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Home My WebLink About06-1309 TABAS & ROSEN, P.C. BY: LEWIS C. TRAUFFER I. D. 116026-7 22nd Fl.,1845 Walnut Street Phila. PA 19103 (215) 569-5050- Plaintiff(s) THE MILTON S. HERSHEY MEDICAL CENTER P.O. Box 853 Hershey, PA 17033 / ATT,-PRNEYFOR Plaintiff vs Defimdanls(s) GEORGE COSNER & LEILA COSNER, h/w 935 S. 30th Street Camp Hill, PA 17011 COURTOFCOMMON PLEAS DIVISION CUMBERLAND COUNTY TERM, No,O~-13{)9 Clo\LY~ NOTICE COMPLAINT - CIVIL ACTION AVISO 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 wi thout 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 rel ief 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, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A lAIJYER. 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 2 Liberty Avenue Carlisle, PA 17013 (717) 249-3166 (800)990-9108 Le han demandado a usted en la corte. 5i usted qui ere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene veinte (20) dias de plazo al partir de la fecha de la demandanda y la notificacion. Haee fal ta asentar una eomparencia escrita 0 en persona 0 eon un abogado y entregar a la corte en for escrita sus defensas 0 sus objeciones alas demandas en contra de su persona. Sea avisado que si usted no se defiende, La corte tamara medidas y puede continuar la demandanda en contra suya sin previa aviso 0 notificacion. Ademas, la corte puede decidir a favor del demandante y requiere que usted cumpla con todas Las provisiones de esta demanda. Usted puede perder dinero 0 sus propiedades u otros derechos importantes para usted. LLEVE ESrA OEMANDA A UN ABOGADO INMEDIATAMENTL SI USTED NO TIENE ABOGADO, VAYA PERSONALMENTE 0 LLAME POR TELEFONO A LA OFICINA MENCIONADA A CONTI NUACION. ESTA OFICINA LE PUEOE PROVEER LA INFORMACION NECESARIA PARA CONTRATAR A UN ABOGADO. SI USTED CARECE DE LOS MEOIOS NECESARIOS PARA CONTRA TAR A UN ABOGADO, DICHA OFICINA LE PUEDE SUMINISTRAR LA INFORMACIoN NECESARIA ACERCA DE AQUELLAS AGENCIAS QUE OFRECEN SERVICIOS LEGALES A LAS PERSONAS QUE TIENEN DERECHO A RECIBIR TAL AYUDA GRATIS 0 A UNA cuorA REDUCIDA. CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, PA 17013 (717)249-3166 (800)990-9108 COMPLAINT - CIVIL ACTION COUNT I THE MILTON S. HERSHEY MEDICAL CENTER VS. GEORGE COSNER 1. Plaintiff is a non-profit corporation located at the address indicated in the caption hereof. 2. Count I defendant is an individual who resides at the address indicated in the caption hereof. 3. As the result of a certain medical condition, Count I defendant was treated at the plaintiff hospital on June 18, 2004 thru July 6, 2004. 4. The amounts, quantities and nature of the medical care rendered, the date on which said medical care waf; rendered, and the charges therefore are set forth in Exhibit "A", which is incorporated herein as if set forth at length. S. Said medical care was commensurate with the condition of Count I defendant and was necessary for the health and welfare of Count I defendant. 6. At or about the time of Count I defendant's treatment at the plaintiff hospital, implied, constructive and oral con- tracts arose between Count I defendant and plaintiff by the terms of which Count I defendant became obligated to pay plaintiff the charges incurred for the medical care rendered by plaintiff to Count I defendant. 