HomeMy WebLinkAbout13-0250~- ,~ ,
Christina L. Bradley, Esquire ~"- °`, t ~ #~
FREEBURN 8v HAMILTON ~ ~~ ~~_~i! ~~~` _ k ~' ,r~~-. ..,,_
ID No. 89107 ~~~~~A~'~
2040 Linglestown Road, Suite 300 ~-'~~ +{ ~' = P~tflT~
Harrisburg PA 17110
(717) 671-1956 Z~)3 OAK ~ S Ph4 ~ ~ ~ $
christinabu ~~_injui-~~la~~~-er.com ~~~`R~~;~p ~~~~Qt`t9rney for Plaintiffs
t iT
COURTNEY MOTES, EUGENE MOTES
AND TRICIA MOTES,
Plaintiffs
~.
GIANT FOOD STORES, LLC,
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
~o.: ~ 3-asv c~~~i
CIVIL ACTION -LAW
NOTICE
YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims
set forth in the following pages, you must take action within twenty (20) days after this
Complaint and Notice are served, by entering a written appearance personally or by
attorney and filing in writing with the Court your defenses or objections to the claims
set forth against you. You are warned that if you fail to do so the case may proceed
without you and a judgment may be entered against you by the Court without further
notice for any money claimed in the Complaint or for any other claim or relief
requested by the Plaintiff. You may lose money or property or other rights important
to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH
INFORMATION ABOUT HIRING A LAWYER.
IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE
TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL
SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE.
CUMBERLAND COUNTY BAR ASSOCIATION
32 S. Bedford Street
Carlisle, PA 17013
(800) 990-9108
Dated: o ~a.~..,.~ 1 ~r.. 2a i3
Christina L. Bradley, squire
Attorneys for Plaintiff
Q~~ ~~ag.~s~~Q~l
C~ ~ ~ Ste'
~,~~ Y
Christina L. Bradley, Esquire
FREEBURN & HAMILTON
ID No. 89107
2040 Linglestown Road, Suite 300
Harrisburg PA 17110
(717) 671-1955
christinab~u r~-irliurvla~n~~er.com
Attorney for Plaintiffs
COURTNEY MOTES, EUGENE MOTES IN THE COURT OF COMMON PLEAS
AND TRICIA MOTES, CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiffs
v.
NO..
GIANT FOOD STORES, LLC,
Defendant.
CIVIL ACTION -LAW
NOTICE
LISTED HA SIDO DEMANDADO/A EN CORTE. Si usted quiere defenderse de
estas demandas expuestas e~ las paginas siguientes, usted tiene viente (20) Bias de
plazo al partir de la fecha de la demanda y la notification. Usted debe presentar ua
apariencia esrita o en persona o por abogado y archivar en la Corte en forma escrita
sus defensas o sus objeciones a las demandas en contra de su persona. Sea avisado
que si usted no se defiende, la Corte tomara medidas y puede entrar una Orden contra
usted sin previo aviso o notifcacion y por cualquier queja o alivio que es pedido en la
peticion de demanda. Usted puede perder dinero o sus propiedades o otros derechos
importantes para usted.
LISTED DEBE LLBVAR ESTATE DOCUMENTO A SU ABOGADO
IMMEDIATAMENTE. SI LISTED NO TIENE UN ABOGADO, LLAME O VAYA A LA
SIGUIENTE OFICINA. ESTA OFICINA PUEDE PROVEERLE INFORMACION A CERCA
DE COMO CONSEQUIR UN ABOGADO.
SI LISTED NO PUEDE PAGAR POR LOS SERVICIOS DE UN ABOGADO, ES
POSIBLE QUE ESTA OFICINA LE PUEDA PROVEER INFORMACION SOBRE
AGENCIAS QUE OFREZCAN SERVICIOS LEGALES SIN CARGO O BAJO COSTO A
PERSONAS QUE CUALIFICAN.
CUMBERLAND COUNTY BAR ASSOCIATION
32 S. Bedford Street
Carlisle, PA 17013
(800) 990-9108
Dated: ~ t ~ _
Christina L. Bradley, E ire
Attorneys for Plaintiff
Christina L. Bradley, Esquire
FREEBURN &; HAMILTON
ID No. 89107
2040 Linglestown Road, Suite 300
Harrisburg PA 17110
(717) 671-1955
christinabiu ua -iniuryla«~~er.com Attorney for Plaintiffs
COURTNEY MOTES, EUGENE MOTES IN THE COURT OF COMMON PLEAS
AND TRICIA MOTES, CUMBERLAND COUNTY, PENNSYLVANIA
Plaintiffs
v. NO..
GIANT FOOD STORES, LLC, CIVIL ACTION -LAW
Defendant.
COMPLAINT
AND NOW come Plaintiffs, Courtney Motes, Eugene Motes, and Tricia Motes, by
their attorneys, Freeburn 8v Hamilton, and file the following Complaint:
1. Plaintiff, Courtney Motes, is an adult individual who resides at 279
Susquehanna Avenue, East Pennsboro Township, Cumberland County, Pennsylvania.
2. Plaintiffs, Eugene Motes and Tricia Motes, husband and wife, are adult
individuals who reside at 279 Susquehanna Avenue, East Pennsboro Township,
Cumberland County, Pennsylvania.
3. Defendant, Giant Food Stores, LLC, is a Delaware Limited Liability
Corporation, with its Corporate Headquarters located at 27 Brookwood Avenue,
Carlisle, Cumberland County, Pennsylvania.
