HomeMy WebLinkAbout94-00413
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COURT OF (:OMMON I'LF;AS
DAlJl'HIN COUNTY CIVIl~ A(;'flON
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RUTN OJ. DAHIlL I
Plaintiff
IN TNI/COURT or CONNON PLlAI
CUMBIRLAND COUNTY, PINN'YLVANIA
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. NO. 413 CIVIL 1VV4
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CIVIL ACTION - LAW
CHARLa. R. INNIRB, N.D.,
INNI.. PAVI' AI.oeIATE',
tuANNI GRAMM, R.N., and
HOLY 8PIRIT HOSPITAL,
Defendant.
JURY TRIAL DEMANDED
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PRAIlCIP.
To the Prothonotary.
Pha.e mark the above-captioned action .etUed, .aU.ti.d, and
dhoonUnued.
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.ubmitted,
c. Ol.on, ..qu r.
52 7
~d03 N 'ront street
Harri.bu 9, PA 17110
Attorney. for Plaintiff.
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J: hereby outity that I, e.n4ic. H. B.k.r, an ..ploy.. ot
Anvino I Rovn.r, p.e., have thi. dat. ..rvad a true and corr.ct
oopy ot ''''01'., by ..nding .... Unit.d It.t.. tir.t ola.. .ail,
po.taV. pr.paid, .ddr....d .. tollow..
Leigh Elli., I.quir.
ILLII . AssoeIATls, p.e.
1850 WilHam Pann way/ lte 209
P.O. Box 10696
Lane..ter, PA 17605-0696
Craig stona, I.quir.
HITTI, IVANS , WOODSIDI
3401 Horth front str.at
P.O. Box 15950
Karri.burv, PA 17110-09150
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RUTH J. DANIEL,
Plaintiff
: IN THE COURT OF CuMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
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: CIVIL ACTION. LAW
: 94.0413 CIVIL TERM
v.
CHARLES R. INNERS, M.D.,
INNERS DAVIS ASSOCIATES,
LUAN GRAMM, R.N. and
HOLY SPIRIT HOSPITAL,
Defendante
~
AND NOW, tI4. ,~ ,~, after careful consideration of oral
arguments and the briefS; co~sel, defendants' preliminary objection In the nature
of a demurrer to paragraphs 111, 112, 113 and 116 of plaintiff's Amended
Complaint Is d.nl.d. Defendants' motion to strike Is also denl.d a8to paragraphs
83 (q),(t), (v), (z) (gO), 89(h), 94, 95, the remainder of paragraphs In Count IV, and
to paragraphs 102, 104, 108, 109, 117 and 121(a), (b), (c) and (e).
By the Court,
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".0413 CIVIL. TERM
NlloIe C. OIlon, Eaqulre
Anglno' Rovner, P.C.
4803 North Front atr..t
Harrllburg, PA 17110
For the plalntlffl
Crllg ,... Stone, Elqulre
MItte, Evana . Woodalde
~01 North Front atreet
PO Box e9150
Harrlaburg, PA 17110.09150
For Defendante Gramm and Holy Spirit
Michael W. MoGuckln, Esquire
18150 William Penn Way
suite 209
PO Box 10696
lanCAster, PA 17605.0696
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RUTH J. DANIEL,
. Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMB:iRLAND COUNTY, PENNSYLVANIA
.
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: CIVIL ACTION. LAW
: 94.0413 CIVIL TERM
v.
CHARLES R. INNERS, M.D.,
INNERS DAVIS ASSOCIATES,
LUAN GRAMM, R.N. and
HOLY SPIRIT HOSPITAl.,
Defendant'
QfINJ.QN
The Instant case Is a medical malprautlce action against defendants
Chartes R. Inners, M.D., Inners Davis Associates, Luan Gramm, R.N., and Holy
Splrtt HOlpltal (hereinafter HSH) for the alleged negligence of defendant In
admlnl'tsrtng a quantity of Insulin to plaintiff Ruth J. Daniel. Plaintiff, a dlabstlo,
had been admitted to HSH for orthopedic evaluation of foot pain and was glvsn a
quantity of Inlulln. As a result of the alleged overdo.., plaintiff suffsred
hypoglycemic shock resulting In seizure. PlaIntiff avers she lustalned numsrous
bodily InJurtes due to the ,,'zure.
Plaintiffs theortel agalnlt defendant Gramm Include negligence and
84.0413 OIVIL TERM
abandonment. Her th.orl.. .galnlt defendant HSH Includ. vlc.rlou. lI.blllty for
thl negligence of It I .g.ntl, I.rvantl .nd employe.., abandonment and corporate
liability .
D.fendante Gramm and HSH have pre..ntly fil.d preliminary
obJection. to p1alntlffl Amended Oomplalnt. Defendantl move to .trlke certain
paragraphl for Insufflclent specificity, or In the .Itematlve, requllt a more ,plclfic
pl.adlng. Defendantl alia demur to the paragraphs relating to plalntlff'1 corporate
negligence claim.
DllCulllon
Defendants' first preliminary objection Is a motion to strike paragraphl
83(q), (t), (v), (z), (gg), 89(h), and Count IV of plalntlff'1 Amended Complaint,
Including paragraph I 94,95, and paragraphs 102, 104, 108, 109, 117, 121 (a), (b),
(c) and (e). Def.ndant. contend that these paragraphs are boilerplate and vague
and that plaintiff could later amend her complaint to allege a new theory of
negligence aft.r the statute of limitations has lapsed.
Pennlylvanla Rulli of CIvil Procedure r.qulre the pl.ad.r to lit forth,
In concl.. and summary form, the material factI upon which a caU88 of action II
ba..d. Pa.R.O.P. 1019(s). To comply with the rulll "s complaint mlllt apprl..
the defendant of th. nature and oxtent of the plaintiff'. claim 10 that th. defendant
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94.0413 CIVil. TERM
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hit notice of what the plaintiff Intends to prove at trial and may prepare to meet
IUch proof with his own evidence.. ~I 313 Pa. Superior Ct. 446,
453, 460 A.2d 271, 274.275 (1983).
Boilerplate allegations of negligence are subject to particular Icrutlny
10 al to preclude a plaintiff from alsertlng a new claim after the Itatute of
limitations has run. So ' 501 Pa. 306, 461
A.2d 600 (1983). Such scrutiny Is mandated at thll stage because Connor
..tablllh.. that where preliminary objections are not filed, a party Is deemed to
know what the complainant hal alleged. !.d. at 311, 461 A.2d at 602, n.3.
In the present llale, plaintiff ha$ let forth her allegations In exhaultlve
detail In her 27.page 122.paragraph Amsnded Complaint. We believe that the
complaint read al a whole sufficiently apprises defendants of the clalms agalnlt
them and places defendants on notice of what plaintiff attempts to prove at trial.
Accordingly, defendants' preliminary objections to paragraphs 83 (q),(t), (v), (z),
(gg), 89(h), 94, 95 and the remainder of Count IV are denied. Similarly, obJectlonl
to paragraphs 102, 104, 108, 109, 117,121(8), (b), (c) and (e) are denied. A.
thell paragraphs rolate to plaintiff's corporate negligence theory, we find that
defendants' concem that plaintiff could later allege a new theory of negligence II
without merit.
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94.0413 OIVIL TERM
Cefendant.' lecond and final preliminary objeotlonls In the nature of
a dlmurrer to paragraph. 111, 112, 113 and 115 In plaintiff' I Amended Complaint.
Th..e paragraphs relate to plalntlff'1 corporate negligence olalm.
In Pennlylvanla, the Itandard for deciding preliminary objeotlon. II
wIIl.letlled: .Prellmlnary objeotlonl, the end rellult of which would be dllmlllal
of", oaule of aotlon, Ihould be IUltalned only In oa"l that are clear and free from
doubt.' ~,531 Pa. 64, 67,611 A.2d 181, 182 (1992). Thl.oourt
mUlt accept al true all material faots al set forth In the complaint a. well a. all
reasonable Inferenoes realonably deducible therefrom. ~,382 Pa.
Superior Ot. 487, 666 A.2d 1304, 1306 (1989), ~, 623 Pa. 636, 665
A.ad 446 (1989). The question presented by the demurrer Is whether on the faots
averred, the law says with certainty that no reoovery Is possible. kI.
In the oase at bar, defendants objeot to the following paragraphs In
plalntlff'1 Amended Complaint:
111. In 1992, Cefendant Holy Spirit Hospital was
acoredlted by the Joint Commission for Accreditation of Hospitals
(herein JCAH).
112. In 1992, hospitals accredited by JOAH were required
to establish and maintain various committe.. to review speolflo
aspects of the praotlce of medicine within Its Institution,
Including the proc..llng and a..8..lng of physician and nur..
oredentlals and the tevlew, analysis and evaluation of physlclan'l
and nurse's clinical performance.
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84-0413 CIVIL TERM
113. In holding It..,f out to the publlo al JCAH aooredlted,
cefendant Holy Spirit Hospital wal proclaiming that It formulated and
enforced procedur.. and pollcl.. for the lafety and protection of
patients In accordanoe with the minimum Itandardl ..t forth by JCAH.
118. cefendant Holy Spirit HOlpltalls liable for It I failure
to comply with the requirements of JCAH with regard to enforcing polloi..
and procldures for the quality and lafety of hOlpltal-ba..d patient
care, Including oare provided to Ruth canlelln 1992.
In ...8nce, plaintiff asserts that defendant HSH, as a hos~ltal
acoredlted by Ihe Joint Commission for Acoredltatlon of Hospitals (hereinafter
JCAH)', was negligent for failing to ensure the safety of Its pallents and for failing
to enforce Its policies for quality patient oare. Conversely, defendant as..rts that
even If HSH Is JCAH-acoredlted and had failed to meet JCAH standards, no
recovery Is possible because JCAH standards are Irrelevant In determining the
I,andare! of oare owed by HSH to plaintiff under a corporat. negligence theory.
To set forth a corporate n.gllgenoe theory, a plaintiff must show that
the hospital breached a duty wllhln the four categories of non-delegable duties that
a hospital owes directly to Its patients. These duties Include: (1) a duty to u..
'To reoelve JCAH accreditation a hospital must comply with minimum
hOlpltal Itandardl for patient oare as promulgated In Ihe Accreditation Manual for
Hospltale. JCAH standarde mandate that the govemlng tlody of the hOlpltal Is
ultimately responSIble f\)r the overall quality of patient care provided In the
Inltltutlon. Joint Commle,lon of Aocredltatlon of HOlpltals, ~
~, 1983 Edition 181. Th..e Itandards require the hospital medical staff
to organize Into committe.. for tho purpose of regularly evaluating the quality of
medical oare given within the Institution. jd. at 106.
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84-0413 CIVIL. TERM
,..,onable care in the malntenanoe of life and adequate faollltl.. and equipment,
(2) . duty to ..Iect and rltaln only competent phyalcJlane; (3) a duty to OVlr... all
per.on. who pr.ctloe medlolne within It. will. as to patient oare; and (4) a duty to
formul.te, adopt and enforoe adequate rul.. and polloi.. to en.ure quality o.re for
the patient..
, 527 Pa. 330, 339-340, ~91 A.2d 703,
707 (1991) (oltatlons omitted). In addition, plaintiff must show that a ho.p1tal had
.actual or consttuotlve knowledge of the defect or prooedure, which oreated thl
harm.. J.d. at 341, ~91 A.2d at 708. Finally, the hospital's negllgenoe must have
bien a sub.tantlal factor In bringing about the harm to the plaintiff, J.d,
In the Inltant oa88, plalntlffl allegations oenter on HSH'e breaoh of
dutl.. within the flrlt and fourth of the above-delineated oategorl... In a
jurtldlctlon that hal adopted the oorporate negligence theory, th..e dutl.. are
dutl.. owed by all hOlpltals to their patlentl without regard to whether a hOlpltal
Ie JCAH accredited. However, we reject defendant's contention that JCAH
.tandarde are Irrelevant In al..Bllng whether the conduct of HSH fell below thca
.tandardl of re..onable medical care limply beoau.. JCAH aocredltatlon I.
voluntary. To the oontrary, we believe that Ilnce HSH aought JCAH aocredltatlon
and reoelved Ita aooompanylng benefltla, JCAH atandardl are germane to
aHOlpltal1 voluntarily leek accreditation for financial and pr..tlge rlalonl
IUch a. to qualify to participate In the fedlral Medicare and Medicaid programl,
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84.041S CIVIL TERM
p1a1ntlff'1 corporate negllgenc. claim If not on the 'BlU. of the .tendard of car.
owed by HSH to plalntlff,' thin at "'It on the IlIue of notice to HSH of the
proc.dur.. which cr.at.d plalntlff'1 harm. Conllqu.ntly, w. flnd plaintiff h.
ad.quatlly all.ged the requl.lt. element. to lit forth a corporat. negligence claim
end the paragraphl re'atlng to defendant.' failure to compiy with JCAH
requlremlntl are r.l.vant to .uoh a clalm. Accordingly, d.fendant.' d.murrer II
overruled.
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wher.by JCAH accreditation I. deemed .ubstantlal compllanoe with the condition.
of participation. 42 U.S.C. 0 1G9~ bb (1982); 42 C.F.R. 0 40~.1901(d) (1888).
In addition, JCAH accreditation II often a prerequisite for obtaining approval of
Intemlhlp and residency programs Ind allo affectl an In.tltutlon's reputation and
Itandlng In the community. So Holbrook & Cunn, JrR. c~mmlstliB:;;~
Ibt..Qj.coverabUjty an~y A..u ,
18 Walhbum L.J. ~4, ~7 (1978). '
'NumerouI JUrlldlctlons hold that JCAH guldellnealn addition to 8 hOlpltal'l
own bylawl are relevent to determine the Itandard of care ow.d by 8 ho.pltal to
8 patl.nt und.r 8 corporate negligence theory. .au~. 877 P.2d
188 (Walh. 1984); WbJ.y v. ~up.rvl.or. of~, 490 So.2d
G07 (La. Ct. App. 11t Clr. 1988).otI1. dInlJd, 498 So.2d G2~ (La. 19S8); ~
Ml.dd/.IIQn, 708 S.W.2d 891 (Mo. Ct. App. 1988).
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RUTH J. DANIIL
IN THI COUR~ or COMMON PUlA.
DAUPHIN COUNTY, PENNSYLVANIA
plaintiff
v.
CIVIL ACTION - LAW
NO. 371!l4-S-!l3
CHAltLl. R. INNIlR8, M.D.,
INN.ft. DAVIS AB80CIA~ES,
WAN OIWOlL R.N.,
HOLY SPIRIT HOSPITAL ,
Defendant.
JURY TRIAL DEMANDED
AMENDED COMPLAINT
1. Ruth J. Daniel i. an adult individual re.idinv in Harri.burv,
Dauphin County, p~nn.ylvftni..
2. Defendant Charl.. R. Inn.re, M.D., an adult individual, 18
Uoen.ed to practice medicine in the Commonwealth of Penn.ylvania, who, in
llla envaged in the practice ot Internal Medicine in camp Hill, Cumber~and
County, Plnnaylvania.
3. Inner. DaviB Associates, is a profe..ional profit-.akinv
oorporation, whioh provides medical Bervice. in Cumberland county,
Pennsylvania.
4. Defendant tuan aramm, R.N., an adult individual, is a rev1stlrad
nur.., who in un practiced nursing in camp Hill, Cumberland county,
Pennsylvania.
5. Defendant Hely spirit Hospital, is a oorporate medioal
in.titution with office. and medical facilitieB in Camp Hill, Cumb.rland
County, 'Innsylvania.
I
6. Defendant Charlae R. Innera, M.D. wa. at all relevant tille.
hereinafter, acting a. an agent, apparent agent, .ervant and/or employ.e
ot Defendant Inner. Davi. A..cciat...
",
7. Defendant Charlea R. Innen, M.D. w.. at aU relevantU...
hereinafter, aotinv a. an avent, apparent aqent, .ervant and/or e.~loyee
of Defendant Hoiy spirit Hoapital.
I. Defen~.nt Gramm wal at all relevant timea hereinafter aotlnq a.
an avent, apparent avent, ..rvant and/or employe. of Defendant Holy spirit
HO.pital.
lI. On Auvult I!l, 191:1, Dr. stephen J. Davia a~mitted hi. 10n9-
atan~inv patient, plaintiff, Ruth Daniel, to Defendant Holy spirit
Ho.pitalfor orthopedic evaluation of foot pain.
10. upon her admi..ion to oefendant Holy spirit Hoapital, Plaintiff,
Ruth Daniel waa atarted on ineulin coverage with a maximum daily allotment
,
of ao unita NPH inaulin.
11. Plaintiff' a daughter, Debra Nicodemua, adviaed the hoapital'a
nuraea and phyaioiana oaring for Ruth Daniel that her mother waa allervio
to ReVular inlulin.
12. plaintiff, Ruth Daniel'e nureing oare reoord, ~atad Auquat 6,
ll1l1:1, noted her allergic reaction to Regular ineulin aa followal "dauvhter
atatea patient haa never been able to be ccntrolled with Ravular inaulin.
st~tea that they have had problems in the paat with her auvar fluctuatinv
when ua1nq Revular. inaulin."
13. More~ver, attached to Plaintiff, Ruth Daniel'a medicine Rarde~
were warninq aticken advisinv the ho.pita!'a nun.. and phya1cian. of
Mr.. Daniel'e allerqic reaotion to Regular ineulin.
14. On Augult 7, 199:1, at approximately 7130 a.m., Plaintiff, Ruth
Daniel receive~ inaulin coverage of :10 unita of NPH insulin.
:I
"
15. Plaintiff, Ruth Daniel'a receipt cf 30 unit. of NPH in.ulin at
0730 hn on AUljIuat 7, U9:1 waa d\1ned oft on her medicine lCardex by
Defendant Holy spirit Hoapital'a ataff nur.e, un LPN with the abbreviated
1ni tiala, .. PHil ,
16. six houra later at 1330 hra on AU\1U8t 7, 199a, Defendant Inner.
vave STAT ordera for Plaintiff, Ruth Daniel, to receive additional inaulin
amountinv to 40 unit. of NPH inaulin and :I~ unit. of Regular in.ulin.
17. 8ivnif1cantly, Defendant Innerl ordered the overdoae of 1nlulin
without ever examininv hie patient.
18. Defendant Inner. ordered the overdo.. of inlulln by telephone.
11. Defendant Inner. ordered the overdo.. ot in.ulin at 1330 hr. on
Auvuat 7, 191:1, despite Plaintitt, Ruth Daniel'. prior coveralle with ao
unita of NPH inaulin at 0730 hr..
ao. An overdo.. of inaul1n cauael blood qluco.. levela to lower
dramatically, r,.ultin\1 in hYPo\11ycemia with .eizure. and .oock.
21. Nur.. Gramm did not prop.rly review or relay the intonation
noted in Pldnt1ff Ruth Daniel's medicine l<ardex on Auguat 7, 1911a.
:1:1. Nur.e Gramm did not report Detendant Innera' overdo.e of inaulin
to hil patient, Plaintitt Ruth Daniel to her supervilor or other of
Plaintiff'a treatinq phyaicians.
a3. Nurae Gr~mm failed to under.tand that any additional in.ulin at
1330 hn on Auqu.t 7, 199a could reault in Plaintiff patient, Ruth
Daniel'. experienoinq hypo\11ycemic shock and .eizure.
a4. Following Defendant Inners', STAT order overdoainv hi. patient
with inaulin, Plaintiff Ruth Daniel wea tun.ported to the radio10llY
department tor an ultraaound relating to her orthopedic evaluation.
3
u. 8ivniUcantly, neither Nune Grallllll or any ot Detendant 80.11
8pirit Hoaplta~'a nu~ainv ataft mcnitor.ed plaintiff Ruth Daniel'. blood
Vluoo.e lavela follow1nv Defendant Inneu' STAT o~der overdo.inv hi.
patient with ineulin.
a6. Plaintiff, Ruth Daniel waR returned to her roo~ tollowlnq an
ultraaound examination at approximatelY 1l!lOO hr..
a7. At that time, Plaintiff'e dauqhter, Debra Nioodemu., w.. preaent
in ber motber'a room.
as. Not aurpridnq, tollowinv Defendant Innera' STAT order
overdo.inv hi. patient with in.ulin a few hours earlier, Mra. Nioodemu.
oba.rved her mother thra.hinq and convulainq in her bed uncontrollably.
al. Plaintiff" dauqhter, Mre. Nicodemus, ran to the nur.ea .tation
to vet help tor her mother.
30. Nurae. not.. documented Plaintiff, Ruth Daniel, .hakinv trom a
a.ilure, unreaponaive to atimuli and pupile unreepon.ive to livht.
31. Aa Plaintiff, Ruth Daniel'e primary treatinv phy.ioian,
Detendant Innera wa. contacted by Defendant Holy spirit Hoapital'a nuralnv
atatt and reaponded by giving orders by telephone for blood auvar .tudie.
to be drawn and that Plaintift, Ruth Daniel, receive an ampule ot vluoo.e
and water (D~O).
3a. Nur.ea note. document that Plaintitfl Ruth Daniel'. blood .uVar
waa unauooe..tully drawn.
33.' Nuraea notes also documented that the failure to draw blood-on
the fir.t attempt we. not reported to staft.
34. Sivnificantly, before plaintiff, Ruth Deni~l'a blood auqar waa
drawn, ahe received an ampule of qlucose and water (050).
4
35. Th. overdoee of ineuUn crdered by Defendant Inner. w.. ..0
exoe..ive, that by 8100 p.m. on the eveninq ot AUqu.t 7, lee3, Plaintiff,
Ruth Oaniel'e blood euvar WBS down to 28 mqldl and a .eoOnd a.pul. of lOt
gluoo.. and water waa adminietered.
3.. Brain tunction depend. on an adequate luPply ot vluooa. tro. the
bloOd and a blood auvar ae low .e 28 ie conai.tent with hYPOVlyo..io ahook
whioh can r~.ult in aev'~e brain damave, aeilurea, coma, and nlurologio
detioit.
37. Approximately one hour atter Delendant Holy Spirit Ho.pital',
nurainv .taff obaerved Plaintiff, Ruth Daniel'a hypoglyoemio oonvulainq
.ei.urea and ahock, Plaintiff'. complainta of right ahoulder pain w.r.
documented and reported to Defendant Inner..
38. Defendant Inner. failed to reepond to call. or to oome into the
hoapital to examine hie patient.
31. Over the next .everal hours Plaintitf, Ruth Danill waa
dooumented to be moaninq in pain with noted quarding of her riVht upp'r
ahoulder.
40. Plaintiff, Ruth Daniel was l1Qt taken to the radioloVY depart.ent
tor x-ray evaluation of her riqht shoulder until approximately 1140 hr. or
well over five houre atter her convuleinq hypoglyoemic .eilurl wa. noted.
41. At that time X-ray examination ot Pldntift, Ruth Oanill'. r1vht
ahoulder documented a fracture ot the neck ot the riVht humeru. with .om.
rotation of the humeral head.
42. Following the x-ray examination an orthopedio Ivaluation by Dr.
landa noted Plaintiff, Ruth Daniel's unr8.pon.ivenea. to verbal .timuli,
!l
ri9ht .houlder edema and x-ray tinding. con.i.tent with a fraotured and
dialocatld rivht .houlder.
43. Dr. "Inda further noted that Plaintiff, Ruth Daniel required
.edation before any attempt at reduotion aurgery for her .houlder fracture
and d1alooaUon.
44. By 10100 p.m. or 9 hcur. atter hia telephone Qrder overdoainv
h18 patient with ineuUn Defendant Inner8 finally oame in to .ee hi,
patient.
41!l. At that time, Defendant Inner. recorded in the provre., note..
that he ordered an overdo.e ot ineulin at 1330 hra.
46. At that time Detendant Innera 81.0 documented Plaintiff patient,
Ruth Daniel'a .eizure following hi. order overdo.inV her inlulin.
47. Defendant Innera further dooumented that Plaintiff patient, Ruth
Daniel reoeived one ampule ot D~O prior to her blood luqarl bein, drawn
whioh acoounted tor her reported blood auqar of 433.
48. At that time, Detendant Inner. allo dooumented Plaintiff
patient, Ruth Daniel'a tractured and dialocated rivht IhoulcSer followinv
her .eilure aecondary to hypoglycemia.
41. At that time Detendant Inner. alao documented review of hi.
patient'a medicine ~ardex only after he ordered the overdo.e of inaulin.
80. In the early morning hour. of Auqu.t 8, 1192, Defendant Inner.
documented Plaintiff patient, Ruth Daniel'. inability to move her rivht
arm .eoondary to her fracture.
1!l1. In light of Plaintiff patient, Ruth Daniel'a failure to re.pond
to external atimuli, a neuroloVio con.ult waa ordered.
6
l5a. NeurolovJ.at, Dr. Tcdd Samuell, examined Plaintiff Ruth Daniel on
AU9uat ., llla and documented her eeizure activity, and perai.tent laok ot
reaponaiveneaa ae aecondary to an overdoae of. inauUn oauain9
hypovlyoeJllia .
1!l3. Neuroloviat, Dr. Samuele further documented Plaintiff patient,
Ruth Daniel' a encephalopathy ae secondary to hYP091yceJllio ahock and
.eilure, and, coneequent1y recommended that orthopedio intervention tor
her fraotured and dialocated right ehoulder be delayed until her
neuroloqic etatua improved.
1!l4. On Auvuet 10, 1992, orthopedic aurveon, Dr. Band., doo~mented
Pla1ntift patient, Ruth Daniel'a pereietent rivht .houlder pain and
cautioned that her prognoeil tor cloeed reduction we.. vuarded.
1!l15. On Auguat 12, 1992, Dr. Banda, attempted c10aed reduotion ot
Plaintitf Ruth Daniel'. fractured and die100ated rivht ahoulder under IV
eedation.