7. Count I defendant refuses to pay the balance due although plaintiff has made demand that Count I defendant do so. S. As a result of the foregoing, there is due and owing from Count I defendant to plaintiff the sum indicated in Exhibit HAll . WHEREFORE, plaintiff demands judgment against Count I defendant for the sum of $19,091.95 plus six percent (6%) interest per annum from the date of discharge to the date of judgment, record costs and non-record costs. COUNT II THE MILTON S. HERSHEY MEDICAL CENTER VS. LEILA COSNER 9. The foregoing paragraphs are incorporated herein as if set forth at length. 10. Count II defendant is an individual who resides at the address indicated in the caption hereof. 11. Count II defendant is the spouse of Count I defendant. 12. Defendant's spouse was treated at the plaintiff hospi- talon June lS, 2004 thru July 6, 2004. 13. Said medical care was commensurate with the condition of defendant's spouse and was necessary for the health and welfare of defendant's spouse. 14. Count I defendant is indigent. 15. Count II defendant is financially able to pay for the medical care of Count I defendant. 16. By virtue of the marital relationship, the Act of 1937, June 24, P.L. 2045, Sec. 3, as amended, 62 Pa. Cons. Stat. Ann. Sec. 1973 and Article 1, Sec. 28 of the Pennsylvania Constitution and all other applicable statutes, laws and ordinances, Count II defendant has a duty to support Count I defendant. 17. Count II defendant has been unjustly enriched by plain- tiff's discharge of Count II defendant's duty to support Count I defendant, which duty Count II defendant failed to perform. 18. Count II defendant refuses to pay the balance due, although plaintiff has made demand that Count II defendant do so. 19. As a result of the foregoing, there is due and owing from Count II defendant to plaintiff the sum indicated in Exhibit IlAIl. WHEREFORE, plaintiff demands judgment against Count II defendant for the sum of $19,091.95 plus six percent (6%) interest per annum from the date of discharge to the date of judgment, record costs and non-record costs. TABAS & ROSEN ,. P. C . ~ ----- LEWIS C. TRAUFFER, ESQUIRE Attorney for Plaintiff MS HERSHEY MEDICAL CENTER 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 01/19/05 at 10:13 AM Guarantor: COSNER GEORGE A 935 S 30TH ST CAMP HILL, PA 17011-0000 Date 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/01 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 OG/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 OG/18/04 OG/18/01 06/18/04 06/18/04 06/18/04 06/18/04 I Svc Code I 16501 46121 46122 46473 46479 46630 46673 46696 46697 4671 7 101003 101004 101005 104002 104009 104042 104060 104111 104131 104145 104156 104711 105037 105052 105059 105656 106011 121107 247786 305602 305603 305605 307101 307205 307220 307275 307286 307310 310501 310516 310519 310534 Description ADULT LEVEL I TRAUMA URINALYSIS DIPSTIX PR HEMOCCULT, STOOL ER,CRITICL CARE,30-75 CLOSED DRAIN SYSTEM S ARTERIAL PUNCTURE BLADDER CATH, SIMPLE IV INFUSION TX 0-1 HR IV INF TX,EA ADDL HR NONINVAS PULSE OX, MU ABO BLOOD GROUP ANTIBODY SCREEN RH TYPE ALCOHOL (ETOH), BLOOD AMYLASE, BLOOD CREATININE, BLOOD GLUCOSE, BLOOD BLOOD GAS PANEL W/02 POTASSIUM (K), BLOOD SODIUM (NA) , BLOOD SGPT (ALT) DRUG SCREEN, URINE HEMOGLOBIN PARTIAL THROMBOPLAS T PROTHROMBIN TIME CBC W/PLT AUTO URINALYSIS-BASIC & MI P PRIVATE MED/SURG RM MORPHINE SULFATE lO M RT CLAVICLE X RAY RIGHT SCAPULA X RAY RT SHOULDER 2 OR MORE CHEST 1 VIEW C-SPINE 2-3 VIEWS PELVIS 1-2 VIEWS ELBOW 1-2 VIEWS LEFT WRIST 3+ VIEWS LEFT KNEE 1-2 VIEWS LEFT CT HEAD UNENHANCED CT THORAX ENH]\~CED CT A3DOMEN EN!