The URL can be used to link to this page

Home My WebLink About15-0266 Supreme Court of-Pennsylvania Cou ';t'O ommoi,Tleas For Prothonotary Use Only: Civil' over Sheet Docket No: CUMBERLAND County The information collected on this form is used.solely for court administration puiposes. This form does not supplement or replace the filing and service qfpleadings or other papers as required by low or rules of court. Commencement of Action: S El Complaint R Writ of Summons El Petition [] Transfer from Another Jurisdiction E] Declaration of Taking E C Lead Plaintiffs Name: Lead Defendant's Name: T William John Holloway as Executor of the Estate of Willi MESSIAH LIFEWAYS, et al. Dollar Amount Requested: Elwithin arbitration limits Are money damages requested? R Yes 0 No (check one) E]outside arbitration limits 0 N Is this a Class Action Suit? rl Yes x No Is this an MDJAppeal? El Yes 0 No A Name of Plainti ff/Appel]ant's Attorney: William P. Murray, 111, Esquire ED Check here if you have no attorney(are a Self-Represented JPro Sel Litigant) Nature of the Case: Place an "X"to the left of the ONE case category that most accurately describes your PRIMARY CASE. If you are making more than one type of claim, check the one that you consider most important. TORT (do not include Mass Tort) CONTRACT (do not include Judgments) CIVIL APPEALS 0 Intentional Buyer Plaintiff Administrative Agencies El Malicious Prosecution Debt Collection:Credit Card 0 Board of Assessment E) Motor Vehicle 0 Debt Collection: Other 0 Board of Elections [] Nuisance 0 Dept. of Transportation E] Premises Liability El Statutory Appeal:Other S E] Product Liability(does not include 0 Employment Dispute: E mass fort) Discrimination El Slander/Libel/Defamation C El Other: 0 Employment Dispute:Other 0 Zoning Board T 0 Other: I 0 Other: O MASS TORT ril Asbestos N E] Tobacco E] Toxic Tort- DES ril Toxic Tort-Implant REAL PROPERTY MISCELLANEOUS Toxic Waste Ejectment El Common Law/Statutory Arbitration B Other: Eminent Domain/Condemnation 0 Declaratory Judgment Ground Rent Mandamus Landlord/Tenant Dispute E]Non-Domestic Relations El Mortgage Foreclosure:Residential Restraining Order PROFESSIONAL LIABLITY in Mortgage Foreclosure:Commercial El Quo Warranto f"I Dental 0 Partition 0 Replevin El Legal C] Quiet Title ❑Other: F! Medical E] Other: Other Professional: Nursing Home Negligence Updated 11112011 WILKES &McHUGH, P.A. William P. Murray, III, Esquire THIS IS NOT AN ARBITRATION CASE; Attorney Identification No. 205016 AN ASSESSMENT OF DAMAGES IS Three Parkway REQUIRED; JURY TRIAL DEMANDED 1601 Cherry Street, Suite 1300 Philadelphia, PA 19102 Attorney for Plaintiff, William John Holloway Tel No. (215) 972-0811 as Executor of the Estate of William J. Holloway, Email: wmurray@wilkesmchugh.com deceased WILLIAM JOHN HOLLOWAY, as IN THE COURT OF COMMON PL ,S Executor of The Estate of WILLIAM J. HOLLOWAY, deceased CUMBERLAND COUNTY, P4q-- c� - 5 Hilltop Circles Mechanicsburg, Pennsylvania 10755 DOCKET NO. Plaintiff, -vs- - - X MESSIAH LIFEWAYSU�M 4, 100 Mount Allen Drive Mechanicsburg, PA 17055 1!S -7-S' and MESSIAH HOME, d/b/a MESSIAH LIFEWAYS AT MESSIAH VILLAGE P41 100 Mount Allen Drive 3 Mechanicsburg, PA 17055 Defendants. PRAECIPE FOR WRIT OF SUMMONS (Medical Professional Liability