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HomeMy WebLinkAbout01-4594TYLER CONAWAY, a minor by and through his parents and guardians RONALD & KIMBERLY CONAWAY, RICHARD L. MAUS, Petitioners Respondent · IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA · NO. O_,t.-.Z~,~Z:./ C;v;I · CIVIL ACTION - LAW PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTION Pursuant to Pennsylvania Rule of Civil Procedure No. 2039, Ronald & Kimberly Conaway, the natural parents and guardians of minor, Tyler Conaway, by and through their attorney, W. Scott Henning, Esq., HANDLER, HENNING & ROSENBERG, petition this Honorable Court to enter an Order permitting settlement and compromise of this action and, in support, aver: 1. Petitioners, Ronald and Kimberly Conaway are the natural parents and guardians of minor, Tyler Conaway, currently age five (6) years old, whose date of birth is November 4, 1994. 2. Petitioners reside with their minor child at 5 Locust Circle, Mechanicsburg, Cumberland County, PA 17055. 3. Respondent, Richard L. Maus is insured by Allstate. 4. On or about July 8, 2000, Tyler Conaway was visiting the cabin of Richard L. Maus, when a mixed lab dog owned by Respondent attacked and bit Tyler Conaway causing lacerations about the head and face area. 5. As a result of the dog attack and bite wounds inflicted by the dog, Tyler Conaway was taken to Soldiers & Sailors Memorial Hospital in Wellsville, Pennsylvania. Tyler's wounds were irrigated and sutured. Tyler's parents were instructed to take Tyler to his family physician for follow-up care. 6. Tyler Conaway underwent a course of medical Barnes & Condon Pediatrics. Tyler had obtained treatment with Ryder, a good result from the laceration repairs and Tyler was released from their care on July 14, 2000. Tyler also was experiencing anxiety and nightmares and underwent a course of treatment with Sally E. Rooney, M.S. - Licensed Psychologist. Medical Expenses totaling $571.00 were incurred. Attached hereto, and incorporated herein as Exhibit "A" is a copy of the medical records and office notes from Tyler's treating physicians. 7. Petitioners have pursued a claim to seek compensation for Tyler's injuries asserting negligence on the part of the Respondent thereby causing the injuries suffered by Tyler Conaway. Respondent has offered the Petitioners a structured settlement, with a present value of $10,000.00, for settlement of the claim against the Respondent. The structured settlement provides for an initial lump sum payment of $2,500.00 and future payments as follows: a) b) c) d) e) $2,500 on November 4, 2012; $3,500 on November 4, 2015; $4,500 on November 4, 2019; $6,400 on November 4, 2022; $8,000 on November 4, 2024 9. Petitioners propose to accept the settlement thereby releasing Respondent from any all claims, suits, to the injuries in the present case. proposal from Respondent and other actions pursuant 10. W. Scott Henning, Esq., of HANDLER, HENNING & ROSENBERG, has been the attorney for the minor in this action and he requests the reasonable counsel fees of $2,500.00 for services rendered pursuant to a Power of Attorney and Contingent Fee Agreement signed by Petitioner, plus costs and expenses of $148.63. The Fee Agreement provides for a contingency fee of 33%, however, the aforesaid figure of $2,500.00 is calculated based upon a contingency fee of 25% of the present value of the structured settlement. (A copy of said Agreement and billing summary are attached hereto, made a part hereof and marked, "Exhibit B".) 