~CED CT MULTIPLANA? 3D - Continue - It - I PAGE: 1 Patient: COSNER GEORGE A Visit #: 6500189 I Units I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Debits Credits 3180.00 7.00 7.00 1013.00 18.00 46.00 41.00 179.00 89.00 82.00 18.00 32.00 17.00 45.00 38.00 11.00 10.00 131.00 11.00 11.00 12.00 84.00 15.00 32.00 20.00 27.00 19.00 1015.00 2.55 106.00 116.00 131.00 104.00 133.00 136.00 95.00 112.00 121. 00 649.00 1344.00 929.00 490.00 MS HERSHEY MEDICAL CENTER 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 01/19/05 at 10: 13 A'l Guarantor: COSNER GEORGE A 935 S 30TH ST CAMP HILL, PA 17011-0000 Date I Svc Code I 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/18/04 06/19/04 06/19/04 06/19/04 06/19/04 06/19/04 06/19/04 06/19/04 06/19/04 06/19/04 06/19/04 06/19/04 08/25/04 09/30/04 11/05/04 11/30/04 11/30/04 12/06/04 310560 310567 310694 310704 621054 622023 670330 670334 104438 105656 246021 246705 246706 246"/88 248225 251129 274478 621054 667768 900011 900011 900011 980090 980091 900011 'k - Not posted Description CT C-SPINE UNENHANCED CT PELVIS ENHANCED CT TRAUMA SPINE RECON OMNIPAQUE 300MG/ML 15 IV LACTATED RINGERS 1 IRRIGATION SOD CHL O. IV INFUSION SET, UNIV IV INFUSION SET, UNIV RENAL FUNCTION PANEL CBC W/PLT AUTO BACITRACIN 15 GM MORPHINE SULFATE 4 MG MORPHINE SULFATE 2 MG HYDROMORPHONE 4 MG SENNA SYRUP IML POTASSIUM CHLORIDE 10 PANTOPRAZOLE 40MG/I00 IV LACTATED RINGERS 1 AV SLEEVE, REG FOOT C PATIENT PAY CHECK PATIENT PAY CHECK PATIENT PAY CHECK HOSPITAL BAD DEBT W/O HOSPITAL BAD DEBT PLA PATIENT PAY CHECK rr-J---- PAGE: 2 Patient: COSNER GEORGE A Visit #: 6500189 I. Units I 1 1 1 1 1 1 1 1 1 1 2 4 1 2 1 1 2 1 1 -1 -1 -1 -1 1 -~ Debits 719.00 1054.00 490.00 70.00 6.00 6.00 16.00 8.00 38.00 27.00 8.60 8.40 2.30 4.20 6.40 11.60 28.90 6.00 75.00 13173.95 Balance: Credits 30.00- 30.00- 30.00- 13173.95- 30.00- 13143.95 I PEN NSTATE !!5:! The Milton S. Hershey Medical Center .. The College of Medicme GEORGE A COSNER 935 S 30TH ST CAMP HILL PA 17011.5807 1 .r 2 STATEMENT DATE: 01/21/05 LAST STATEMENT DATE: 11/25/04 ACCOUNT # 7000324 H IF 'NY QUESTIONS, PLEASE CONTACT: MSHMC PATIENT FINANCIAL SERVICES DATE PROCEDURE DIAG QTY DESCRIPTION CODE CODE ))) pmENT: GEORGE A COSNER 70003Z4 07/0,/04 7301026 07/0>104 99024 811. 00 V54.11 06/U/04 9924521 959.8 08/Zl/04 09117104 10/H/04 11/11/04 06/18/04 99253.57 811.00 06/18/04 Z3500.RT 811.00 06/18/04 99242 959.8 06/18/04 00999 959.8 06/16/04 76~7526 06/16/04 76~7526.76 06/16/04 721252. 0./18/04 70450Z. 06/18/04 721932. 06/18/04 71260Z6 06/18/04 741602. 06/18/04 730302. 06/18/04 7204026 06/18/04 7101026 06/18/04 7~56026 06/18/04 7301026 06/18/04 721702. 06/18/04 7311026 06/18/04 730002. 