Action) TO THE PROTHONOTARY/CLERK OF SAID COURT: Issue Summons in the above case. Writ of Summons shall be issued and forwarded to Attorney/Sheriff. (Please Circle Choice) Dated: ( y Signature o Atto Print Nam Wliam P. Muggy, III Esquire Address: ee Parkway 1601 Cherry Street Suite 1300 Philadelphia, PA 19102 Telephone No.: 215-972-0811 Supreme Court ID No.: 205016 WILKES &McHUGH, P.A. William P. Murray, III,Esquire THIS IS NOT AN ARBITRATION CASE; Attorney Identification No. 205016 AN ASSESSMENT OF DAMAGES IS Three Parkway REQUIRED; JURY TRIAL DEMANDED 1601 Cherry Street, Suite 1300 Philadelphia, PA 19102 Attorney for Plaintiff, William John Holloway Tel No. (215) 972-0811 as Executor of the Estate of William J. Holloway, Email: wmurray@wilkesmchugh.com deceased WILLIAM JOHN HOLLOWAY, as IN THE COURT OF COMMON PLEAS Executor of The Estate of WILLIAM J. HOLLOWAY, deceased CUMBERLAND COUNTY, PA 5 Hilltop Circle Mechanicsburg, Pennsylvania 10755 DOCKET NO. �� Plaintiff, -vs- MESSIAH LIFEWAYS 100 Mount Allen Drive Mechanicsburg, PA 17055 and MESSIAH HOME, d/b/a MESSIAH LIFEWAYS AT MESSIAH VILLAGE 100 Mount Allen Drive Mechanicsburg, PA 17055 Defendants. WRIT OF SUMMONS TO: DEFENDANT, MESSIAH LIFEWAYS YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFF HAS COMMENCED AN ACTION AGAINST YOU. lea Prothonotary/Clerk, Civil Division Date: /y �� WILKES &McHUGH,P.A. William P. Murray, I11, Esquire THIS IS NOT AN ARBITRATION CASE; Attorney Identification No. 205016 AN ASSESSMENT OF DAMAGES IS Three Parkway REQUIRED; JURY TRIAL DEMANDED 1601 Cherry Street, Suite 1300 Philadelphia, PA 19102 Attorney for Plaintiff, William John Holloway Tel No. (215) 972-0811 as Executor of the Estate of William J. Holloway, Email: wmurray@wilkesmchugh.com deceased WILLIAM JOHN HOLLOWAY, as IN THE COURT OF COMMON PLEAS Executor of The Estate of WILLIAM J. HOLLOWAY, deceased CUMBERLAND COUNTY, PA 5 Hilltop Circle Mechanicsburg, Pennsylvania 10755 DOCKET NO. Plaintiff, -vs- MESSIAH LIFEWAYS 100 Mount Allen Drive Mechanicsburg, PA 17055 and MESSIAH HOME, d/b/a MESSIAH LIFEWAYS AT MESSIAH VILLAGE 100 Mount Allen Drive Mechanicsburg, PA 17055 Defendants. WRIT OF SUMMONS TO: DEFENDANT MESSIAH HOME, D/B/A MESSIAH LIFEWAYS AT MESSIAH VILLAGE YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFF HAS COMMENCED AN ACTION AGAINST YOU. lrae�_ -I .R- W'LL Prothonotary/Clerk, Civil Division Date: .� "16" . By: vo WILKES &McHUGH, P.A. William P. Murray, I11, Esquire THIS IS NOT Attorney Identification No. 205016 AN ASSESSMENT 0"A&YMWA Three Parkway REQUIRED; JURY TRIAL DEMANDED 1601 Cherry Street, Suite 1300 Philadelphia, PA 19102 Attorney for Plaintiff, William John Holloway Tel No. (215) 972-0811 as Executor of the Estate of William J. Holloway, Email: wmurray@wilkesmchugh.com deceased WILLIAM JOHN HOLLOWAY, as IN THE COURT OF COMMON PLEAS Executor of The Estate of WILLIAM J. HOLLOWAY, deceased CUMBERLAND COUNTY,PA Plaintiff, -vs- DOCKET NO. @/�✓ � � o,�-�(v c�Y{(.