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HomeMy WebLinkAbout06-11-12IN RE: BRYAN K. CHRIST an alleged incapacitated person On the Petition of Marcia J. Christ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS COURT DIVISION NO. 21-12-0533 NOTICE OF FILING OF DEPOSITION NOW COMES, Petitioner, Marcia J. Christ, by and through her attorney, Christa M. Aplin, Esquire and files the deposition of Dr. Donald Kovacs, M.D. that was held on Tuesday, May 22, 2012, at 2:15 p.m. at his office at 1358 Lutztown Road, Boiling Springs, Pennsylvania 17007. A true and correct copy of the deposition is attached hereto as Exhibit A. Respectfully submitted, JAN L. BROWN & ASSOCIATES ~~ -~. By; ~~~ ~ Dat Chr'sta M. Aplin, Esq. PA I.D. No. 207949 Jan L. Brown & Associates 845 Sir Thomas Court, Suite 12 t1. '- Harrisburg, PA 17109 ~~ ~ `~ }--:¢ (717) 541-5550 ~~ - ~Y ~ .1 ., _~ .~ .~ ~ Fax: (717) 541-9223 `~- ~" -~ e-mail: christajlb@verizon.net --3 ~ ^~ - "~ ~ Attorney for Petitioner -,~ m~cr E; c :~ i~ ;._ 3._u (.i. r..: t' .n C v p.1 .1L' In Re: Bryan Christ Donald Kovacs May 22, 2012 1 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No. 21-12-0533 --------------------------------x IN RE: BRYAN K. CHRIST . --------------------------------x Examination Under Oath of DONALD KOVACS, M.D. 1358 Lutztown Road Boiling Springs, PA May 22, 2012 2:15 p.m. LEARY REPORTING 112 West Main Street, Ste. 200 Mechanicsburg, PA 17055 (717) 233-2660 Fax (717) 691-7768 Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Donald Kovacs May 22, 201? 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 APPEARANCES: JAN L. BROWN & ASSOCIATES 845 Sir Thomas Court Suite 12 Harrisburg, PA 17109 BY: CHRISTA M. APLIN, ESQ. ,(717) 541-5550 For the Petitioner, Marcia Christ LAW OFFICE OF ANDREW SHEELY 127 South Market Street Mechanicsburg, PA 17055 BY: ANDREW SHEELY, ESQ. (717) 697-7050 For Bryan Christ Leary Reporting (717) 233-2660 4e 150 c99-55df-44c6-a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 3 1 2 3 4 5 6 I N D E X 7 WITNESS EXAMINATION BY PAGE 8 Donald Kovacs Ms. Aplin 4 9 Mr. Sheely 21 10 11 ~ * * ~ 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 201:? 41 1 PROCEEDINGS 2 DONALD KOVACS, having been duly 3 sworn by Gwen A. Leary, Notary Public, was 4 examined and testified as follows: 5 6 EXAMINATION BY MS. APLIN: ~ Q This is the deposition of Dr. Donald 8 Kovacs regarding Bryan Christ, an alleged 9 incapacitated person. 10 Dr. Kovacs, I have some questions 11 for you. If you do not hear me, please ask me to 12 restate the question -- or I'm sorry. If you do 13 not hear me, yes, please ask me to restate t:he 14 question . 15 If you do not understand a question, 16 please ask me to rephrase it for you. Do you 17 understand? 18 A Yes. 19 Q And in attendance are myself, 20 Attorney Crista Aplin from the Law Firm of Jan L. 21 Brown & Associates, who represents the 22 petitioner, Marcia J. Christ; Attorney Andrew 23 Sheely, from the Law Office of Andrew Sheely, 24 representing Bryan K. Christ; Dr. Donald Kovacs; 25 and Gwen Leary from Leary Reporting. Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 51 1 Dr. Kovacs, could you state your 2 name and professional address? 3 A Donald J. Kovacs, M.D., 1358 4 Lutztown Road, Boiling Springs, Pennsylvania. 5 Q And what is your profession? 6 A Medical doctor. ~ Q And are you licensed to practice in 8 Pennsylvania? 9 A Yes. 10 Q And when did you acquire your 11 license? 12 A Probably 1976. I3 Q And in what type of practice do you 14 work? I5 A Family practice, private family 16 practice. I~ Q And the name of that practice? 18 A Yellow Breeches Family Practice. 19 Q How long have you been with the 20 practice? 21 A Thirty-two years. 22 Q And can you describe -- I am going 23 to ask yo u some questions about your education, 24 training and background. 25 When did you get your college Leary Reporting (7I7) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Donald Kovacs May 22, 201:? 6 1 degree? 2 A 1971. 3 Q And where? 4 A College of Wooster in Ohio. 5 Q And your postgraduate training, 6 where was t hat at? ~ A University of Cincinnati, graduated 8 1976. 9 Q And then where did you do your 10 internship? 11 A It's a three-year residency program 12 at Harrisbu rg Hospital, 1976 to 1979. 13 Q And do you have any continuing 14 medical edu cation? 15 A I maintain the required 150 hours 16 every three years. 