No. 12-730 CIVIL TERM IN RE: REQUEST TO AMEND ORDER OF COURT APPROVING SETTLEMENT OF A MINOR'S CLAIM ORDER OF COURT 10* AND NOW, this day of February, 2012, upon receipt of a written request of Devon M. Jacob, Esquire, attorney for Petitioners, Aaron and Shari Dym, as parents and natural guardians of Brian Joseph Dym, a minor, the February 10, 2012 Order Of Court is AMENDED as follows: 1) Paragraph 1(c) of the February 10, 2012 Order of Court is STRICKEN in its entirety, and the following language is INSERTED in its place: "Petitioners, as natural parents and legal guardians for Brian Joseph Dym, are Ordered and Directed, to deposit the balance of the settlement amount into an account for the benefit of Brian Joseph Dum. Such account shall be established with a federally insured investment institution. The account may include a current 529 college savings account at American Funds, a PA 529 college savings program account, an UGMA brokerage account, an interest bearing account, certificates of deposit or any other such investment account of similar kind." 2) The February 10, 2012 Order of Court will otherwise remain in full effect. By the Court I A.1 Placey C.P.J. Distribution List: f Devon M. Jacob, Esq Lavery Faherty Patterson 225 Market Street P.O. Box 1245 Harrisburg, PA 17108 Corey J. Adamson, Esq. Thomas, Thomas and Hafer, LLP 305 North Front Street P.O. Box 999 Harrisburg, PA 17108 C? Ffs tom. f? a j???,a Feb 24 2012 3:21PM Hoyle, Rutry & Murphy 4660 Trindlo Road Suite 200 Camp Hill, PA 17011 Phone: 717.737.2430 Fax: 717.737.2483 Email: dmiscoMpennhoboylelaw.com C To: Honorable Thomas Pluey - From. ( 717 737 2452 w 1 Jkob, Esquire p.I Fax: 244-6462 Date: February 24, 2012 Phone: 240-5417 Pages: 4, including cover sheet Re: In Re: Brian Jo!R& E,M 12-73Q Acct: CC: O Urgent 0 For Review C3 Please Comment 0 Please Reply 0 Please Recycle -Comments: See attached correspondence. PbR nobs: The information contained in this facsimile message may be prtvllepd and confidentled, and is lnftvMd only for dw use of M IndNMusl(s) or erdy named above who has been speckmily authariaed to n C&O It. If the reorder b not the intended redplent, you are hereby mtM@d lhat any dMeminedon, dMPibuUon or copying of this communication Is stoldiy prohibited, if you have roosived this oommunicatlon In ermr, please notify us immediately by telephone and return all peges to the address shorn above. Thank you. r? Feb 24 2012 3:21PM Hoyle, Rutru & Murphy 717 737 2452 p.2 le, Autry X11 urphy ATTOR EYS AT LAW Devon M. Jacob, Esquire dmjwob@demisboyielaw.com February 24, 2012 VIA FAX The Honorable Thomas A. Placey Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: IN RE: Br' Josenh Dvm, aMinor Aaron and Shari Dvm, as parents and natural guardians of Brian Joseph R m, a Miter No. 12-730 Dear Judge Placey: I represent the Petitioners in this matter. The Petitioners are in receipt of your Order dated February 10, 2012, a copy of which is enclosed. The Petitioners respectfully request that paragraph 1(c) of the Order be stricken and that the following language be added in its place: "Petitioners, as natural parents and legal guardians for Brian Joseph Dym, are Ordered and Directed, to deposit the balance of the settlement amount into an account for the benefit of Brian Joseph Dym. Such account shall be established with a federally insured investment institution. The account may include a current 529 college savings account at American Funds, a PA 529 college savings program account, an UGMA brokerage account, an interest bearing account, certificates of deposit or any other such investment account of similar kind," The proposed language both respects and fulfills the purpose of yoxv original Order by providing additional investment options in the present financial market. Counsel for Cumberland Apothecary concurs in this request. FVO M. Jac AM DMJlldl Enclosure cc: Corey J. Adamson, Esquire Sunshine J. Thomas, Esquire W m 4660 Trindle Road, Suite 200 1 Camp HIII, PA 17011 J T 717.737.2430 1 F 717.737.2452 www pa-injurylawccom Feb 24 2012 3:21PM Boyle, Autry & Murphy 717 737 2452 IN RE: 'BRIAN JOSEPH DYM, a Minor AARON and SHARI DYM, as. parents and natural guardians of BRIAN JOSEPH DYM, a minor p.3 IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL, DISTRICT No. 17-730 CIVIL TERM jN a P.=O. rFrOR.APFRQ ML..OF. LEMKKT- dF.MINOR'S CLAM. ORDER-OF COURT AND NOW, this day of February, 2012, upon consideration of the "Petition for Approval of Settlement of Minor's Clain" and the • "Genera! Release," attached thereto as Exhibit, B, flied by Petitioners, Aaron Dym and Shari Dym, as the' ?. natural parents and guardians of Brian Joseph Dym, a minor, the Petition is GRANTED to the extent as follows: 1, The Settlement between Petitioners and Cumberland Apothecary, Inc. Is APPROVED, In the total settlement amount of $25,000;00, which sum Is'to be paid as follows: a. The sum of Twenty-Five Thousand dollars ($25,000.00), shall be payable to Aaron and Shari Dym, as natural parents and. guardians of Brian. Joseph Dym, by' Pennsylvania National Mutual Casual Irisurance Company, on behalf of Cumberland Apothecary, and for the benefit of Brian Joseph Dym, a minor; Feb 24 2012 3:21PM Boyle, Rutry a Murphy 717 737 2452 b. Aaron and Shari Dym shall distribute twenty-five percent of the total setttlemn n amount ($6,250.00) to Lavery Faherty Patterson to satisry Petitioners' reasonable athomey's fees and Costs; p.4 c. Petitioners, as natural parents and 'guardians of Brian Joseph Dym,-are-Ordemd and 01rected.ta deposItAl e-balance of.the... settlement amount Into an Interest bearing account with , a federally insured savings and loan or banking Institution of Petitioner's choosing, In the name of Brian Joseph Oym; d. The account created for Brian Joseph ' Dym pursuant to this order shal l bear, the Express ft trlctfon that there shall be no withdrawals from the minor's account prior to the minor having obtained th6 age of majority, except (I) For payment of skate or federal Income taxes, or (II) upon subsequent order of court, 2. Petitioners are authorized to execute (a) any documents related to the said deposit, and. (b) a full and final Release. PE 1 Am OIKERS shall file, or cause to be filed, .with the court affldavlts of compliance with this order within sixty (60) days of distribution of the Settlement. CV f; r w ?C. 'T'RUE CAP, ROM RECORD t'?Im,? ti+feR t?Ap!?t nr!' ??p^el . ?,?., CecMl?, Pa. 00 C. P Pmewawy CM C) 7, ms`s A. Piacey C.* p rn R` -K;