1!l15. The attempt to treat P1aintitf Ruth Daniel'a fractured and
dialocated right ehoulder eecondary to hypoglyoemic .ehure by oloaed
reduotion failed.
1!l7. General anesthesia Watl considered prohibitive in Plaintiff
patient, Ruth Daniel and her right arm we. immobilized in a alinv.
1!l8. At that time it wae Dr. Band'a opinion that Plaintiff patient,
Ruth Daniel'a prognolia for her right ahou1der wae poor.
I!ll. Throughout her Auguet and Sephmber, UI2 hoepitalhat1on,
Plaintiff, Ruth Daniel's tractured and dialo~~ted right ahoulder remained
awollen, edematoua, tender and extremely painful to the touch.
7
60. Additionally, Plaintiff Ruth Daniel aho compldnect of l.ft knee
pain foUowinq her hypoqlycemic seizure for which x-ray. w.r. not taken
untll September 11, 1112 or 311 days after the Clonvuldnv ....ill,u:. oau.ed by
Defendant Innera' order overdosing insulin.
61. Radioqraphic examination ot Plaintift, Ruth Daniel'. left knee
taken on September 11, 1992 reveahd a fractur. of the l.ft tibial
plateau.
62. rollowing the unsucoesstul attempt at cloaed red~otion .urq.ry
for Plaintiff Ruth Daniel's fractured and dialocated riVht ahoulder,
phyaioal therapy and rehabilitative prcgrame were in.tituted.
63. How.ver, Plaintiff, Ruth Daniel'e rehabilitation wa. very .low.
64. According to the physical therapy progre.s reoord., Plaintiff,
Ruth Daniel waa tound to be of queetionable rehab potential until .uoh
time a. ahe had acquired better use of her right upper extremity.
65. In her many attempts to ambulate, the physical therapy reoorda
conaietently documented Plaintitf, Ruth Daniel ae screaminv in pain.
66. Finally, it wae the physical therapiat'a reoomm.ndation that
Plaintiff, Ruth Daniel utilize a wheelohair for ambulatinq rather than a
walker becauae the weight-bear: ing required in udnq a walker, oauaect
tremendous pain to her tractured ftnd dislocated right ehoulder.
67. On September 23, 1992, Defendant Inners' aeaooiat., Dr. Davi.
noted in hia discharge eummary that Plaintiff, Ruth Daniel wa. viv.n an
overdo.. of inaulin which resulted in severe hypoglycemia and .eilur. and
I
subeequent fracture and dislocation ot her right ahoulder.
68. Since Defendant Innere' crder overdoeing hia patient with
inaulin and her subsequent hypoglycemic seizure and ahook, Plaintiff, Ruth
8
Daniel'. fractured and di8located rivht .houlder oompoundelS her other
med!cal problem. including pulmonary conqe.tion for which .he Qannot ~e
adequately turned becau.e of her right shoulder pain and ha. render,d her
entirely dependent on her daughter for even her moat ba.ic and rUdimentary
need..
6'. In an effort to a..i.t in the full-time ta.k of carinv tor her
mother, Plaintiff, Ruth Daniel'a daughter, Mra. Nicodemu., had to prooure
the a..i.tance of at-home nursing servic.s.
70. Plaintiff, Ruth Daniel, remains entirely dependent on her
dauqhter .ince the overdoBe ot insulin ordered by Defendant Inner..
71. Plaintiff, Ruth Daniel, ha. no u.e of her rivht arm.
72. Plaintiff, Ruth Daniel, will never recover tull function of her
rivht am and shoulder to the extent Bhe was able prior to Defendent
Inner.' order overdoeing his patient with insulin.
73. A. the direct and proximate reBult of the Defendant'. neVlivence
a. alleqed herein and incorporated by reterence, Plaintiff, Ruth Daniel,
ha. .uffered permanent and aevere injuriea and claim i. made theretore.
74. Defendant. Charlell R. Innere, M. D., Inners Davi. A.sociate.,
Luan oremm, R.N., and Holy spirit Hospital are jointly and ..verely liable
for injurie. and damaqeB aB Bet torth herein and incorporated by
reference.
71!l. A. the direct and proximate reBult of the Defendant'. nevlivence
a. alleved herein and inoorporated by reference, Plaintiff, Ruth Daniel
has .uffered a permanent disfiguring and di8abling injury and claim 18
made therefore.
9
79. AI the direct and proximate result ot the Def.nd.nt' II n,vUVllno.
.. .11eged h.rein and incorporated by referenoe, plaintiff, Ruth D.ni.l
will be forced to inour liability tor medioal treatmentll, llIedioine.,
hOlpitalizations, physical therapy and .imilar mi.cellaneou. .xplln... in
the tuture and olaim i. made theretore.
80. A. the direot arid proximate re.ult of the Def.nd.nt'. ne"Uvenoe
a. alieqed h.rein and incorporated by ref.renoe, plairltiff, Ruth D.niel
Q
76. AI the direct and proximate result of the D.fendant'. ne,liv.nOI
a. .ll.ved h.rein and incorporated by re~erence, pl.intiff, Ruth D.ni.l',
rivht .hould'r injury will cause residual probl.m. for thl rl..ind.r or
her life and .inc. she continuee to have sever. riqht .houlder p.in, thl
probability of her requiring additional treatment .nd ther.pi.. in
incr....d .nd claim i. made therefore.
77. AI the direct and proximate result of the Defendant'. n'Vliv.noe
.. .11'Ved her.in and inoorporated by ret~rence, Plaintiff, Ruth Daniel'l
ri9ht .hould.r injury will cause residual problem. aff.ctinq her v.ner.1
h..lth, includinv the inability to adequately turn or lay on her rivht
lid. which compromiaes her pulmonary statue and the probability or
increa.ed conqe.tion, pneumonia and other medical condition. i. inor....d
r.quirinv additional treatment and therapie. and claim i. m.d. ther.torl.
78. A. the direct and proximate result of the Def.ndant'. n.vliv.nol
a. all.qed herein and incorporated by reference, plaintiff, Ruth Daniel
wa. forced to incur liability tor medioal tr.atm.nt., .edioinl.,
hospitalization., phYlical therapy and similar mi.cellaneou. .xp.n..., in
and about an effort to attempt to restore hereelf to he.lth and ol.i. i.
m.de therefore.
10
ha. undervone and in the future will underqo vre.t mental and pbYlical
pain and Iffferin9, qreat inccmvenience in oarinv out h'lr dany
aotivitie., 10.. of life'. pl~a.urea and Qlaim ia made therefore.
81. Plaintiff, Ruth Daniel, has been advi.ed and therefore aVer.
that the damage. and injuries," aUeqed herein and inoorporated by
reference are permanent and claim i. made therefore.
COUNT I
Ruth Daniel v. Chari.. H. Inner., M.D.
sa. Paraqraph. 1 through 81 ot this complaint are inoorporated
herein by reference a. if .et forth at length.
83. Defendant Ch"rles R. Inners, M.D. is Hable to Plaintiff for hi,
nevHqence in,
(a) tailin9 to examine Ruth Oaniel prior to orderinV
ineulin on August 7, 19921
(b) faUinq to properly ..se.. Ruth Daniel and the
contradictions a~scciated with orderinv
additional insulin on Auquat 7, 19921
(c) fdHnq to properly review and inspect Rut.h
Daniel'. medicine Rardex prior to orderinq
in.ulin on Auqust 7, 19921
(d) improperly overdosing Ruth Daniel with
exce.sive insulin on Auqust 7, 1992 caueinv
hypoqlycemic seizure and shock 1
(.) failinq to determine or to ask a qualified
11
r
~
peraon to determine, the exact amount of
inaulin Ruth Daniel had reoeived on Augult 7,
1!192 prior to his order overdoling inaulin
on August 7, 1992'
(t) purpo.elY and ~nowinglY orderinv pevular
inaulin de.pite Ruth Daniel'a known allergia
reaction to Regular inaulin,
(g) failinv to nttend to hia patient and provide
medioal care to Ruth Daniel on Auguat 7, 199a,
(h) tailing to properlY obtain a careful hiltory
of Ruth Daniel'a insulin ooverave on Auguat 7,
1992'
(i) failing to monitor Ruth Daniel IUbaequent to
hil order overdosing inaulin on Augult 7, 1..a,
(1) inappropriatelY delaying radiographio evaluation
of Ruth Daniel's shoulder fol1.owinV the hypot1yae.io
aeilure caua.d by the overdoee of inlulin order.d
on Auguat 7, 1992'
(k) failing to order and obtain blood glUQOI.
meaauremente following the overdoa. of inlulin
ordered on Auguat 7, 1992'
(1) improper management ot inlulin coverage in an
inlulin-dependent labile diabetio,
(m) failing to properly inquire into the atatuI of
inaulin coverage on Ruth Daniel'l medioine larde.
prio~ to ordering additional insulin at 1"0 hre
12
on Auqu.t 7, 1912'
(n) tailing to under.tand and accordinVly manage
hi. patient ba.ed on 'the in.ulin oove~aV'
dooumented on Ruth Daniel'B medicine Rardex
on Auvu.t 7, 1992'
(0) tallinq to phy.ica1ly examine, evaluate,
...... and monitor Ruth Daniel cn AugU.t 7, lii2,
(p) failing to properly reviow, interpr.t and
re.pond to the intormation contain.d in Ruth
paniel'. medicine Rardex which docu~ented
in.ulin' coverage in the early morninV hour. of
Augu.t 7, 1992,
.. (q) viol.ting the principle ot patient-phy.ician
car. which required Defendant Inner. to make
IVlry po.sible .ffort for the benefit of hi.
patient, Ruth Daniel,
(r) fal.ely and erroneou.ly aBsuming th~t Ruth D.ni.l
did not rec.ive insulin coveragl in thl morninv
hour. of Auqust 7, 1992,
(~) failing to minimize the risk and/or prev.nt
hypoglyoemic .eizure and shook,
(t) inappropriately permitting Ruth Dani.l'. blood
glucose to drop to Buch low level. .. to r..ult
in hypoglycemia seizure, .hook, r,.ultinq in
convul.ions, neurologic compromi.., 10..
of coneciou.nese,injury to h.r ~Itt knee and
13
fraoture and dialocation ot her right ahou14.r,
(u) inappropriately permitting hi. patient, Ruth
Daniel to aeize and convulae in hypoVlycemio
ahook without any eftort to intervene,
.Jv) in contravention of hia fiduciary duty,
abandoning hie patient, Ruth Daniel,
(w) failing to order blocd atudie. to b. drawn
prior to the adminietration of DeOW,
(x) precipitating Ruth Daniel'e labile diabetio
condition by overdosing he~ with in.ulin
to the point where she suocumbed to hypovlyoemio
.eizure and ehock,
(y) tailinv to notify other physicians or to
enaure that another physician was preaent
and prepared to care for Ruth Oaniel at the
ti.me Defendant Innere ordered the overdoa. of
inaulin by telephone on August 7, 1992,
(I) inappropriately engaging in a medical practic.
that was too demandinq for one pereon in order
to maximize volume and therefore revenue,
precluding Defendant Inner. from properly
attending to hi. patient, Ruth Daniel on
Auguet 7, 1992,
(aa) tailinq to inform Ruth Daniel a. to the mat.~ial
,
riaka, cons.quences and contraindicationa
aaaociated with adminiaterinq exces. inaulin,
14
(bb) tailing to inform Ruth Daniel a. to the material
l'lIk., con.equence. and contrdndit;aUon.
a..ociated with orderin~ medioation. to whioh
Ruth Daniel wae dooumented a. beinv allerVio/
(00) de.pite hi. awarenea. that Ruth Daniel had
labile diabet.., and that .he wa. .en.itive
tu the adju.tment of in.ulin, neverthele..,
failinv to be phyaically pre.ent to a.....,
monitor and evaluate hi. patient, includinv
review of her medicine Kardex before orderinv an
overdo.e of in.ulin on Auguat 7, 1992/
(dd) do.pite his awarenes. that his patient WI. a
labile diabetic and wae .eneitive to the
edjuetment of insulin,neverthele.a, failing
to .ummon any physician to be pre.ent at the
time he ordered the overdose of in.ulin on
Augu.t 7, 1!192/
(ee) failing to eneure proper dosaq8 and
adminietration of insulin in a labile diabetio,
(ft) failinv to plan, arrange, and en.ure proper
in.ulin coveraqe for hie patient, Ruth Daniel
on Auqu.t 7, 1992, and
_.(qV) inappropriately abandoninq hiB patient, Ruth
Daniel by permittinq her to aeize, convul.e,
fracture and dislocate her riqht shoulder,
fracture her left knee, .uetain neuroloqio
11!l
I'
defio~t and 108. of con.Qio~.n... a. a re.ult
of orde~inq an overdo.. of in.ulin on Auvu.t 7,
UU.
84. A. a direct and proximate re.ult of the Defendant'a ne91ivenoe,
Plaintiff Ruth Daniel .u.tained injuri.. and damaVe. .. .et fOl'th in
. parav~aphe 28 th~ouqh 81 above which are inoorporated herein by ~efereno.
a. if .et forth at lenqth and claim i. made therefore.
WHIRIFORE, plaint1ft, Ruth Daniel, demand. jud9lllent a9a1n.t Defendant
Charle~ R. Inner., M.D. for compen.atory damaqe. in an amount in exoe.. of
Twenty Thou.and ($20,000.00) Dollar. exclu.ive of intere.t and co.t. and
in exce.. of any juri.dictional amount requirinq compul.ory arbitratiQn.
s;.OUNT II
Ruth Daniel v. Inner. Davi. A..ooiataa
81!l. Paragraph. 1 throuqh 81 and count I ot thb complaint are
incorporated herein by reterence as if set forth at lenvth.
86. At all relevant time. herein, Defendant Inner. wa. actinv a. the
avent, apparent agent, .ervant and/or employee of Inner. Davi. A..ooi.te.,
a profe..ional protit~makinq medioal corporation and wa. aotin9 within the
.oope of .aid employment.
S7. Defendant Inners Davis Associates, actinv throuvh it. avent.,
apparent agent., servants and/or employees, is liable to the Plaintiff for
the injurie. and damaqe. alleqed herein which were di~eotly and
proximately cau.ed by the Defendant's neqliqence a. .et forth in
paragraph. 38 throuqh 81 above which are inoorporated herein by reference
a. if .et forth at lenqth and claim i. made therefore.
16
CI~\IFIC~TR or SERYJC~
I h.r.by c.rtifY that I, Sandra L. Ri.h.ll, an .mploy.. of
Anqino . RQvn.r, P.C., thil lith day of Novemb.r, 1113, have ..rv.
a true anI! corr.ct copy of AMENDED COMPLAINT by ..ndinv ..m. unit.d
stat.. t1r.t cla.. .mail, po.taqe prepaid, addr....d a. follow..
Michael W. McGuckin, Esquira
1850 William Fenn Way
suite :l09
P.O. BOlC 10696
Lancaster, PA. 17605
Attorney for Detendante,
Charle. R. Inners, M.D. and
Inner. Davis Associate.
Jason R. Woltqanq, Esquire
METTE, EVANS , WOODSIDE
3401 North Front Street
Harriaburq, PA. 17110
Attorney for Defendant.
LUan Gramm R.N. and
Holy spirit Hospital
~,..".,,,,~ ,cl> (~u~'U,I:/...._
Sandra L. Rishell .
.J
. .j
,I
147151lLR
o
WHIRJrORI, Plaintiff, Ruth Daniel, demands judqement avainat Innera
Davi. A..ooiate. for compenutory damal]es in an amount in _xcea. of Twenty
Thou.and (UO,OOo.OO) Dollan elCcludve of inter..t and coat. anll in
exce.. of any juriadictional amount requirinl] ccmpu180ry arbitration.
.QPUNT II I
Buth Dan!.l y. Luan Gramm. R.N.
j
I
i
,
"
t
... Paraqrapha 1 throuqh 81 and Count. I and XI of th18 Complaint
are incorporated herein by reference a8 if aet forth at lenvth.
ell. Defendant Luan Gramm, R.N. ia liable to the Plaintiff for her
ne911venoe in.
(a) failing to properly investiqate and relay the
information containe~ in Ruth Daniel'e
medicine Rardex/
(b) failinq to properly read the information contained
in Ruth Daniel'e medicine Rardex/
(0) failinq to appreciato the aiqnificance which
additional insulin would have on a labile diabetic
patient suoh as Ruth Daniel, particularly after
her receipt of insulin coverage in the early mornin9
houra of Auqust 7, 1992/
(d) feiHnq to notify 8upervJ.sora, department head.,
medical direotors, phyeiciana or hospital
adminiatrators ot Defendant Innera' overdo.e of
inaulin cn August 7, 1992/
(e) feiHl'Iq to appreciate that Defendant Inner.' order
17
overdo.inq hia patient Ruth Daniel with in,ulin
on Auquet 7, 1lg3 could reault in a draetio
drop in blood vlucoa. cauainv hYPovlyoemio .hook
and aeilure,
(f) failinv to attend, monitor and provide for proper
nur,inv care to Ruth Daniel followinv Oef.ndant
Inner.' order overdoainV hi. patient with in,ulin
on Auquat 7, 1993,
(V) improperly .acertaininv the .tatua of Ruth
Daniel'. in.ulin coverave on Auvuat 7, lIla,
~h) abandoninv h.r pati.nt, Ruth Daniel by f.ilinv
to properly monitor, evaluate and ...... Ruth D.niel
following D.fendant Inner.'order ov.rdoainv the
patient with ineulin,
(i) failing to minimize the riek and/or prevent
hypoglycemic ehook and eeizure,
(j) failinv to r.port Defendant Innera' order
overdo.ing hi. patient, Ruth Daniel with in,ulin
on Augu.t 7, 1993,
(k) ~nappropriately monitoring Ruth Dani'l'a blood
gluco.e level, on Auguat 7, 19113, and
(1) failing to remain with her patient ruth D.niel
followin9 h~r hypoglyoemic a.izure and ahook to
monitor, a..... and evaluate her traumatio injuri..
and neurologic damage.
18
VO, A. the direct and proKimate re.ult ot the D.tend*nt'.
n'vliglnce, Plaintiff, Ruth Uaniel luetained injuri.. Ind d..age. .. .et
fo~th in paravraph. 38 through 81 above which are incorpor.ted herein by
~ete~enoe a. if eet forth at length and ola1m i. made ther.fore.
WHIRIFORI, Plaintiff Ruth Daniel, demand. jUdgment ag.in.t Defend.nt
Luan oramm, R.N. for compenaatory damage a in an amount in Ixoe.. of Twenty
Thou.and <UO,OOO.OO) DOllar. eKclualve ot intere.t and oo.te .nd in
exoea. of any juriadiotional amount requiring compulaory .rbitr.tion.
\ OOUijT IV
Ruth Daniel v. Holy Spirit Hoapital
11. paragraphs 1 through 81 and count. I throuvh IU of thb
complaint are incorporated herein by reference as if .et forth .t lenvth.
U. At all relevant times herein, Defendant Charle. R. Inner., M.D.,
Defendant Luan Gramm, R.N., and all medical penonnel inolUdinV .t.U
nun.. who provided care to Ruth Daniel in Auguet, 1912, were thl aVent.,
apparent agenta, .ervants and/or employeea of Defendant Holy spirit
HOlpital.
93. Defendant Holy spirit Hospital, acting through it. avent.,
apparent agent., aervants and/or employ.es, is liable t~ Plaintiff fo~
injurie. and damage. aa set forth in paragraph. 28 through 11 .bov. which
are incorporated herein by referenoe a. if aet forth at length .nd ol.i~
i. made therefore.
94. Defendant Holy spirit Hospital, acting throuvh it. .g.nt.,
apparent agent., servanta and/or employ.e., failed to taka the n.o....ry
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Itepa in order to enaure the aatety ot Mra. Daniel, know1nv that Ihe wa.
dependent upon Defendant Holy Spirit Hospital and its ataft, and ia liabl.
tor itll tanure to intervene and prevent the improper adm1niatreUon of an
overdoae of inaulin to Plaintift, Ruth Daniel.
... .I!I. Defenclant Holy spirit HOlpital, actlnv throuqh it. aVent.,
apparent aventa, aer.vanta and/or employeea 18 liable to the Plaintiff,
Ruth Daniel for ita failure to provide vuidelinea, protocol., pOlioi..,
and procedurea for intervention when a phyaician ordera an overdoae of
inaulin in a labile diabetic patient, resulting in hypoglycemic ahock end
aehure.
1I6. Aa a direct and proximate result of Defendant Holy spirit
Hoapital'_ negligence u alleged herein, Pldntitf, Ruth Daniel, ha.
auatained injuries and damages as .et forth in paravraphl 28 throuqh 11
above which are incorporated herein by reterence as if aet forth at lenvth
and a olaim ie made therefore.
WHIREFORE, Plaintitf demands jud9ment against Defendant, Holy Spirit
Hoapital, in an amount in excel. ot Twenty Thouland ($20,000.00) Dollar.
axcluaive of interest and cosh and in exce.. of any jur18dictional amount
requirinq compulBory arbitration.
COUNT V
Ruth Daniel v. Holv spirit Hospital
16. paragraphs 1 throuqh 81 and Count. I throuvh IV of thi.
Complaint are incorporated herein by reterence as if aet forth at 1envth.
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P7.. All nuraea, physioians and ancillary ho.pital pa~.onnel,
provicSinV oare tor Plaintift., Ruth Daniel, in a1l2, were at aU relannt
ti~ea, avent., apparent agent., servants and/or employe.a or o.rendant
Holy spirit HOlpital and acting within the scope of aaid e.ployment.
,.. In 19113, all m~dical staft, committee membera, boapital
oommittee members, and board members were aVenta, apparent av.nte,
ae"antl and/or employ",e. of Oefendant Holy spirit Hoapital, aotinv in the
aoope or their employment ftnd authority al ve.ted in them by DetencSant
Holy spirit HOlpital.
19. Defendant Holy spirit Hospital's negligence, aa alleqed herein
and inoorporated by reference, was a aubatantial factor in brlnvinq about
the harm .uatained by plaintiff, Ruth Daniel.
100. Defendant Holy spirit Hospital had a nondeleqable duty owecS
directly to it. patient, Ruth Daniel.
101. In 11192, Defendant Holy spirit Hospital, throuvh it. aven~e,
apparent agentl, aervllnts and/or employees had a duty to overaee aU
p.raonl who practiced mediciM within itl walls a. to patient oar.,
inoludinq Defendanta Inners and Gramm.
102. Defendant Holy spirit Hospital is liable for fa1Un'1 to over.e.
Defendant Inners' and Defendant Gramm's practice of medicine within it.
walla al to patient care and in partioular, aa to plaintiff patient, Ruth
Oanlel.
103. In 1992, Defendant Holy spirit Hoapital had a duty to u..
r.aaonabl. care in the proviaion of safe and adequate .quip~.nt ancS
peraonne1 .
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apparent av.nt., ..rvant. and/or employ.e. i. ~i.bl. for it. failure to
u.e rea.onabl. car. in the provi.ion and maint.nanc. of .at. and adequate
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p.r.onn.l for the care of Plaintitf pati.nt, Ruth Dani.l.
105. In 181a, Defendant Holy Spirit Ho.pital had a duty to ..l.ot and
r.tain only comp.t.nt phy.ician. and nur....
106. In lila, D.f.ndant Holy Spirit Ho.pital had notioe that
Def.ndant Oramm wa. not a qualified nur.e.
107. Specifioally, D.fendant Holy spirit Hoapita!'. Qulpabl. concluct
wa"
(a) it. failure to formulate, adopt and enforce
polici.. and prooedure. to .n.ure quality
monitoring and managing of a labile in,ulin
dependent diabetic such AI Plaintiff
patient, Ruth Daniel,
(b) improp.rly proces.inq and .valuating
Defendant Gramm's cred.ntial.,
(0) failinq to v.rify Defendant Gramm'. .kill
a. ~ nurse b.fore allowinq her to a..... a
labile insulin dependent diab.tic pati.nt
.uoh ae Plaintift patient, Ruth Daniel,
(d) fail1nq t,o test D.fendant Gramm'.
profioiency and compet'ncy in monitorinv
and managinq an insulin dep.ndent diabetic
patient to .n.ure that her. nur.inq .kill.
w.re current with .tat. of the art
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development. in the manaqement and oare ot
an in.ulin dependent aiabetic patientl and
(e) tail1nq to limit, .u.p.nd or revoke
Detendant Gramm'e nureinq privi18qe. in
monitorinv and manaqinq patient. at lh
faoility.
,.0. 108. D.fendant Holy spirit 1I0epital, actin9 throuvh it. .Ventl,
apparent aqent., .ervant. and/or employee., i. liable tor it. .el.otiQn
and retention of Defendants Inners and Gramm and it. failure to .upervi.e
and monitor the practice ot Oetenaants Innere and Gramm within it. wall..
101, Defendant Holy Spirit Hospitd, actinv throuvh it. avent.,
appar.nt avent., servants and/or employeee, i. liable for it. failure to
formulate, al1opt'., and entorce adequate rules and polioie. to en.ure
quaUty ot cere tor ite patients, includinq plaintiff patient, Ruth
Daniel.
110. Oetendant Holy spirit Hospital haa a duty to formulat., .dopt,
and enforoe adequate rules and polioies to ensure q\lality ot oare for it.
patient., inoludinq plaintitf patient, Ruth Daniel.
111. In 1992, Defendant Holy spirit Hcspital wa. accredit.d by the
Joint commie.ion tor Accreditation ot Hospitale (herein JCAH) .
112. In 1992, hospitals accredited by JCAH were required to e.tabU.h
and maintaJ,n variou. committees to review specific aspeot. of the pr.oUoe
ot medioine within ita institution, including the proce..inv and ......1n9
ot phyeioian and nuree creaentials and the review, analyeis and .valuation
of phyaioian'. ahd nurae's clinical performance.