11. Petitioner believes that this Compromise is in the best interests of minor, Tyler Conaway. WHEREFORE, Petitioner requests this Honorable Court to: a. Approve the Compromise above-stated; b. Authorize the payment of fees in the amount of $2,500.00 from the funds due the minor; c. Authorize the payment of costs in the amount of $148.63 from the funds due the minor; d. Approve payment of the remaining settlement in the form of a structured settlement as follows: $2,500 on November 4, 2012; $3,500 on November 4, 2015; $4,500 on November 4, 2019; $6,400 on November 4, 2022; $8,000 on November 4, 2024. Respectfully Submitted, HANDLER, HENNING & ROSENBERG I.D. #32298 ~' / / 1300 Lingle,~bwn ~oaj;Y' Harrisburg, PA ~'/1/1,0 (717) 23 20~//~ Attorneys for Petitioner Ronald Kimberly Conaway, on behalf of minor child, Tyler Conaway and their VERIFICATION I verify that the statements made in the foregoing Petition for Leave To Compromise Minor's Action are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. Date RONALD CONAW~Y Parent and Guardian of Tyler Conaway KIMBERLi~ONAWAY Pareroj[ and Guardian of Tyler Conaway HENN G& ROSENBERG ATTORNEYS LESUE B. HANDER, btir~ W. SC01T HENNIN6 DAVID H ROSENBER6 (PA, FL) CAROLYN ~. ANNER (PA, NY; RN) MAITH~ S. CROSBY (PA, NJ) SREG~RY~ FEATHER (PA, NJ) :STEPHEN G. HEED AT LAW A']-rENTION: Medical Records Sailors & Soldiers Memorial Hospital 32-36 Central Avenue Wellsboro, PA 16901 July 28, 2000 HARRISBURG OFFICE 1300 L~gles~n R~d Hnnisbu~ PA ! 7110 717.238-20(~0 717-233-3029 (~) LANCASTER OFFICE 140 A East King Street LoncasteL PA 17602 717-431-4000 DIRECT MAIL TO: P.O. Box 1177 Hontsburg, PA 17108 www. HHRlow. com Henning@flflrlaw.com Re: Our Client/Your Patient Patient SSN Date of Birth Date of Incident Tyler Conaway 161-76-3753 t J 14H 995 7~8~00 FOR RECORDS FROM TO PRESENT. SINGLE-SIDED COPIES ONLY PLEASEIIII 5 200o Dear Sir or Madam: As referenced by the enclosed Authorization, I have been retained to represent the above- referenced individual. Kindly provide me with a copy of the following: · · · · · · · · · Discharge summary ER and outpatient reports Patient's chart (Please retain a hard copy of the entire record,) History and physical Operative and pathology reports X-ray reports (Please tag all x-ray films for possible court use.) Lab reports · Progress notes by physicians and nurses Doctor's orders Consultation reports · Nurses' notes · Alcohol and drug treatment notes · "Physical therapy records ' , · Psychiatric records '' .~ .~- i I If there are any questions as to what portions should be included, please call my officd':'. WSH/bsk Enclosure cc: Ronald K. Conaway _~ SOLDIEI~S 5 -t=q35 'lq g.~ EMERGENCY SERVICE RECORD ~ SAILORS ... C.n,~., ~..... 6~O178756e NO. 123447 PATI£NTNAME~DADORESS PATIENTNO BIRTHDATE SEX RACE M.S. DATE AND TIME REGISTL~ED ~ PT FC ADM C 0 N AI~ A Y, T Y L i R PATIENT TELEPHONE PL~ ,/lENT SOC. SEC. NO SERV, CODE EMERGENCy ATTENDING PHYSICIAN '5 LOCUST CIRCLE 717 796-O6B9r~OO-OO-0OOO EMR WONG, EDGAR MECHANICSBURO , PA 17050 COMPLAINTDoG BITE TO SKULL Acc. cOOeo5 ACCIDENTDATEANOTtI~IE07/O8/OO 00:00 5 LOCUST CIRCLE GUAREMPLOYERANDADO.