17 Q Do you have any specialty? 18 A I am board certified in family 19 medicine. And I took boards in geriatric 20 medicine in 1994, but did not renew them in 2004. 21 Q Are you board eligible for any other 22 specialties at all? 23 A No. 24 Q Are you affiliated with any 25 hospitals? Leary Reporting (717) 233-266C) 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 7 1 A Carlisle Regional Medical Center. 2 Q In what capacity? 3 A I am on the attending staff there. 4 Q Any other medical facilities that 5 you are affiliated with? 6 A Nope. ~ Q Do you have any special 8 qualifications and training with respect to 9 evaluating persons with incapacities? 10 A No. 11 Q Do you see any other patients with 12 conditions similar to Bryan Christ? 13 A Yes. 14 Q Approximately how many patients do 15 you see with conditions similar to Bryan Christ? 16 A I think I see about 20 to 30 group 17 home patients. 18 MS. APLIN: I will offer Dr. Kovacs 19 for cross to Attorney Sheely as to 20 qualifications. 21 MR. SHEELY: I have no objections. 22 MS. APLIN: And then so there is no 23 objection, I would offer Dr. Donald 24 Kovacs as an expert witness. 25 ~~ Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a 8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 81 1 BY MS. APLIN: 2 Q When did you first examine Bryan 3 Christ? 4 A When did I or when was he first: 5 examined in the practice? Dr. Wood saw -- okay. 6 Here we go. ~ Q So Dr. Wood first examined him:' 8 A We11, let's see. I first saw him 9 September 12, 1991. 10 Q Was he referred by anyone at all? 11 A This was -- he was brought here by 12 the group home. 13 Q Did you receive his history from 14 another physician? 15 A I received it from the group home. 16 They maintai n a pretty good record. l~ Q Is that group home that you refer to 18 Keystone? 19 A Yes. 20 Q Since that first visit, how 21 frequently h ave you examined Bryan Christ? 22 A Well, seeing him for an annual exam. 23 And I would say two or three times a year for 24 intercurrent illnesses. 25 Q When was your most recent Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 9 1 appointment with him? 2 A January 26 of this year. 3 Q And what was that for? 4 A That was for an annual physical_ 5 exam. 6 Q Where are Bryan Christ's medical 7 records maintained? 8 A Here at the Yellow Breeches Family 9 Practice. 10 Q And when did you last review hi.s 11 chart or medical records? 12 A Probably yesterday. 13 Q And the group home that -- the 14 Keystone group home, do you know how long he has 15 resided t here, Bryan Christ has resided there? 16 A I believe for 20-some years. l~ Q What has been the general course of 18 treatment since you started treating Bryan 19 Christ? 20 A Well, I see him for annual exams, 21 maintenan ce of his medication. He gets a monthly 22 Lupron in jection for a hypersexualit t e ' Y- YP 23 disorder. He is also followed at Hershey Medical 24 Center in their epilepsy clinic. 25 Q Are there other psychiatrists or Leary Reporting (717) 233-2660 4e150c99-55df-44c6a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 10 I 1 psychologists involved in his treatment? 2 A There have been, yes. He sees 3 doctor -- I think he has been seen at Philhaven 4 every three months for medication checks by Dr. 5 Michael Fueyo, F-u-e-y-o. 6 Q Other than his annual exams, 7 maintenance and medication and the monthly Lupron 8 injection, have you personally performed any 9 tests or evaluations on Bryan Christ? 10 A Not really. He is supposed to get 11 some -- getting routine blood work is very 12 difficult because he is not very cooperative. 13 Q So he is not very cooperative 14 getting routine blood work? 15 A No, it is very difficult. 16 Q And can you explain why it is very 17 difficult? 18 A He will just resist any approach. 19 It is almost impossible to examine him. He will 20 kind of stand off in the corner and you just kind 21 of have to -- you can't get him to get up on the 22 table and lie down. 23 Q What is Bryan Christ's diagnosis as 24 to his mental condition? 25 A Well, severe developmental Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Donald Kovacs Mary 22, 2012 11 I 1 disability, autistic disorder, impulse control 2 disorder, mood disorder, paraphilia. 3 Q And his diagnosis as to his physical 4 condition? 5 A He carries the diagnosis of 6 irritable bowel syndrome; some hyperopic ~ astigmatism; some mild left blepharitis, 8 B-1-e-p-h-a-r-i-t-i-s; some acne, seborrheic 9 dermatitis; seizure disorder. I think that is 10 enough. 