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113. In ho1c1inq itaelf out tq the publio a. JCAH aoor.-editad,
Defendant Holy spirit Hospital wu. Pfoclaiminq that it formulatelt and
enforo.d procedure. and policies for the safety and protection of patient.
in acoordano. with the minimum standards set forth by JCAH.
114. In 111112, Detendant Holy Spirit Ho.p1tal had a duty to
inveatiqate, monitor, and it necesaary, revoke, limit or auapend Detendant
Inner. and/Qr ~ramm's privilege. in the face ~t que.tionable or
aubatandard oare.
111!l. Defendant Holy spirit Hoepital 1e liable tor ita tailure to
oomply with the requirements of JCAH wj,th regard to entorcinq polioiea and
procedurea for the quality and satety of hoapital-ba..d patient oare,
includinq care provided to Ruth Daniel in 1992.
116. Defendant Holy Spirit Hospital 18 liable for ita failure to
provide any 8ubatantive testing or concrete evaluation ejf Defendant
Inner'a and/or Gramm's skills betore permittin9 them to evaluate and
monitor patient'e including Plaintift patient, Ruth Daniel within ita four
walla.
-- 117. Defendant Holy Spirit Hospital failed to aupervia. Defendanta
Inner. and Gramm properly, and as a re8ul t ot their tailUre to do eo,
Defendant Holy spirit Hospital brellched its duty to ih patient, Ruth
Daniel.
118. Thie breach ot duty by Defendant Holy spirit Hoapital w.a the
direct and proximate result ot the injuries alleved herein and
incorporated by reference.
119. Defendant Holy Spirit Hospital, throu9h ita aqent., inoludinv
medical ataff committee membera, hospital oommitt.e membera, and board of
24
truatee membera, h.a the ri9ht and duty to control atatt privilege. and
praotioea within ita inatitution, inaludinv the privilevea and praotio..
ot Defendant. Innera and Gramm.
120. Neverthel..., Defendant Holy spirit Hoepital did not inveativate
Defendanta Innera or Gramm, nor take any steps to limit, auapend, or
revoke their privileves or test their prof!QienQY and oompetenoy in
ourrent manavement and care ot insulin diabetiQ patienta, or limit and
diaoipline them for inappropriate or subatandard patient care.
121. Additionally, Defendant Holy Spirit Hoapital ia liable fori
(a) failin9 to select and retain only competent
physicians,
(b) failing to overaee all peraons who practiQe
medicine within its Walls aa to patient
care,
(0) failing to tormulate, adopt, and enforoe
adequate rules and pclioies to ensure
quality care to its patient, Ruth Daniel,
(d) failin9 to report conditions and question
Defendant Inners' practice and procedurea
when not in accordance with the atandarda
of medical practioe,
(e) failin9 to ensure patient aatety and well-
bein9 while at the hospital,
(f) failing to review, analyu and evaluate
Defendant Innera' clinical performanoe,
2~
(9) faiUnv to prccel. and ...... D.f.ndant
Inn.r.' credlntialinq and reappointm.nt
prop.rly,
(h) failinv to properly dllineat. D.fendant
Inn.r.' privillqe. and limit hi. praotio.
at Defendant Holy spirit HOlpital,
(i) taUinv to revoke, limit or .u.p.nd
Def.ndant Inner.' privileV1. de.pitl
.ubltandard care, and
(j) failinq to verify updat.d knowl.dve and
.kill to en lure that Defendant Inner.'
skill and knowledqe comported with
contemporary standardB ot medical practic..
122. Def.ndant Holy Spirit HOlpital, actinv throllvh it. av.nt.,
apparent aventl, .ervante and/or employ.ea il liable to the Pla~ntiff,
Ruth Dani.l, for injurie. and d8maqel 8llelled herein whioh were direotly
and proximately causod by it. nelllillence a. ..t forth in paravraph. 2.
through 81 above whioh are inoorporated herein by reference .. it ..t
forth at l.ngth and claim il made therefore.
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WHIR.rORI, Plaintiff demand. jud9ment a9ainat Detendant Rolf .,1r1t
Ko.p1tal for Clompen..tory ".magea in an I\mount in .xoea. of ~.nty
Thou...nd (tao,ooo.OO) DoU.ra excluaive of intu..ta and ao.t. and in
exa.a. ot any juri.dictional amount requirinq oompulaory .rbitr.tiQn.
Respectfully aUbmitted,
ROVNER, P.C.
N 0 e C. 0 aon
I.D. . 221187
4110 rth Front str.et
HarriBbur9, PA, 17110
(717) 238-6791
Counael for Plaintiff
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RUTH J. DAN 1II., I IN THI COURT or COHHON PI.IAD
Plaintiff I DAUPHIN COUNTY PINNSYLVANIA
I
V8. I CIVIL ACTION - LAW
I
CHARLIS R. INHIRS, M.D., I NO. 37~4-S-93
INNIRS DAVIS ASSOCIATBS, I t.JO. ll13 c; v~'1 , '1 ~ II
LUAN ORAXH, R.N'i and I
HOLY SPIRIT HOSP TAL, I
Defendanta I JURY TRIAL DlMANOID
aRD..
AND NOW, thil 3 ~ day 0;~'C""""~ , uu,
upon con.ideration of the within Stipulation of Coun.~l, 1.
hereby ORDIRID that Plaintiff ia granted leave to voluntarily
tranafer the above-captioned ca.e avainat Defendant. Charl.a R.
Inner., N.D., Inner. Davi. A.aociate., Luan Gramm, R.N. and
Holy Spirit Ho.pital from the Court of Common Plea. of Dauphin
County to the Court of Common Pleas of Cumberl~nd County,
Penn.ylvania, all proceedinv. to atay meanwhile. Upon
execution of thi. Otder, a petition .hall be filed with thia
Court and the Prothonotary ahall thereafter tranafer all
record. to the Court of Common Plea. in Cumberland county,
Pennaylvania.
J:
o
.
RUTH J. DAHIlL, . IN THI COURT or COMMON P~IAI
Plaintiff . DAUPHIN COUNTY PINNSYLVANIA
.
V8. . CIVIL ACTION - LAW
.
CIWlLIS R. INN.RS, ". D. , . NO. 3754-8-93
INNIR' DAVI' A'80CIATIS, .
LUAH GIWIII, R. N . X and .
HOLY IPIRIT HOIP TAL, .
Defendante . JURY TRIAL DEMANDED
'''JlllpoA'l'IOIll Q. CQIDIB.~ 1'08 _&N",..
0' to1l8' '1'0 CIIIIR..UIlft CODll'l'Y, P.IIIIBYLYUI,
It i. hereby Itipulated and aqreed by and between
coun.el for all parti~1 to the above-captioned matter that
Plaintiff may tranlfer thil ca.e aqain.t Defendant. Charle. R.
Inner., M.D., Innerl Davi. A.lociate., Luan Gramm, R.N. and
Holy Spirit Ho.pital from the Court of Common Plea. of Dauphin
County to the Court of Common Plea. of Cumberland county,
'enn.ylvania. All proceedinv_ to _tay meanwhile. The matter
_hall continue, again_t all above-named Defendant. in the Court
of Common Plea.
Pen
ania.
~ 1f,lcfQ3
DATI. "IZ2 / c:,).
, , . .;:" ( \
(,! ,( _J
ahael W. ~GUckin, I.quire
ICHAIL W. ~CGUCKIN . ASSOCIATIS
1850 William Penn Way
suite 209
P.O. BOll 101596
Lanaa.ter, PA 17605-0696
Attorney. for Charle. R. Inner.,
M.D. and Inner. Davi. A..ociate.
(dll', ,A,
~~J<<Jr1lI1j/iY#~!;.t\-i~~(li"J':,:i"I,q'J-II" 'J''-' '. I ',I,'
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DATI. "..1(''' 'J
LJkw'1&04+
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C~a A. Stone, ..q
Jay on ~. wolfian96 .qui~e
NITTI IVANB. WOO SIDI
3401 'o~th rront Street
..0. lOx SUO
~.rri.bur9,'A 17110-0i50
Attorney. for Luan Oramm, R.N.
and Holy Sp1r1t Ho.p1tal
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Q.RTI.ICA~. Q, '.~ICI
J hereby o.rtify th.t J, I.ndr. L. Ri.h.l~, .n e.ployee of
,Angino I Rovner, P.c., thi. 2nd d.y of Deoember, 1"3, ~.ve .erve
. tne .nd oorl'.ot oopy of ITIPULATION or COUNll1,o rOR TlWfIPIR or
CAli . TO CUIIIIIU",AND COUNTY, PINNIYLVANIA by .end1nv .... U~itecl
.t.te. fir.t 01... ...il, po.tav' pr.paid, .ddr....d a. follow..
Michael W. MOGuQkin, I.~ire
1850 Willia. P.nn Way
Iuite aOt
P.O. Box 106116
Lano..tel', PA, 17605
Attorn.y for De~.nd.nt.,
Oh.rl.. R. Inner., M.D. and
Inner. Davi. A..ooiat..
J..on R. Wolfv.nv, a.quire
NITTI IVAN.' WOODIIDI
3401 North .ront street
H.rri.burv, PA, 17110
Attorn_y for Def.nd.nt.
Lu.n Gra.. R.N. .nd
"oly spirit Hoapit.l
~;:r if. . ~ ~\..\ \. \
.n ra . It .he
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RUTH J. DANIIL,
'hintitf
VS.
CHAR~IS R. INNIRS, M.D.,
INN.RS DAVIS ASSOCIATIS,
LUAH GRAMM, R.N., .nd
HO~Y SPIRIT HOSPITAL,
Defendlntl
IN THE COURT or COMMON P~IAS
DAUPHIN COUNTY PENNSYLVANIA
CIVIL ACTION - LAW
NO. 37~"-s-n
JURY TRIAL DEMANDED
I01:lCI_m..fLIAD
TOI Ruth J. Daniel, Pllintiff
clo li'ole C. Ol.en, laquire, her attorney
Angina . Rovner
4503 lorth rront Street
H.rriaburv, PA 11110
You are hereby notitied to file I written reaponle to the
enolo.ed Preliminery Objection" within twenty (20) dlya from
aervice hereof or I jUdgment may be entered eVlinat you.
On..., !VAlIS .
BYI
e, B.quire
Sup. Ct. . '1~907
Jlyaon R. lfveng, Blquire
Sup. Ct. I. D. '62076
1801 North Pront Street
P.O. Boa 729
Hlrtilburv, fA 17108-0729
(717) 232-~0()0
Attorney. for Detendantl
Luan Grimm, R.N. Ind Holy Spirit
HOlpital
DATIl 10/21/93
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RUTH J. DAHIlL,
Pllintift
V8.
IN THB COURT or COMMON P~'AS
DAUPHIN COUNTY PBNN8YLVANIA
CIVIL ACTION - ~AW
NO. 37~"-8-U
CHARLI8 R. INNIRS, M.D.,
I"HIR8 DAVIS AS8OCIATI8,
LUAN G~, R.N., and
HOLY SPIRIT HOSPITAL,
Detend.nt.
JURY TRIAL DSMANDJlD
LV1:.UJ''::~::~I':L~ ~pf:Ir:=TAL
AND NOW, come Defendant. Luan Gramm, R.N. and Holy 8pirit
Ho.pital filinv the.e Prelimin.ry Objection. to Pl.intitt'.
Complaint ba.ed upon the tollowinVI
1. A true and correct oopy ot Plaintift'. Complaint il
Ittlched hereto a. Exhibit "A."
IlIllIfo~r Vellu.
2. Acoordinv to the Complaint, Plaintitt all,v.411
luftered personll injuries while I pltient at Holy 8pirit
HOlpital, Camp Hill, Cumberllnd County, Pennlylvanil.
3. Accordinv to the Complaint, individual Defendant.
Chlrlel R. Innerl, M.D. and LUln Grimm, R.N. mlintlined
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A oOijnty where I tran.lction or occurrenoe took pl,ce
out of whioh the caue. of let ion Iroee.
... PI. R.C.P. 2179(1).
8. Defendant Holy Spirit Ho.pitel doe. not revularly
conduct bu.ine.. in Dauphin County, Penn.ylvanil, end venije in
thi. lotion in Dauphin County ie therefore improper.
WHEREfOR., Defendante Luan Grimm, R.N. and Holy Spirit
Ho.pital re.pectfully reque.t thet thie Court .u.tain their
Preliminary Objeotion Ie to improper venue and tran.fer thi.
ca.e to Cumberland County, Pennsylvani..
Leqal In.ufflol'~-Df the p'1.a41nv (n-..rr.r)
9. In the Complaint, Pllintitf .et. forth general,
boilerplate alle9ltion. of "vross nevlivence" in In effort to
reCOver punitive dlmlve.. Iaa Exhibit "A," parlvraph 73.
10. In paravraph 82 of the Complaint, Plaintiff alleve.
the followinVI
82. A. the direct and proximate re.ult of
[all) the Defendant'. (eic) reckle..
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dl.revard and compl.te indifference for
'l*intiff, Ruth Olni.l'. welfar., pllintiff,
Ruth Oani.l hi' .uffer.d injurie. for which
.he may r.oov.r punitive dlmIV" and clalm
i. made ther.fore.
... lahibit .A,. plravraph 82.
11. In Count III of the Compllint, Pllintiff .et. forth
h.r cau.. of let ion 19lin.t Defendlnt Luan Gremm, R.N. for
.n'Vliv.nc. and/or vro.. ne9ligenoe.. Saa 2zhibit .A,. Count
III, parl9rlph 90.
12. Paravraph. 82 and 90 Ibove er. incorporated by
raferenc. la a9ainat D.fendant Holy Spirit Ho.pital via
plr.vraph 92 in Count IV of the Compl.int, in which Plaintiff
.et. forth her c.u.. of action a9ainet Def.ndlnt Holy Spirit
Ho.pital for the nevlivence of it. .Ivent., epparent agent.,
..rvlnt. Ind/or employ..... s.. Bahibit .A,. Count IV.
13. Under p.nn.ylvanil law, punitive dam.ve. mu.t be ba..d
on conduct that i. mlliciou., wanton, reckle.., willful or
oppr...iv./ punitive d.mIge. Ir. not ju.tified wh.r. the
d.f.ndent'. conduot .ri.e. to no more than 9ro.. ne9livence.
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14. Th. Compl.int f.il. to .t.t. a claim upon which
punitive d.mav.. o.n b. vr.nt.d av.in.t Def.nd.nt. Lu.n Gr.mm,
a.H. .nd Holy spirit HOlpit.l b.C.UI. it l.ckl the faotu.l
Ill,vation. n.c....ry to .upport .uch a claim.
l~. punitive d.m.v.. h.v. no pl.ce in .n ordinary
n'Vliv.nc. .ction luch al the ca.. at hand.
WHSRlrORS, D.fendantl Luan Gramm, R.N. end Holy 8~irit
HOlpital r.IP.ctfully reque.t that thi. Court .uetain th.ir
demurr.r .nd di.mi.l, with pr.judic., Plaintift" all.vation.
of .nd d.mand for punitive damave..
la.ufflal.nt .,.alflalty In ~ Pl.a41ag
16. In p.r.vreph 90 of the Complaint, Plaintiff all.ve.
th.t Def.ndant Lu.n Gramm, R.N. waa n.vliv.nt and/or vro..ly
navlivent .. followal
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(.) f.ilinv to properly inveativ.t. Ruth
D.ni.l', medicine k.rde.,
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r.ilinv to prop.rly .el.ct .nd
.upervil' phy.ici.n Ind oth.r p.rlonn.l
to whom they entrUlt the car. or '
p.ti.ntl with Ruth Dlnt.l'. condition!
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rlilinv to hive per.onl properly
trlined in nur.in; ......inv . labile
dilbetic p.tient tor compromi.inv .iVp.
.nd .ymptom. tollowinv Detendant
Inner.' order overdo.inv hi. pltilnt
with in.ulin on AUvuDt 7, 1992/
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(m) rlilinv to initilte and maintli" the
proce.. of onvoin; .hlred information
in the care provided to Ruth Olniel/
(q)
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rlilinv to minimlle the ri.k Ind/or
prevent hypovlycemic .eilure and .hock
by que.tioninv Detendlnt Inn.r.' ord.r.
for In Idditional forty unit. of NPH
and twenty-rive unit. of Revular
In,ulin at 13130 hr.. when Ruth Daniel
already rec.ived tw.nty unit. of NPH
in,ulin It 07130 hr.. on Auvu.t 7, 1992/
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(Ia) tailinv to minimile the ri.k Ind/or
avoid injury to Ruth Dlniel/
(bb) railinv to pro~.rly provide tor clr.rul
pllnninv .nd monitorinV of in.ulin
cov.rlV' throu;hout Ruth Daniel'.
Auvu.t 1992 ho.pitllil.tion/ Ind
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(ee) failinv to minimi.e the ria~ .nd/or
prevent Mr. (aio) Daniel'. hypov1yoemio
.ei.ure .nd ahock on AUQuat 7, 1992.
au ..Mbit fA," pUIVupha 94(a), (b), (k), (m), (q), (II),
(bb) .nd (ee).
19. under Penn.ylvlnia law, "[t)he mlterill flota on whioh
I clu.e of lotion or defen.. i. bl.ed ahal1 be .t,ted in ·
oonoi.e and lummary form." Pa. R.C.P. 1019(a).
20. PIUguph. 90(.), (V), (i) Ind (1) and 94(.), (b),
(k), (m), (q), (u), (bb) .n4 (.e) of the Complaint flU to
a11eQe, with .ufticient leVll .peoificity, the material fact.
upon whioh the clua. of Iction ie baled.
21. The non-.pecifio, boilerplate IlleVltion. oontained in
parlQr,ph. 90(v) Ind (i) of the Complaint do not provide
Defendant. Luen Grimm, R.N. and/or Holy Spirit Hoapital with an
adequate opportunity to defend the olaim. av.in.t them, and
they are preiudiced thereby.
WHIRBfORB, Defendant. Luan Gramm, R.N. and Holy Spirit
Ho.pita1 relpectfully reque.t that thi. Court diamia., with
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prejudio., paravrapha 90(V) and (i) for inauffioient
apeoifioity or, in the alternativ., that Plaintiff be direoted
to file a more Ip*oifio pl.adinv.
raUur. 'l'o CoDfJaI'll 'l'q La. Or Ru}. Qf Cou,t
22. In Count IV of the Complaint, Plaintiff leta forth h.r
allevationa av.inlt Def.ndant Holy Spirit HOlpital for the
neVliveno. of "ita .venta, apparent .venta, lerv.nta and/or
.mploy...." lea lahibit "A,. par.vrlph 94.
23. In .ubp.revreph. 94(a), (b), (k), (m) .nd (q) of the
Complaint, Pl.intiff' ..t. forth allev.tion. in the nature Of
corporat. liability .vain.t Defendant Holy Spirit HOlpital
under the holdinv in Thomp.on v. Ha.on Ho.pital, 527 Pa. 33Q,
591 A.2d 703 (1991).
24. Und.r Pa. R.C.P. 1020(a), a plaintiff may .tat. in the
COlnplaint more than on. caule of .ction avainat the lam.
Defendant, how.ver, "[.lach cauae of aotion and any apecial
demave r.lated th.r.to Ihall be atated in e I.parat. oount
containinv a demand for r.lief." Pa. R.C.P. 1020(a).
~ ~
2~. Pllintiff hll fliled to oomply with ~I. R.C~P. 1020(1)
I
in thlt Count IV ot the Compllint oontlina more than one olua.
of lotion aVlinat Defendlnt Holy Spirit HOlpitll.
WHIRBrORB, Defendlnt Holy Spirit Hoapitll relpeotfully
reque.tl thlt thil Court atrike plrlvrlphl 94(1), (b), (k), (m)
Ind (q) or, in the Ilternltive, thlt Plaintiff be direoted to
fil. In amended pleldinv in complilnoe with PI. R.C.P. 1020(a).
R..pectfully lubmitted,
.
MlTTE, NS & IDE
IYI ) -l
Creiv A' St
3401 North Front Stre.t
P. O. loa 5950
Harrilburv, PA 17110-0950
(717) 232-5000
Attorneya for Defendanta
LUln Grimm, R.N. Ind Holy Spirit
HOlpitll
DATI, 10/21/83
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RUTH J. DANIIL
I IN THI COURT 01 COMMON PLIU
I DAUPHIN COUNTY, PINNSYLVANIA
I
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I CIVIL ACTION - LAW
I
: NO. 3';SV- S-'?)
I
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I JURY TRIAL DEMANDED
Plaintiff
v.
v<i1L~'U:S R. INNIRI, N.D.,
INNIRI DAVI' ASSOCIATES,
tuAN GRAMM, R,N., and
HOLY SPIRIT HOSPITAL
Dlfandlnt.
NOTte,
YOU HAVE BIIN SUED IN COl1R'I.'. If you wiah to d.fend aVa1nat
the clai.a aet forth in the followinq paqla, you mUlt take action
within twenty (20) day I after thil Compldnt and Notice are aerved,
br .ntlrinq a written appearance penonally or by attorn.y and
f Unv in writinv with the Court you!:, detena.. or objectiona to thl
c18i.. aet fo!:'th aqainlt you. You are warned that if yo~ fail to
do .0 the cu. .ay proceed withcut you and a jUd91Dlnt may be
entered avainat you by the Court without fu!:'ther notice for any
mon.y clai..d in the Complaint or for any other claim or relief
requ..ted by the Plaintiff. You may 10.. money or property or
other rivht. important to you.
YOU SHOULD TAXI THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TIlLlPHONIl THE
OrrICE SET rORTH BELOW TO rIND OUT WHERE YOU CAN GET LEGAL HILP.
Court Adminiltrator
DI~phin County Courthouae
rront and Markat Stre.t
Harrilbur9, PA, 17101
2157-1511
JI041I1LR
CLAIMS
OCT 0 5 199:
RECEIVED
, ,
RUTH J. DANIEL
I
IN THJ COURT or aOHMOM PLlAS
DAUPHIN COUNTY, PENNSYLVANIA
I
plaintiff
v.
CIVIL ACTION - LAW
NO..3 :;:u-~- $- T3
CHARLIlS R. INNlRS, M.D.,
lKNIRB DAVIS ASSOCIATES,
'WAN GRAMM, R.N.,
HOLY SPIRIT HOSPITAL
Defendanta
JURY TRIAL DEMANDEO
NOTA-CIA
Le han demandado a u.ted en la ocrte. Si uated quiere defenderae de
eat.a demandaa expueataa en la. pagina. .iquient.a, uated tien. viente
(30) diae de plaza al partir de la fecha de la demanda y la notificaoion.
Vated debe p~eaentar una apariencia e.crita 0 en perlona 0 por aboqado Y
arohivar en la corte en forma eacrita aua defen.aa 0 aua obieotionea ala.
demanda. en contra de .u pereon.. Sea avi..do que a uated no ae
defiende, la oorte tomara medida. y puede entrar una orden oontra u.ted
dn pr.vio avi.o 0 notiticacion y par cualquiu queja 0 alivio que e.
pedido en 1. petioion de ~emanda. Uetad puede puder dinuo 0 au.
propiedadea c otro. derachol impcrtantel para ulted.
LLEVE ESTA DEMANDA A UN ABODAGO INMEDIATAMENTA. SI NO TItNE ABODAGO
o SI NO TIENE EL DtNERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA
o LLAMJ: POR TELEFONO A LA OFICINA CUYA DIRECCION S!l ENCUENTRA ESCRITA
ABAJO PARA AVERIGUAR DONDE SE PUEDI CONSEGUIR ASISTENCIA LEGAL.
Court Admininatrator
Oauphin county ccurthoua.
Front , Market street.
Harriaburq, PA, 17101
2!57-1I!lU
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COMPLAINT
1. Ruth J. Daniel 11 an adult individual ruidinq in Harriaburv,
Dauphin County, pennsylvania.
~. Detendant Charles R. Innen, M.D., an adult individual, 11
l1cenaed to practice medicine in the commonwealth of pen",aylvania, who, ir
1992 enqaqed in the practice ot Internal Medicine in camp Hill, cumberlanc
county, pennsylvania.
3. Inners Davis Associates, is a prot.ssional profit-makin~
corporation, which provides medioal services in cumberland county,
Pennsylvania.
4. Detendant Luan Gramm, R.N., an adult individual, is a reqisterec:
nurae, who in 1992 practiced nurainq in Camp Hill, cumberland county,
pennsylvania.
5. Detendant Holy spirit Hospital, is a corporate medica:
inat1tution with oHio.. and medical facilities in Harrllburq, Dauphir
county, pennsylvania.
fl. Defendant Charles R. Innera, M.D. wae at all relevant timel
hereinafter, actinq as an aqent, apparent aqent, servant and/or employe(
of Defendant Inners Davis Associates.
RUTH J. DANIEL I IN THE COURT or COMMON ~LEAS
I DAUPHIN COUNTV, PENNSYLVANIA
PldntUf I
I
v. I CIVIL ACTION - LAW
I No.3? 5'1-S - "'::1
CHAlU..I:S R. INNEIUJ, M.D., I
INNIIUJ DAVIS ASSOCIATES, I
WAN oJWIM, R.N., I
HOLY SPIRIT HOSPITAL I
I
Defendants I JURY TRIAL DEMANDED
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15. pldnUff, Ruth Danielf' r.odpt of 20 unita of NPH inluUI\ at
, ,
0730 hn on Auvuat 7, un w.. dqned off on he~ .edJ.oine l(udex ~y
Defendant Holy Spirit Ho.pital', atatt nurae, an LPN with the abbreviated
initiall, "PH".
16. Six hour. later at 1330 hra on Auquat 7, 1"2, Defendant Inner.
vave STAT ordera for Plaintiff, Ruth Daniel, to reoeive additional inaulin
a.ountinv to 40 unit. ot NPH ineulin and 2S unitl of Revul.~ J.n.ulin.
17. Sivnificantly, Defendant Innera ordered the overdoae of inaulin
without ever examininq hi. patient.