4. The facts and occurrences hereinafter related took place on or about July
31, 2011, at approximately 1'0:45 p.m. inside Giant Food Stores, located at 310 East
Penn Drive, Enola, Cumberland County, Pennsylvania (hereinafter "Giant Enola").
5. At that time and place, Defendant was in exclusive possession,
management and control of the interior of Giant Enola through its employees who
were acting within the scope and course of their employment by Defendant, and in
furtherance of Defendant's business.
6. At that time and place, Plaintiff, Courtney Motes, was a business visitor
at Giant Enola.
7. At that time and place, Plaintiff, Courtney Motes, was walking in the
frozen food aisle of Giant Enola.
8. At that time and place, an employee of Giant Enola was in the process of
stocking the freezer with ice cream.
9. At that time and place, the box from which the Giant Enola employee
was taking the ice cream was leaking a foreign substance unknown to Plaintiff,
Courtney Motes, but believed to be either melted ice cream or water from melted ice.
10. This foreign, unknown, melted substance caused Plaintiff, Courtney
Motes, to slip and fall.
11. The foregoing incident and all of the injuries and damages as set forth
hereinafter are the direct and proximate result of the negligent, gross negligence,
careless, wanton and reckless manner in which Defendant operated and maintained
the Giant Enola as follows:
a. In failing to exercise reasonable care to ensure the safety of
business visitors such as Plaintiff;
b. In failing to inspect the premises and discover the foreign
substance that caused the incident;
c. In failing to discover and/or keep the premises and floor of Giant
Enola free and clear of foreign substances that would create a
hazard to business visitors such as Plaintiff;
d. In failing to adequately supervise and manage its employees who
should have discovered and removed the foreign substance that
caused the incident;
e. In failing to anticipate the harm that the foreign substance would
cause business visitors;
f. In permitting a foreign substance to accumulate on the floor at a
point where it posed an unreasonable risk of injury to Plaintiff
and other business visitors;
g. In failing.. to give warning of the dangerous condition posed by the
accumulation of the foreign substance, erect barricades, or take
any other safety precautions to prevent injury to Plaintiff and
other business visitors; and
h. In failing to remove the foreign substance from the floor and keep
the floor clean and free of hazardous conditions.
COUNT I -- NEGLIGENCE
Courtney Motes, Plaintiff v. Giant Food Stores, LLC, Defendant
12. Paragraphs 1-11 are incorporated herein by reference thereto.
13. As a result of Defendant's negligence, carelessness and recklessness,
Plaintiff, Courtney Motes, suffered painful and severe injuries to her nerves, bones and
soft tissues, which include, but are not limited to, her head, right elbow and right
knee.
14. By reason of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she has suffered a heightened possibility that she will suffer other or additional injury
in the future, and claim is made therefore.
15. The aforesaid injuries suffered by Plaintiff, Courtney Motes, may have
aggravated or been aggravated by an existing infirmity, condition or disease, resulting
in a prolongation or worsening of the injuries and an enhanced risk of future harm to
Plaintiff, and claim is made therefore.
16. By reason of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she was forced to incur liability for reasonable and necessary medical tests, medical
examinations, medical treatment, medications, hospitalizations and similar expenses
in an effort to diagnose her injuries and to restore herself to health, and claim is made
therefore.
17. Plaintiff, Courtney Motes, has not fully recovered from her injuries and it
is reasonably likely that she will incur similar expenses in the future, and claim is
made therefore.
18. By reason of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she has suffered a loss of earnings and earning capacity and is entitled to recover the
value of the time, earnings and employment benefits she has lost and which she might
reasonably have earned in the pursuit of her ordinary calling, and claim is made
therefore.
19. By reason of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she has suffered a loss or impairment of future earning capacity, and claim is made
therefore.
20. By reason of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she has incurred incidental costs and expenses, the exact amount of which cannot be
ascertained at this time, and claim is made therefore.
21. As a result of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she has undergone and in the future will undergo great physical and mental pain and
suffering, great inconvenience in carrying out her daily activities, loss of life's
pleasures and enjoyment, and claim is made therefore.
22. As a result of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she has been subjected to humiliation, embarrassment, shame, worry and anger.
23. As a result of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she has been subjected to severe mental anguish, emotional distress, nervous shock,
fright and horror.
24. As a result of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she will continue to endure great mental anguish, emotional distress, shame, worry
and anger in the future.
25. By reason of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she has been deprived her enjoyment of the pleasures of life.
26. Plaintiff, Courtney Motes, continues to be plagued by persistent pain and
limitation and, therefore, avers that her injuries may be of a permanent nature,
causing residual problems for the remainder of her lifetime, and claim is made
therefore.
27. As a result of the aforesaid injuries suffered by Plaintiff, Courtney Motes,
she has suffered a disfigurement., and claim is made therefore.
WHEREFORE, Plaintiff, Courtney Motes, demands judgment in her favor and
against Defendant, Giant Food Stores, LLC, in an amount in excess of FIFTY
THOUSAND 8v 00/ 100 ($50,000.00) DOLLARS, exclusive of interest and costs and in
excess of any jurisdictional amount requiring compulsory arbitration.
COUNT II
Eugene Motes, Plaintiff v. Giant Food Stores. LLC, Defendant
28. Paragraphs 1-27 are incorporated herein by reference thereto.
29. At the time of the incident herein referred, Plaintiff, Courtney Motes, was
a minor, born October 12, 1994.