�-�/�l MESSIAH LIFEWAYS; and MESSIAH HOME, d/b/a MESSIAH LIFEWAYS AT MESSIAH VILLAGE Defendants. PLAINTIFF'S PRE-COMPLAINT REQUESTS FOR PRODUCTION OF DOCUMENTS PROPOUNDED UPON DEFENDANT MESSIAH HOME, d/b/a MESSIAH LIFEWAYS AT MESSIAH VILLAGE Plaintiff, by and through counsel, Wilkes & McHugh, P.A.,propounds the following Pre- Complaint Requests for Production of Documents upon Defendant Messiah Home, d/b/a Messiah Lifeways at Messiah Village, to be answered under oath within thirty days, as follows: DEFINITIONS 1. "Facility." For purposes of these Requests, "facility" is defined as Messiah Lifeways at Messiah Village, located at 100 Mount Allen Drive, Mechanicsurg, PA. 2. "Resident." For purposes of these Requests, "resident" is defined as William J. Holloway. 1 DEMAND FOR PRESERVATION Plaintiff hereby demands that all writings, documents, emails and other electronic information that is responsive to the requests herein be preserved, maintained, placed on a "litigation hold"; and kept safe from loss or destruction until the final conclusion of this litigation. REQUESTS FOR PRODUCTION OF DOCUMENTS (SET I) 1. A bates-stamped black and white copy of the resident's complete original facility chart, including but not limited to the following: a. admission and discharge documents; b. nursing assessments; c. care plans; d. physician's notes and orders; e. nursing notes; f. skin audits; g. pressure sore/ skin integrity risk assessments; h. wound tracking and assessment documents; i. pain assessments; j. fall risk assessments; k. bowel and bladder assessments; 1. social service notes; m. dietary and nutritional notes; n. intake and output records; 2 1 o. therapy and rehabilitation notes, summaries and assessments; p. diagnoses, including EKG, x-ray, laboratory studies, or other test results; q. nurse aide flowsheets and/or records; r. Activities of Daily Living (ADL) documents; s. Treatment Administration Records (TAR); t. Medication Administration Records (MAR); u. Minimum Data Sets (MDS); v. Resident Assessment Protocols (RAP); w. DNR, advance directive, power-of-attorney, guardianship, living will, and any other consent documents; x. any other miscellaneous assessments; and, y. any other medical record regarding the resident that was either generated by or received by the facility before, during or after the residency. 2. All medical records pertaining to the resident in Defendants' or their counsel's possession, other than records produced by Plaintiff in this matter. 3. The reverse side and signature pages of all flowsheets, MARs, TARs, ADLs and other two-sided chart documents pertaining to the resident, to the extent not already provided. 4. All electronic charting or documentation that relates to the resident in any way, including but not limited to all entries in the facility's CareTracker or similar system. 3 5. All draft and/or deleted electronic chart entries regarding the resident, to the extent not already provided. 6. The facility's complete admissions and administrative files for the resident. WILKES & McHUGH, P.A. Attorney for Plaint DATED: BY: 1 William P. M ay, III 4 CERTIFICATE OF SERVICE I, William P. Murray, III, Esquire, attorney for Plaintiff, attest and certify that a copy of the foregoing Pre-Complaint Discovery was served upon the following Defendant simultaneous with the service of original process on this Defendant: MESSIAH HOME, d/b/a MESSIAH LIFEWAYS AT MESSIAH VILLAGE 100 Mount Allen Drive Mechanicsburg, Pa 17055 WILKES & MCHUGH, P.A. Dated: ( 1-7 Ir By: (__ William . Mu ay, III Counsel or Plai tiff 5