18. Defendant Inner. ordered the overdo.e of in.ulin by telephone.
lll. Defendant Innera ordered the overdcae of inaulin at 1330 hra on
AuVUat 7, 1112, deapite Plaintiff, Ruth Daniel'. prior coveraq' with 20
unita of NPH in,ulin at 0730 hr..
20. An overdo.. of inaulin causes blood Vlucoae l.vela to lower
drmmatically, re.ulting in hypoglycemia with aeizure. and ahock.
21. Nuree Gramm did not properly review or relay the information
noted in Plaintiff Ruth Daniel'a medicine Kardex on Auvuat 7, 1"2.
22. Nur.. Gramm did not report Detendant Innera' overdoae of in.uUn
to hie patient, Plaintitt Ruth Daniel to hClr luperv180r or other of
Plaintiff'a treating phy.iciana.
23. Nurae Gramm tailed to underatand that any additional inaulin at
1330 hra cn Auquet 7, 1992 could ruult in Plaintiff patient, Ruth
Daniel" experiencinq hypoglyoemic ahock and aeiaure.
24. Following Defendant Innar,' STAT order overdoainv hia patient
with inaulin, Plaintiff Ruth Daniel waa tranaport'd to the radiolo9'Y
department for an ultralound relating to her orthopedic evaluation.
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as. Iivn1tioantly, neLther. Nune GraN or any o( Def~ndant Hol)'
,Ipirit Hoapital'. nur.inv .taff monitored Plaintiff Ruth Dani.l'. blood
vluco.. leve1a followinv Defendant Innera' STAT order overdodnv hb
patient with inaulin.
2.. Plaintiff, Ruth Daniel wa. returned to her room followinV an
ultra.ound examination at approximately 11!lOO hr..
27. At that tillie, Plaintiff'. dauvhter, Debra Nioodemua, wa. pre.ent
in her mother'. room.
aI. Not .urprilinq, fcllowinq Cefendant Innera' STAT ord.er
overdo.inq hi. pati.nt with in.ulin a few hour. earlier, Mr.. Nloodemu.
ob.erv.d ~er mother thra.hinq and convul.inv in her bed unoontrollably.
29. Plaintiff'. dauqhter, Mr.. Niccdemu., ran to the nur... atation
to vet help for her mother.
30. Nur.e. notee documented Plaintift, Ruth caniel, .hakinv from a
.eizure, unr..ponaive to at1muli and pupil. unre.pon.ive to liqht.
31. AI plaintiff, Ruth Daniel'. primary treatinq phy.ician,
DefencSant Innera wa. ccntaoted by Cefendant Holy spirit Ho.pital'. nurai.-.,
.taff and re.ponded by vivinq ordere by telephone for blood euVar .tudi..
to be drawn and that Plaintiff, Ruth Daniel, receive an ampule of vluco.e
and water (CI!lO).
32. Nur.e. note. document that plaintiff, Ruth Daniel'. blood luqar
wal unluooe.lfully drawn.
33. Nur.e. note. allo dooumented that the failure to draw blood on
the firlt attempt wa. not reported to .taff.
34. sivnifioantly, before Plaintiff, Ruth Oaniel'l blOOd luvar wa.
drawn, Ihe raoeivecS an ampule of qluco.e and water (DeO).
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~5. Th. overcSo.. of in.ul!n orcS.rod by Def.nd.nll Inn.n v.. .0
.xo...iv., that by 8100 p... on the eveninV of AuqU.t 7, 1"2, Plaintiff,
Ruth Dani.l', blood .uvar wa. down to 28 .V/dl and a .Icond ampule of 80t
Vluco.e and watlr wa. a~ini.tered.
~6. Brain function depend. on an adequate .upply of V1UCO.I fro. the
blood and a blood .uvar a. low a. 28 ie con.i.tent with hypovlycl.ic .hock
which can re.ult in .evere brain da.ave, .eizur.., oo.a, and n.uroloqio
daficit.
37. Approximately one hour after Defendant Holy spirit Ko.pital'l
nur.inv ,taff ob.erved Plaintiff, Ruth Daniel'S hypoVlycl.ic oonvul.inv
.eiaure. and .hock, Plaintiff" ccmpl.int. of rivht .houlder pain wer.
dooumented and repcrted to Defendant Innlr',
38. Defendant Inner. failed to re.pond to calls or to come into the
~'.pital to Ixaminl hi. patient.
39. over the next .evlral hours Plaintiff, Ruth Danill wa.
documented to be .oaninq in pain with noted quardinv of her rivht upper
.houlder.
40. plaintiff, Ruth Daniel WII ~ taken to the radiolovy d.partmant
for x-ray .valuation of her r1qht Ihoulder until approximately 1940 hr. or
Will oVlr tive hour. after her oonvulainv hypoqlycemic .Iilure wa, noted.
41. At that ti.e x-ray Ixamination of plaintiff, Ruth Danial'. riqht
.houlder dooumented a fracture of the neck of the rivht hu.eru. with .ome
rotation of the humeral head.
42. Followin; the x-ray examination an orthopedic .valuation by Dr.
land. noted Plaintiff, Ruth Danill'. unre.pon.ivene.. to vlrbal .timuli,
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~ivht ahou14e~ ade.a and x-~ay ~indin9a coneiatent with . I~.otu~e4 and
dialooatad ~ivht ahoulder.
4~. Dr. Banda further notad that Plaintiff, Ruth Danial r.quir.~
aedation befo~e any attempt at r.eduction .urgery for her ahoulder Iraoture
and dialooation.
44. By 10100 p.m. or 1I houra after hia telephone order overdoainq
hh patient with inaul1n Defendant Innen finally oame in to aee hi,
patient.
45. At that time, Defendant Innera recordad in tha provreaa notea
that he ordered an overdo.e of inaulin at 1330 hra.
U. At that time Oetendant Innen aleo dooumented Plaintiff patient,
Ruth Daniel'a aeizure followinv hia order overdo.inq her inaulin.
47. Defendant Inner. further dccumented that plaintiff patient, Ruth
Daniel received one ampule of 050 prior to her blood augara being drawn
which aocounted for her reported blood augar ot 433.
48. At that time, Defendant Inner. alao documented Plaintiff
patient, Ruth Daniel'. tractured and dislocated riiht ahoulder following
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her aeizure .eoondary to hypoglycemia.
49. At that tim. Defendant Innen a180 documented reviaw of hil
patient" medioine ~ardex only attar he ordered the overdo.e of inaulin.
1!l0. In the early morning hour. of Augu.t 8, 1912, Defandant Innera
documented plaintiff patient, Ruth Daniel'. inability to move her rivht,
arm aeoondery to her fracture.
51. In livht of Plaintiff patient, Ruth Daniel'. failure to reapond
to external atimuli, a neufolovio conault waa ordarad.
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, la.' NluroloCjJiat, Dr. Todd 'I.uela, eXI.ined Pldnt1~f au~h Daniel on
AUfUlt 0, 1"a and dooumented her aeilure Ictivity, and peraiatlnt lack of
I'lapondveneaa aa 'Icondal')' to an overdoa. of inaul1n oaulin9
hyp09lyoe.ia.
13. Nlurolovi.t, Dr. lamuIl. further dooumlnted plaintiff patient,
Ruth Daniel'a enoephalopathy .. aecondary to hypoqlyce.io ahock ancS
.eilure, and, oonaequently re~ommended that orthopecSic intervention for
her fraoturld and dialocated rivht .houlder be delayed until her
neuroloqio atatua improved.
I.. On Auvu1t 10, 199~, orthopedio lurqeon, Dr. Banda, dooumented
plaintiff patient, Ruth Daniel'a perallt:ent rivht ahoulder pain and
oautioned that her provnolia for olol.d reduction waa fUarded.
I!ll. On AUVu1t 12, 1992, Cr. Banda, attempted cloled reduotion of
Plaintiff Ruth Daniel'l fractured and di.located ri9ht ahoulder under IV
adation.
115. The attempt to treat Plaintiff Ruth Daniel'a fractured and
d18looated riVht ahoulder ..condary tQ hypoqlycemio ..hun by cloud
r'duotion failld.
17. General aneatheah v.. conaidered prohibitive in Plaintiff
patient, Ruth Daniel and her rivht arm waa immobilized in a alinv.
II. At: that time it waa Cr. Band'a opinion that plaintiff patiant,
luth Daniel'a provnolia for her riqht ahoulder wa. poor.
!II. Throuvhout her Auvu1t and September, lU2 hOlpitdhation,
plaintiff, Ruth caniel'l fraotured and dialooat.d rivht .hould.r remained
Iwol1en, edemat~ua, tinder and .xtrlmely painful to the touoh.
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, 60. Additionally, PlaintUt, Ruth Daniel alao compla~ned o,f left len..
pain followinv her hypo91yoemio aeilure tor whioh x-raya were not taken
until .ept.JI))er 11, 1192 or 3" daya after the convula1nq aehUn cauaecS by
Defendant Innera' order overdoainv in,ulin.
41. Radiovraphic examination 01' Plaintiff, Ruth Daniel'. left len.e
taken on 'eptember 11, UI2 nvealad a fraotun of the l.ft tibial
plate.u.
62. rollowinV the uneucceaaful attempt at cloaed reduotion aurqery
for Plaint if l' Ruth Daniel" fractured and dialocat.d r19ht .hould.r,
phyaioal therapy and rehabilitative proqrama were inatituted.
63. However, Plaintift, Ruth Dani.l'a rehabilitation waa very .low.
64. Aecordinv to the phy.ical therapy provre.a r.corda, Plaintiff,
Ruth Daniel waa found to be of que.tionable rehab pctential until .uch
time aa .he had acquired better U.e ot her ri~ht upper extre~ity.
61!l. In her many attempt. to ambulate, the phyaical therapy recorda
oonaiatently documented plaintiff, Ruth Daniel aa acreamin9 in pain.
66. Finally, it was the physical therapiet'a recommendation that
plaintiff, Ruth Daniel utilize a wheelchair for ambulatin9 rather than. ,
walk.r beeau.. the weight-bearinv required in udnv Il walker, oau..11
trelDendoua pain to her fractured and dialocatad rivht .houldar.
67. On September 23, 1992, Defendant Inner.' ae.ociate, Dr. Cavia
noted in hi. l1iacharve lummary that Plaintiff, Ruth Daniel waa vivan an
overdoae ot inauUn whieh ruul ted in .aver. hypovlycalDia and .a1zun IInd
aubaequ.nt fracture and dialocation of her riqht ehoulder.
68. Sinc. Defendant Innere' order overdoe1nv hi. patient with
,inauUn and her sub..qu.nt hypoqlycelDio aa1zun and shock, Plaintiff, Ruth
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Da",iel'. treetunc1 and cSlIlocat,d ri9ht .houlder cQmp~uncSe~ her othel'
.ecSioal problem. 1noludinv pulmonary conge.tion tor which .he oannot b.
acSequately turned beoau.e of her riVht .houlder pain and ha. renderecS hel'
entirely cSepencSent on her dauqhter for even her 1II0.t buic and rudimentary
,..........
need. . .
el, In an .ttort to a..i.t in the full-time ta.k of carinv tor hel'
mother, Plaintitt, Ruth Daniel'. dauvhter, Mr.. Nicodemu., had to procure
the a..i.tanoe ot at-home nur.inv .erviee..
70. Plaintiff, Ruth Daniel, :remain. entirely dependent on her
cSauvhter .ince the overdo.. of in.ulin ordered by Defendant Inner..
71. Plaintiff, Ruth Danial, ha. no u.e of her rivht arm.
72. Plaintiff, Ruth Daniel, will never recover full function of her,
right arm and .houlder to the extant .he wu able prior to Defendant
Inner.' order overdo.ing hi. patient with in.ulin.
73. A. the direct and proximate result of the Defendant'. ne9ligence
and/or gro.. negligence a. alleged herein and incorporat.d by reference,
Plaintiff, Ruth Daniel, hu BUffered permanent and .evere injurie. and
olaim i. made therefore.
74. Detendant. Charle. R. Inner., M.D., Inner. Davi. A..ociate.,
Luan Grallllll, R.N., and Holy spirit Ho.pital are jointly and .everely Uable
tor injuri88 and. damagll u ..t forth herein and incorporated by
reference.
71!l. A. the direct and proxiDlate reeult of the afore.aid evente,
Plaintiff, Ruth Daniel ha. .uffered a permanent di.fivurinv and di.ablinv
injury and olaim i. made therefore.
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76. A. the direot .nlt pro:llim.te re.ult ot the .fon.dd event.,
PldntUt, Ruth l).niel'. dVht~ .houlder injury will CI.u.e I'e.idual
proble.. tot' the r.mainder of her lite and .ino. .he oontinue. to have
.evere riVht .houlder p.in, the probability of her r.quirinv additional
treat.ent .nd ther.pie. in incr....d and claim i. .ade theretore.
77. A. the direot .nd proxim.te r..ult of the atorementioned event.,
PlaintUt, auth Daniel'. r1Vht .houlder injury will oau.e reddual
problem. .ff.otinv her veneral h.alth, inoludinv the inability to
adequ.tely turn or lay on h.r rivht .ide which compromi... her pulmonary
.tatu. and the probability of incr.a.ed cong..tion, pneumonia and other
medioal conditione ie incre.a.d r.quiring additional tre.t.ent and
therapi.. and claim i. m.de therefore.
78. Aa the direct and proximate r,.ul t of tha .toreuid ev.nt.,
pl.intiff, Ruth Daniel waa torced to incur liability for madical
tre.tments, madicines, hospitalizations, phyeical th.rapy .nd dmilar
m18cellaneou. expens.., in and about an effort to attempt to raatore
her.elf to health and claim i. made therefore.
71. Aa the direct and proximate naul t of the .fore.aid ev.nt.,
Plaintiff, Ruth Daniel will be fcrced to incur liability for .edical
treatment., m.dicin.., hospitalizations, phyaical therapy and aimilar
.i.c.llaneou. expenses in the future and claim i. made th.refore.
80. As the direct and proximate result of the afor..aid event.,
Plaintiff, Ruth Daniel ha. undervcne and in the future will undervo vreat
.ental and phy.ical pain and .ufferinq, great inconvenience in Clarinv out
her d.ily .Cltivities, losa of life'. plea.ure. and Cllaim i. .ad'
therefore.
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11. plaintitt, Ruth D,ani.l" h811 be.n advi..d and, th.refore aVln
thlt the damaV" and inju~i.. a. allev.d h.~.in are perr'nlnt and olai. i.
mad. the~.fon.
8a. A. the direot and p~oximate ~e.ult of th. Defendant" rec~le'.
di.r_vard and compl.tl indift.~enoe to~ plaintiff, Ruth Daniel'. weltarl,
plaintitt, Ruth Daniel hn .uttered injud.. for which .h. may r.cover
punitive da.av.. and clui. i. .ade therefo~..
COUNT I
~uth Dani,l v. Chari.. R. lnn.r.. M.D~
83. paraqraph. 1 throuvh 8~ of thia Complaint are incorporated
h.r.in by reter.nce al if ..t tcrth at lenvth.
84. Cetendant Charle. R. Inner., M.D. i. liable to plaintiff, for
injuria. and damaqe. .. alleqed herein which were direotly ancl proximately
cau.ed by hi. novlivenc. and/or qx'o.. neqliVence in I
(a) failinq to examine Ruth Daniel prior to orderinq
in.ulin on Auquat 7, 199~,
(b) failinq to properly...... Ruth Daniel and the
contradiction. a..ociat.d with orderinv
additional in,ulin on Auguat: 7, 119~'
(0) tailinv to properly ravi.w and in.pect Ruth
Daniel'. medicine Xard.x prior to orderinq
in.ulin on Augu.t 7, 111~,
(d) improperly overdo.inv Ruth Daniel with
exce..ive in.ulin on Augu.t: 7, 191~ cau.inv
hypovlycemic .eizure and .hock,
11
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(e) fa11in9 to d.te~1ne or to aak a qua11f1~d
pe~aon to dete~ine, the exaat amount of
inaulin Ruth Daniel had reoeivsd on Auvuat 7,
1"2 prior to hi. order overdoainv 1naulin
on AuVUat 7, 1"2/
I
(f) purpolely and knowinVly orderinv Revular
1naulin d.apite Ruth Daniel'a known aller9ia
~eaction to Revular inlulin/
(V) failinv to attend to hia patient and provide
medical care to Ruth Daniel on Auquat 7, 1992/
(h) failin9 to properly obtain a oareful hiatory
of Ruth Daniel'e inlulin coverave on AUVUlt 7,
1992/
(i) failing to monitor Ruth Daniel lubaequent to
hi. order overdosing inlulin on Auquet 7, 1192/
(j) inappropriately delayinq radiovraphic evaluation
of Ruth Daniel'a ahculder followinq the hypoVlycemio
leizure cauled by the overdose of inlulin ordered
on AUVUlt 7, 1992/
(k) failing to order and obtain blood qluooae
mealuramentl following the overdoa. of inlulin
ordered on Auvuat 7, 1'92/
(1) improper management of inlulin coveraqe in an
inaulin-dependent labile diabetic/
(m) failinv to properly inquire into the statuI of
inaulin ooveraVe on Ruth Daniel'a medioine Xardex
12
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prier to orderin9'.dditional' in.ulin at l330 ~r.
on Auvu.t 7, 1112'
(n) t.iling to under.t.nd and .ocordinqly ..nI9'
h1. pati.nt ba..d on the in.ulin cov.r.ve
dooum.nt.d on Ruth D.niel'. m.dioin. Xardax
on AuVU.t 7, 1912/
(0) t.iling to phy.io.lly .x.min~, evalu.te,
...... Ind monitor Ruth Daniel on Auvuat 7, 19i2/
(p) f.ilinv to properly rev1.w, interpret and
re.pond to the information oontlined in Ruth
D.n1el'. medicine X.rd.x which documented
in.ulin coverage in the .arly morninq hour. of
AUCJUlt 7, 199:1/
(q) violatinv the principle ot patient-phyaioiln
care which required Detendant Inn.r. to ma~.
every pO'lible effort for the ben.fit of hi.
p.thnt, Ruth Daniel I
(r) fal..ly .nd arron.ou.ly a..uminq that Ruth Dani.l
did not receive in.ulin cov.rag. in the morninq
hourI of Auquet 7, 1992/
(.) . failing to Illinimiu the riBk and/or prevent
hypoqlyoemic ..izur. and .hock/
(t) inappropri.t.ly p.rmitting Ruth Dani.l'. blOOd
vluco.e to drop to .uch low l.vel. .. to r..ult
in hypovlycamic ..izur., .hock, r..ultinq 1n
convul.iona, neurologic compromi.., 10..
13
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(u)
(v)
(
of oon.o1oua~eaa,~njury to her lett knee and
fracture and dblooation of hII:' riVht ahouldll:"
inappropriately ~ermit~inv hia patient, Ruth
Danhl to ..in and cJnwlae in hypovlyce.ic
ahock w1thout any ettort to intervene,
in oontrawention of hia fiduciary duty,
,
abandon1nv h1a patient, Ruth Daniel,
fdUng to order blood atudila to be drawn
Drior to the ad.l\linlltration of DI!lOW I
precipitatinv Ruth Daniel'a labile diabetic
condition by overdoain9 her with inaulin
to the point where .he aUClcuabed to hypovlycemio
aehun and .hock 1
faiUn\l to notify cther phyaicillna or to
enaun that another phyeicilln WaI preeent
and prepared to care for Ruth Daniel at the
time Defendant Inner. ordered tha overdo.e of
inaulin by telephone on Auvuat 7, lU::I1
(I) inappropriately envaqinq in a medioal practice
that wa. too demandinq tor one peraon in order
to max1mize volume and therefore revenue,
precluding Detendant Innera from properly
attend1nv to hia patient, Ruth Daniel on
AuVUat 7, UI::II
(aa) failing to intorm Ruth Daniel aa to the material
ri.ka, uon.equenoe. and oontraindioationa
(w)
(x)
(y)
14
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a..ooiata4 yith adaini.tering exo... in.~linl,
(bb) failinv to inform Ruth Daniel a. to the material
riak., con.equenoe. and contraindioation.
,..Qoiated with orderinv .edioation. to whioh
Ruth Dani.l wa. dooumented a. being allergiol
(00) de.pite hi. awarene..that Ruth Daniel had
labile diabete., .nd that .he w.. .en.itive
to the Idju.tment of in.ulin, neverthel...,
failing to be phy.ically pre.ent to ......,
monitor and evaluate hi. patient, including
review of her m.dioine Xardex b.fore or4.rinv an
overdo.e of in.ulin on Auqu.~ 7, 1992,
(dd) de.pite hi. awarene.. tbat hi. patient wa. a
labile diabetic and wa. .eneitive to the
adju.tment cf inAulin,nevlrthele.., failinv
to .ummon any phyeician to be pre.ent at the
time he orderod the overdole of inlulin on
Auquat 7, 1192,
(ee) failing to en.ure proper do. age and
adminiltration of inlulin in a labile diabetio,
(ff) failinv to plan, arrlng., and en.ure propar
in.ulin ooverave tor hiM patient, Ruth Daniel
on Auqu.t 7, 1112, and
(gv) inappropriately abandoninv hi. patient, Ruth
Daniel by permitting her to .eize, oonvul.e,
fraoture and di.locate her right .houlder,
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fracture her, left.. knee, .u.ta1n n.urol09~0
defioit and 10.. of oon.oioulnel. .. a re.ult
of orderinv an overdcl.. of in.ulin on A\.\VUlt 7,
1992'
lIS. ,.. the db.ot .nd proxilll8te 1'11\101 t of the afolre.ention'd
ne9livence and/or Vro.. nevlivenoe, Def.ndant Inner. i. liable to
plaintiff for injurie. and damave. a. .et forth in paravraph. 28 thro\.\vh
12 a~ovI which are inoorporated herein by ret.rencI a. it .It forth at
lenqth.
WHEREFORE, plaintiff, Ruth Daniel, demand. jUdqment aqa1n.t Defendant
Charle. R. Innar., M.D. for compen.atory damave. in an a.ount in IXOI.. ot
tWlnty thou.and ($30,000.00) dollar. exclu.ive ot int.re~tl and oo.t. and
in exce.. of any juri.dictional amount r.quirinq compul.ory arbitration.
COUNT II
~uth Daniel v~ Inner. Davi. A..oc1a~..
86. Paraqraph' 1 throuqh 83 and Count I of thll complaint are
incorporated herein by reference a. if .et forth at llnvth.
,
87. At all relevant tim.. herein, Def.ndant Inner. wa. actinv .. the
avent, apparent a<lent, ..rvant and/or employ.. of Inner. Davi. A..ociate.,
a profe..ional profit-makinq llIedical corporation and wu autin; within the
.oope of .aid .mployment.
II. Defendant Innere Davi. A..ociate., actinq throuvh it. agent.,
apparent aqent., .ervant. and/or employee., il liabll to tha plaintiff for
the injurie. and damaqe. alllqed herein Which wara directly and
proximateiy cau.ecS by thl Defendant'. nevlivence and/or 91'0" naqliqence
16
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a.. .et fonh in pa:n9nphe. n throu9h n above whioh ,8I'e ~noo:rpo...te'
b.I'.1n by I'efereno. a. if .et forth at lenvth.
WHlalrORl, Plaintiff, Ruth Daniel, demand. judv.ment avain.t Inn.r.
Davi. A..ooiat.. for compen.atory dlmage. in an amount in exoe.. of twenty
thou.and (t20,000.00) dollar. Clxcludve of inten.t. and co.t. and in
.xc... of any jUl'i.dictional amount I'equil'inv oompul.ory arbitration.
COUN't' I II
Ruth Dani.l v. Lua~ Gramm. R.N.
It. puavraph. 1 throuvh sa Ind Count. I and II of th1a Complaint
are incorporated herein by reference a. if .et forth at lenvth.
to. Defendant LUln Gramm, R.N. is liable to the Defendant for the
injurie. and damaqe. alleqed herein which were directly and proximately
oau.ecS by her nevlivence and/or vroll neV1iqence inl
(a) failinq ~o properly inve.tiqate Ruth Daniel'.
medicine l(ardex/
(b) failing to properly read Ruth Dlniel'. medicine
l(ardex /
(c) failinq to properly relay the information contained
in Ruth Daniel'. medicine Kardex/
(d) failinv to appreciate the .ivniticance that
additional in.ulin would have on a labile diab.tic
.uch al Ruth Daniel, par~1cularly after receipt
of inlulin cove raVe in the early morninv hour. of
AuVU.t 7, lU2/
(e) tailinv to notify .upervi.or., department head.,
17
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..d1c.l direqtore, phy.ici.n. or ho.p1tal,
.da1ni.tr.tor. of D.f.nd.nt Inn.r.' ov.~do.. ot
in,ulin on AuVU.t 7, lila,
(f) t.ilini to .ppr.ciat. th.t D.f.nd.nt Inn.r.' ord.r
ov.rdo.ini hi. p.tilnt Ruth D.ni.l with in.ulin
on AuVU.t 7, 1..a oould re.ult in I d~..tio
drop in blood iluoo.. c.u.inv hypovlyc.mio .hock
,
.nd ..hure,
(V) fullinv to provide for proper nllr81n9' clre to
Ruth D.ni.l followinv D.f.nd.nt Inn.r.' order
ov.rdo.inV hi. patient with in,ulin on AuVU.t
7, Uta,
(h) improperly a.certaininV the .tltll. of Rllth
D.ni.l'. in.ulin cov.ra9' on Allvu.t 7, lila,
(i) abandonin9 her patient, Ruth Daniel by tailin9
to properly monitor, Ivaluate .nd ...... Ruth
tollowin9 D.t.ndant Inn.r.' ord.r oVlrdo.inv
hi. patient with in,ulin,
(j) failinv to remain with Ruth Dani.l to ......
h.r traumatic injuri.. .nd nluroloVic d.m.9'
followinv h.r hypovlyc.miCl ..bllre .nd .hook on
AUi\1.t 7, UU,
(k) f.ilin9 to raport Det.nd.nt Inn.r.' ord.r
ov.rdo.inv hi. pati.nt, Ruth Dlni.l with in.ulin
on AuVU.t 7, 1',2,
(1) t.~lini to minimi.. the ri.k .nd/or pr.v.nt
18
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Ruth Daniel'e hypoglyoemic .hook and .ei~ure ~n
Auqu.t 7, 1"2/ and
(m) inappropriately monitoring Ruth Dani.l'. blood
gluoo.e level. on Auqu.t 7, 1112.
n. h the direot and proximatl re.ult of the aforementionld
nevligenoe and/or qro.. nevliqence, Deflndant Gramm i. liable to Plaintiff
for injurie. and damaVe. I' .et forth in paraVraph. 2. through .2 abovl
whioh are incorporated herein by reference a. if .et forth at length.