30. As a result of the injuries suffered by his minor daughter, Courtney
Motes, Plaintiff, Eugene Motes, has incurred expenses and/or liability for the
reasonable and necessary medical tests, medical examinations, medical treatment,
medications, medical care, hospitalizations and similar expenses in an effort to
diagnose and treat her injuries, and claim is made therefore.
WHEREFORE, Plaintiff, Eugene Motes, demands judgment in his favor and
against Defendant, Giant Food Stores, LLC, for compensatory damages in an amount
in excess of FIFTY THOUSAND 8s 00/ 100 ($50,000.00) DOLLARS, exclusive of interest
and costs and in excess of any jurisdictional amount requiring compulsory arbitration.
f'~AiTNT iii
Tricia Motes, Plaintiff v. Giant Food Stores, LLC, Defendant
31. Paragraphs 1-30 are incorporated herein by reference thereto.
32. At the time of the incident herein referred, Plaintiff, Courtney Motes, was
a minor, born October 12, 1994.
32. As a result of the injuries suffered by her minor daughter, Courtney
Motes, Plaintiff, Tricia Motes, has incurred expenses and/or liability for the reasonable
and necessary medical tests, medical examinations, medical treatment, medications,
medical care, hospitalizations and similar expenses in an effort to diagnose and treat
her injuries, and claim is made therefore.
WHEREFORE, Plaintiff, Tricia Motes, demands judgment in her favor and
against Defendant, Giant Food Stores, LLC, for compensatory damages in an amount
in excess of FIFTY THOUSAND 8v 00/ 100 ($50,000.00) DOLLARS, exclusive of interest
and costs and in excess of any jurisdictional amount requiring compulsory arbitration.
Respectfully Submitted,
FREEBURN & HAMILTON
By: C
Christina L. Bradley, Es ire
I.D. No. 89107
2040 Linglestown Road
Suite 300
Harrisburg PA 17110
(717) 671-1955
Date: ~~~~~~~ ~ 13 Counsel for Plaintiffs
VERIFICATION
I, Eugene Motes, hereby verify that the statements in the foregoing
Complaint 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.
Dated: i I ~ 1
Eugene Motes
VERIFICATION
I, Tricia Motes, hereby verify that the statements in the foregoing
Complaint 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.
Dated: J I ~~ ~'~ ~`^~M1-~~J/
Tricia Motes
VERIFICATION
I, Courtney Motes, hereby verify that the statements in the
foregoing Complaint 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.
Dated: ~-~-~v~
Courtney Motes
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA ,
PURSUANT TO RULE 4009.22 �` J(J1'
AL
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
As a prerequisite to service of a subpoena for documents and things p� ualit�` .-,
to Rule 4009.22 t'- -n. =mr
:>>
7::cD c7
MCS on behalf of GEORGE B. FALLER, JR. , ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCS o r-/-l f`.f
DATE: 10/07/2013 ��,,�y 1 I
GEORGE B. F' Ab R, JR. , ES7
Attorney for DEFENDANT
MCS # 36912-L01
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES
-VS- CASE NO: 13-250
GIANT FOOD STORES
NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND
THINGS FOR DISCOVERY PURSUANT TO RULE 4009 .21
CAMP HILL FAMILY CARE MEDICAL RECORDS & BILLING
HARRISBURG HOSPITAL MEDICAL RECORDS
HARRISBURG HOSPITAL BILLING ONLY
TO: CHRISTINA L. BRADLEY, ESQ. , PLAINTIFF COUNSEL
MCS on behalf of GEORGE B. FALLER, JR. , ESQ. intends to serve a subpoena
identical to the one that is attached to this notice. You have twenty (20)
days from the date listed below in which to file of record and serve upon the
undersigned an objection to the subpoena. If the twenty day notice period is
waived or if no objection is made, then the subpoena may be served. Complete
copies of any reproduced records may be ordered at your expense by completing
the attached counsel card and returning same to MCS or by contacting our local
MCS office.
DATE: 09/13/2013
MCS on behalf of
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
CC: GEORGE B. FALLER, JR. , ESQ. - 9500.622
THE MCS GROUP INC.
CHRISTINA L. BRADLEY, ESQ. 1601 MARKET STREET
FREEBURN & HAMILTON #800
2040 LINGLESTOWN ROAD PHILADELPHIA, PA 19103
SUITE 300 (215) 246-0900
HARRISBURG, PA 17110
MCS # 36912-CO1
DE02
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
•
•
COURTNEY MOTES,EUGENE MOTES &TRICIA :
MOTES File No. 13-250
•
vs.
•
GIANT FOOD STORES
•
•
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for CAMP HILL FAMILY CARE
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER ****
at The MCS Group.Inc.. 1601 Market Street.Suite 800.Philadelphia,PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek, in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20) days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B.FALLER, JR.,ESQ.
ADDRESS: 10 E.HIGH STREET
CARLISLE.PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT:
I i . ! i,
Prothonotary/Clerk,Civil Division
q//0/8 3 Deputy
Date:
Seal of the Court
36912-01
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
CAMP- HILL FAMILY CARE
4400 CARLISLE PIKE
CAMP HILL, PA 17011
RE: MCS # 36912-L01
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: XXX-XX-3759
Date of Birth: 10-12-1994
Please provide entire medical and billing file, including but not
limited to any and all inpatient and outpatient records, ER records, physical
therapy records, correspondence to and from the consulting and treating
physicians. Include all files, memoranda, handwritten notes, emails, phone
messages, history, physical reports and all prescriptions records. Including
but not limited to, itemized billing, insurance claims, invoices and payments
This should contain all records in your possession, all office and admission
charts, all archived records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is required for fees in excess of $150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-LOl
SU10
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR. , ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCS o b-half if
DATE: 10/07/2013 ./# i
GEORGE :ALLER, JR. , ESS'
Attorney for DEFENDANT
MCS # 36912-L02
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
•
COURTNEY MOTES,EUGENE MOTES&TRICIA :
MOTES File No. 13-250
vs. •
•
GIANT FOOD STORES •
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for HARRISBURG HOSPITAL
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER****
at The MCS Group,Inc.. 1601 Market Street.Suite 800,Philadelphia.PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek, in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20) days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B. FALLER.JR.. ESQ.