~SS OT~E. NECHANICSBURG, PA 17050 NATURAL CHILB/INSU OO OO * ; ; < ; ; · PR~V' AI3MI$SION DATE BIRTHpLaCE MAIDEN NAME COMPLETE TH S SECTIO~ IF PATIEN~DMiTTED / / CONAWAY, RONALD (717) 796-0659 HOME OFFICE 3SP, PAGE TEL. PAGE PHYSICIAN NAME TIME OF RESPONSE TIME OF ARRIVAL TEACHING M ERIALS GIV ~-i A~ER~CARE [~ VOMITING / DIARRHEA INSTRUCTIONS [] VACCINE ~NFORMAT~ON SHEET. [] HEAD INJURY [] CRUTCH WALKING INSTRUCTIONS [] TETANUS / DIPTHERIA SHEET DATED. [] COBRA SIGNED __ DATED SOLDIERS ? SAILORS EMERGENCY SERVICE RECORD NO. 12.3447 LMP TIME BP T P R OD OU SALEM SUM~ CBC LYTES BUN CREATININE GLUCOSE ICCU WORKUP F9 PT, PTT AMYLASE BLOOD ALCOHOL TYPE &CM X__U UA UA C/S BLOOD C/S STREP SCREEN URINE PREGNANCY LIVER PROFILE HEMOCCULT +/- FINGER GLUCOSE CMP BMP TROPONIN LANOXIN TSH FREE T4 CHEST CT HEAD, NO DYE IVP BP RHYTHM STRIP ABG EKG HOLTER MONITOR EVENT MONITOR BIPAP SEE CPT ORDERS ~HOME O OTHER DOOD ¢ONAklAY, TYLER PATIENT NO. - ~ATE AND TIME REGISTERED 600178756G 7/08/r~0 23:38 ROOM NO ASSIGNED MONEY JEWELRY OTHER FAMILY NOTIFIED RELATIONSHIP TO PATIENT TIME NOTIFIE 0 YES 0 NO ORIGINAL © 1995-99 T-S~stem, Inc. Circle or check affirmatives, backslash (~) negatives. 21 Soldiers & Sailors Memorial Hospital EMERGENCY PHYSICIAN RECORD Animal Bite (3) TIME SEEN: ROOM: HISTORIAN: ~atJent _~paramedics~ HX / EXAM LIMITED BY: chief complaint: ~----6-r~r-~ ~-~ ~ o~ourred: where: -~~ __home __school __today __neighbor's ~ark .__yesterday work __street hcat other:. borh~od animal __unknown animal Al~earance of animal. ~peared well __appeared ill __unknown DescHpUon: ~ Animal's Immunization st~tu~D __unknown __not immunized Observation~capture.. __animal is known; can be observed for I0 days __~imal unknown; not captured _~imal control notified clrc. um stanc,.ea of attack: L~n p?ovoked* attac~Z~ -- provoked attack (see below~ __approached animal __entered animars domain ._.animals figfir~ng ~olaying with or teasing animal __o~er_ severity of Injury:. ~-~__i~__scratched __mucous membrane contact location of Ini~  neck shoulder R/L men hip R/L back (upper mid- lower) RUE LUE RLE LLE PAST HISTORY: __negative [] Nurses note reviewed [] T.e. tanus immun. LrrD [] Vital signs reviewed PHYSICAL EXAM .__~ert. D/stres~ __NAD __mild __moderate __severe HEENT __see diagram. /~_~_~' ENT uninjured, nmi inspcm __eye lids / conjun, uninjured NECK / u~ninjured, nmi inspection -/'~-HEST ~ __uninjured, nmi inspecrJon /'~.BDOMEN so~injured, nmi inspection BACK __uninjured. nmi inspection __see diagram_ __see diagram. __see diagram_ __see diagram 155~97 60017e, 7560 , , :~S~~ 37 O,~ 2000 ':~': CT OEP~RTT~E:'IT/E ~ , ,~ ,:[ 'I~CLE i. - . ~'- "~,PA 1705} ~TREMITIES __see di~m ~uninlur~d~nml inspecd~ g C ~neuro ~c / ~ndon func~on in~ n~ial pulses ~ual (see reveme for further diagrams of hands and feet) Animal Bite - 21 __discussed with Dr. __Rx given CLINICAL IMPRESSION: LAnimal Bite~ I Puncture Wound I at R/L arm Bite Scratch R/L forearm R / L hand head .~ R/L wrist ~-~.~__~ R I L thigh chest R / L leg abdomen R / L ankle back R / L foot DISPOSITION- ~e [] admi~ed [] transferred. CONO~'rlON- [] unchanged [] improved.~table____ ATTORNEYS AT LAW Ryder, Barnes & Condon Pediatrics 2106 Aspen Drwe Mechan~csburg, PA 17055 July 28, 20C~ ~ Re Our Chent/Your Pahent Date of Incident SSN Patient Date of Birth Dear Ryder, Barnes & Condon PeQatncs' · Tyler Conaway 718/00 1t/04/1995 AU6 1 ZoO0 717~238-3)0Q iANCks'TEIt OFfiCE T40A E~ iGng Slmaf Laflmster, PA 17~02 717-431-4000 IXlt~/MIt TO Po Bm 1177 www HflRLow cam This office has been retained to represent the above Indnndual reletwe to injtmas sustmned as the result of an incident, for which injuries I understand you have been rendenng treatment l am enclesmg a properly executed m~dmceJ re[ease authodzatlort and would respectfully request that you forward to thru office at your