WHEREFORE, Plaintiff Ruth Daniel, damand. jUdqment aqain.t Defendant
~uan Gramm, R.N. for compen.atory damave. in an amount in exoe.. of tWlnty
thouund (UO,OOO.OO) doUare exclualve of intere.t:. and oo.ta and in
exoe.. of any juri.dictional amount requirinv oompullory arbitration.
I,'
COUNT IV
Ruth Daniel v. Holv s~irit Hoapital
"
U. paragraph. 1 through a:a and Count. I, II AND III of thia
complaint are inoorporated herein by raferenoe a. if .et forth at length.
113. At aU relevant time. herein, Defendant Charle. R. Innen, M.D.,
Defendant ~uan GraDllD, R.N., and all medical per.onnel inoludinv .taft
nur.e. ~ho provided care to Ruth Daniel in Auqu.t, 19112, were thl agentl,
apparent aglnt.1 ..rvant. and/cr employee. of Defendant Holy Spirit
Ho.pital.
114. Deflndant Holy Spirit Ho.pital, aotinv through ita agenta,
apparent aVlnt., .ervant. and/or employee., i. liable for it. nlvligl~ol
with re.peat to Ruth Daniel bYI
11
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(a) tailinv to Pfovid~ vuidelinea and proaed~~e.
tor the treatment and care of inaulin-depen4ent
labile diabetioa,
(b) tai1inv to properly ael.ct and aupervise
phyaiciana and othe~ personnel to whom
they entru.t the oa~. of patienta with
~lth Daniel'e oondition,
(0) failinv to appreciate and ~ecovnile the
riaka of a patient known to be aller9ia to
Reqular in.ulin and, n.verthele.., permittinv
the adminiatration of Reqular inaulin in Auvuat,
1912,
(d) although aware that Ruth Daniel had labile
diabete. and wa. .en.itive to adjuatment
of inaulin, neverthele.a, failing to notifY
.upervieora, department heade, medical direotor.
or hoapital adminiatrator. when Defendant Innera
ordered an overdoa. of insulin on Auquat 7, 1992'
(e) fai~ing to under.tand that additional inaulin
adminiatration in the afternoon houra of Auvuat
7, 1112 in a patient who already received inaulin
coverave at 0730 hre on Auguat 7, 1112 could
r.ault in hypovlycemic a.ilure, ahock and ita
attendant conaaquenc.a,
(f) failinv to appreciate that Defendant Innera'
order for an overdo.e of inaulin in Auvuat 7,
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1112 could r~.ul~ in . dra.tic drop in R~th
D.niel'. bloOd vluco., ,r,.ultinv in hyp091yc.lIlio
.hock and ..ilur"
(V) f.ilinv to provide for proper nur.in9 car. to
Ruth Daniel followinv D.f.nd.nt Inner.' order
for an overdo.. of in,ulin on AuVU.t 7, lelal
(h) f.ilinq to prop.rly revi.w .11 of Ruth Daniel'.
mldic.l record. includin9 her lIl.dicine Xardex
on ~UVu.t 7, 1992 to a.certain the .tatu. of
h.r in.ulin cov.raqe/
(i) in.ppropriat.ly .b.ndoninq the p.tilnt, Ruth
D.ni.l by f.ilinv to prop.rly lIlonitor, evaluate
.nd ...... Ruth D.niel followirlV D.fendant
Innere' order overdoeinq hil patient with inlulin
on Auqu.t 7, 1992/
(j) failinv to plan, arranqe, and remain with Ruth
Daniel to ...... for neuroloqic.l defioit or
traumatic injurie. fOllowinq her hypoqlyolmic
.eilure .nd .hockl
(k) f.ilinq to h.v. p.r.on. properly train.d in
nur.inq a.....inq a l.bile diab.tio patient
for compromi.inq .ivn. and .ymptoma followinv
D.f.ndant Inn.r.' order overdo.inv hi. pati.nt
with in.ulln on Auqu.t 7, 19921
(1) f.ilinv to en.ur. that Ruth Daniel received
proper examination .nd fOllow-up care attar
21
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her hypovlyc..io ...izur. .nd .hock,
Cm) t.ilinv to initiat. an4 m.intain the prooe..
of ongoing .h.red information in the c.r.
provided to Ruth Daniel,
Cn> tailing to properly r.view .nd r..pond to
the information contained in Ruth Daniel'.
m.dicin. Xardex on AuVU&t 7, 1112,
Co) tailing to prop.rly r..pond to the n.urolovic
d.ficit and traumatic injUry to Ruth Dani.l
tollowing h.r hypoglycemic .hock and .eizure,
(p) failinv tc draw a blood .ampl. from Ruth
Dani.l prior to the admini.tration of the
bolu. of D50W on Auquet 7, 1992,
(q) failing to minimize the ri.k and/or pr.v.nt
hypoglycemic aeizure and ahock by qu..tioning
Defendant Innera' ordera for an additional
40 unite ot NPH and 21!l units of Regular in.ulin
at 1330 hre when Ruth Dani.l alr.ady r.c.ived
20 unite of NPH ineulin at 0730 hra on Auquet 7, 1112,
(r) inappropriat.ly abandoninv the pati.nt by
,
permitting Ruth Dani.l to agonize in hypovlycemic
..izure and ahock tor hour. without further
......m.nt of her condition,
C.) in.ppropriately mi.r.ading Ruth Daniel'.
medic in. Xard.x on Auvu.t 7, 11112,
Ct) tailing to comply with Defendant Holy spirit
22
...". i."..; I
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Hoapital'a P9lio~ on aonitorinq and .anavinq
,
labile in.ulin-dependent diabetioa,
I
(U) failinv to notify a aupervi.or, .edical
direotor, department head, hoapital
adminiatrator or other phYlioian to monitor
and Ivaluate Ruth Daniel tollowinq Dlfendant
Inner.' ord.r overdo.inq hi. pati.nt with
inaulin on AU9Uat 7, l1e21
(v) inappropriately adminilt.rinq Deow Drior to
drawinv . bloOd .uqar .a ord.r.d by Det.ndant
Inner. on AU9U.t 7, 1992,
(w) inappropriat.ly holdinv it..lf out to the
public ~. havinq all the n.c....ry f.cilitiea
.nd .ervic.. to car. for Ruth Dani.l in a
aafa and appropriate manner,
(x) inappropriately r.pre.entinq tc the public,
and Ruth D,niel, in particular, that it w.a
able to provide medical .ervic.a in .n ad.quat.
tUhion,
(y) tailing to properly refer Ruth Dani~l" ca.e to
a phyeician more familiar and b.tter able to
handle Ruth Daniel'a medical condition durinq her
hoapitalization in Auquat, 1912,
(I) inappropriat.ly r.pre'.ntinV that Ruth D.niel
wa. not in danver by lack of facilitiea, equipmant,
and/or aervi .a,
23
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Ca.) fa11inv to mini.tae tha riak and/or avoi~ inj~ry
to Ruth Daniel,
Cbb) tailinv to p~operlY p~ovide to~ oa~etul planninq
and monitorinv of inaulin cove~ava throuvhout
Ruth paniel'a AuVUat, 1"2 hoapitali.ation,
(00) inappropriately monitorinq Ruth Daniel" blood
Vluooae levela du~inq her Auvuat, 1~12
hoapitalization,
(dd) failinq to provide adequate orde~a to~ the
hoap!tal nu~ainv ataff, nurle clinioiana And
other hoapital per.onnll in charql of monitorinv
Mra. Danill'a inaulin coveraqe, and
Cee) failinq to minimize the ri.k and/or prevent
Mr. Daniel'a hypoqlyclmic leizurl and ahoe~
on AuqUlt 7, 1992.
II!l. Dlfel'\dant Holy spirit HOlpi tal, acUnq throuvh ita aqent.,
apparent aqenta, .ervantl and/or employee. ia liable to the plaintiff, tor
the injurie. and damav" as alhqad herein whioh win directly and
proximately aau.ed by the Defendant'a neqlivenol aa .et forth in
paraqrapha 28 throuqh 82 above which are inoorporated herein by reference
a. it aetforth at lenqth.
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WHIQroU, Plaintiff, Rutll Daniel, d...n4. judp.nt a9dl1..t D.f.ndant
HOlY 'pi~1t Ko.p1tal fo~ oo.p.n.ato~ d..av.. in an a.ount 1n .xo... of
tw.nty tllou.and <,20,000.00) dollar. .xolu.iv. of 1nter..tl and OOltl and
1n exo... of any juri.diotional a.ount ~.quirinv oo.pullory arbitrat10n.
Re.peotfully .u~.1tted,
ANQINO . ROVNIR, P.c.
DA'l'IDa September 27, 1993
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1, Ruth Daniel hereby verify that the facta aet forth in th.
in the ton901nv COMPLAINT are trlle and coneot to
the ~eat of .y knowledge, information and ~eliet.
1 undentand that any talae atate.enta therein are ..de
a~ject to the penaltie. of 11 pa.e.s.", I 4104, relat;inq to
un.worn tal.itlcation to authoritle..
WITNISSI
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~t.'.~r IDYICIl
ANO tiP'", thh :llIt day 'If october, 19U, I, JA'tIOtl ..
WOLfGANO, 18QIIIRI, hlreby oertify that 1 a", aervinv a copy of
thl forlvoinv document upon the peraon(.) Ind in the ",anner
indiclted below, whioh aervice .ati.fiea the requiremanta or
the pennaylv.nia Rule. of Civil procedure, by depo.itinv a coPy
Qr the lI",e in the United 8tat.. Mail, Hurhburv,
Pennaylv.ni., with firlt-ola.a POltlVe prepaid, aa fol10wal
Nijole C. Ola.n, I.quire
Anvino . Rovner, P.C.
4~03 North front Street
Hlrrilburv, PA 17110
Mioha.l w. McGUCkin, laquire
18~0 Willilm Penn WlY
suite :109
P.O. Box 10696
~Incalter, PA 1760&-0696
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I.quir.
1801 N r h 'ront Str.et
P. o. x !U&O
Karr~aburv, PA 17110-09&0
(717) :13:1-&000
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DANIIL
;1ainUU
"U'l'H J.
I IN THI COURT or COKNON 'LIA.
I DAU,HIN COUNTY 'INHSYLVANIA
I
I CIVIL ACTION - LAW
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I NO. 3754-S-93
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. JURY TRIAL DIMANDID
VS.
C~LI8 R. INNIR~l M.D.,
INNIR. D~V~8 AS8OCIATI8,
LUAN GRAMM R.N. and
HOLY SPI~If HOSpiTAL,
Pefendanu
U,ID"VI'l' 01' MaIIl'I" 'l'U.ICIIIIR
I, Marcia McAlicher, R.N., depole and .tate the
following ba.ed upon my per.onal knowledve.
1. I am an adult individual currently reaiding at
213 North 35th Street, Camp Hill, Cumberland County,
'.nnaylvania,
2. I am currently Ri.k Manaver for Defendant Holy
Spirit Hoapital. I have held the poaition of Riak ManaVer
aince October 11, 1993,
3. Prior to my employment by Holy Spirit Hoapital a.
Riak Kanager, I wa. employed by Holy Spirit Ho.pital aa
Reimburaement Nurae for approximately aeven yeara,
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4. Defandant Holy Spirit Ho.pital'. prinoipal plloa
of bU.i~ea. in looated at 503 North 21at Straet, Camp Hill,
Cumberland County, Pennaylvania,
5. Defendant Holy Spirit Hoapital doe a not now have,
nor haa it at any time relevant t~ the above-captioned action
had, offic.a end/or medical facilitie. in Harriaburg, or
anywhere el.e in, Dauphin County, Penn.ylvania, and
5. Defendant Holy Spirit Hoapital doe. not now, nor
did it at any time relevant to the above-captioned action,
regularly conduct buaine.. in Dauphin County, Penn.ylvania.
I make the foreg~~nv Affidavit ,in aupport of Defendant
Holy Spirit Hoapital'a Preliminary Objection. to the Complaint
in the above-captioned action. I under.tand that any fal.e
atatement. made herein are aUbject to the penal tie. of 18 Pa.
C.S.A. '4904, relating to unaworn falaifioation to authoritiea.
oHitlg~
DAT .
---)1'1 a A.d'''''' )n ~O i?L.L..., e)
Xarcia XCAlicher, R.N.
Riak Xanager
Holy Spirit Koapital
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q.R~I'I~~ O' ...vle.
AND NOW, thia 4th day of November, 1993, I, JAYSON R.
WOLfGANG, ISQUIRE, hereby certify that I am lervinV a copy of
the forevoino document upon the perlon(l) and in the manner
indicated below, which eervice latilf1.1 the requirement a of
the Pennlylvania Rulel of C1vil procedure, by depolitinv a oopy
of the lame in the united State. Ma1l, Harr1lburV,
penn.ylvan1a, with firlt-claal pOltaoe prepaid, aa followa.
N1jole C. Ollen, Ilquire
Anv1no . Rovner, P.C.
4503 North Front Street
Harr1lburv, PA 17110
Michael W. McGuck1n, laquire
1850 William Penn Way
Suite 209
P.O. Box 1011911
Lancaater, PA 171105-011911
MITTI, IVANS . WOODSIDI
8y.
Ja 0 R. WoUllan e
1801 North Front Street
P. O. BOX 5950
Harr1lburv! PA 17110-0950
(717) 232-0000
",.)..473
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REGUVEO
OFFI\:F of
t>N"':' '1:IHM1Y
OIUC!
Now
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RUTH J. DAN X IlIp I IN TUB COURT or COKHON PLIAS
. la1ntiU I DAUPHIN COUNTY PINNSYLVA"IA
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VB. I CIVIL ACTION - LAW
I
CHARLie R. INIIIRB b M.D., I NO. 3754-S-93
INNIRS DAVIS ASSO IATIS, I
LUAN OIWUl R. II. And I
HOLY SPIRIT HospiTAL, I
Defendanta I JURY TRIAL DIKANDID
BRIlr OF DlrSNDANTS LUAN GIWUIJ R.N. AND
HOLY SPIRIT HOSPITAL IN SUP~ORT or
~R.LIMI~ARY OBJICTIONS TO THE COMPLAINT
MITTI, EVANS , WOODSIDI
BYI
erai
Bup Ct. I. D. '15
JAY on R. wolfqanv, I.quire
Bup. Ct. I. D. '62076
340l.North Front Street
P. O. Box 5950
Harrilburq, PA 17110-0950
(717) 232-5000
Attorneya for Defendantl
Luan Gramm, R.N. and Holy Spirit
!tolpita!
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TABLI 0' CONTINT.
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I. PROCIDlJRAZ, AJjD 'ACTI,JAL HISTORY . . . . . . . . . · .'. · . '1
XI. . 8'/o'ATIMINT or QlJlSTIONS INVOLVID ............. 3
A. WHITHIR VINUI IN DAUPHIN COI,JNTY IS IMPROPIR UNOIR
THI 'INNSYLVANIA RI,JLBS or CIVIL PROCIOlJRI, R'OUIRING
THAT Tal CASI BI TRANSflRRIO TO CUMSlRUANO COUNTY
WHIRl PROPIR VINUI LUIS . . . . . . . . . . . . . · . . . 3
B. WHITHIR THI COMPLAINT fAILS TO STATI A CLAIM 'OR
PUNITIVI DAMAGIS alCAUSI IT LAC~S THI 'ACTUAL
ALLIGATION! NBCBSSARY TO SUPPORT SUCK A CLAIM
. . .
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C. w~:~:~~ ~~~G~~~s(:~~alQI~ql~al~) (~~~t(~~DA~~.1 MUST
SI STRIC~iN, OR A MORI SPBCIfIC PLIADING RBQUIRBD,
BBCAUSB THI COMPLAINT LAC~S SPBCIfIC SUPPORTING
'ACTUAL ALLIGATIONS .................. 3
D. WHITHIR COUNT IV OF TaB COMPLAINT, IN ITS
INTIRITY, MUST al STRIC~IN, OR AN AMINDED COMPLAINT
RIOUIRID, FOR fAILURE TO CONFORM TO PA R.C.P. 1020(a) . . 3
III. ARGUMENT . . . . . . . . . . . . . . . . . . . . . . · . . ..
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A. V.nu. In Dauphin county In Thil Action II Improper
Und.r The p.nnlylvania Rulel Of Civil ptoc.dur.,
R.quirinv That The Ca.e ae Tranlferred To cumb.rland
county Wh.re Proper Venue Liel . . . . . . . . . . . . . 4
Th. Complaint faill To state A Claim ror punitive
oam.qe. Blcau.. It Lack. The ,actual All.vationl
N.c....ry To support Such A Claim ........... 8
pauVraphl 90(8), (V), (i) and (1) and 94(a), .
(b), (k), (m), (q), (ea), ibb1i and (..) MUlt B.
Strick.nL Or A More Specif c P eadinv R.quir.d,
a.caule The complaint Lacke Sp.cific supportinq
,.ctual All.qationl .................. 12
D. Count IV Of The complaint, In It I Intir.ty, Mu.t
a. Stricken, Or An Amended Complaint R.quir.d, for
,.ilur. To Conform To PA R.C.P. 1020(a) ........ 20
IV CONCLUSION. . . . . . . . . . . . . . . . . . . · . . · . . 2.
B.
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TAIL' or CITATION~
CA'.'
~,:: ~p'~9~t11f:2d 355 (1963)
Connq; v. ~lleabInY a.ner,1 po,Q1t&1,
501 ,.. 30S, 411 A.2d ilOO (lU3)
t . . t . , . . .,.
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"ld v. M.rr~am,
506 'a. 383, 485 ~.2d 742 (1984) ...........,.. 'f
Herr v. ~ilton B. Her.h8J M.dical Center,
23 Leb.Co.Le9.J. 5, (1985) ....
. . . , . I . . . .
. . 20
Laur,en v. pene;al UQ.pital of Monroe ~oun~y,
259 'a.Super. UO! 393 A.2d 761 (1981)! revereed QJl other
vround., 491 P.. :;144, 431 A.2d 240 (19111) ......... 13
Martio v. John.-M,Qvill. corp.,
508 'a. 154, 494 A.2d 1088 (1985)
. .
. . , . . . . . . . . .
Kill,r v. Gr..ne C~~n~y M.morial He.pital,
6 Gnene R. 1 (No. 13) (1988) . . . . . . . . . . . . . . . . 11.
Naae y. Dent~1 CA~e A,.oaiat.., Inc.,
112 Dauph. 4~ (1992) ................,.,. 10
Packrall v. Park,
47 'ay.Lev.J. 68 (1984)
. . . . . . . . . . . . '," , ,'. . 18
Pin.kat v. Harri.town ~.v.lopm8nt Coxp. ,
11 Dauph. 281 (19 0) ... . . . . . . . . . . . ~ l . . . .
"
Starr v. 1Iy.~., (1988 ) ~ I 14
109 Daup . 147 . . . . . . . . . . . . " , . . ,
~;~n,:: !!3~n5~~.i~~~1;03 (1991)
. . . '. , , . . . . . , i . 22,23
Van Inqan v. ~ant.,
70 D.. c.2d 555 (Monroe 1975)
. . . . . " ~ . . ., " , . . .
Wurth v. Phil.dal;hia,
136 Pa.cmmw. 629, 584 A.2d 403 (1990)
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Pa.R.C.P. 10015(a) " ~ ,', " ~ , ~ ' ,.
Pa.R.C.P. 100tl(Q) . / ~ /' ,/ ~, " , ,.
Pa.R.C.P. 10015(.) . . I. , , 1,1
Pa.R.C.P, 1019(a) . . . , /' . , 12
Pa. R.C.P. 1020(a) . . . . u,n
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pa. R.C.P. 1028(a) (1) . '. " I
P..R.C.P. 2179(a) . .-11J.-. , , 5
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I. p.~.nllRu. &lID nC'PUAL HI8'l'ORY
Thi. medical m.lp~actice action ariaea out of treatment and
o,ne received by the plaintiff at Defendant Holy Spirit
Hoapital beqinninq Auvuat 7, 1"2. The Plaintiff commenoed
thia aotion by filinq a complaint cn or about September 27,
1"'3.
Accordinv to the Complaint, Plaintiff, a labile
inaulin-dependent diabetic, received an overdoae of regular
inaulin while a patient at Defendant Holy Spirit Hoapital. Aa
a reault of the alleVed overdoae, Plaintiff auffered
hypoVlycemic ahock reaultinv in, inter &lLA, aei.ure. Aa a
reault of aeilurel .econdary to hypovlycemia, Plaintiff alle;ea
that ahe auatained a fractured and dislocated rivht ah~ulder
and I fracture of her left tibial plateau, amonv other
injuriea.
Plaintiff haa brou~ht luit avainat charle. R. Innera, M.D.
and Innera Davia Aaaociat.a, under whoae care Plaintiff waa
alleqedly admitted to Defendant Holy Spirit Hoapital.
Plaintiff hae alao brouvht au it a~ainat Luan Gramm, R.N. and
Holy Spirit Hoapital. Plaintiff'a theoriea avainat Oefendant
Gramm include nevliqence and abandonment. Plaintiff'a theoriea
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.g.in.t Defendan~ Holy spirit Ho.pital include vioariou.
liability for the nevligence of it. agent., .ervant. and
employee., abandonment and corporate liability.
In paraVraph 5 of the Complaint, plaintiff allege. that
"Defendant Holy Sp1rit Ho.pltal, i. . corporate medical
in.titution with office. and medioal f.cilitie. in H.rri.burV,
Dauphin County, penn.ylvani.." au Complaint, p.ravraph 5.
Re.ident. .nd bu. in... .ddr..... for all remaining Defendant.
are alleged to be in Cumberl.nd County, Penneylvania. IIa
Complaint, p.ravraphl ~-4. D.fendant. Gramm and Holy Spirit
Ho.pital have preliminarily objected to vanue in D.uphin county
bec.u.e Defendant Holy spirit Ho.pital i. not located, nor doe.
it revularly conduct bu.ine.. in, Dauphin County.
The plaintiff ha. allo ....rt.d claim. for punitive damaVe.
again.t both Defendant. Gr.mm and Holy Spirit Ho.pital. Said
Defendant. have preliminarily objected to .uch cl.im. becau.e
they have no place in an ordinary nevlivence action .uch a. the
ca.e at hand. Defendant. have al.o preliminarily objected to
variou. boilerplate allegation. and becauoe Plaintiff ha.
failed to plead .eparate cau.e. of action in .eparate count. a.
required by the Penn.ylvania RUle. of Civil Procedure.
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Thia brief ia re,pectfUlly aubmitted in aupport of the
preliminary objectiona of Defendanta Luan Gramm, R.N. and "011
Spirit Ho.pital.
I I . 8'l'A'l'-II-W C' CIm_TIOII_ IIIYm.y.D
A. WHITHIR VI NUl IN DAUPHIN COUNTY IS IMPROPIR UNOIR THI
PINNSYLVANIA RULIS or CIVIL PROCIDURI, RIQUIRINO THAT
THI CAS I 81 TRANSflRRID TO CUMBIRLAND COUNTY WHIRl
PROPIR VINUI LIIS?
Suvve.ted anawer in the affirmative.
8. WHITHIR THI COMPLAINT fAILS TO STATI A CLAIM 'OR
PUNITIVI DAKAGIS BICAUSI IT LACKS THI 'ACTUAL
ALLIGATIONS NICISSARY TO SUPPORT SUCH A CLAIM?
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Suvveated an.wer in the affirmative.
WHITHIR PARAGRAPHS 90(a/, (V)( (i) and (1) AND 94(a),
(b~, (k~, (m), (g~' (146, (bbV AND (ee~ MUST BI
::c~g:: TH~RC~M:LA~N~P~~~~Csp~~~~~~Gs~pgg~~~~o
'ACTUAL ALLIGATIONS?
Suvveated anawer in the affirmative.
D. WHITHIR COUNT IV or THI COMPLAINT, IN ITS INTIRITY,
MUST 81 STRICKIN, OR AN AMINDID COMPLAINT RIQUIRID,
'OR 'AILURI TO CONrORM TO PA R.c.P. 1020(a)?
c.
Sugve.ted anawer in the affirmative.
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The county where ite regietered office or principle
place of buaineaa ia located,
A county where it regularly conducte buaineee,
The county where the cauae of action aroa.,
A county where a traneaction or occurrence took plac.
out of which the cauee of action aroae.
2.
3.
4.
Pa.R.C.P. 2179(a).
If venue ia improper, it muat be raiaed by preliminary
objection or it ie waived. Pa.R.C.P. 1006(e) and 1028(a)(1).
"If a preUminary objeotion to venue 11 auetained and there i.
a oounty of proper venue within the State the action ehall not
be diemi.aed but ahall b. traneferred to the appropriate court
of that county." Pa.R.C.P. 1006(e). "(CJo.ta and teee for
tranafer and removal of the record .hall be paid by the
plaintiff." Pa.R.C.p. 1006(e).