ADDRESS: 10 E. HIGH STREET
CARLISLE. PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT: rgUe--66--
e Prothonotary/Clerk,Civil Division
(9/0 /! Deputy
Date:
Seal of the Court
36912-02
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
HARRISBURG HOSPITAL
MEDICAL RECORDS
111 S. FRONT STREET
HARRISBURG, PA 17101
RE: MCS # 36912-L02
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: 162-76-3759
Date of Birth: 10-12-1994
Please provide the entire hospital medical file, including but not
limited to all inpatient and outpatient records, ER records, physical therapy
records, intake or admission forms, correspondence to and from the
consulting and treating physicians, and discharge forms. Include all files,
memoranda, handwritten notes, history and physical reports. Supply all
medication and prescription records, nurses' notes, doctor's comments,
dietary and all patient consent or refusal of treatment, . This should contain
all records in your possession, including all archived records, records in
storage. Including any and all items as may be stored in a computer database
or otherwise in electronic form.
Prior approval is required for fees in excess of $150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L02
SU10
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR. , ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCS o •- , al f of
DATE: 10/07/2013 , /44 r2;
GEOR=E B. A LER, JR. , ESQ.
Attorney for DEFENDANT
MCS # 36912-L03
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
•
•
COURTNEY MO TES,EUGENE MOTES&TRICIA :
MOTES File No. 13-250
vs.
•
GIANT FOOD STORES
•
•
•
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for HARRISBURG HOSPITAL
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER****
at The MCS Group.Inc.. 1601 Market Street,Suite 800.Philadelphia.PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek, in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20)days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B. FALLER.JR.. ESQ.
ADDRESS: 10 E. HIGH STREET
CARLISLE,PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT:
Prothonotary/Clerk, Civil Division
4.... /al:Zit...L..4C?eVa2/24,14c
Deputy
Date: 9/0/2
Seal of the Court
36912-03
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
HARRISBURG HOSPITAL
BILLING DEPARTMENT
111 S. FRONT STREET
HARRISBURG. PA 17105
RE: MCS # 36912-L03
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: 162-76-3759
Date of Birth: 10-12-1994
Please provide any and all billing, insurance claims, and payments, outstanding
and delinquent invoices. This should contain all records in your
possession, all archived records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is required for fees in excess of $150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L03
SU10
A
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22 ORIGINAL
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
c?g
As a prerequisite to service of a subpoena for documents and things uds+t ---f
to Rule 4009.22
O P
t
t"w
+;r is CD
MCS on behalf of GEORGE B. FALLER, JR. , ESQ. I*Cz
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
110 on b alf of
DATE: 10/23/2013
GEORGE B. F L ER, JR. , ESQ.
Attorney fcfr nEFENDANT
MCS # 36912-L04
DE11
. .s
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES
-VS- CASE NO: 13-250
GIANT FOOD STORES
NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND
THINGS FOR DISCOVERY PURSUANT TO RULE 4009 .21
PA BUREAU OF DISABILITY DETER. RECORDS
TO: CHRISTINA L. BRADLEY, ESQ. , PLAINTIFF COUNSEL
MCS on behalf of GEORGE B. FALLER, JR. , ESQ. intends to serve a subpoena
identical to the one that is attached to this notice. You have twenty (20)
days from the date listed below in which to file of record and serve upon the
undersigned an objection to the subpoena. If the twenty day notice period is
waived or if no objection is made, then the subpoena may be served. Complete
copies of any reproduced records may be ordered at your expense by completing
the attached counsel card and returning same to MCS or by contacting our local
MCS office.
DATE: 10/01/2013
MCS on behalf of
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
CC: GEORGE B. FALLER, JR. , ESQ. - 9500.622
THE MCS GROUP INC.
CHRISTINA L. BRADLEY, ESQ. 1601 MARKET STREET
FREEBURN & HAMILTON #800
2040 LINGLESTOWN ROAD PHILADELPHIA, PA 19103
SUITE 300 (215) 246-0900
HARRISBURG, PA 17110
MCS # 36912-001
DE02
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES, EUGENE MOTES&TRICIA
File No. 13-250
vs.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for PA BUREAU OF DISABILITY DETER.
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER****
at The MCS Group,Inc.. 1601 Market Street,Suite 800.Philadelphia.PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance, to the party making this request at the address listed above. You have the right
to seek, in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20) days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B. FALLER, JR.,ESQ.
ADDRESS: 10 E. HIGH STREET
CARLISLE, PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT:
' - -S.,,ZL
OCT 2 3 2013 Prothonotary/Clerk, Civil Division
(n Deputy C, LWFCe
Date: � ��`'`
Seal of the Court
36912-04
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
PA BUREAU OF DISABILITY DETER.