11 Q And what is Bryan Christ's prognosis 12 as to his mental conditions? 13 A I see no chance for improvement:. 14 Q And how about his prognosis foz- his 15 physical condition? 16 A He could probably continue for quite 17 a few years. 18 Q How old is Bryan Christ? 19 A I believe he is 36. He was born -- 20 yes, 3 6 . 21 Q And would you say he has the mind of 22 a 36-year-old? 23 A No. 24 Q Can you give us an estimate of the 25 age or what age his mind is? Leary Reporting (717) 233-2660 4e156c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 12 1 A Maybe a three-year-old. 2 Q Would you describe his mental 3 impairment s as mild, moderate or severe? 4 A Severe. 5 Q What about his physical impairments, 6 would you say they are mild, moderate or severe? ~ A I would say moderate. 8 Q And can you describe your assessment 9 of Bryan C hrist's short-term and long-term 10 memory? 11 A That is impossible to say because he 12 is totally nonverbal. 13 Q What social skills does he have, if 14 any? 15 A I would say none. 16 Q Can he communicate in writing at 17 all? 18 A No. 19 Q Does he have any other means of 20 communication since he can't communicate in 21 writing or speaking? 22 A He uses a few hand signals and 23 gestures to communicate. 24 Q Can he receive information by 25 reading at all? Leary Reporting (717) 233-2660 4e 150c99-55df-44c6-a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 13 1 A No. 2 Q Can he receive -- can Bryan Christ 3 receive information by hearing? 4 A Not in any meaningful way. 5 Q Can Bryan Christ follow simple 6 directions? ~ A Very simple; like come into-the 8 room, leave the room, come here. 9 Q Can he follow complex directions? 10 A Absolutely not. 11 Q What is the extent of Bryan Christ's 12 ability to evaluate information? 13 A None. 14 Q How is his judgment as to issues 15 such as living arrangements? 16 A None. 17 Q How is his judgment as to personal 18 health and safety? 19 A None. 20 Q How is his judgment as to needs for 21 medical care? 22 A None. 23 Q How is his judgment as relates to 24 financial management? 25 A None. Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 14 1 Q Does Bryan Christ suffer from any 2 behavioral limitations, such as being withdz-awn 3 at all? 4 A Yes. Yes, he often becomes agitated 5 at medical appointments. He does not like t:o be 6 touched. Needs assistance to complete all tasks 7 of daily living. 8 Q So all tasks of daily living, would 9 that include eating? 10 A He seeks food on a constant ba~;is 11 and will gorge himself until support worker; 12 prompt him to stop. 13 Q Is he able to prepare any food? 14 A No . 15 Q Does he need assistance in bathing 16 at; all? 17 A Probably. I don't know for sure. 18 Q How about with dressing? 19 A I know he is able to take his 20 clothes off; that has been a problem. But I 21 don't know whether he can dress himself. 22 Q Does he have any problems ambulating 23 at all? 24 A He can ambulate independently but 25 may need physical assistance with walking on Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 15 1 uneven terrain, on stairs or down hills. 2 Q Any issues toileting at all? 3 A He has a history of enuresis. 4 Q What is enuresis? 5 A Wetting himself. 6 Q Is the ability of Bryan Christ to 7 receive and evaluate information effectively and 8 communicate decisions in any way impaired to such 9 significant extent that he is totally unable to 10 meet his es sential requirements for his physical 11 health and safety? 12 A Definitely. 13 Q Is the ability of Bryan Christ to 14 receive and evaluate information effectively and 15 communicate decisions in any way impaired to such 16 significant extent that he is totally unable to 17 manage his financial resources? 18 A Definitely. 19 Q Is Bryan Christ independently able 20 to manage taking medications at all? 21 A No. 22 Q Is Bryan Christ independently able 23 to manage making his own medical decisions? 24 A No. 25 Q Who has been I guess making those Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 16 1 medical decisions for the past 36 years? 2 A I guess his caregivers at the group 3 home. I believe that would be who. 4 Q Can Bryan Christ monitor and manage 5 his own medical care without supervision or 6 assistance'? 7 A No. 8 Q How much supervision is required? 9 A Total. 