Accordinv to the Complaint, Plaintiff allevedly euffered
peraonal injuriea bevinninv Augu.t 7, 1993 while a patient at
Defendant Holy Spirit HQapital. ita Complaint. Defendant Holy
Spirit Hoapital i. located at 503 North 21at Street, Camp Hill,
Cumberland County, pennaylvanil. iIa Affidavit of Marcia
McAlicher, R.N., a true and correct copy of which i. attached
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attached her"to a. Ixhibit "A." Def.ndant Holy Spirit Ho.pital
ha. D'Y.~ had office. and/or m.dical far.iliti.. anywh.re in
Dauphin County. au Ilxhibit "A."
Th. only party for whcm venue i. all.qedly prop.r in
Dauphin county i. D.fendant Holy Spirit Ho.pital. However, a.
d.mon.trated above, Defendant Holy Spirit Ho.pital dQ.. not
have an officft or principle plaoe of bu.ine.., nor doe. it
revularly conduct bu.ine.., in Dauphin county. Clearly, venue
i. proper a. to the Defendant. in thi. ca.. in and only in
Cumberland County. The cau.e of action aro.e, and all
Defendant. maintain their individual and bu.ine.. addr..... and
activitie., in Cumberland county. Therefore, thi. matter
.hould be r.moved from Dauphin County and tran.ferred to
Cumberland County in aocordance with Pa.R.C.P. l006(e).
'or th. forevoinq r.a.one, Defendant. Luan Gramm, R.N. and
Holy Spirit Ho.pital relpectfully requelt that thi. Court
.u.tain their preliminary objection a. to improper venu. and
tran.fer thi. ca.e to Cumb.rland county, p.nn.ylvania.
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B. The complaint reil. To Stete A Cleim for Punitive
DameVe. aecau.e It Lack. The 'actual Allegation.
N.a....ry ~o ~uQPort 8~ch A Claim.
The .tenderd. for e demurrer ere well-~.tabli.hed. A
demurrer to e Complaint mu.t be vranted where the oourt i.
certain that, a. a matter of law, there could be no reoovery
upon the fact. alleged. iIa Wurth v. Philad'~phil, 13&
Pa.Cmmw. &29, 584 A.2d 403 (1990). In determining a demurrer,
~ll .uffioiently pleaded relevant fact. and inference. fairly
deducible therefrom mu.t be accepted a. true. !d. Here, when
the allegation. ot the Complaint are taken in the light mo.t
favorable to the Plaintiff, it i. certain that, a. a matter of
law, the Plaintiff cannot prevail on her olaim for punitive
damave..
Under Penn.ylvania law, "punitive damage. may be awarded
for conduct that i. outrageous, becau.e of defendant'. evil
motive or hie reckle.. indifference to the right. of other.."
ae.tatement (Seoond) of Tort. 1908(2) (1979). Punitive damage.
mu.t be b~.ed on oonduot that i. malioious, wanton, ~eckle..,
willful or oppres.ive. One mu.t look to the aot it.elf
tovether with all the oircum.tance. including the motive of the
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w~ongdoe~ and the ~elation. between the parti.a. ~b.~ber, v.
)lQnt.gou~y, 411 Pa. :J39, 344-45, 193 A.3d 3!l!l (lU3). "The
atate of mind of the acto~ i. vital. The aot, or failure to
aot, muat be intentional, r..cklll" or mallcioua." ..eid v.
Merriam, 506 P.. 383, 485 A.3d 742, 748 (1984). punitive
damag~a are not ju.tified where the defendant'a mental atate
~iae. to no more than gro.. negligence. Martin v.
Johna-Manvil~e Corp., 508 PI. 154, 494 A.3d 1088, 1089 (1985).
Claima for punitive damavee which require "malloiou.,
wanton, wilful, recklea. or oppreaaive conduct and would aerve
aa puniahment for outravecu8 conduct have no place in the
ordln.~y n.v1iqanc8 aotton." fiJi.key v. HAJ"riat.own n.v.loPIll.nt.
Corn., 110 Dauph. 381, 383 (1990) (emphaaia added). Thua, in
order to atate a claim for punitive damagea, a complaint muat
alleve facta that indicate in what manner the defendant knew or
had re.aon to know that hi. conduct involved a hiVh devre. of
probability that subatantial harm to the plaintiff would
result. Van Inv.n v. Wente, 70 D.. C.2d 555, !l!l7*58 (Monroe
1975). Mere allevations of wanton, recklesa, or vroaa
neVligence are insufficient. lA. at 556.
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~eva~dlnq a punltlve damaqe. olalm ba.ed on ~ecklel.
indiffe~enoe, thil Court ha. Itatedl
"~eckle.. lnd.Ufe~ence" meanl that the .cto~
ha. intentionally done an act of
unre.lonable character, ln dilreqard of a
known rilk to him or .0 obvlou. that he mUlt
be taken to be aware of it, and loqreat al
to make lt hiVhly probable that harm would
follow. Smith v. Brown~ 283 Pa. Super. 116,
423 A.2d 743, 74~ (1980. In addition/
plalntiffl mu.t .how ac ual malice oi the
pa~t of the defendant. Wal~er V. Lo :~i 339
Pa. Super. 203, 488 A.2d 62 , 626 (1 ~.
Sectlon 9082 of the Re.tatement (Second of
Tort. and pennlylvanla cue law "requlre
eVreqiou. conduot and a hiqh devree of
culpabllity on the part of the defendant to
=rt a claim for punlt1ve damave.."
muth v. H rlh Medical Ct~., 111
Daup . 3~3, 36: (1112). punitive damave.
may not be awarded for ordinary neqliqence
luoh a. inadvertenco, miltake or errorl in
judvment. Martin v. John.-Manville Corp.,
494 A.2d at 1097.
N.ce v. Dental Care A.loaiate., Inc., 112 Dauph. 48/ 52
(1992) .
In the Complaint, Plaintiff let. forth veneral, boilerplate
alleqationl of "Vro.. nevligence" in an effort to recover
punitive damaqe.. iIa complaint, paraqraph 73. In paraqraph
,
82 of the Complalnt, the Plaintiff alleve. the followlnVI
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.82. Aa a direot and proximate reault of
(alll the defendant'a laicl reokle..
di.regard and oomplete ind fference for
Plaintiff, Ruth Daniel'. welfare, plaintiff
Ruth Daniel ha. auffered injuriea for which
.he may recover punitive damag.a and claim
ia made therefor.
... Complaint, paraqraph 82. In Count III of the Complaint,
Plaintift aet. forth her caua. of action avain.t D.fendant Luan
Gramm, Il.N., for "nevl1l1ence and/or vro.. nevl1Vence." ...
Complaint, Count III, paraqraph 90. Paraqrapha 82 and 90 are
incorporated by reference a. aqainat Defendant Holy Spirit
Hoapital via paraqraph 92, which ia contained in Count IV of
the Complaint. In Count IV of the Complaint, Plaintiff .eta
forth her cau.e of action aqain.t Defendant Holy Spirit
Ho.pital for the nevliqence of ita "aqent., appar.nt aventa,
aervant. and/or .mploy...." m Complaint, Count IV, paraqraph
92.
Iven when vi.w.d in the liVht moet favorable to the
Plaintiff, the Complaint i. devoid of apecific factual
alleqationa that would .upport a claim for punitive damagea.
ror example, th.r. ar. no all.vationa that any of the
Defendanta had an evil .tate of mind, or that actual malice
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r..ulted in the Pl.intift'. injuri... aea Compl.int.
AocordinV to the f.ct. .1 ple.ded/ thil i. . ba.io, medical
negligence c..e, completely l.ckinv in t~e .egreViou. conduct
and . . . high degree ot culpability" n.c....ry to .upport a
claim tor punitive dam.gel. ba 1iIQa, ,"pra. Th.retore/
paravraph 82, and Plaintitt'. cl.im tor punitive dam ave.
ven.nlly, hila no pl.ce in t,hi. ordinary nevligenc. action and
mUlt be di.mi.lad.
for the forevoinv realon., Detendantl Luan Gramm, R.N. and
Holy spirit nOlpit.l re.pectfully requelt t~at thil Court
.ult.in their demurrer .nd dilmil., with prejudice, Plaintiff'l
allevation. of .nd dem.nd for punitive d.m.ve,.
C.
p.r.vraph. 90(a), (V), (i) and (1) .nd 94(.), (b)
(k)t (m)/ (q), (.a), (bbl' and (ee) Mu.t Be strick.n,
Or A More Spocific Plead nV ~equired, Becaule The
Complaint Lack. specitic sUPPQrting 'actual Alla9&tiona
Undu Pennlylvania law, "[t)he maUdal fact. on which a
cau.. of action or defenle i. ba.ed .hall be .tated in a
conci.. and .ummary form." Pa.R.C.P. 1019(.). The courtl h.ve
elabor.t.d on thi. provilion, noting that it i. de.ivn.d to
define the i.lue. clearly and to apprile the oppo.inV party of
pr.ci.ely what the pleading party intend. to e.tabli.h at
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trial. III Laura.p V. aaQ.raJ HQapi~al of MO~1oa ~ountx, 25'
'a.Super. 150, 393 A.2d 761 (1'81), r.var.ad go Q~~ar ground.,
"1 Pa. 244, 431 A.2d 240 (UIl). SpeciUcaUy, "[p)l..dinga
aerve the function of defininv i..uee and Viving notice to the
oppo.inV partiea of what the pleader intend. to prove at trial
ao that the oppoaition may, in turn, prepare to meet .uch proof
with ita own evidence." Id., 3'3 A.2d at 766 (citationa
omitted) .
Non-apecific allegationa of negligence have been
increaaingly .crutini.ed .ince the Penn.ylvania Supreme Court
deci.ion in Connor v. A~lavh.~ aan.ral Hoapi~al, 501 Pa. 306,
461 A.2d 600 (1983). In CQllnor, the trial court aUowed the
plaintiff, ahortly before trial, to alle9~ a new theury of
neglivenoe by amending hi. oomplaint, in whioh plaintiff had
aUeged that the defendant "otherwiae failed to uae due care
and caution." In reapon.e to the defendant'a arvument that the
delayed amendmenb waa beyond the .tatute of limitationa, the
oourt atated.
If (defendantl did not know how it
"otherwi.e fa l[ed] to u.e due care and
oaution under the oiroum.tance." it oould
have filed a preliminary objection in the
nature of a reque.t for a more .pecific
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pleadin~ or it oould have moved to atrike
that portion (If appellant'. complaint.
~., 461 A.2d 15 603, n.3.. Conpo~ therefore eatabli.he. that
where preliminary objection. are not f~led, a party i. deemed
to know what the complainant ha. alleged. ld.
Accordingly, thia court ha. held that in order to .urvive
preliminary objeotiona, a pleadinv mUlt be apecifio enough to
allow the oppolinV party to properly meet each alle~ation.
It i. our feelinv that the only principle
which offora any meaningful VU dance to
proapective pleader. 11 to require
opecifioity in all alle9ationa of
neVlivence. Thu., ~ll no longer
Qg~nt'D'Dge veperal Jv,rmente of
1liQ1lve"ce. Should d1lcovery dilcloae the
axiatenoe of other act. of nevlivence, it
.hould be noted that the Rule. of Civil
Procedure provide for liberality Ln
permittinv amendment.. , .
It iI, of aourae! the rule that an amendment
will not be permitted after the .tatute of
limitation. hu run if it introduced A new
cauae of action. (Citation. oMitted).
Starr v. lyera, 109 D4Uph. 147,155-56 (1988)(empha.i. added).
The apecific alle~ationa of medLcal negliVence .tricken in
Starr included. (1) improperly treatinq plaintiff', condition,
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(2) fdUng to properly treat pl/aintUf '. condition, (3)
f.iling to properly diagno.e plaintiff', condition, .nd (4) the
.1tu.tion that ocourred in re.pect to plaintiff would occur
only in the pre.eno. of negligence and would not have ocourred
1n the ab.enoe of n.vliQence. ld., at 148. Thu., non-.peoific
boilerpl.te .lleg.tion. of neVligenco .hould be .tricken.
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In par'Vraph. ~O .nd ~4 of the complaint, the Plaintiff
.et. forth her allev.tion. of negligence *gain.t Defend.nt.
Lu.n Gramm, R.N. .nd Holy Spirit Ho.pital. In paragraph ~O of
the Complaint, the Plaintiff al1eve. a. follow.,
f
,:<,
90. Defendant Luan Gramm, R.N. i. liable to
the Defendant (.ic) for the injurie. and
d.m.v" alleved herein which are directly
and proximat.ly cau.ed bI h.r n'vlivenc.
alld/or vroll nevl1vence n,
(a) failing to properly inve.tiqate
Ruth Daniel', medicine ~.rdex,
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failinv to provide for proper
nur.ing oare to Ruth Daniel
followinv Defendant. Inner.' order
overdo.inV hi. patient with
in.ulin on Auvu.t 7, 1992,
***
(1)
abandoning her patient, Ruth
Daniel by failinv to properly
monitor, evalu.te .nd ...... Ruth
\\,
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I,~'d'i:,,;~l,' :(,;
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following Defendant Inner.' order
overdo.ing hi. patient with
in.uUnl
...
,
(1)
failing to minimi.e the ri.k
and/or prevent Ruth Daniel'.
hypoglyoemio .hook and .ei.ure on
Augu.t 7, 1992.
... complaint, paragr~ph. 90(a), (g), (i) and (1). The
above-quoted paragraph. are inoorporated by referenQe a.
aqain.t Defendant Holy Spirit Ho.pital via paragraph 92. IIa
complaint, paragraph 92.
In paragraph 94 of the Complaint, Plaintiff allege. that
~efendant Holy Spirit Ho.pital i. liable for the negligent aot.
of it. agent., apparent agent., .ervant. and/or employee. a.
follow. I
...
(a)
failing to provide guideline. and
prooedure. for the treatment and care
of in.ulin-dependent labile diab~tioll
failing to properly .ul.ot and
lupervi.e phy.ioiane and other
per.onnel to whom they entru.t the oare
~f patient. with Ruth Daniel',
oonditionl
(b)
...
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(k) failinx to have per.on. properly
train. in nur.iny a.....ing a abil.
di~betio patient or compromi.ing .ign.
and .ymptom. followiny Defendant
Inner.' order overdo. 1'1' hi. ~ati.nt
with in.ulin on Augu.t , 199 ,
../1
(m) failing to initiate and maintain the
~roc... of ongOin~ .hared information
1'1 the care provi ed to Ruth Daniel, '
...
(q) failing to minimime the ri.k and/or
crevent hypoglycemic .ei.ure and .hook
y que.tioning D.fendant Inner.' order.
for an additional forty unit. of NPH
and twentr-five unit. of Regular
In.ulin a 1330 hr.. when Ruth Daniel
already received twenty unit. of NPH
in.ulin at 0730 ~r', on Augu.t 7, 19921
../1 \1
(aa) failiny to minimi.e the ri.k and/or
avoid njury to Ruth Daniell
(bb) failing to prop.rly rroVide for car.ful
planning and monitor ng of inlulin
cov.rage throughout Ruth Daniel',
Augult 1992 hOlpitali.ationl [and]
...
(ee) failing to minimi.e the rilk and{or
prevent Mr. ('iO~ Daniel'. h~poy Io.mio
.ei.ure and .hoc on Augu.t , 9 2.
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lu Complaint, paragraph" 94(a), (b), (k), (m), (q), (n), (bb)
and (e.).
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Und.r penn.ylvania law, Defendant Gramm i. entitl.d to know
how .he "faUed[.d] to prop.rly inve.tigate Ruth Daniel'.
medicine lardex." She h al.o entitled to know how "he
"faUed[ed] to provide for proper nurl1nq oare to," and
"abandon[ed] her patient;, Ruth Dani.l by failing to properly
monitor, evalullte and ......." her, If D.f.ndant Gramm
"faU[.d] to minimile the ri.k and/or prevent Ruth Daniel'.
hypoglycemic .hock and .eillure," then .h. i. entitl.d to know
what faot. .upport .uch alleqation.. The Complaint, however,
i. devoid of any .uch factual avermentel in.tead, Plaintiff
merely pl.ad., in a conclu.ory manner, that Defendant Gramm wa.
negliqent. paragraph. 90(a), (g), (i) and (1) do not contain
the factual .pecificity required under Penn.ylvania law.
With r.gard to Defendant Holy Spirit Ho.pital, .aid
Defendant 11 entitled to know how it allegedly "fail[ed] to
provide guideline. and procedure. for the treatment and care of
in.ul1n-dependent labile diabetic.." It 11 allo entitled to
know how it "fail[ed] to properly select and lupervi.e
phyl1cian and other peraonnel," how it "fAil(.d] to have
per.on. properly trained in nur.ing a.....ing a labile diabetio
patient" and how it "faU[ed) to initiate and maintain the
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prooe.. of ongoing Ihared information in the oare provided to
Ruth Daniel." Like Defendant Gramm, Defendant Holy Spirit
Ho'pital i. entitled to fact. .upporting the allegation that it
"faU[ed] to minilllile the d.k and/or prevent hypoglyoemio
.ehure and .hook." Inltead, the Plaintiff pleadl in a
conolulory manner that Defendant Holy Spirit HOlpital "fail[ed]
to minimile the dlk and/or avoid injury to Ruth Daniel." The
allegationl that laid Defendant "fail[ed] to properly provide
for oareful planning and monitoring of in.ulin coverage" and
"faU [ed] to minimile the d.k and/or prevent" Plaintiff I .
hypoglyoemic .eilure and .hock are likewi.e non-.pecific,
boilerplate allegationl completely lacking in factual .upport.
It i. clear that the allegationl let forth in paraqraph.
90(a), (g), (i) and (1) and 94(a), (b), (k), (m), Cq), (aa),
(bb), and Cee) are non-Ipecific, boilerplate allegation. of
negligenoe that in no way appri.ed Defendantl Gramm and Holy
Spirit HOlpital of the claim. aqain.t them. iIa,~, Miller
v. Qreene Coun~y Memorial HOlpital, 6 Greene R. 1, 2 (No. l3)
(1988) (Itriking alleqation. of failure "to properly monitor
and oontrol the oare and treatment" of plaintiff) I packrall v.
iaEk, 47 ray.Leq.J. 68, 69 (l984) (Itriking allegationl that
tha defendant "fail[ed) to adequately care for" plaintiff).
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Plaintiff'. allegation. do not conta!n luffioient Ipecificity
'0 a. to allow Defendlnt. Gramm and Holy Spirit HOlpital to
ad.quately defend the claiml againlt them, and the averment.
are therefore prejudioial. 1Ia,~, Herr v. Miltqn 8.
HI~.h.y ~.dic.l C,oter, 23 Leb.Co.Leg.J. 5, 9 (1985) (.triking
allegationl that Defendant "faU[ed] to properly lupervile the
..edioal .taU" "faU[ed] to properly .upervile oompUance with
[internal] by-law." and "negligen[tly] .upervil[ed] aU . . .
perlonnel" ) . The above-quoted paragraph. mUlt thltrefore be
Itrioken, or a more Ipeoific pleading required, becau.e .aid
paragraphl lack ,ploifio factual Iupport.
'or the foreqoing rea.onl, Defendant. Luan Gramm, R.N. and
Holy Spirit Ho.pital re.pectfully reque.t that thil oourt
dilmill, with prejudioe, paraqraph. 90(a), (g), (i), and (l)
and 94(a), (b), (k), (m), (q), (aa), (bb), and (ee) for
inluffioient .pe~ificity or, in the alternative, that Plaintiff
be directed to file a more .peoifio pleading.
D. COllnt IV Of The Complaint, In It. Intirety, Mu.t 88
Strioken, Or An Amended Compla!nt Required, 'or
railur. To Conform To PA R.C.P. 1020(.)~
Under Pennlylvania Rule of Civil Procedure 1020(a), .
plaintiff may Itate in the oomplaint more than one oaule of
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aotio~ again.t the .am. d.t.ndant. How.v.r, "[.]aoh cau.. of
aotion and any .p.cial damag. r.lat.d ther.to .hall b. .tat.d
in a ..parat. count containinq a d.mand for r.lief." Pa.
R.C.P. 1020(a).
In Count IV of the Complaint, Plaintiff .et. forth h.r
all.gation. again.t Def.ndant Holy Spirit Ho.pital for the
n.qlig.nce of "it. agent., appar.nt agent., ..r:vant., and/or
.mploy...." .... Complaint, Count IV, paraqraph 94. Within
Count IV of the Complaint, Plaintiff inolude. the following
.ubpar.graph., all.ginq that Defendant Holy Spirit Ho.pital wa.
n."l1g.nt inl
(a)
(b)
(k)
failinq to provide guidellne. and
proc.dur.. for the treatm.nt and car.
of in.ulin-depend.nt labile diab.tioll
failing to properly .elect and
.up.rvi.. phy.ician. and oth.r
p.r.onnel to whom th.y .ntru.t the car.
of pati.nt. with Ruth Dani.l',
oonditionl
...
failing to have per. on. properly
train.d in nur.ing a.....ing a abil.
dieb.tic patient for compromi.ing .ign.
and .ymptom. followinq Def.ndant
Inn.rs' order ov.rdo.ing hi. patient
with in.ulin on Augu.t 7, 19921
...
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Th. ho.pital'. duti.. have b.an cla..ified
1nto four general area.. 11) a duty to U.e
rea.onable oar. in the ma nt..nanoe of .afe
and adequate faoilitie. And .quipment
[citation omitted)1 (2) a duty to ..leot and
retain only oompetent phy.ioian. {Citation
omitted] 1 (3) a duty to ov.r... a 1 per. on.
who praotio. m.dicin. within it. wall. a. to
pati.nt oare {Oitation omitted]I and (4) a
duty to formu at., adopt and enforce
ad.quat. rul.. and polioie. to en.ur.
quality oar. for the patient. (citation
olllitted].
Thc~p.cOI 591 A.2d at 707. Thu., the theory of corporat.
liability againet the hOJpital exi.t. indep.ndent of the
viaariou. liability a ho.pital might incur for the neglig.nce
of it. aqent., apparent agent., .ftrvant. and/or .mploy.... ill
Complaint, paragraph 94.
In Count IV of the Complaint, the Plaintiff ha. COllllllingl.d
cau.e. of action in the .ame count in derogation of Pa. R.C.p.
1020(a). Count IV of the Complaint oontain. allegation. of
vicariou. liability ba'.d on neglig.nce and abandonment
theorie., inter &l1A. Count IV al.o contain. the above-quot.d
allegation. of oorporate liability. Under Pa, R.C.p. 1020(a),
the corporate liability caUSe of action mu.t b. pl.aded in a
.eparate count.
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'or the foregoinq re.lonl, Defendant Holy Spirit HOlpital
relpectfully requelt that thi. Court Itrike paragraph I 94(a),
(b), (k), (m) and (q) or, in the alternat1ve, that Plaintiff be
direoted to file an amended oomplaint in complianoe w1th Pa.
R.C.P. 1020(a).
IV COIICLU8ION
8as~d on the foreqoing, Defendantl Luan Gramm, R.N. and
Holy Spirit Ho.pltal re.pectfully reque.t that thil Court
,ultain itl preliminary objectionl to the Complaint.
Respectfully lubmitted,
MITTI, IVAHS , WooDSIDI
BYI
Crai A. Stone, ..
Sup. Ct. I. D. '15
JaYlon R. WOlfqang6 .squire
Sup. Ct, I. D. '62 76
3401 North 'rant Street
P. O. Box 5950
Harri.burg, PA l7l10-0950
(717) 232-5000
AttorneYI for Defendantl
Luan Gramm, R.N. and Holy Spirit
Ho.pital
I
DATI. 11/5/93
"P+1416
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Alj"A"I"I~I~',r'1'LlI '.lOm<Jl'~ fill' ~11't.!Ul @'
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RUTH J. DANIIL, , IN THI COURT or COHKON PLIAS
Plaintiff , DAUPHIN COUNTY PENNSYLVANIA
,
VS. I CIVIL ACTION - LAW
,
CHARLES R. INNIRS, M.D., , NO. 37S4-S-93
INNIRS DAVIS ASSOCIATIS, ,
LUAN GRAMM, R.N., and ,
HOLY SPIRIT HOSPITAL, ,
Defendant" , JURY TRIAL DEMANDED
Al'rIDAVIT or KARCIA IICALICIIIIR
I, Marcia McAlicher, R.N., depole and Itate the
followino based upon my personal knowledqe,
1. I am an adult individual currently reaidinq at
213 North 36th Street, Camp Hill, Cumberland County,
Penneylvanial
2. I am currently Rilk Manager for Defendant Holy
Spirit HOlpital. I have held the position of Rilk Manager
since October ll, 1993;
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3. Prior to my employment by Holy Spirit HOlpital al
Ri.k Manaqer, I was employed by Holy Spirit Hospital al
Reimbur.ement Nurse for approximately .even year.,
.
)
--
4. Defendant Holy Spirit HOlpital'1 prinoipal plaoe
of bUline'l in located It 503 North 21lt Street, Camp Hill,
Cumberland County, Pennlylvania,
,
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5. Defendant Holy Spirit HOlpital doe. not now have,
nor ha. it at any time relevant to the above-captioned action
hid, officel and/or medical faoiliti.1 in Harrilburq, or
anywhere el.e in, Dauphin County, Pennlylvania, and
6. Defendant Holy Spirit Hospital does not now, nor
did it at any time relevant to the above-captioned action,
reqularly conduct business in Dauphin County, Pennsylvania.
"
I make the foregoing Affidavit in support of Defendant
Holy Spirit HOlpital's Preliminary Objections to the Complaint
in the above-captioned action. I understand that any fal.e
Itatementl made herein are subject to the penal tiel of 18 Pa.
C.S.A. 54904, relating to unlworn falsification to authoritiel.
'!
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ili'4/93
DAT
~-OL 00) 0 i t:' tJ
;;'\,,,.)...01.... "",-. ;\ c 0_ f~L(. ,~-' I .A
Maroia McAlicher, R.N.