1171 S. CAMERON STREET
ROOM 109
HARRISBURG, PA 171042594
RE: MCS # 36912-L04
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: 162-76-3759
Date of Birth: 10-12-1994
ANY & ALL RECORDS AVAILABLE
Prior approval is required for fees in excess of $150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L04
SU10
` CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
C. -v
As a prerequisite to service of a subpoena for documents and thingsiFr7uaLt
to Rule 4009.22 ==1 -
MCS on behalf of GEORGE B. FALLER, JR. , ESQ. y C7-
certifies that :.
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MC b
DATE: 01/13/2014
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
MCS # 36912-,L05
DE11
t
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES
-VS- CASE NO: 13-250
GIANT FOOD STORES
NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND
THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21
ORTHOPAEDIC INSTITUTE OF PA MEDICAL RECORDS & BILLING
DRAYER PHYSICAL THERAPY INSTIT MEDICAL RECORDS & BILLING
DIAKON FAMILY LIFE SERVICES MEDICAL RECORDS & BILLING
BEHAVIROAL HEALTH CENTER MEDICAL RECORDS & BILLING
CPRS PHYSICAL THERAPY MEDICAL RECORDS & BILLING
CAMP HILL FAMILY CARE MEDICAL RECORDS & BILLING
TRISTAN ASSOCIATES MEDICAL RECORDS & BILLING
TO: CHRISTINA L. BRADLEY, ESQ. , PLAINTIFF COUNSEL
MCS on behalf of GEORGE B. FALLER, JR. , ESQ. intends to serve a subpoena
identical to the one that is attached to this notice. You have twenty (20)
days from the date listed below in which to file of record and serve upon the
undersigned an objection to the subpoena. If the twenty day notice period is
waived or if no objection is made, then the subpoena may be served. Complete
copies of any reproduced records may be ordered at your expense by completing
the attached counsel card and returning same to MCS or by contacting our local
MCS office.
DATE: 12/20/2013
MCS on behalf of
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
CC: GEORGE B. FALLER, JR. , ESQ. - 9500.622
THE MCS GROUP INC.
CHRISTINA L. BRADLEY, ESQ. 1601 MARKET STREET
FREEBURN & HAMILTON #800
2040 LINGLESTOWN ROAD PHILADELPHIA, PA 19103
SUITE 300 (215) 246-0900
HARRISBURG, PA 17110
MCS # 36912-CO1
DE02
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES,EUGENE MOTES&TRICIAMOTES
File No. 13-250
VS.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for ORTHOPAEDIC INSTITUTE OF PA
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER****
at The MCS Group.Inc., 1601 Market Street,Suite 800,P ila&whia,PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek,in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20)days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B.FALLER_JR.,ESQ.
ADDRESS: 10 E.HIGH STREET
CARLISLE,PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT:
7 I
Prothonotary/Clerk,Civil Division
JAN 1 3 2014
Deputy
Date: p(
Seal of the Court
36912-05
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
ORTHOPAEDIC INSTITUTE OF PA
3399 TRINDLE ROAD
2ND FLOOR
CAMP HILL, PA 17011
RE: MCS # 36912-L05
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: XXX-XX-3759
Date of Birth: 10-12-1994
Please provide entire medical and billing file, including but not
limited to any and all inpatient and outpatient records, ER records, physical
therapy records, correspondence to and from the consulting and treating
physicians. Include all files, memoranda, handwritten notes, emails, phone
messages, history, physical reports and all prescriptions records. Including
but not limited to, itemized billing, insurance claims, invoices and payments
This should contain all records in your possession, all office and admission
charts, all archived records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is required for fees in excess of$150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L05
SU10
+ CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR. , ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCS on behalf of
DATE: 01/13/2014
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
MCS # 36912-L06
DE11
' COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES,EUGENE MOTES&TRICIAMOTES
File No. 13-250
VS.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for DRAYER PHYSICAL THERAPY INSTIT
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER ****
at The MCS Group,Inc., 1601 Market Street,Suite 800.PhiladelphijL PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek, in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20)days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B.FALLER JR.,ESQ.
ADDRESS: 10 E HIGH STREET
C ARUSLE,PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT:
jum, 1AA
Prothonotary/Clerk,Civil Division
1,14
3 Deputy
Date:
Seal of the Court
36912-06
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
DRAYER PHYSICAL THERAPY INSTIT
8205 PRESIDENTS DRIVE
FIRST FLOOR
HUMMELSTOWN, PA 17036
RE: MCS # 36912-L06
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: XXX-XX-3759
Date of Birth: 10-12-1994
Please provide entire medical and billing file, including but not
limited to any and all inpatient and outpatient records, ER records, physical
therapy records, correspondence to and from the consulting and treating
physicians. Include all files, memoranda, handwritten notes, emails, phone
messages, history, physical reports and all prescriptions records. Including
but not limited to, itemized billing, insurance claims, invoices and payments
This should contain all records in your possession, all office and admission
charts, all archived records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is required for fees in excess of $150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L06
SU10
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR. , ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCS on behalf of
DATE: 01/13/2014
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
MCS # 36912-L07
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES,EUGENE MOTES&TRICIAMOTES
File No. 13-250
VS.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for DLAKON FAMILY LIKE SERVICES
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER****
at The MCS Group,Inc., 1601 Market Stre"Suite 800,Ph11adelplia,PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek,in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20)days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B.FALLER.JR..ESQ.