10 Q Can he monitor and manage his own 11 medications without supervision or assistance? 12 A No. 13 Q And how much supervision is 14 required? 15 A Total. 16 Q Can Bryan Christ comprehend what 17 medications he needs? 18 A No. 19 Q Can Bryan Christ comprehend when he 20 needs to take the medication? 21 A No. 22 Q Can Bryan Christ comprehend doses of 23 medication? 24 A No. 25 Q Does Bryan Christ have the Leary Reporting (717) 233-2660 4e 150c99-55df-44c6-a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 17 1 independent ability to provide informed consent 2 to a medical procedure or treatment? 3 A No. 4 Q Does Bryan Christ have the ability 5 to receive and evaluate information so as to be 6 able to make independent decisions about hi~~ 7 physical health and safety and financial 8 resources? 9 A No. 10 Q Does Bryan Christ have the ability 11 to communicate any decisions? 12 A No. 13 Q Are Bryan Christ's limitations 14 likely to increase or decrease in the immediate 15 future? 16 A In the immediate future I would 17 think they will just stay the same. 18 Q How about the next year? 19 A Probably stay the same. 20 Q Based on your examination of Bryan 21 Christ, your examinations of Bryan Christ and any 22 review of his records, do you have an opinion as 23 to whether or not Bryan Christ is totally or 24 partially unable to independently manage his own 25 personal affairs, such as physical health and Leary Reporting (717) 233-2660 4e 150c99-55df-44c6-a 8f3-d96dcea 14b3c In Re : F3ryan Christ Donald Kovacs May 22, 2012 18 1 safety, placement or living arrangements and 2 medical care? 3 A Totally unable. 4 Q What recommendations would you make 5 concerning services necessary to meet the 6 essential :requirements for his physical health 7 and safety'? 8 A Continued group home residence. 9 Q Do you believe that having Marcia 10 Christ appointed as guardian of the person for 11 Bryan Christ is appropriate in order for Bryan 12 Christ to meet the essential requirements far his 13 physical health and safety? 14 A I never met the woman, but I think 15 it is appropriate to have somebody appointed to 16 that. 17 Q What recommendations, if any, would 18 you make concerning the management of his 19 financial resources as Keystone human resources 20 is handling them? 21 A Continue. 22 Q Do you recommend any other placement 23 for Bryan Christ other than with the Keystone 24 group home? 25 A No. Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 19 I 1 Q Do you recommend any other financial 2 management? 3 A No. 4 Q What is the probability that the 5 extent of the incapacities of Bryan Christ may 6 significantly lessen or change? ~ A I think there may be gradual decline 8 with aging. 9 Q So you don't expect him to regain 10 any of his abilities? 11 A No. 12 Q Would the physical or mental 13 condition of Bryan Christ be harmed by his 14 presence irl open court? 15 A State that again. 16 Q Would the physical or mental 17 condition of Bryan Christ be harmed by his 18 presence in open court? 19 A I don't think so. 20 Q Would there be any anxiety to Bryan 21 Christ by be ing made to appear in court? 22 A Yes. 23 Q And to what extent does anxiety 24 manifest itself in Bryan Christ? 25 A Well, Bryan often becomes agitated Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 20 1 at medical appointments, which he is accustomed 2 to. So he may be more agitated in an unfamiliar 3 surrounding. 4 Q Does he -- when he becomes agitated, 5 what does he do? 6 A I have just usually seen him 7 withdraw and be totally uncooperative. 8 Q Has he ever harmed himself or 9 others? 10 A Bryan's challenging behaviors 11 consist of disrobing, physical aggression, 12 self-injurious behavior, grunting and property 13 destruction. 14 Q So do you see any issues that can 15 arise by having Bryan Christ be present in court? 16 A I don't think it would be a good 17 idea. It would not serve any useful purpose and 18 he may become agitated. 19 Q Okay. Is there anything else you 20 would like to say concerning Bryan Christ at all? 21 A I think we have said it. 22 Q Have all of your opinions today been 23 rendered with a reasonable degree of medical 24 certainty? 25 A Yes. Leary Re~>orting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Don<~ld Kovacs May 22, 2012 21 1 MS. APLIN: I have no other 2 questions. I would like to offer Dr. 3 Kovacs for cross-examination. 