06/18/04 7307026 06/19/04 99231 PAYMENTS OF 723.1 724.9 723.1 959.01 789.9 959.19 959.12 959.2 723.1 959.19 959.7 811.00 959.8 959.3 810.00 959.3 959.8 FED TAX 10 # 251857035 INS CHARGE PAYMENTI GUARANTOR . ADJUSTMENT BALANCE 4565317 PERFORMED BY, DIV OF DIAG RADIOLOGY PLACE OF SVC, OP PHYSICIAN SCAPULA PERFORMED BY, ORTHOPAEDICS DIVISION POST -OP FOL -UP VISIT ' 51. 00 51.00 0.00 0.00 .5001B9 PERFORMED BY: TRAUMA SURGERY DIV PLACE OF SVC: EMERGENCY ROOM TRAUMA TEAM DIAG EVAL INT THANK YOU FOR PAYMENT THANK YOU FOR PAYMENT THANK YOU FOR PAYMENT THANK YOU FOR PAYMENT PERFORMED BY, ORTHOPAEDICS DIVISION PLACE OF SVC: INPATIENT INITIAL INPT CONSULTATION FRACT CLAVICULAR W/O MANP PERFORMED BY: DIV OF ANESTHESIA PLACE OF SVC: EMERGENCY ROOM OFFICE CONSULTATION PERFORMED BY: DIV OF EMERG ROOM NO CHARGE VISIT TRAUMA PERFORMED BY: DIV OF DIAG RADIOLOGY PLACE OF SVC: INPATIENT CT CORONAL SAGITTAL 08LIO CT CORONAL SAGITTAL 08LIO CT CERVICAL SPINE UNENHAN CT HEAD UNENHANCEO CT PELVIS ENHANCED CT THORAX ENHANCED C T ABDOMEN ENHANCED SHOULDER COMP >2VIEWS SPINE CERVIC ANT/POS LAT CHEST 1 VIEW KNEE LIMITED SCAPULA PELVIS ANTERPOSTER ~RIST COMPLETE >3 VIEWS CLAVICLE ELBO~ ANTEROPOSTE LAT PERFORMED BY: TRAUMA SURGERY DIV DAILY HOSPITAL CARE BALANCE: GEORGE A COSNER ~5948.DO 263..00 30.00- 30.00- 30.00- 30.00- 2666.00 212.00 212.00 661.00 661. 00 123.00 123.00 0.00 0.00 47.00 47.DO 47.00 47.00 ~2..00 326.00 240.00 240.00 326.00 326.00 347.00 347.00 35..00 356,00 51. 00 51. 00 63.00 63.00 51.00 51. 00 51. 00 51. 00 49.00 49.00 49.00 49.00 49.00 49.00 47.00 47.00 42.00 42.00 74.00 74.00 30.00 APPLIED TO YOUR CHARGES NOT INCLUDED ON THIS BILL. o CHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK PENNSTATE 5 The Milton S. Hershey Medical Center . The College of Medicme GEORGE A COSNER 935 S 30TH ST CAMP HILL PA 17011-5807 2 of 2 ACCOUNT # 7000324 STATEMENT DArE: 01/21/05 LAST STATEMENT DATE: 11/25/04 ili IF my QUESTIONS, PLEASE CONTACT: MSHMC PATIENT FINANCIAL SERVICES DATE PROCEDURE OIAG QTY DESCRIPTION CODE CODE IF YOU HAYE ANY QUESTIONS ABOUT THE AMOUNT YOUR INSURANCE COMPANY PAID, CONTACT THEM DIRECTLY. FOR ANY OTHER QUESTIONS REGARDING YOUR BALANCE, PLEASE CONTACT OUR OFFICE. IF PAYMENT HAS BEEN MADE, THANK YOU AND DISREGARD THIS BILL. INS FED TAX ID # 251857035 CHARGE PAYMENTI GUARANTOR ADJUSTMENT 8ALANCE Rif'l3 THANK YOU FOR USING MSHMC PHYSICIANS GROUP FOR YOUR PHYSICIAN SERYICES. IF YOU HAVE ANY QUESTIONS REGARDING THIS BILL, PLEASE CONTACT US AT 717-531-5069 OR 800-254-2619, BETWEEN 8:00AM AND 5:30PM MONDAY THROUGH HEDNESDAY OR BETWEEN 8:00AM AND 4:30PM THURSDAY AND FRIDAY. BALANCE SlJ1MARY RESPDNSIBLE PARTY *"" GUARANTOR RESPONSIBILITY POLICY . TOTAL $ 5948. DO ___________________________1_LM.f.9B.I.Mf['-f-'=-~~li.1._'2.~IA.r;!:LtJllQft..lirYl!fj_Y_Qrr_Q.M.1'-QB]"LQI!L9L~}:AJ_{'!'-~I!T_Y'-'.:r..tLrstI!.Ke.ArM.~tJ.:r__l_________~____________________ STATEMENT DATE: GUARANTOR RESPONSIBILITY: MINIMUM PAYMENT: 01/21/05 $ 5948.00 $ 5948.00 8F6 MSHMC PHYSICIANS GROUP BilLING SERVICES POBOX 854 HERSHEY PA 17033.0854 00007000324 UP 0000000000594800012105 1,..11.1.1.,,1.1.11...1..1..11...11....11,.11....11..11.1.,1.1 Mail MSHMC PHYSICIANS GROUP To' 1.,.111.,.111......11..,11.1.1.1..1.11,..1...1..11..1.1...1.11 PO BOX 643313 PITTSBURGH PA 15264-3313 GEORGE A COSNER 935 S 30TH ST CAMP HILL PA 17011-5807 OFFICE USE ONLY ,; CHECK ONE fOR CREDIT CARD PAYMENT, PLEASE fiLL IN INfORMATION BELOW :~:;;;'.t5~mw;Rtt M/C _VISA 7000324 CARD NUMBER EXP DATE 02/11/05 He, F5BO TY?, DMND CARDHOLDER NAME (PRINT) o CHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK COSNER, GEORGE 1/7000324 $13,143.95 (Hasp) 5,948.00 (Phys) VERIFICATION LINDA SCHLADER hereby states that she is the Team Manager, Customer Service of the Milton S. Hershey Medical Center and verifies that the statements made in the foregoing pleading are true and correct to the best of her knowledge, information and belief. The undersigned understands that the statements therein are made subject to the penalties of 18 Pa. C.S. 54904 relating to unsworn falsification to authorities. .~(); ~J LINDA SCHLADER DATE: ~/)4 JOb ;:::) ~ t ?t - ~ w ~ 0- Cr) V( p..J \J"" w ---..n ~ If( U\ erz ~J t r , d' :C',-~ @J " V) c~) LEWIS C. TRAUFFER ATTORNEY I.D. 60267 1845 Walnut Street, 22nd Floor Philadelphia, PA 19103.4788 (215) 569-5050 THE MILTON S. HERSHEY MEDICAL CENTER P.O. Box 853 Hershey, PA 17264 Attorney for Plaintiff COURT OF COMMON PLEAS OF CUMBERLAND COUNTY CIVIL ACTION Y. No.: 06,1309 - C1VIL TERM GEORGE COSNER & LEILA COSNER 935 South 30th Street Carn Hill, PA 17011 Agreement for Judgment (Judgments by Agreement are non-appealable) The undersigned defendants agree that a judgment be entered against them in the above matter in the amount of nineteen thousand one hundred ninety-nine ($19,1199.00) with no additional costs. Execution will be stayed pending the payment of one hundred dollars ($100.00) monthly beginning April 20, 2006. No interest at law shall accrue as long as monthly payments are received by Tabas & Rosen, P.C., attorneys for the plaintiff, on or before the seventh day of each month. In ~:vitrless whereof, the defend2TIts have signed belo\v and agree to be bound thereby. ~~~p _ Date: "t/;/06 George osner Q}z1~ D",.M,( .:.:-- ~ ~- Lewis C. Trauffer, Esquire ---::::, Date: 't 10 10 6 ..., ,\ '.', v c::> (='>' ~J ~"--') 1"';.. <:::> ~~ll -+- ~,\, --.....'\ , ~ 1. .. L-'- . SHERIFF'S RETURN - REGULAR CASE NO: 2006-01309 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND MILTON S HERSHEY MEDICAL CTR VS COSNER GEORGE ET AL JASON VIORAL , Sheriff or Deputy Sheriff of Cumberland County, Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon COSNER GEORGE the DEFENDANT , at 1059:00 HOURS, on the 10th day of March , 2006 at 935 S 30TH STREET CAMP HILL, PA 17011 by handing to GEORGE COSNER a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge 18.00 12.32 .00 10.00 .00 40.32 So Answers: .r-~~"<~ R. Thomas Kline 03/15/2006 TABAS & ROSEN Sworn and Subscribed to before By: me this J./.-f day of ~ ho~~ { pr~on , SHERIFF'S RETURN - REGULAR CASE NO: 2006-01309 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND MILTON S HERSHEY MEDICAL CTR VS COSNER GEORGE ET AL JASON VIORAL , Sheriff or Deputy Sheriff of Cumberland County, Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon COSNER LEILA the DEFENDANT , at 1059:00 HOURS, on the lOth day of March , 2006 at 935 S 30TH STREET CAMP HILL, PA 17011 by handing to GEORGE COSNER, HUSBAND a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge So Answers: 6.00 .00 .00 10.00 .00 16.00 '~~L<'1~~ R. Thomas Kline 03/15/2006 TABAS & ROSEN Sworn and Subscribed to before By: ~ me this :llA.t- day of Sheriff ~~~D ki~ ry