ADDRESS: 10 E.HIGH STREET
CARLISLE,PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT:
Prothonotary/Clerk,Civil Division
-- J 2014
Deputy
Date:
Seal of the Court
36912-07
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
DIAKON FAMILY LIFE SERVICES
960 CENTURY DRIVE
MECHANICSBURG, PA 17055
RE: MCS # 36912-L07
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: XXX-XX-3759
Date of Birth: 10-12-1994
Please provide entire medical and billing file, including but not
limited to any and all inpatient and outpatient records, ER records, physical
therapy records, correspondence to and from the consulting and treating
physicians. Include all files, memoranda, handwritten notes, emails, phone
messages, history, physical reports and all prescriptions records. Including
but not limited to, itemized billing, insurance claims, invoices and payments
.This should contain all records in your possession, all office and admission
charts, all archived records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is required for fees in excess of $150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-,L07
SU10
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR. , ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCS on behalf of
DATE: 01/13/2014
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
MCS # 36912-L08
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES,EUGENE MOTES&TRICIAMOTES
File No. 13-250
VS.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for BEHAVIROAL HEALTH CENTER
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER****
at The MCS Cg= Inc.. 1601 Market Street,Suite 800,Philadelphia.PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek, in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20)days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B.FALLER.JR..ESQ.
ADDRESS: 10 E.HIGH STREET
CARLISLE,PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
IBY THE COURT:
Yli 1�
Prothonotary/Clerk,Civil Division
1 2 4 Deputy
Date:
Seal of the Court
36912-08
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
BEHAVIROAL HEALTH CENTER
503 N 21ST. STREET
CAMP HILL, PA 17011
RE: MCS # 36912-L08
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: XXX-XX-3759
Date of Birth: 10-12-1994
Please provide entire medical and billing file, including but not
limited to any and all inpatient and outpatient records, ER records, physical
therapy records, correspondence to and from the consulting and treating
physicians. Include all files, memoranda handwritten notes, emails, phone
messages, history,, physical reports and all prescriptions records. Including
but not limited to, itemized billing, insurance claims, invoices and payments
This should contain all records in your possession, all office and admission
charts, all archived"records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is qeq ui red for fees in excess of$150.00 for
hospitals, $100.00 or all other providers.
MCS # 36912-LO8
SU10
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR. , ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCS on behalf of
DATE: 01/13/2014
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
MCS # 36912-L09
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES,EUGENE MOTES&TRICIAMOTES
File No. 13-250
VS.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for CPRS PHYSICAL THERAPY
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER****
at The MCS Q=,Inc., 1601 Market Street,Suite 800,Philadelphia-PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek, in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20)days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B.FALLER.JR.,ESQ.
ADDRESS: 10 E.HIGH STREET
CARLISLE,PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: _Defendant
BY THE COURT:
Prothonotary/Clerk,Civil Division
- I NI P 2014
/ f Deputy
Date:
Seal of the Court
36912-09
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
CPRS PHYSICAL THERAPY
3916 TRINDLE ROAD
CAMP HILL, PA 17011
RE: MCS # 36912-LO9
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: XXX-XX-3759
Date of Birth: 10-12-1994
Please provide entire medical and billing file, including but not
limited to any and all inpatient and outpatient records, ER records, physical
therapy records, correspondence to and from the consulting and treating
,physicians. Include all files, memoranda, handwritten notes, emails, phone
messages, history, physical reports and all prescriptions records. Including
but not limited to, itemized billing, insurance claims, invoices and payments
This should contain all records in your possession, all office and admission
charts, all archived records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is required for fees in excess of$150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L09
SU10
• CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR. , ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCS on behalf of
DATE: 01/13/2014
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
MCS # 36912-LlO
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES,EUGENE MOTES&TRICIAMOTES
File No. 13-250
VS.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for CAMP HILL FAMILY CARE
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER****
at The MCS Group Inc., 1601 Market Street,Suite 800 Philadelphia.PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena,together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek,in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20) days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B FALLER JR..ESQ.
ADDRESS: 10 E. HIGH STREET
CARLISLE.PA 17013
TELEPHONE:0)746-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT:
Prothonotary/Clerk,Civil Division
J� �. � 14 uty
/� /� Dep
Date:
Seal of the Court
36912-10
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
CAMP HILL FAMILY CARE
4400 CARLISLE PIKE
CAMP HILL, PA 17011
RE: MCS # 36912-L10
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: XXX-XX-3759
Date of Birth: 10-12-1994
Please provide entire medical and billing file, including but not
limited to any and all inpatient and outpatient records, ER records, physical
therapy records, correspondence to and from the consulting and treating
physicians. Include all files, memoranda, handwritten notes, emails, phone
messages, history, physical reports and all prescriptions records. Including
but not limited to, itemized billing, insurance claims, invoices and payments
This should contain all records in your possession, all office and admission
charts, all archived records- or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is required for fees in excess of$150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L10
SU10
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-vs- CASE NO: 13-250
GIANT FOOD STORES
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR. , ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCS on behalf of
DATE: 01/13/2014
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
MCS # 36912-L11
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES,EUGENE MOTES&TRICIAMOTES
File No. 13-250
VS.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for TRIST N ASSOCIATES
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: **** SEE ATTACHED RIDER****
at The MCS Group,Inc., 1601 Market Street,Suite 800,Philadelphia.PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek,in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20)days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B.FALLER JR..ESO.