4 MR. SHEELY: Thank you. 5 6 EXAMINATION BY MR. SHEELY: ~ Q Dr. Kovacs, my name is Andrew 8 Sheely. I have been appointed by Judge Plac:ey to 9 represent the interests of Bryan Christ. 10 I have been present throughout your 11 testimony and I have heard what you said. And I 12 don't want you to have to repeat anything treat 13 you have previously said. 14 You have known Bryan for 15 approximately 20 years? 16 A Yes. 17 Q Has his condition changed really at 18 al_1 within that period of time? 19 A No. 20 Q You said he communicates in hand 21 gestures. What types of communications would he 22 do? 23 A I don't know. I don't know what to 24 say there. I think that is mostly in the context 25 of the group home setting where he does that. Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 22 1 Q When he comes for his physicals. and 2 medical reviews, is he accompanied by someone 3 ease? 4 A Oh, yes. 5 Q And are they present with him at all 6 times? ~ A Yes. 8 Q Is it possible to identify a life 9 expectancy for Bryan? 10 A I think he could easily live another 11 20 years. 12 Q Do you prescribe any medication for 13 him? 14 A I think most of his medications are 15 prescribed by the neurologist and the 16 psychiatris t. l~ I will prescribe things for minor 18 problems th at come up, like skin infection, some 19 of his acne products. That would be the extent 20 of~ it . 21 Q Does Bryan know you? 22 A That is hard to say. That's hard to 23 say whether he -- he has certainly seen me enough 24 times. Whe ther there is a recognition is very 25 hard to say , since he is totally nonverbal. Leary Reporting (717) 233-2660 4e 150c99-55df-44c6-a 8f3-d96dcea 7 4b3c In Re: F3ryan Christ Donald Kovacs May 22, 2012 23 1 Q And you described his mental 2 condition as suffering from four disabilities, a 3 severe development disability? 4 A Yes. 5 Q What does that mean? 6 A Retardation, mental retardation. ~ Q And with the autistic disability, 8 what problem does that cause him? 9 A Serious problems reading any kind of 10 social cues, a need for a lot of self-stimulating 11 behavior. 12 Q And what characterizes an impulse 13 disorder? 14 i A Acting thoughtlessly in ways that 15 are harmfu_1 or destructive to self or others or 16 property. 17 Q And the last one was paraphilia. 18 What is that ? 19 A A kind of sexual beha vior that -- I 20 am not sure of the details of what his particular 21 disease is. Sexual disorder with foreign 22 objects. If you want more details -- 23 Q That is fine. I was uncertain what 24 the term mea nt. 25 You said that he has no meaningful Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: F3ryan Christ Donald Kovacs May 22, 2012. 24 1 measure of hearing. Do you measure that? 2 A Of hearing? 3 4 Yes. 4 A No. I think he can hear. Let's see 5 what they say here. 6 Bryan has yearly audiological 7 evaluations completed at Polyclinic and it i.s 8 believed Bryan is not impaired for the reception 9 o:E speech. I guess that is probably using the 10 same kind of technology that they use to evaluate 11 hearing in newborns, to see if there is a 12 stapedius reflex to sound. 13 MR. SHEELY: I have nothing further. 14 MS. APLIN: Okay. And I have 15 nothing further. 16 Dr. Kovacs, are you willing to waive 17 a review of the transcript of this 18 deposition and trust the skills of the 19 court reporter or would you like an 20 opportunity to review the transcript to 21 correct typographical errors but not :make 22 substantive changes to your testimony. 23 THE WITNESS: I think I can trust 24 the court reporter. 25 MS. APLIN: Thank you very much. Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 25 1 And the family thanks you as well. 2 3 (Deposition adjourned, 3:03 p.m.) 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Leary Reporting (717) 233-2660 4e150c99-55df-44c6-a8f3-d96dcea 14b3c In Re: E'~ryan Christ Donald Kovac~~ May 22, 2012 26 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 C E R T I F I C A T E I, Gwen A. Leary, the officer before whom the w=ithin deposition(s) was taken, do hereby certify that the witness whose testimony appears in the foregoing deposition(s) was duly sworn by men on said date and that the ,transcribed deposition of said witness is a true record of the testimony given by said witness; That the proceeding is herein recorded fully arld accurately; That I am neither attorney nor counsel, nor rE~lated to any of the parties to the action