RiBk Manager
Holy Spirit HOlpital
.
I"'"
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.
~.R~I.I~" O. 8.~YIC.
AND NOW, thi. 4th day of November,. 1993, I, JAYSON R.
WOLrGANG, ESQUIRE, hareby certify that I am lerving a copy of
the foreqoin9 document upon the perlon(.) and in the manner
indicated below, which .ervice lati.fiel the requirementl of
the penn.ylvania Rule. of Civil Procedure, by depoliting a copy
of the lame in the United State. Mail, Harrilburg,
Pennlylvania, with first~clas. postage prepaid, as followl'
Nijole C. Ollen, Esquire
An9ino , Rovner, P.C.
4503 North Front Street
Hardsburg, PA. l7110
Michael W. McGuckin, Elquire
lB50 William Penn Way
Suite 209
P.O. Box l0696
Lanca.ter, PA 17605-0696
METTE, EVANS' WOODSIDE
By.
-du~:i) W~ ~
J?"oI'l'R. Wolf9';n~
lBOl North Front Street
P. O. Box 5950
Harrilburg, PA l71l0-0950
(7l7) 232-5000
WP+1473
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3. In paragraph. 1 thro~gh 8l of the Amend.d Complaint
plaintiff .et. forth all.qation. ino1uding h.r in~uri...
Speoifically, Plaintiff a...rt. that the alleged negligence of
Defendant. r..ult.d in fr.oture and di.10oationof her right
.boulder .eoendary to hypoglyoemic .hock and ..l.ure. ...
Am.nded Complaint, paragraph. 37, 41-43 and 55-56.
4. In Count I of the Amended Complaint, Plaintiff .et.
forth her olaim(.) again.t Defondant Charle. R. Inner., M.D.
In paragraph 83 of Count I, Plaintiff Il1eqe. that D.fendant
Inn'r. wa. neglig.nt for the following.
.11.
(q)
violatinq th. prinoipal of
patient-phy.ician oare whioh required
Defendant tnner. to make .Very po..ibll
effort for the benefit of hi. patient,
Ruth Daniel,
...
(t)
inappropriately p.rmitting Ruth
Daniel'. blood gluco.e to drop to .uch
low l.vel. a. to r..ult in hypoglycemio
..ilur', .hook, r..ultln9 in
oonvul.ion., neurologic compromi.e,
10.. of oon.oiou.ne.., inju~I to hlf
left knee and fraoture and d elooat on
of her right .hould.rl
"
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(v)
in oQntravention of hi. liduoiarr duty,
abandQn1ng hi. patient, Ruth Dan ell
. ...
:1 '
1nappropriately engaginq in medioal
practioe that wa. too demanding for one
per.on in order to maximi.e volume and
therefore revenue, precluding Defendant
Inner. from properly attending tQ hie
patient, Ruth Danie on Augult 7, 19921
(I)
...
(99)
inappropriately abandoning' hie pat~ent,
Ruth Daniel by permitting her to lei.e,
oonvul.e, fracture and dillocate her
right Ihoulder, fracture her left knee,
.u.tain neuroloqic deficit and 101. of
con.cioulnel. a. a relu~t of orderinq
an overdole of inlulin on Augu.t 7,
1992.
1Ia, .xhibit "A," paraqraph. 83(Q), (t), (v), (.) and (q9)
(emphalil added).
5 . paraqraphl 83 ( q), ( t), ( v), (.) and (gg) are
inoorporated by reference al again.t Defendantl Luan Gramm,
,
R.N. and Holy Spirit HOlpital in paragraph. 88, 9l and 96. ...
Ixhibi t "A," para9raphl U, 91 and 96.
6. In Count III of the Amended Complaint, Plaintiff .et.
forth her claim(.) a9ainlt Defendant Luan Gramm, R.N. In
..
.
pa~.v~aph Ie of Count III, Pl.intiff alleg.. th.t D.fendant
Gramm wa. nevligent for the followingl
...
(h)
ab.ndoning h.r pati.nt, Ruth Daniel, by
failing to prop.rly monitor, evaluate
and ...... Ruth Dani.l following
Defendant Inn.r.' ord.r ov.rdo.ing the
patient with inlulin.
... Ixhibit "A," paragraph 89(h).
7. Xn Count IV of the Amend.d Complaint, Plaintiff
purport. to .et forth a olaim(.) aqain.t Defendant Holy Spirit
Hoapital inoluding the followingl
94. D.f.ndant Holy Spirit Ho.pital, actinq
through it. aq.nt., apparent agent.,
.ervant. and/or .m~loy.e., fail.d to take
the n.o....ry .t.p. in order .nlure the
..fety of Mr.. Daniel, knowinq that .h. wa.
depend.nt upon Defendant HOlt Spirit
Hoapital and it. ataff, and . liable for
it. failure to intervene and prevent the
improper admini.tration of an ov.rdo.. of
in.ulin to Plaintiff, Ruth Daniel.
95. Def.ndant Holy Spirit Ho.pital, aoting
through it. ag.nt., apparent agent.,
.ervant. and/or emPloye.. il liable to the
Plaintiff, Ruth Dani. for ita failure to
provide quideline., protoool, polioi.., and
proo.dur.. for interv.ntion when a phy.ioi.n
order. an overdo.e of inlulin in a labile
.
10~. Defendant Holy Spirit Ho.pital, aoting
throu;h it. .gent., .pparent aqent., !
.ervant. and/or employe.., i. liable for it.
failure to formulate, adopt and enforce
adequate rul~. and policie. to en.ure
qualitr of o.re for it. patient., includin9
Plaint ff patient, Ruth Daniel.
...
117. Defendant Holy Spirit Ho.pital failed
to .upervi.e Defendant. Inner. and Gramm
properly, and a. a re.ult of their failure
to do '0, Defendant Holy Spirit Ho.pital
breached it. duty to it. patient, Ruth
Daniel.
...
121. Additionally' Defendant Holy Spirit
Ho.pital i. .liab e forI
(a)
(b)
(c)
(e)
failing to .elect and retain only
oompetent phy.ician"
failinq to over.ee all per.on. who
praotioe medicine within it. wall.
al to patient carel
failing to formulate, adopt, and
enforoe adequate rule. and
polloi.. to en.ure quality care to
it. patient, Ruth Daniel,
...
failinq to en.ure patient .afety
and well-being while at the
ho.pital.
... Amended Complaint, paragrlph 12l(a-o) and (e).
,
.
,
,. paragrlphl 83(q), (t), (v), (I) and (gg), 89(h), Icount
IV in it. entirety, inoludinq parag,~ph. 94 and 9S, and
pa~agraph' 102, 104, 108, 10', 117, Ind 121(a-o) and (e) of the
Amended compllint fai~ed to alleg., with .ufticient legal
!
.peoifioity, the material fact. upon whioh Plaintiff'l cau.e.
of aotion are ba.ed.
10. The non-.pecifio boilarplate allegation. contained in
.aid paragraph. do not provide Defendant, Luan Gramm, R.N.
and/or Holy spirit Ho.pital with an adequate opportunity to
defend the olaiml again.t them, and they are pl'. judice thereby.
WHIRI'ORI, Defendantl Luann Gramm, R.N. and Holy Spirit
Ho.pital relpectfully requelt that thi. Court Itrike paragraph.
83(q)~ (t), (v), (I) and (9q), 89(h), Count IV in it. entirety,
includinq paraqraph. 94 and 9S, and paragraph. l02, 104, lOB,
109, 117, and l2l(a-o) and (e) for in.uffioient Ipeoificity or,
in the Ilternative, that plaintiff be directed to file a more
.peoific pleadinq.
L.GAL INSU"ICIINCY or THI PLIADINGS (DIXURRIR)
ll. In Count V of the Amended Complaint, Plaintiff
allegel, in part, a. follow.,
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13. Acoo~dingly, faLlure to oomply with the requirement.
of the Joint COlllllli..ion for AocreditatLon of Ho.pit.l. doe. not
oon.titute negligenoe under Penn.ylvania law.
14. Therefore, paragraph. 111 through 113 and 115 fail to
.tate a ooqni.able oLaim upQn which relief oan be granted.
WHIRIPORI, Defendant Holy Spirit Ho.pital re.peotfully
reque.t. that thi. Court di.mi.., with prejudice, paragraph.
111 through 113 and 115 for failure to .tate a coqni.able olaim
upon whioh relief can be granted.
MITTI, IVANS , WOODSIDI
BYI
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DATI. 2/l7/.4
"'+1750
Cra A. Stone, I.q
su~ Ct. I. D. f15'
Ja .on R. Wolfgang, I.quire
Sup. Ct. I. D. '62076
340l North Front Street
P. O. Box 5950
Harri.burgt PA 17110-0950
. (7l7) 232-!l000
Attorney. for Defendant
Luan Gramm, R,N. and Holy Spirit
Ho.pital
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,
aUTH J. ~AIlllL
plaint1ff
IN TH! COURT 0' COMMON ,LEA,
DAUPHIN COUNTY, PINNIYLVANIA
v.
CIVI~ ACTION - LAW
NO. 3754-'-113
.,
CIWtLlI a. JNNIRI, ". D. ,
ZHNIItI DAVII AlIOCIATI',
~AN OJtAMHL a.N'L .
HOLY "laIT HOIPITAL
Defendant.
JURY TRIAL DEMANDED
AMENDED COMPLAINT
1. Ruth J. Daniel i. an adult individual re.idinq in Harri.burg,
Dauphin county, 'enn.ylvania.
2. Defendant Charle. R. Innera, M.D., an adult inlUvidual, i.
lieen.ed to practioe medicine in the Commonwealth of Pennaylvania, who, in
1.92 engaqed in the praotice of Internal Medicine in c.mp Hill, cumbarland
county, Penn.ylvania.
3. Inner. Davi. A..ociate., i. a profe..ional profit-makinq
corporation, which provide. medical .ervice. in CUmberland county,
I'enn.ylvania.
4. Defandant Luan Grau, R.N., an adult individual, 18 a reg18terad
nur.e, who in 111112 practioed nurainq in Camp Hill, CUmberland county,
Penn.ylvania.
II. Defendant Holy spirit HOBpital, i. a corporate medical
in.UtuUon with offioe. and medical faciliUe. in Camp Hill, cumberland
county, Penn.ylvania.
.. Defendant Charle. R. Innera, M.D. wa. at all relevant U.a.
hereinafter, aotinq a. an aqent, apparent avent, .arvant and/or employ..
of Defandant Inner. Davia A..ociate..
7. D.fendlnt Charhl R. Innera, M.D. WII at IU nl.vlnt U...
h.~ein'fte~, lotinv .. .n Igent, app.r.nt .g.nt, eervant .nd/o~ e.ploy..
ot Detend.nt Holy Spirit Ho.pit.l.
.. D.fendlnt OraDIII w.. It aU n1evant Ume. h.reinlft.~ lot.t.n, I' ..
.n ag.nt, app.~ent Iv.nt, lervlnt and/or employ.e of Def.ndant Holy 8pirit
Ho.pital.
I. On Auqult II, lU2, Dr. st.phen J. Pavb admitted hia long-
.tancUnlJ paUel'lt, Plaintiff, Ruth Daniel, to Def.ndant Holy Spirit
Hoepital for orthopedio evaluation of foot pain.
10. Upon her admi..ion to Defendant Holy spirit Ho.pital, Ple1ntiff,
Ruth Dani.l wa. .tart.d on inlulin cov.raq. with a maximum daily allot.ent
of 20 unitl NPH inlulin.
11. Plaintiff'l dauqht.r, Debra Nicodemu., Idvi.ed the ho.pit.l',
nurl.. Ind phy.ioi.n. oarinq for Ruth Daniel that her mother wal allergic
to R.qular in.ulin.
12. Pl.intiff, Ruth Daniel'l nurlinq care record, dated Auqu.t 6,
1192, noted her aUerqic reaction to R.gular in.ulin AI folloWI' "dau,hter
.tatel patient ha. n.v.r been able to be controlled with R.qular in.uli~.
st.te. that they have had problems in the pa.t with h.r .ugar fluotu.ting
wh.n u.inq Regular inluUn."
13. Mor.ov.r, att~ched to Plaintiff, Ruth Daniel', m.dioin. Kardex,
were warl')inq .ticker. advbing the hOlpita!" nun'l Ind physioian. of
Mrl. Dani.l', all.rgio reaction to R.gular in,ulin.
14. On Augu.t 7, 1992, at approximately 7130 a.m., Plaintiff, Ruth
D.niel reoeived inlulin oov.rlve of 20 unitl of NPH inlulin.
2
15. plaintiff, Ruth Dani.l'l r.c.ipt of 30 unit. of NPH 1nlul1n .~
01)0 hu on AU9U.t 7, un w.. dqneet off on hn lDecUcine ltal'deX ~)'
Defendant Holy .pirit Ho.pital'. .taft nur.., an LPN with the ab~l'ev1~te4
1n1Uall, "PH".
le. .ix hour. later at 1330 hr. on AUi\l.t 7, 1"2, Detendant xnnel"
vave 'TAT order. for Plaintiff, Ruth Daniel, to reoeive additional in.u11n
amounUng to 40 unit. of NPH in.ul1n lInet 2e1 unit. of Requlu 1nlulln.
17. Signifioantly, Defendant Innar. ordered the overdo.e of in.ulin
w1thout eVer examininq hi. patient.
1.. Defendant Inner. ordered the overdo.e of in.ulin by telephone.
1'. Defendant Inner' ordered the overdo.e of in.ulin at 1330 hr. on
AUi\l.t 7, 1"2, de.pite plaintiff, Ruth Daniel'. prior coverage with 20
unit. ot NPH in.ulin at 0730 hr..
20. An overdo.e of in.ulin cau.e. blood gluoo.e levd. to lower
dramatioally, re.ulting in hypoglycemia with .etmure. and .hook.
21. Nur.e GraM did not properly review or relay the infolMllaUon
noted in Plaintiff Ruth Daniel' II medicine 1<ardu' on AUqu.t 7, un.
22. N'11'1e GraM did not report Der.ndant 1nnel'l' overdo.e of in.ulin
to hi. patient, plaintiff Ruth Daniel to her .up8t'vbor 01' other of
Plaintiff" treating phyuicianl.
23. Nur.e GraM failed to underetand that any aetditional in.ulin at
1330 hl'l on Auqu.t 7, 1992 could r..ult in plaintiff patient, Ruth
Daniel" experiencing hypoglyoemic .hock and .eizure.
24. Following Defendant Inner.' STAT order overdo.ing hi. patiant
with in.ulin, plaintiff Ruth Daniel wa. tran.ported to the radiolovy
department for an ultra.dund relating to har orthopedic evaluation.
3
a5. 1i9nUioantly, ne1thllr NUl'll Gnu 01' any of Dlfendant H01)'
.p1r1t HOlp1tal', nur.ing Itaff monitorld Plaintiff Ruth Daniel'l ~loo.
,luee.. level. foUowinV netlndant Innere' /STAT ordlr Illverdo.1n9 hi.
patient with inlulin.
36. Plaintift, Ruth Daniel wal rlturned to her rooa followin, an
ultra.ound eXlmination at approximately leoo hrl.
n, At that Ume, Plaintiff'l cSaughter, Dlbn N1oodlaul, wa. pre"nt
in hiI' aother" room.
21. Not lurpridng, following Defendant Inner.' /STAT ordar
ov.rdo.1nv hi. patient with inlulin a taw hourI earl ill', Mrl. Nioodeau.
ob.erved her mother thralhinq and oonvul.ing in her bid unoontrollably.
2t. Plaintiff'. daughter, Mr.. Niecdemu., ran to the nurl" Itation
to ,et help for her mother.
30. Nur.e. notel dooumented Plaintiff, Ruth Danill, Ihakinq froa a
.eilure, unre.pon.ive to .timuli snd pupill unrelpon.ivl to li,ht.
31. A. Plaintiff, Ruth Daniel' I primary trllUnq phylichn,
Defendant Innere wu o,ontaoted by Defendant Holy Spirit HOlpital'. nurling
.tatf and re.ponded by qivinq order. by telephone for blood luqar Itudi..
to b. drawn and that Plaintiff, Ruth Danial, reo.ive an ampUle of qluco.e
and water (D50).
32. Nur.e. nota. dooument that Plaintiff, Ruth Daniel'l blood .uqar
wa. un.udoa.lfully drawn.
33. Nur.el nota. al.o cSccumented that the failurl to cSr~w bloocS'on
the firlt attempt wal not reported to Itaff.
34. Si,nifioantly, before Plaintiff, Ruth Danial'. blood ,uqar wa.
drawn, .hl reoeived an ampule of qluco.e and water (D50).
4
n. The overdo.. of inau1in orderet! by Defendant Innen WI' .0
axce..ive, that by 8'00 p.m. on the evening of Augu.t 7, 1'92, 'llintitt,
auth Daniel'. blood .uqar wa. down to 28 mg/dl and a .econd ampule of 10'
vluco.e and water wa. adm!ni.tered.
36. Brain function depend. on an adequate .upply of glucoee from tbe
blood and a blood .uqar a. low a. 28 ia conai.tent with hypoqlyoemic .hook
whioh can raault in .evere brain damaqe, .aizurea, coma, and neuroloqic
deUcit.
37. Approximately one hour after Defendant Holy spirit Hoapital'.
nurainq ataff obaerved plaintiff, Ruth Daniel'. hypoqlyc.mic oonvul.inq
.ei.ure. and ahook, Plaintiff'S complaint. of riqht .houlder pain were
documented and reported to Defendant Inners.
38. Defendant Innera failed to respond to calla or to come into the
hoap1tal to examine his patient.
3'. Over the next several hour. plaintiff, Ruth Daniel waa
documented to be moaning in pain with noted guarding of her right upper
ahoulder.
40. Plaintiff, ~uth Daniel was n2t taken to the radiology department
for x-ray .valuation of her right shoulder until approximately 1'40 hr. or
,
well over five houra after her convulsing hypoglycemic .elzure wa. noted.
41. At that time X-ray examination of Plaintiff, Ruth Daniel'. right
.houlder dooumented s fracture of the neck of the right hum.ru. with .ome
rotation of the humeral head.
42. Following the x-ray examination an orthopedic evaluation by Dr.
,
Band. noted plaintiff, Ruth Daniel'. unrelponaivene.. to verbal .timuli,
15
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~iqht .houlder edema and x-ray tindinq. con.i.t.nt with a fraotur.d and
dialoo.ted riqht ahouldlr.
4). Dr. .and. turther notld that Plaintitt, Ruth Daniel requ1~ed
eedation before any attlmpt at nlSuot1on .urqery for her .houlder fraoture "
and dillocaUon.
44. By 10100 p.m. or g hour. attlr hi. tlllphone order overdoe1nq
hil p.Uent with in.ulin DetlnlSant Innln finally oallle in to .ee hi.
paUlnt.
45. At that timl, Detendant Innlr. recordld in thl progre.. note.
that he orlSerelS an oVlrdo.e ot in.ulin at 1330 hr..
U. At that Ume Defendant Innln allo dooumlnted PlainUff paUent,
Ruth Daniel'. .eizure tollowinq hi. order overdosing hlr in.ulin.
47. Detendant Inner. further documeTlted that: Plaintiff paUent, Ruth
Daniel reoeivelS 01'11 alllpule of 050 prior to hlr blood .uqar. beinq d~awn
whioh .ccounted for hlr reported blcod .uqar of 433.
48. At that time, Defendant Inner. also dooumented Plaintiff
patient, Ruth Daniel'. fractured and dislocated riqht .houlder followinq
her .eizure .Ioondary to hypoqlycemia.
49. At that time Defendant Innlrs allo documented review of hi.
patient'a medicine Rardex only after he ordered the overlSo.e of in.ulin.
50. In the early morninq hour. of Auqult 8, 1992, Dlfendant Inner.
dooumlntelS Plaintiff patient, Ruth Daniel'. inability to move her riqht
arm Iloondary to hlr tracture.
51. In liqht of Plaintiff patilnt, Ruth Daniel'. failure to r..pond
to Ixternal .timuli, a nluroloqic con.ult wa. ordered.
6
e2. Neuroloq1lt, Dr. Todd Samuel., examined flaintift Ruth Daniel Qn
Auvuat 8, 1'92 and documented her .eizure activity, and perliltent lao~ 0'
r..poneivene.. aa 18condllry to In overdole of inll~1in olulin,
hypoglyoemia..
53. Neuroloqilt, Dr. Samuell further dooumented Plaintiff Pltient,
Ruth Daniel'l encephalopathy .. lecondary to hypoglycemic Ihook and
.ei.ure, and, oon.equently recommended that orthopedio intervention for
her fractured and dislooated ri9ht shoulder be delaYld until her
nau~olo9io etatua improved.
!l4. On AUqUBt 10, 1992, orthopedic aurqeon, Dr.lIanda, dooumented
plaintiff patient, Ruth Daniel's persilftent riqht .houlder pain and
oautioned that her proqnosiB for closed reduction wa. quarded.
ee, On Auquat 12, 1992, Dr. Bands, attempted clo.ed reduction of
Plaintiff Ruth Daniel's fractured and dislooated riqht ahoulder under IV
ledation.
56. The attempt to treat Plaintiff Ruth Daniel' a fractured and
dialocated riqht Bhoulder secondary to hypoqlycemic aeizure by cloud
reduction tailed.
57. General anesthesia was considered prohibitive in Plaintiff
petient, ~uth Daniel and her right arm was immobilized in a aling.
eB. At that time it was Dr. Band's opinion that Plaintiff patient,
Ruth Daniel'l prognoais for her right shculder was poor.
!l9. Throuqhout her August and September, 1992 hoepitalization,
Plaintiff, Ruth Daniel's fractured and dislocated right .houlder remained
Iwollen, edematous, tender and extremely painful to the touoh.
7
60. Additionally, pldntitf Ruth Daniel al.o complained of left Ien..
pain following her hypoglycemic seizure tor which x-ray. were not tlken
until september 11, 1992 or 3~ day. atter the convul.inq _eizure clu..d ~y
Defendant Inn.r.' order overdosing inaulin.
61. Radioqraphio examination of Plaintiff, Ruth Daniel'. left lenee
taken on s.ptemkler 11, 1992 revuhd a fraoture at the left tibial
platlau.
62. Following the unsucoe..tul attempt at olo.ed reduction .urgery
for plaintiff Ruth Daniel'. tractured and dillocated right .hould.r,
phy.ioal therapy and rehabilitative program. were in.tituted.
63. However, Plaintitt, Rut~ Daniel'. rehabilitation wa. very .low.
64. Accordinq to the phyaica1 therapy progre.. record., Plaintiff,
Ruth Daniel wa. found to be ot questionable rehab potential until .uoh
time a. .he had aoquired better UBe ot her right upper extremity.
65. In her many attempts to ambulate, the physical therapy reoord.
con.i.tently documented Plaintitf, Ruth Daniel a. Bcreaming in pain.
66. Finally, it was the physical therapilt' a recommendation that
Plaintiff, Ruth Oaniel utilize a wheelchair for amklulating rather than a
walker beoau.. the weight-bearing required in uBinq a welker, oau.ed
tremendou. pain to her tractured and dislocated right .houlder.
67. On September 23, 1992, Detendant Inners' a..ooiate, Dr. Davi.
noted in hi. diucharge summary that Plaintiff, Ruth Daniel wa. giVen an
ovsrdo.e of insulin which resulted in severe hypoglycemia and .eizure and
.ubaequent fnoture and dislooation of her right shoulder.
68. since Defendant Inners' order overdo.inq hie patient with
in8ulin and her subsequent hypoglycemic seizure and .hock, Plaintiff, Ruth
8
:'
Dan1.l', fraotured and dialoo.tad dqht Ihoulder oompounded har oth...
..d1oal problem. inQludin~ pulmonary Qonqe.tion for which ,he oannot b.
adequately turned beoau.e at her riqht .houlder pain and h.. rendered her
entirely dependent on her dauqhter for even her mo.t ba.ic and rudimentary
n..d..
.,. In an effort to a..i.t in the fUll-time taek of carinq for her
mother, plaintiff, Ruth Daniel" daughtar, Mr.. Nioodemu., had to procure
the ...i.tance of at-home nur.inq .ervieas.
70. plaintiff, Ruth Daniel, remain. entirely dependent on her
dauqhter .inoe the overdoae ot in.ulin ordered by Defendant Inner..
71. plaintiff, Ruth Daniel, hat no uee of her riqht arm.
72. plaintiff, Ruth Daniel, will never reoover full funot1on of her
right aZ'1ll and shoulder to the extent .he w.. able prior to Defendant
Inner.' order overdosing his patient with in.ulin.
73. A. the direct and proximate result of the Defendant'l negligence
a. alleqed herein and inoorporated by referenoe, plaintiff, Ruth D.niel,
hal luffered permanent and lavere injuries and olaim i. iliad. therefore.
74. Defendant. Charles R. Innera, M.D., Inneu Davia 'A..ooiate.,
~uan Gramm, R.N., and Holy spirit Hospital are jointly and ..verely liable
for injurie. and d~maqes a. let forth herein and inoorporated by
reference.
75. A. the direct and proximate result of the Defendant" negligence
a. elleged herein and incorporated by referenoe, Plaintiff, Ruth Dlniel
ha. .uftered a perlllanent dhf1qurinq and dhabling injury and olaim 11
made therefore.
.,
9
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76. A. the direct and proximate ruu1 t ot the Detendant'. ne9Uv.noe
a. alle9'4 herein and incorporated by reterenoe, Plaintift, Ruth Daniel"
right .hould,r injury will cause residual problema tor the re~.in4er Of .
her lite and .ince .he ccntinuee to have .ever, riqht .houlder pain, the
probability ot her requiring additional treatment .nd therapie. in
increa.'d and claim i. made therefore.