ADDRESS: 10 E.HIGH STREET
CARLISLE,PA 17013
TELEPHONE: (215)246-0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT:
1
Prothonotary/Clerk,Civil Division
JANl 20
Dep
/� 10 ,?uty
Date:
Seal of the Court
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
TRISTAN ASSOCIATES
240 GRANDVIEW AVE.
CAMP HILL, PA 17011
RE: MCS # 36912-Lll
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
Social Security #: XXX-XX-3759
Date of Birth: 10-12-1994
Please provide entire medical and billing file, including but not
limited to any and all inpatient and outpatient records, ER records, physical
therapy records, correspondence to and from the consulting and treating
physicians. Include all files, memoranda, handwritten notes, emails, phone
messages, history, physical reports and all prescriptions records. Including
but not limited to, itemized billing, insurance claims, invoices and payments
This should contain all records in your possession, all office and admission
charts, all archived records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is required for fees in excess of$150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-Lll
SU10
4.
CERTIFICATE �y
PREREQUISITE TO SERVICE OF A SUBPOENA ORIGINAL
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES CUMBERLAND
-VS- CASE NO: 13-250
GIANT FOOD STORES
f-- -
P p g P
As a prerequisite to service of a subpoena for documents and things a , �'ry`:
to Rule 4009.22 :2
- C,
=c) _.
MCS on behalf of GEORGE B. FALLER, JR. , ESQ. `
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
MCar4� 'f of
DATE: 02/03/2014
GEORGE B. F'.LER, JR. , ESQ.
Attorney fo: DEFENDANT
MCS # 36912-L12
DE11
-.0i -4.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA TERM,
MOTES
-VS- CASE NO: 13-250
GIANT FOOD STORES
NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND
THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21
KLINE FAMILY PRACTICE MEDICAL RECORDS & BILLING
TO: CHRISTINA L. BRADLEY, ESQ. , PLAINTIFF COUNSEL
MCS on behalf of GEORGE B. FALLER, JR. , ESQ. intends to serve a subpoena
identical to the one that is attached to this notice. You have twenty (20)
days from the date listed below in which to file of record and serve upon the
undersigned an objection to the subpoena. If the twenty day notice period is
waived or if no objection is made, then the subpoena may be served. Complete
copies of any reproduced records may be ordered at your expense by completing
the attached counsel card and returning same to MCS or by contacting our local
MCS office.
DATE: 01/10/2014
MCS on behalf of
GEORGE B. FALLER, JR. , ESQ.
Attorney for DEFENDANT
CC: GEORGE B. FALLER, JR. , ESQ. - 9500.622
THE MCS GROUP INC.
CHRISTINA L. BRADLEY, ESQ. 1601 MARKET STREET
FREEBURN & HAMILTON #800
2040 LINGLESTOWN ROAD PHILADELPHIA, PA 19103
SUITE 300 (215) 246-0900
HARRISBURG, PA 17110
MCS # 36912-CO1
DE02
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
•
•
COURTNEY MOTES,EUGENE MOTES &TRICIAMOTES •
• File No. 13-250
vs.
•
GIANT FOOD STORES
•
•
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for KLINE FAMILY PRACTICE
(Name of Person or Entity)
Within twenty(20)days after service of this subpoena,you are ordered by the court to produce the following
documents or things: . **** SEE ATTACHED RIDER****
at The MCS Group.Inc.. 1601 Market Street.Suite 800,Philadelphia.PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance,to the party making this request at the address listed above. You have the right
to seek, in advance,the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty(20)days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B.FALLER,JR.,ESQ.
ADDRESS: 10 E.HIGH STREET
CARLISLE,PA 17013
TELEPHONE: (215)24 -0900
SUPREME COURT ID#:
ATTORNEY FOR: Defendant
BY THE COURT:
Prothonotary/Clerk,Civil Division
Deputy
Date:
Seal of the Court
36912-12
NIMINIIIIIIMMIl
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
KLINE FAMILY PRACTICE
2601 N.3RD STREET
HARRISBURG, PA 17110
RE: MCS # 36912-L12
COURTNEY MOTES
279 SUSQUEHANNA AVENUE
ENOLA, PA 17025
•
Social Security #: XXX-XX-3759
Date of Birth: 10-12-1994
Please provide entire medical and billing file, including but not
limited to any and all inpatient and outpatient -records, ER records, physical
therapy records, correspondence to and from the consulting and treating
physicians. Include all files, memoranda, handwritten notes, emails, phone
messages, history, physical reports and all prescriptions records. Including
but not limited to, itemized billing, insurance claims, invoices and payments
This should contain all records in your possession, all office and admission
charts, all archived records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form. -
Prior approval is required for fees in excess of$150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L12
Su10
22V; 07i 20 Ft 1'
COUTY
11 '77
L..r.SPt
IN THE MATTER OF:
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA:'
PURSUANT TO RULE 4009.22
COURTNEY MOTES, EUGENE MOTES & TRICIA
MOTES
GIANT FOOD STORES
COURT OF COMMON PLEAS
TERM,
CUMBERLAND
-VS- CASE NO: 13-250
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR., ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
DATE: 10/03/2014
MCS
GEO• B. FAAF,
Attorney for DEFE 4
, ESQ.
T
MCS # 36912-L13
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
IN THE MATTER OF:
COURTNEY MOTES, EUGENE MOTES & TRICIA
MOTES
-VS-
GIANT FOOD STORES
COURT OF COMMON PLEAS
TERM,
CASE NO: 13-250
NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND
THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21
CITIZENS HOSE COMPANY EMS RECORDS
GRANDVIEW SURGERY CENTER MEDICAL RECORDS
TO: CHRISTINA L. BRADLEY, ESQ., PLAINTIFF COUNSEL
MCS on behalf of GEORGE B. FALLER, JR., ESQ. intends to serve a subpoena
identical to the one that is attached to this notice. You have twenty (20)
days from the date listed below in which to file of record and serve upon the
undersigned an objection to the subpoena. If the twenty day notice period is
waived or if no objection is made, then the subpoena may be served.