in which these depositions were taken, and further that I am not a relative of any attorney or cc>unsel employed by the parties hereto, or financially interested in this action. Gwen A. e rter Notary Public in and for the Commonwealth of Pennsylvania My commission expires September 1, 2014 Leary Reporting (717) 233-2660 4e150c99-55df-44c&a8f3-d96dcea 14b3c In Re: Bryan Christ Donald Kovacs May 22, 2012 A abilities 19:10 ability 13:12 15:6 15:13 17:1,4,10 able 14:13,19 15:19,22 17:6 Absolutely 13:10 accompanied 22:2 accurately 26:11 accustomed 20:1 acne l 1:8 22:19 acquire 5:10 Acting 23:14 action 26:13,17 address 5:2 adjourned 25:3 affairs 17:25 affiliated 6:24 7:5 age 11:25,25 aggression 20:1 1 aging 19:8 agitated 14:4 19:25 20:2,4,18 alleged 4:8 ambulate 14:24 ambulating 14:22 Andrew 2:10,1 l 4:22,23 21:7 annual 8:22 9:4 9:20 10:6 anxiety 19:20,23 Aplin 2:6 3:8 4:6 4:20 7:l 8,22 8:1 21:1 24:14,25 appear 19:21 APPEARANC... 2:2 appears 26:5 appointed 18:10 18:15 21:8 appointment 9:1 appointments 14:5 20:1 approach 10:18 appropriate 18:11,15 approximately 7:14 21:15 arrangements 13:15 18:1 assessment 12:8 assistance 14:6 14:15,25 16:6 16:11 Associates 2:4 4:21 astigmatism 11:7 attendance 4:19 attending 7:3 attorney 4:20,22 7:19 26:12,15 audiological 24:6 autistic 11:1 23:7 background 5:24 Based l 7:20 basis 14:10 bathing 14:15 behavior 20:12 23:11,19 behavioral 14:2 behaviors 20:10 believe 9:16 11:19 16:3 18:9 believed 24:8 blepharitis 11:7 blood 10:11,14 board 6:18,21 boards 6:19 Boiling 1:12 5:4 born 11:19 bowel 11:6 Breeches 5:18 9:8 brought 8:11 Brown 2:4 4:21 Bryan 1:6 2:13 4:8,24 7:12,15 8:2,21 9:6,15,18 10:9,23 11:11 11:18 12:9 13:2 13:5,11 14:1 15:6,13,19,22 16:4,16,19,22 16:25 17:4,10 17:13,20,21,23 18:11,11,23 19:5,13,17,20 19:24,25 20:15 20:20 21:9,14 22:9,21 24:6,8 Bryan's 20:10 B-1-e-p-h-a-r-i-... 11:8 C26:1,1 capacity 7:2 care 13:21 16:5 18:2 caregivers 16:2 Carlisle 7:1 carries 11:5 cause 23:8 Center 7:1 9:24 certainly 22:23 certainty 20:24 certified 6:18 certify 26:4 challenging 20: I 0 chance 11:13 change 19:6 changed 21:17 changes 24:22 characterizes 23:12 chart 9:11 checks 10:4 Christ ] :6 2:7, 13 4:8,22,24 7:12 7:15 8:3,21 9:15 9:19 10:9 11:18 13:2,5 14:1 15:6 15:13,19,22 16:4, l 6,19,22 16:25 17:4,10 17:21,21,23 18: l 0,11,12,23 19:5,13, 17,21 l 9:24 20:15,20 21:9 CHRISTA 2:6 Christ's 9:6 10:23 11:11 12:9 13:11 17:13 Cincinnati 6:7 clinic 9:24 clothes 14:20 college 5:25 6:4 come 13:7,8 22:18 comes 22:1 commission 26:22 COMMON 1:1 Commonwealth 26:21 communicate ~~, 12:16,20,23 15:8,15 17:11 communicates 21:20 communication 12:20 communications 21:21 complete 14:6 completed 24:7 complex 13:9 comprehend 16:16,19,22 concerning 18:5 18:18 20:20 condition 10:24 11:4,15 19:13 19:17 21:17 23:2 conditions 7:12 7:15 11:12 consent 17:1 consist 20:1 1 constant 14:10 context 21:24 continue 11:16 18:21 Continued 18:8 continuing 6:13 control 11:1 cooperative 10:12 10:13 corner 10:20 correct 24:21 counsel 26:12,16 COUNTY 1:1 course 9:17 court 1:1,2 2:4 19:14,18,21 20:15 24:19,24 Crista 4:20 cross 7:19 cross-examinat... 21:3 cues 23:10 CUMBERLAND 1:1 D 3:6 daily 14:7,8 date 26:7 decisions 15:8,15 15:23 16:1 17:6 17:11 decline 19:7 decrease 17:14 Definitely 15:12 15:18 degree 6:1 20:23 deposition 4:7 24::18 25:3 26:7 depositions 26:14 deposition(s) 26:4 26.:6 dermatitis 11:9 describe 5:22 12::2,8 described 23:1 destruction 20:13 destructive 23:15 details 23:20,22 development 23:3 developmental 10:25 diagnosis 10:23 11:3,5 difficult 10:12,15 10:17 directions 13:6,9 disabilities 23:2 disability 11:1 23:3,7 disease 23:21 disorder 9:23 11:1,2,2,9 23:13 23:21 disrobing 20:1 l DIVISION 1:2 doctor 5:6 10:3 Donald 1:10 3:8 4:2,7,24 5:3 7:23 doses 16:22 Dr 4:7,10,24 S; 7:18,23 8:5,7 10:4 21:2,7 24:16 dress 14:21 Leary Re~~orting (717) 233-2660 In Re: Bryan Christ Donald Kovacs May 22, 201:? ,~ dressing 14:18 duly 4:2 26;6 E 3:6 26:1,1 easily 22:10 eating 14:9 education 5:23 6:14 effectively 15:7 15:14 eligible 6:21 employed 26:16 enuresis 15:3,4 epilepsy 9:24 errors 24:2 ]. ESQ 2:6,11 essential 15:10 18:6,12 estimate 11:24 evaluate 13:12 15:7,14 17:5 24:10 evaluating 7:9 evaluations 10:9 24:7 exam 8:22 9:5 examination 1:10 3:7 4:6 17:20 21:6 examinations 17:21 examine 8:2 10:19 examined 4:4 8:5 8:7,21 exams 9:20 10:6 expect 19:9 expectancy 22:9 expert 7:24 expires 26:22 explain 10:16 extent 13:11 15:9 15:16 19:5,23 22:19 F 26:1 facilities 7:4 