earlmst convenmnoe, copras of all of your office records regarding your cam of the patient, as well as a complete billing h~story We would appreciate R if you would I~OVfde one-sided cop,es only You may release ,nformabon to your patient's insurance career ~or bdhng puq3osas only If any further treatment is required, please send cop~es of further bdl~,to this office If you are submitting these bills for payment to an insurance company, please prowde thru office w~th cop,es of the bills you aubmR PLEASE DO NOT RELEASE ANY INFORMATION REGARDING THE ABOVE CAPTIONED MATTER TO ANYONE OTHER THAN A REPRESENTATIVE OF THIS OFFICE. Please bdl this office for any charges incurred as a result of supplying the above mforrnahon Please contact me w~th any questions or comments Thank you for your antmlpated cooperation ,n this maffer Very truly yours, ,& WSH/bsk Enclosure cc Ronald L Conaway W ~t~,'%~6 //'~e Hr. H.C. A!;"'~;ps Medtca. t~ons Head Clrc~.meerence ~-~'~ Temperature INTERVAL HISTORY AND CONCERNS~ mmUT ON., j Milk ~ Cup Juice / ~ Vlts/Fe Eating Problem: "Pat-a-Calm" ~ Waves By. Bye ~/ Word~ ~/' ' Concerns? FAMILY/SOCIAL Risk Fac~tor~ For:, ~-t, R~k Factors For:. ,x- Parents Verimlize UnderstandingT. B. Education Food ~/~ Appetite Decrease ~ Cup Bottle ~'~ Caries ~/ Simp '-'-"- R~din~ ~ TV When To Call Doctor: Fe~em ~ T' Control Stairs ~ Choki~ Falls Buras -~ lp~me? ~ C~r Se~t I-g yr Safety Sheet /~ ~ to Date? ~/~._,z/- Pr~vimm ~.F~ ~ Up Vartcella Vaeelna ~' S.F.. Diseusm~? Other Consent Signed? D. ~ ~ . ,, Tel. # Imtmls · * PLmcl m iIlem'l madic~ meaed ~ Wt ~,,,%0-,~ Lbs Ht '~'~'~e~' H C Temo \~ ,ct."r~ P Allergies Medications WRI.L CHILD CAILE -- 18 MONTH8 Nme Weight ~ Length ~ Head Circunlferenee INTERVAl. HIS]DRY AND ~ON~KILq~ Soil(b, Fruit Vegs Other Eatl~ PruMems: ~["~'~ Tempera t ure_~ 6 O~her:. ~ learnt 7 wurdw) PHYBICAL ~XAMINATJO]~ L~rmph lqad# NOILMAL CO M MFmNTH/RXP J~qATI ON B. Education ~ . Previous ~E~ DPT(aceliular~ SE Diacumed Hl~fr~'w'~l~ Discussed M A M~ FOR DAT6__TIME__ P M OF j /~ ~HOtatO PHONE Y~R~LL MESSAGB .... _ ~ SEE YOU £ /---' LIMPORTANT MESSAGE Lbs. ut %$" H.C Temp,~-l<~ B,P Allergies %_____LL Wt. L~ Lbs. Ht. H.C. Temp ~J~-Oi B P Allergies Me,~, tions Eyes ~ Ears Moutl~Tk,rc at .J P H 0 N E E 0 TD~.,~ DATE TIME FROM - / AREA CODC G ' ~ '- ~ - , I --' , TOI~N$1 ii P/UOIiOUGil ~ F~f~ rAL F'AHILY Pi'LY$ l C 1AN/AOOIIE $S: HCI,)[ CA l' l ONS ~ I)AII. I.~1 I I;~1. I:IJNIAI'I :~.,~ /-/~o o CllflS.~ II1':1": ~/,IPL U¥CII: , ,fN.~I/I1ANI:[: ACEI -'-':~' St.'X:,/~ RI':I. II;ION: $185: /' I11'IDINAL POS11 li],',h_¢ /~"(-$S h~U: $Clt00~.: ~ ...... UL~: Client Name ~ Date -"Clin-ician'~ Signatur~ ~/ ' HANDLER, HENNING & ROSENBERG JuLy 11, 2001 BilLed through 07/11/01 BiLL number 205136-00000-001WSH TYLER CONAWAY 5 LOCUST CIRCLE MECHANICSBURG, PA 17055 DISBURSEHENTS 08/18/00 08/18/00 03/30/01 04/05/01 05/07/01 07/11/01 07/11/01 07/11/01 07/11/01 07/11/01 07/11/01 Correspondence Nanagement Smart Corp CutLer Camera Invoice David A. Smith Printing Service Book Binding Costs Proth of Cts~oertand County Document Reproduction Document Reproduction Postage Costs Postage Costs Long Distance TeLephone Charges Total disbursements for this matter BILLING SUMMARY Total Disbursements TOTAL CHARGES FOR THIS BiLL 30.58 20.72 18.00 2.93 2.00 45.50 1.20 21.20 3.31 2.44 .75 $ 148.63 $ 148.63 $ 148.63 biLLing timekeeper ~. Scott Henning date of Last biLL date of Last reminder Last bill through date biLL type code S-4 action to be taken O=hotd entire bill l=a/r