DATE: 09/11/2014
CC: GEORGE B. FALLER, JR., ESQ. - 9500.622
CHRISTINA L. BRADLEY, ESQ.
FREEBURN & HAMILTON
2040 LINGLESTOWN ROAD
SUITE 300
HARRISBURG, PA 17110
MCS on behalf of
GEORGE B. FALLER, JR., ESQ.
Attorney for DEFENDANT
THE MCS GROUP INC.
1601 MARKET STREET
#800
PHILADELPHIA, PA 19103
(215) 246-0900
MCS # 36912-001
DE02
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES, EUGENE MOTES & TRICIAMOTES
File No. 13-250
vs.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for CITIZENS HOSE COMPANY
(Name of Person or Entity)
Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following
documents or things: * * * * SEE ATTACHED RIDER
at The MCS Group. Inc.. 1601 Market Street. Suite 800. Philadelphia. PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance, to the party making this request at the address listed above. You have the right
to seek, in advance, the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B. FALLER, JR., ESQ.
ADDRESS: 10 E. HIGH STREET
CARLISLE, PA 17013
TELEPHONE: (215) 246-0900
SUPREME COURT ID #:
ATTORNEY FOR: Defendant
Date:
OCT 0 3 2014
alghy
Seal of the Court
BY THE COURT:
Protionotaryterk, CiviDivision
Deputy
36912-13
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
CITIZENS HOSE COMPANY
4807 JONESTOWN ROAD
SUITE 247
HARRIBURG, PA 17107
RE: MCS # 36912-L13
COURTNEY MOTES
AKA COURTNEY HEFFELFINGER, 279 SUSQUEHANNA AVE
ENOLA, PA 17025
Social Security #: XXX -XX -3759
Date of Birth: 10-12-1994
Please provide all treatment, transport, and any refusal of treatment records
. This should contain all records in your possession, all archived
records and records in storage. Include any items as may be stored in a
computer database or otherwise in electronic form.
Prior approval is required for fees in excess of $150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L13
SU10
CERTIFICATE
PREREQUISITE TO SERVICE OF A SUBPOENA
PURSUANT TO RULE 4009.22
IN THE MATTER OF: COURT OF COMMON PLEAS
COURTNEY MOTES, EUGENE MOTES & TRICIA
MOTES
GIANT FOOD STORES
TERM,
CUMBERLAND
-VS- CASE NO: 13-250
As a prerequisite to service of a subpoena for documents and things pursuant
to Rule 4009.22
MCS on behalf of GEORGE B. FALLER, JR., ESQ.
certifies that
(1) A notice of intent to serve the subpoena with a copy of the subpoena
attached thereto was mailed or delivered to each party at least
twenty days prior to the date on which the subpoena is sought to be
served,
(2) A copy of the notice of intent, including the proposed subpoena, is
attached to this certificate,
(3) No objection to the subpoena has been received, and
(4) The subpoena which will be served is identical to the subpoena which
is attached to the notice of intent to serve the subpoena.
DATE: 10/03/2014
MCS on behalf of
GEORGE B. FALLER, JR., ESQ.
Attorney for DEFENDANT
MCS # 36912-L14
DE11
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
COURTNEY MOTES, EUGENE MOTES & TRICIAMOTES
File No. 13-250
vs.
GIANT FOOD STORES
SUBPOENA TO PRODUCE DOCUMENTS OR THINGS
FOR DISCOVERY PURSUANT TO RULE 4009.22
TO: Custodian of Records for GRANDVIEW SURGERY CENTER
(Name of Person or Entity)
Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following
documents or things: * * * * SEE ATTACHED RIDER * * *
at The MCS Group. Inc.. 1601 Market Street. Suite 800. Philadelphia. PA 19103
You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together
with the certificate of compliance, to the party making this request at the address listed above. You have the right
to seek, in advance, the reasonable cost of preparing the copies or producing the things sought.
If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service,
the party serving this subpoena may seek a court order compelling you to comply with it.
THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON:
NAME: GEORGE B. FALLER, JR., ESQ.
ADDRESS: 10 E. HIGH STREET
CARLISLE, PA 17013
TELEPHONE: (215) 246-0900
SUPREME COURT ID #:
ATTORNEY FOR: Defendant
Date:
= OCT 0 3 2014
cile/Y.
Seal of the Court
BY T
C • RT:
Prothonotary/Clerk, ' ivil Division
Deputy
36912-14
EXPLANATION OF REQUIRED RECORDS
TO: CUSTODIAN OF RECORDS FOR:
GRANDVIEW SURGERY CENTER
205 GRANDVIEW AVENUE
SUITE 101
CAMP HILL, PA 17011
RE: MCS # 36912-L14
COURTNEY MOTES
AKA COURTNEY HEFFELFINGER, 279 SUSQUEHANNA AVE
ENOLA, PA 17025
Social Security #: XXX -XX -3759
Date of Birth: 10-12-1994
Please provide entire medical file, including but not limited to any
and all inpatient and outpatient records, ER records, physical therapy records
files, memoranda, handwritten notes, emails, phone messages, history, physical
reports, Laboratory & office/admission charts, and all prescriptions records.
This should contain all records in your possession, all office and admission
charts, all archived records, or records in storage. Including any and all
items as may be stored in a computer database or otherwise in electronic form.
Prior approval is required for fees in excess of $150.00 for
hospitals, $100.00 for all other providers.
MCS # 36912-L14
SU10