family 5:15,15,18 6:18 9:8 25:1 Fax 1:24 financial 13:24 15:17 17:7 18:19 19:1 financially 26:17 fine 23:23 Firm 4:20 first 8:2,4,7,8,20 follow 13:5,9 followed 9:23 follows 4:4 food 14:10,13 foregoing 26:6 foreign 23:21 four 23:2 frequently 8:21 Fueyo 10:5 fully 26:10 further 24:13,15 26:14 future 17:15,16 F-u-e-y-o 10:5 genera19:17 geriatric 6:19 gestures 12:23 21:21 getting 10:11,14 give 11:24 given 26:9 go 8:6 going 5:22 good 8: 16 20:16 gorge 14:11 gradual 19:7 graduated 6:7 group 7:16 8:12 8:15,17 9:13,14 16:2 18:8,24 21:25 grunting 20:12 guardian 18:10 guess 15:25 16:2 24:9 Gwen 4:3,25 26:3 26:19 H hand 12:22 21:20 handling 18:20 hard 22:22,22,25 harmed 19:13,17 20:8 harmful 23:15 Harrisburg 2:5 6:12 health 13: ] 8 15:1 1 17:7,25 18:6,13 hear 4:11,13 24:4 heard 21:1 1 hearing 13:3 24:1 24:2,11 hereto 26:16 Hershey 9:23 hills 15:1 history 8:13 15:3 home7:17 8:12 8:15,17 9:13,14 16:3 18:8,24 2l :25 Hospital 6:12 hospitals 6:25 hours 6:15 human 18:19 hyperopic 11:6 hypersexuality-... 9:22 idea 20:17 identify 22:8 illnesses 8:24 immediate 17:14 17:16 impaired 15:8,15 24:8 impairments 12:3 12:5 impossible 10:19 12:11 improvement 11:13 impulse 11:1 23:12 incapacitated 4:9 incapacities 7:9 19:5 include 14:9 increase 17:14 independent 17:1 17:6 independently 14:24 15:19,22 17:24 infection 22:18 information 12:24 13:3,12 15:7,14 17:5 informed 17:1 injection 9:22 10: 8 intercurrent 8:24 interested 26:17 interests 2l :9 internship 6:10 involved 10:1 irritable 11:6 issues 13:14 15:2 20:14 J _ J 4:22 5:3 Jan 2:4 4:20 January 9:2 Judge 21:8 judgment 13:14 13:17,20,23 K 1:6 4:24 Keystone 8:18 9:14 18:19,23 kind 10:20,20 23:9,19 24:10 know 9:14 14:17 14:19,21 21:23 21:23 22:21 known 21:14 Kovacs 1:10 3:8 4:2,8,10,24 S:1 5:3 7:18,24 21: 21:7 24:16 L 2:4 4:20 Law 2:10 4:20,23 Leary 1:22 4:3,25 4:25 26:3,19 leave 13:8 left 11:7 lessen 19:6 let's 8:8 24:4 license 5:11 licensed 5:7 lie 10:22 life 22:8 limitations 14:2 17:13 live 22:10 living 13:1 S 14:7 14:8 18:1 long 5:19 9:14 long-term 12:9 lot 2.3:10 Lupron 9:22 10:7 Lutztown 1:12 5:4 - M --- M 2:6 Main 1:23 maintain 6:15 8:16 maintained 9:7 maintenance 9:21 10:7 making 15:23,25 manage 15:17,20 15:23 16:4,10 17:24 management 13:24 18:18 19:2 manifest 19:24 Marcia 2:7 4:22 18,:9 Market 2:10 mean 23:5 meaningful 13:4 23:25 means 12:19 meant 23:24 measure 24:1,1 Mechanicsburg 1:23 2:11 medica15:6 6:14 7:1,4 9:6,11,23 13:21 14:5 15:23 16:1,5 17:2 18:2 20:1 20:23 22:2 medication 9:21 10:4,7 16:20,23 22:12 medications 15:20 16:11,17 22:14 Leary Reporting (717) 233-2660 In Re: Bryan Christ Donald Kovacs May 22, 201? medicine 6:19,20 meet 15:10 18:5 18:12 memory 12:10 mental 10:24 11:12 12:2 19:12,16 23:1,6 met 18:14 Michael 10:5 mild 11:7 1'2:3,6 mind 11:21.25 minor 22:17 moderate 12:3,6 12:7 monitor 16:4,10 monthly 9:21 10:7 months 10:4 mood 11:2 M.D 1:10 S:3 N 3:6 name 5:2, l 7 21:7 necessary 18:5 need 14:1 S,2S 23:10 needs 13:20 14:6 16:17,20 neither 26:12 neurologist 22:1 S never 18:14 newborns 24:11 nonverbal 12:12 22:25 Nope 7:6 Notary 4:3 26:20 Oath 1:10 objection 7:23 objections 7:21 objects 23:22 offer 7:18,23 21:2 Office 2:10 4:23 officer 26:3 Oh 22:4 Ohio 6:4 okay 8:S 20:19 24:14 old 11:18 open 19:14,18 opinion 17:22 opinions 20:22 opportunity 24:20 order 18:1 1 ORPHANS 1:2 PA 1:12,23 2:5,11 PAGE 3:7 paraphilia 11:2 23:17 partially 17:24 particular 23:20 parties 26:13,16 patients 7:11,14 7:17 Pennsylvania 1:1 5:4,8 26:21 performed 10:8 period 21:18 person 4:9 18: l 0 personal 13:17 17:25 personally 10:8 persons 7:9 petitioner 2:7 4:22 Philhaven 10:3 physica19:4 l 1:3 ] 1:15 12:5 14:25 15:10 17:7,25 18:6,13 19:12,16 20:11 physicals 22:1 physician 8:14 placement 18:1 18:22 Placey 21:8 PLEAS 1:1 please 4:11,13,16 Polyclinic 24:7 possible 22:8 postgraduate 6:S practice 5:7,13,1 S 5:16,17,18,20 8:S 9:9 prepare 14:13 prescribe 22:12 22:17 prescribed 22:1 S presence 19:14,18 present 20:1 S 21:10 22:5 pretty 8:16 previously 21:13 private S:1 S probability 19:4 probably 5:12 9:12 11:16 14:17 17:19 24:9 problem 14:20 23:8 problems 14:22 22:18 23 :9 procedure 17:2 proceeding 26:10 PROCEEDINGS 4:1 products 22:19 profession S:S professional S:2 prognosis 11:11 11:14 program 6: l 1 prompt 14:12 property 20:12 23:16 provide 17:1 psychiatrist 22:16 psychiatrists 9:25 psychologists 10:1 Public 4:3 26:20 purpose 20:17 p.m 1:12 25:3 Q qualifications 7:8 7:20 question 4:12,14 4:15 questions 4:10 5:23 21:2 quite 11:16 R 26:1 reading 12:25 23:9 really 10:10 21:17 reasonable 20:23 receive 8:13 12:24 13:2,3 15:7,14 17:5 received 8:1 S reception 24:8 recognition 22:24 recommend 18:22 19:1 recommendatio... 