reminder 2=bill expo, hold fees current 30 days 60 days 90 days 120 days bitting frequency A-12 [asr payment biLLing realization matter 00000 5057 08/18/00 5428 08/18/00 CUT 03/30/01 7500 04/05/01 BIND 05/07/01 1CUM 07/11/01 COPY summary ISl summary POS summary POST surffnary TELE sun~ary lCU~ 5057 5428 7500 BIND COPY CUT ISI POS POST TELE 3=scemary fees and exp 4=bill fees and exp 5=su~nary fees/detaiL e .00 .00 .00 .00 .00 O~ 30.58 20.72 18.00 2.93 2.00 45.50 1.20 21.20 3.31 2.44 .75 148.63 45.50 30.58 20.72 2.93 2.00 1.20 18.00 21.20 3.31 2.44 .75 148.63 148.63 CONTINGENT FEE AGREEMENT KNOW ALL MEN BY THESE PRESENTS, that we, Ronald L. Conaway and Kimberly M. Conaway, Parents and Guardians of Tyler Conaway, minor child, do hereby retain HANDLER, HENNING & ROSENBERG, of Harrisburg, Pennsylvania, as my attorneys in this mat[er to represent me and to process, negotiate, arbitrate a settlement or to institute for me in my name, any legal proceedings or actions that, in their judgment are necessary, against, R~c~rd Guas, or against anyone else as a result of injuries or damages sustained by Tyler Conaway in an incident that occurred on 7/8/2000. I agree not to settle, negotiate or adjust the above claim or any proceedings based thereon without the written consent of my said attorneys. NOW, THEREFORE, in consideration of the services so to be rendered by Handler, Henning & Rosenberg, I hereby covenant; promis~ and agree to pay them for their professional services rendered, THIRTY-THREE AND ONE-THIRD PERCENT (33 1/~%) of whatever sum is recovered as a result of settlement without suit; or FORTY PERCENT (40%) of whatever sum is recovered after suit is filed or in the event of arbitration or mediation. I will reimburse Handler, Henning & Rosenberg for any necessary expenses and costs advanced on my behalf in pursuing my claim. I also authorize counsel to destroy my file three (3) years after the case is closed. Counsel reserves 'the right to withdraw if they desire to do so, for any reason(s) they deem proper. I ACKNOWLEDGE that I have read, approved and understood the above Contingent Fee Agreement and I acknowledge having received a copy of the same. The terms set forth are accepted... IN WITNESS WHEREOF, I have hereunto set my hand and seal this 27th day of July, 2000. Ro-nald Li Cona_,~, Parent and Guardian of Tyler Conaway Kimberly(~Jl. Conaway, Pa~ Tyler Col'r'away (SEAL) and Guardian of TYLER CONAWAY, a minor by and through his parents and guardians RONALD & KIMBERLY CONAWAY, Petitioners RICHARD L. MAUS, Respondent : IN THE COURT OF COMMON PLEAS :CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW AND NOW, this ~ day of , 2001, upon consideration of the foregoing Petition, IT IS HEREBY ORDERED that: 1. The above parties may compromise the action upon the terms and conditions of the above-proposed compromise set forth in attached Petition; 2. Ronald and Kimberly Conaway, as natural parents and guardians of Tyler Conaway, minor, is authorized to pay the following counsel fees and other costs from the amount to which said minor is entitled to receive in this action: a. $2,500.00 to W. Scott Henning, Esq. as reasonable attorney's fees; and b. $148.63 to W. Scott Henning, Esq. as reasonable expenses; Approve payment of the remaining settlement funds in the form of a structured settlement as follows: $2,500 on November 4, 2012; $3,500 on November 4, 2015; $4,500 on November 4, 2019; $6,400 on November 4, 2022; $8,000 on November 4, 2024. §~ :6 WV 9- 811V I0