18:4,17 record 8:16 26:8 recorded 26:10 records 9:7,11 17:22 refer 8:17 referred 8:10 reflex 24:12 regain 19:9 regarding 4:8 Regiona17:1 related 26:13 relates 13:23 relative 26:1 S rendered 20:23 renew 6:20 repeat 21:12 rephrase 4:16 reporter 24:19,24 26:19 Reporting 1:22 4:25 represent 21:9 representing 4:24 represents 4:21 required 6:1 S 16:8,14 requirements IS:10 18:6,12 resided 9:1 S, l S residence 18:8 residency 6:11 resist 10:18 resources 1 S: l 7 17:8 18:19,19 respect 7:8 restate 4:12,13 retardation 23:6 23:6 review 9:10 17:22 24:17,20 reviews 22:2 Road 1:12 S:4 room 13:8,8 routine l 0:11,14 safety 13:18 15:11 17:7 18:1 18:7,13 saw 8:5,8 seborrheic 11:8 see 7:11,15,16 8:8 9:20 11:13 20:14 24:4,1 ] seeing 8:22 seeks 14:10 seen 10:3 20:6 22:23 sees 10:2 seizure 11:9 self 23 :1 S self-injurious 20:12 self-stimulating 23:10 September 8:9 26:23 Serious 23:9 serve 20:17 services 18:5 setting 21:25 severe 10:25 12:3 12:4,6 23:3 sexua123:19,21 Sheely 2:10,11 3:9 4:23,23 7:19 7:2.1 21:4,6,8 24:13 short-term 12:9 signals 12:22 significant 1 S:9 15:16 significantly 19:6 similar 7:12,1 S simple 13:5,7 Sir 2:4 skills 12:13 24:18 skin 22:18 social 12:13 23:10 somebody 18:1 S sorry 4:12 sound 24:12 South 2:10 Leary Re~>orting (717) 233-2660 In Re: 1=,ryan Christ Donald Kovac;~ May 22, 2012 ~t speaking 12:21 special 7:7 specialties 6:22 specialty 6:17 speech 24:9 Springs 1:12 5:4 staff 7:3 stairs 15:1 stand 10:20 stapedius 24:12 started 9:18 state S:l 19:15 stay 17:17,19 Ste 1:23 stop 14:12 Street 1:23 2:10 substantive 24:22 suffer 14:1 suffering 23:2 Suite 2:5 supervision 16:5 16:8,11,13 support 14:1 l supposed 10:10 sure 14:17 23:20 surrounding 20:3 sworn 4:3 26:6 syndrome 11:6 Thomas 2:4 thoughtlessly 23:14 three 6:16 8:23 10:4 three-year 6:11 three-year-old 12:1 time 2 ] :18 times 8:23 22:6 22:24 today 20:22 toileting 15:2 Total 16:9,15 totally 12:12 15:9 15:16 17:23 18:3 20:7 22:25 touched 14:6 training 5:24 6:5 7:8 transcribed 26:7 transcript 24:17 24:20 treating 9: l 8 treatment 9:18 10:1 17:2 true 26:8 trust 24:18,23 two 8:23 type 5:13 types 21:21 typographical 24:21 -- W waive 24:16 walking 14:25 want 21:12 23:22 ~ way 13:4 ] 5:8,15 ways 23:14 West 1:23 Wetting 15:5 willing 24:16 withdraw 20:7 withdrawn 14:2 witness 3:7 7:24 24:23 26:5,8,9 woman 18:14 Wood 8:5,7 Wooster 6:4 work 8:14 10:1 I 10:14 workers 14:1 l writing 12:16,21 x 1:4,7 3:6 year 8:23 9:2 17:18 yearly 24:6 years 5:21 6:16 9:16 11:17 16:1 21:15 22:11 Yellow 5:18 9:8 yesterday 9:12 22:11 20-some 9:16 200 1:23 2004 6:20 2012 1:12 2014 26:23 213:9 21-12-0533 1:3 221:12 233-26601:24 26 9:2 T26:1,1 table 10:22 take 14:19 16:20 taken 26:4,14 tasks 14:6,8 technology 24:10 term 23:24 terrain 15:1 testified 4:4 testimony 21:11 24:22 26:5,8 tests 10:9 Thank 21:4 24:25 thanks 25:1 things 22:17 think 7:16 10:3 11:9 17:17 18:14 19:7,19 20:16,21 21:24 22:10,14 24:4 24:23 Thirty-two 5:21 unable 15:9,16 17:24 18:3 uncertain 23:23 uncooperative 20:7 understand 4:15 4:17 uneven 15:1 unfamiliar 20:2 University 6:7 use 24:10 usefu120:17 uses 12:22 usually 20:6 visit 8:20 1 26:23 112 1:23 12 2:5 8:9 127 2:10 1358 1:12 5:3 150 6:15 17055 1:23 2:11 17109 2:5 1971 6:2 1976 5:12 6:8,12 1979 6:12 1991 8:9 1994 6:20 2:15 l :12 207:1621:15 3:03 25:3 30 7:16 3611:19,20 16:1 36-year-old 11:22 4 4 3:8 5 541-5550 2:6 6 _ 691-7768 1:24 697-7050 2:12 7 717 1:24,24 2:6 2:12 8 --- 845 2:4 Leary Re~>orting (717) 233-2660 PROOF OF SERVICE I, Christa M. Aplin, Esquire, the attorney for the Petitioner, Marcia J. Christ, certify that on June 8, 2012, I served a true and correct copy of the foregoing Notice of Filing of Deposition, Exhibit, and this proof of service on the following interested parties named below, by depositing same in the United States first-class mail, addressed as follows: Marcia J. Christ 200 N. 67`h Street Harrisburg, PA 17111 Andrew C. Sheely, Esquire 127 S. Market Street Apt. B Mechanicsburg, PA 17055 Keystone Human Services 940 East Park Drive Harrisburg, PA 17101 JAN L. BROWN & ASSOCIATES .{ ~~ ~~ 1 Dat Christa M. Aplin, Esq. PA I.D. No. 207949 Jan L. Brown & Associates 845 Sir Thomas Court, Suite 12 Harrisburg, PA 17109 (717) 541-5550 Fax: (717) 541-9223 e-mail: christajlb@verizon.net Attorney for Petitioner