77. Aa the direct and proximate result ot the Detendant'. neqUlj/ence
.. alleged harein and inoorporated by reterence, Plaintitt, Ruth Daniel'_
rilj/ht .houlder injury will cause res1dual problems affecting her qeneral
health, inclUding the inftbility tc adequately turn or lay on her rilj/ht
aid. which compromises her pulmonny status and the probability of
increa.ad conq..tion, pneumonia and other medical condition. 11 incr....d
requiring additional treatment and therapies and claim i. mad. theretor..
78. Aa the direct and proximate result of the Defendant'. neql.Lqenoe
., alleged herein and .1ncorporated by reference, Plaintiff, Ruth Daniel
wa. forced to incur liability for medical treatments, medicine.,
hospitalizations, physical therapy and similar miscellaneous .xpen.e., in
and about an effort to attempt to restore herself to h.alth and claim i.
made therefore.
79. As the direct and proximate X'esu1 t of the Defendant'. neql.Lqenc.
a. alleqed herein and incorporated by reference, Plaintiff, Ruth Daniel
will be toroed to incur liability for medical tl'eatment:s, medicine.,
ho.pitalizations, physical therapy and similar miscellaneous expen... in
the tuture and claim is made therefore.
80. As the direct and proximate result of the Defendant'. neqliqenoe
a. alleged herein and incorporated by reference, Plaintiff, Ruth Daniel
10
hi. undar90ne and in the future will undar90 qraat ~ental and ph~.ioal
pain and ,uffaring, great inoonveni.noa in oarinq out har dail~
aotivit1a., 10.. of life'. plaa.ure. and olaim 1. made therefore.
,
n. plaintiff, Ruth Daniel, haa been advb.d and therefore Iv.n "
that the da~aqe. end injurie' a. aUeged herein and inoorporated by
ref.renoe are permanent and claim i. made th.refore.
COUNT I
Buth Daniel v. Charl.. R. Inn.ra. M.D.
12. Paragraph. 1 throuqh 81 of thie complaint ara incorporatad .
h.rein by referenoe al it let forth at length.
'3. Defendant Charl.. R. Inner., M.D. i. liable to Plaintiff for hi.
n'gligano. inl
(a)
(b)
(c)
(d)
(e)
failing to examino Ruth Daniel prior to ordering
insulin on Auqu't 7, 1992,
f.Uinq to properly u.... Ruth Daniel
oontradiotion. .,.cciated with ordering
additional in~ulin on Auqult 7, 1992,
!ailinq to properly review and in.pect Ruth
Daniel'. m.dicine Rardex prior to ordering
in.ulin on Auqu.t 7, 1992,
improperly overdo.inq Ruth Daniel with
exoe..ive inaulin on Auquat 7, 1992 cau.ing
hypoglyoemio .eizure and 'hOOk,
failinq to d terminI or to a.k a qualified
11
and
tha
('
pe~eon to determine, the exaot a.ount of
1n..uUn ~uth Daniel had nodved on A11VUlt 7,
1"2 prio~ to h1~ order overdo.1ng inaul1n
on Augu.t 7, 1"21
(I) purpolely and knowingly ordering ~egula~
1na~lin d'lpite ~uth Dln1el', known allergic
r.action to ~egular 1nlul1nl
(g) failing to attend to hi. patient and p~ov1de
medical oare to Ruth Daniel on AUgult 7, 1"2,
(h) failinq to properly obtain a oareful hietory
of ~uth Daniel'. in.ulin ooverage on Auqult 7,
n1l2,
(1) tailing to monitor Ruth Daniel eublequent to
hi. order ov~rdoling inlulin on Augu.t 7, 1..21
(j) inappropriately deleying radiographio evalultion
of Ruth Daniel'l shoulder following the hypoglyoem1c
leizure oau.ed by the overdole of insulin ordered
on Augult 7, 1"2,
(k) failing to order and obtain blood gluco..
mealuremant. following the overdo.e of inlulin
ordered on Augu.t 7, 1"2,
(1) improper management of inlulin coverage in an
inlulin-depend.nt labile diabetic,
(m) failing to properly inquire into the .tatuI of
1nlulin coverage on Ruth Daniel'l madioine Xardax
~rior to ordering additional in,ulin at 1330 hra
12
," ',', "
I'
on AU9u.t 7, 1V02,
(n) tl111nq to unde~.tand and acoordingly .anIV.
hi. patient ba.ed on the in,ulin cove~ag.
dooumented on Ruth Daniel'. medioine Xardex
on Augu.t 7, lVV2,
(0) fdUng to phydcaUy .xamine, .valuat.,
...... and lIIonitor Ruth Daniel on Auqu.t 7, un,
(p) feiling to prop.rly review, interpret and
re.pond to the information oontained in Ruth
Daniel'. medioine ~ardex whioh dooume~ted
in.ulin ooveraqe in the early morning hour. of
Auqu.t 7, 19!12,
(q) violating the prinoiple of patient-phy.ioian
care which required Defendent Inner. to .eke
every po..ible effort for the benetit ot hi.
patient, Ruth Daniel,
(r) tal.ely and erroneou.ly a..uminq that Ruth Daniel
did not reoeive in,ulin coveraqe in the morninq
hour. of Auqu.t 7, 1992,
(.) failinq to minimize the ri.k and/or prevent
hypoglyoemio .eizure and .hock,
(t) in.ppropriately permittinq Ruth Deniel'. blood
gluco.e to drop to .uoh low level. a. to r..ult
in hypoqlycemio .eizure, .hock, re.ultinq in
convul.ion., neuroloqio compromi.e, 10..
of con.oiou.ne..,injury to her 1.tt kn.e Ind
13
, ,
fraoture end di.location of her right .houlder,
(u) inappropriatel~ pe~itting hi. pati.nt, Ruth
Daniel tQ .e11' and conVlll.e in hypovlyoemio
.hock without any effort to intervene,
(v) in cQntrav~ntion of hi. f1duoiary duty,
abandoning hi. patient, Ruth Daniel,
ew) f.ilinv to order blood .tudie. to be drawn
prior to the admini.tr.tion of D50W,
ex) precipitatinv Ruth Daniel'. labile diabetic
condition by overdo.inq her with in.ulin
to the point wh~re .h. .uccumbed to hypoglyoemio
.eilure and .hock,
(y) failinq to notify other phy.ioianl or to
enlure that another phy.ioian wa. pre.ent
and prepared to oare for Ruth Daniel at the
time Dafendant Inner. ordered tha overdo.e of
in.ulin by telephone on Auqu.t 7, 1"21
el) inappropriately engaging in a medioal praotioe
that wa. too demanding for one per.on in order
to maximize volume and therefore revenue,
precluding Defendant Inner. from properly
attending to hi. patient, Ruth Daniel on
Auqu.t 7, 1992,
(a.) failinq to inform Ruth Daniel a. to the material
ri.k., oon.equenoe. and oontraindication.
a..ooiated with admini.tering exoe.. 1n.ulin,
.
14
1!l
(bb) 'ai1inq to in'o~ Ruth D.ni.l a. to the .at.~ial
ri.k., con.equ.nc.. and oontra1ndicat1on.
'a..ociated with orderinq ~.dioation. to which
Ruth caniel w.. doou~ent.d a. b.inq alle~qlo,
(cc) de.pit. hi. awar.n... that Ruth Dani.l had
l.bil. diabet.., and th.t .he w.. ..n.1tiv.
to the adju.tment of in.ulin, neverthel...,
failing to b. phy.ically p~e.ent to ......,
~onitor and .valuate hi. patient, inoludinq
r.vi.w of h.r medioin. ~ard.x ~.fora ord.rinq an
overdo.. of in.ulin on Auqu.t 7, 1992,
(dd) de.pit. hi. awa~en". that hi. patient wa. a
labile diab.tio .nd w.. ..n.itiv. to the
adju.tm.nt of in.ulin,n.v.~thel..., failinq
to .ummon any phy.ician to be pre..nt at the
time he ordered the overdo.e of in.ulin on
Augu.t 7, 1992,
(..) failing to .n.ure prop.r do.ag. and
admini.tration of in.ulin in a labile diab.tio,
(ff) failinq to plan, arrange, and en.ur. prope~
in.uUn cov.rage for hie pati,"t, Ruth Daniel
on Auqu.t 7, 19921 and
(gg) inappropriately abandoninq hi. patient, Ruth
Daniel by p.rmittinq her to ..iz., convul..,
fraotur. and d1.locate her right .hould.r,
fractur. h.r left knee, .u.tain neuroloqic
deficit .nd 10.. of con.ciou.ne.. a. I re.ult
of ord.erin9 all ov.rdo.e of in.ulin on Au.,u.t 7,
1t va .
14. A. a direct and proximlte r..ult of the cef.ndant', nellliglnce, "
pldntiff Ruth Danhl .u.tained injur1'. and dama9" a.. .et fo..th in
pa..aqraph. 28 throuqh 81 above Which ar. incorporated he..ein by refe..ance
.. if .et forth at len9th and claim i. made therefor..
WHEREFORE, plaintiff, Ruth Daniel, demand. judqment aqainat Defend.nt
Cha..le. R. Innen, M. D. tor comp.naatory dama9a. in an amount in .xce.. of
Twenty Thou.and ($20,000.00) Dollar. excluaive of int.re.t and oo.t. and
in exce.. of any juri.dictional amount requirinq compul.ory arbitration.
COUNT II
~u~h Daniel v. Inn.r. Davia A..eclat..
"
8e. lIaragraph. 1 through 81 and Count 1 of thb complaint .re
incorporated herein by reference a. if .et forth at length.
8e. At all relevant tim.. h.rein, Defendant Inn.r. wa. acting .. the
agent, apparent agent, ..rvant and/or .mployee of Inner. Davi. A..ociate.,
a prote.lional profit-making medical ccrporat1ol1 and WI' aotinll within the
.cope of .aid employment.
87. Def.ndant Inn.rs Davis Associate., acting throullh it. aqent.,
apparent allent., urvant. and/or employeell, is Hable to the Plaintiff for
the injuri'. and damlge. Illeged herein which ware direotly and
proximately cau.ed by the Defendant'a negligence a. ..t fo..th in
pa..agrapha 28 throu9h 81 above which are incorporated herein by reflrenoe
a. if ..t forth at len9th and claim i. mad. therefor..
, \
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WHERJrO~E, Plaintitt, Ruth Danill, demandl judgement .gain.t Inner.
Dav1. A..oaiate. for oompen.atory damage. in an amount in exoe.. ot Twenty
Thou.and (UO,OOo.OO) Dollan exolueive ot inten.t and oo.t. and in
IXOI.. ot any juri.diotional amount requiring compul.ory arbitration.
COUNT In
!
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I
I
Ruth Oan1.1 VI Luan Gramm. R.N.
"
88. Paragraph. 1 through 81 and Count. I and II of thi. complaint
are 1ncorporatld herlin by rlterencl a. it .et torth at length.
19. Dlfendant Luan Gramm, R.N. i. liable to the Plaintitt tor her
negligence inl
(a) failinq to properly inve.tiqatl and relay the
intormation containld in Ruth Daniel'.
medioine Rardex/
(b) tailin9 to properly read the information contained
in Ruth Danill', medicine Rardex/
(0) tailinq to appreciate the .iqniticanoe whioh
additional insulin would have on a labile diabetio
patient .uch as Ruth Daniel, particularly att.r
her reoeipt ot inlulin coveraqe in the early morning
hour. at Auqult 7, 19921
(d) tailing to notity .upervisora, department head.,
medioal direotor., phy.iciana or ho.pital
admini.trator. ot Detendant Inner.' overdo.e ot
in.ulin on Auqu.t 7, 1992/
(e) tailing to appreciate that Detendant Inner.' order
17
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overdoeinq hi'. patiiunt Ruth Dsniel with in.uUn .
on AUqu.t 7, 1ig2 could r..ult in . dra.tio
drop in blood qluoo.. clu.inq hypoqlyce.ic .hook
and 1.lhun 1
(f) failinq to att.nd, monitor and provide tor prop.r
nuninq can to Ruth Danill following Def..ndant
Inner.' ord.r oVlrdo.inq hi. patilnt with in.ulin
on Augu.t 7, 1992/
(q) improplrly aecertaining the etatu. of Ruth
Dani.l'. ineulin coverage on Auqu.t 7, 19i21
(h) abandoning hiI' patient, Ruth Daniel by failinq
to properly monitor, .valuate and ...... Ruth Dani.l
following Defendant Innere'order overdo.ing th.
patient with insulinl
(i) failing to minimize the riek and/or pr.vent
hypoglycemia shock and e.izurel
(j) failing to report Defendant Inner.' order
ov.rdosing hie patient, Ruth Caniel with in,ulin
on Auguet 7, 19921
(k) inappropriately monitoring Ruth Daniel'. blood
glucoee l.vels on August 7, 19921 and
(1) failing to remain with her peti.nt ruth Deniel
fOllowing her hypoglycemic .eizure and .hook to
monitor, a.sess and evaluate her traumatio injurie.
and neurologic damage.
"
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to. A. the dirlct and proxim.t. rl.ult of the D.f.ndant'.
nl91igenol, Pl.intiff, Ruth Danill .ultain.d injuri.. and d'.'9" .. ..t
forth in par.9r.ph. al through 11 abovI whioh ar. inoorporatld herlin by
~.flrenc. a. if ..t forth at l.ngth and olaim i. m.d. th.r.tore.
WHERlFORE, Plaintiff Ruth Dani.l, dl..nda jUdqmlnt again.t Defend.nt
Luan Gramm, R.N. for compensatory damagl' in .n amount in exol.. of Twenty
I
Thou.and (UO,OOo.OO) Dolhre exclueivl of inten.t and oo.t. .nd in
.xo... of any juri.dictional amount r.quiring oompul.ory arbitration.
COUNT IV
Ruth Dan!.l V. Holy SDirit Ho.aital
'1. Paragraph. 1 through 81 and count. I through IU of thb
Complaint arl inoorporatld hlrlin by rlflr.ncl a. if ..t forth at l.ngth.
92. At all r.llvant timl. h.rlin, Dlf.ndant Charl.e R. Inner., H.D.,
D.flndant Luan Gramm, R.N., and all medical p.nonn.l inoluding .taU
nur... who providld carl to Ruth Danill in Augu.t, 1992, Wlrl the IVlnt.,
eppannt ag.nta, .Irvantlt and/or emp1cye.. ot Dlf.ndant Holy Spirit
Ho.pi tal .
93. D.f.ndant Holy Spirit Hospital, acting through ita agenta,
appar.nt aglnta, 'Irvanta and/or employe.., i. liable to Plaintiff for
injuril. and damagl. aa .et tcrth in paragraph. 28 through 11 .bovI which
.rl incorporat.d hlr.in by rltlrlncl a. it Bit torth at llngth .nd alai.
i. made thlr.tor..
u. Dehndant iloly Spirit Ho.pital, aoting throulj/h it. agente,
.pparent avent., ..rvant. and/or Imployel., failld to takl the n.o....ry
19
ItlPI in or4er to en.ure the latety of Mr.. Daniel, knowing that Ihe wa.
dependent upon Defendant Holy Ipirit HOlpital and it. .t.ff, Ind i. l1.ble
for it. f.ilure to intervene and prevent the improp.r adm1niltration of an
overdo.e of 1n,ulin to plaintiff, Ruth Dani.l.
n. Defendant Holy spirit Ho.pital, aotin9 tbrou,h it. a,.nt.,
apparent a,.nt., .erYant. and/or .mployee. i. liable to the Plaintiff,
Ruth Dani.l for itl failure to provide guidelin.., protoool., polioi."
.n4 proc.durel for intervention when a phy.ioian order. an overdo.. of
inlulin in a labile diabetio patient, r'lultin\J in hyp09lyoemio Ihook an4
..i_un.
U. A. a direct and proximate n.ult of Def.ndant Holy Spirit
HOlpital'l ne911\1enoe a. alll\1,d herlin, plaintiff, Ruth Daniel, hI'
,ulta1ned injurie. and damage. a. .et forth in para\1raphl 21 throu9h 11
above whioh ar. inoorporated herein by reference a. if let forth at length
and a claim 1. made ther.fore.
WHEREFORE, Plaintiff demand. judqment againlt Defendant, Holy Spirit
HOlpital, in an amount in excos. of Twenty Thou.and ($20,000.00) Dol1.r.
exoludve of inter..t and CO.tl and in exce.. of any jurildictional .mount
requiring oompullory arbitration.
.,
CqUNT V
Ruth Doniel v. Holv Scirit Ho.cital
t6. paraqrapha 1 through 81 and countl I throuqh IV of thil
Complaint are incorporated herein by reterence a. if .et forth at length.
20
e1. All nur.e., phy.ician. and ancillary ho.pital per.onnel,
providinq carl for Plaintift, Ruth Danill, in 1982, wire at all relevant
I
ti.e., aglnt., apparent aglnt., .ervant. and/or employee. ot Detendant
Holy .pidt Ho.pital and acting within the 'COPI ot ..id e.ploYlllnt.
e8. In 1882, all medical .taff, cOllllD~ttee member., ho.pital
cOllllDitte. membere, and board memblr. wire aglnt., apparent aqlnt.,
.erva"t. and/or employee. ot Defendant Holy Spirit Ho.pital, aoting in the
.cope ot thlir employment and authority aa ve.ted in the. by Dltandant
Holy Spirit HOlpital.
gg. Defendant Holy spirit Ho.pital'a neqligence, a. allegld herein
and incorporated by reterence, wa. a lubatantial tactor in bringing about
the harm .u.tained by Plaintitt, Ruth Danill.
100. Dlfendant Holy Spirit Ho.pital had a nondelegable duty owed
directly to it. patient, Ruth Daniel.
101. In 1892, Defendant Holy Spirit Hoapital, through it. agent.,
apparent agent., servantl and/or employee. h.d a duty to ovenee aU
penon. who practiced medicine within it. wall. AI to patient oare,
including Defendant. Inners and Gramm.
102. Defendant Holy Spirit Hospital i. liable tor failing to over.ee
Defendant Inner.' and Defendant Gramm'. practioe of medicine within it.
wall. .. to patient care and in partiCUlar, a. to Plaintift patient, Ruth
Daniel.
10:). In 1992, Deten.dant Holy Spirit Hospital had a duty to U.e
re..onable oare in the provieion of sate and adequate equipment and
per.onnel.
21
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104. Def.ndant Holy spirit Ho.pital, IctinljJ throuljJh it. .'1.ntll,
appar.nt .,.nt., ..rv.nt. and/or employ.e. i. liable for it, tailure to
u.e rea.onabl. care in the provi.ion and maintenanoe ot .ate and adequate
per.onn'l tor the c.r. of Plaintift patient, Ruth Daniel.
1011. In 1812, Defendant Holy Spirit Ho.pital had a duty to IIl.ct and
retain only competent phy.ici.n. and nur....
106. In 11'2, D.tendant Holy Spirit Ho.pital had notice that
Det.ndant Gramm wa. not a qualitied nur.a.
107. Sp.cifically, D.f.ndant Holy Spirit Ho.pital'. culpabl. conduct
"
wa..
(a) it. failure to formulat., adopt .nd enforo.
polioie. and prooedur.. to en.ur. quality
monitorinq and managinq of a labile in.ulin
dep.nd.nt diabetic .uch AI Plaintiff
patient, Ruth Daniel,
(b) improperly proce..inq and evaluatin,
Def.ndant Gramm'. cred.ntial.,
(0) fail1nljJ to verify Def.ndant G:nD\lll'. .kill
a. a nur.e before allowinq h.r to ...... .
labile in.ulin d.pendent diab.tic pati.nt
.uch a. Plaintiff pati.nt, Ruth Dani.l,
(d) failinq to te.t D'fendant Gr.mm'.
profioiency and comp.t.noy in monitoring
and manaljJinljJ an in.ulin d.p.nd.nt di.betic
patient to en.ur. that h.r nur.inq .kill.
w.r. ourrent with .tate of the art
22
"
development. in the management and c.~e of
.n in.ulin dependent di.betic pati.nt, and
(.) tdlin9 to limit, auapend OJ: revoke
Det.ndant O~allllll" nu~.in9 privilege. in
monitorin9 and mana9in9 patient. at ita
tacility.
10.. Defendant Holy Spirit Ho.pital, acting throuvh it. av.nt.,
appaunt agcilt., .ervant. and/o~ employee., 11 liable tOJ: ita lalection
and retlntion of Deflndant. InnlJ:. and Gramm and it. failure to .up.rvia.
and monitor the pJ:actioe of Detlndant. Inner. and Gramm within ita wall..
1011. Defendant Holy Spirit Ko.pital, lotinq through it. agent.,
apparlnt avent., .ervant. and/or employe.., i. liable tor ita failure to
tOX'lllulaU, adopt, and entorce adequate rule. and polic1e. to .n.ure
quality of oan for ita patient., includinq PldntUf p.tient, Ruth
Daniel.
110. Defendant Holy spirit Koapital had a duty to fOX'lllulate, adopt,
.nd en fa roe adequate rule. and policie. to en.ure quality of care for it.
patienta, includin9 Plaintiff patient, Ruth Daniel.
111. In 1992, .Detendant Holy spirit Ko.pital wa. aocredited. by the
L Joint commi..ion for Accreditation of Hcapital. (herein JCAH).
(I
112. In lllll:ll, ho.pitall aocredited by JCAH wen required to e.tabli.h
and maintain various cOlllll\ittees to revilw specl,tlc uplota of thl pr.ctice
of medic in. within it, in.titution, inoludinq the prooe..ing and ......1nv
of phy.ic1.n and nur.1 credential. and the review, analy.i. end evaluation
of phy.ioian'. and nur.e'. clinioal performanoe.
"
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113. %n holding 1 tlltlf out to the pubUc .. JCM accreditad,
Defendant Holy spirit HOlpital W&I proolaimin9 thftt it fOl'lllulatad and
entoro.d prooedur.. and p01ioi.. tor the .at.ty and prot.otion ot patienta
in acoord.nc. with the minimum .tandard. ..t torth by JCM.
114. In 19'2, D.t.ndant Holy spirit Hoepit.l h.d a duty to
inve.Uvat., monitor, and it n.o....ry, revok., limit or .u.p.nd Detend.nt
Inner. and/or Gramm' a privileg.. in the tac. of que.tionabll or
.ub.tandard oar..
UB. D.f.ndant Koly Spirit Ko.pital 11 liable for it. teilur. to
comply with the nquinm.nta of JCM with regard to .ntoroinv polio he and
proc.dur.. tor the quality and eat.ty ot ho.pital-b...d patient care,
inoluding car. provid.d to Ruth Daniel in 1992.
116. Dat.ndant Holy Spirit Ko.pital 11 liable tor it. teilure to
provide any ,ub.tantiv. t.sting or concrete .valuation of Defendant
Inn.r'. and/or Gramm'. .kUl. bat ore perm1ttinq th.m to .valuat. and
monitor pati.nt'. including Plaintift pathnt, Ruth Daniel within it. four
w.U..
117. Detendant Koly spirit Hospital tailed to .uparvi.e Detendant.
Inn.u and GrallUll properly, and a. a r..ult ot th.ir failure to do .0,
Defendant Holy Spirit Ho.pital breached ita duty to it. patient, I'uth
Daniel.
118. Thi. br.ach of duty by Detendant Holy spirit Ho.pital wa. the
direot .nd proximate re.ult ot the injurie. alleg.d herein and
incorporat.d by reflrenc..
119. Def.ndant Holy spirit Ho.pital, through it. agent., inoludinv
medioal etatf committe. member., ho.pital committe. m.mb.r., and board o(
24
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t~.t.. ..~e~', ha. the ri9ht and duty to cont~ol .taff p~ivile,e. an'
practice. within it. in.tltution, lncludln9 the p~ivileg" and practlce.
01 Def.ndant. Inner. and Ora.m.
no. Nevertheh.a, Def.ndant Holy Ipidt Ho.pitel did not inv..ti,ate
o.f8ndant. %nne~. or Olt'.., no~ take any .tep. to 11ll1it, .u.pend, or
...vok. theb' pdvUe9.. or tI.t their proficiency and co.petency in
cUll'r.nt .anave.ent and c.re of in.ulin diabetic patient., or liait and
di.clpline th.m for inappropriate or .ub.tandard patient care.
121. Additionally, Def.ndant Holy spirit Ho.pital i. li.ble fO~1
(a) failing to .elect Ind retlin only oompet.nt
phydoiln. ,
(b) failin9 to ovelt'.e. III p.~.on. who practioe
J1\.dioina within it. wall. a. to patient
care,
(c) fdUn9 to formulate, adopt, and enfo~oe
adequate rule. and pOlicie. to en.ure
quality oara to it. pat1ant, Ruth Daniel,
(d) failin9 to report conditiona and que.tion
Def.ndant Inner.' practice and prooedure.
wh~n not in aooordance with the .tandard.
of ..dioal praotic.,
(e) failin9 to en.ur. patient eafety and well-
b.in9 while at the ho.pital,
(f) falUn, to review, analyze and evaluate
Defendant Inner.' clinioal performanoe,
215
,
C.R1I.lCA~. Qr. ,..VIe.
AIID NOW, thi. 17th day of ,.brulll')', 1994, I, JAYSON R.
WOLrQANO, .SQUIRI, he~eby certify that I am .erving a copy ot
the fo~egoinq document upon the perlon(.) and in the manner
indicated below, which .ervioe lati.fie. the requirement. of
the Penn.ylvania Rule. ot
of the lame in the United
Civil Procedure, by depoliting a oopy
State. Mail,
Hard.burg,
prepaid, a. followll
penn.ylvania, with firlt-cla'l po.tage
Nijole C. Ol.en, I.quire
Angino , Rovner, P.C.
4503 North Front Street
Harrilburq, PA 17110
Miohael W. MoGuckin, Elquire
l850 William Penn Way
Suite 209
P.O. Box 106915
Lanoalter, PA 171505-01596
METTI, EVANS , WOODSIDE
1. f'~_
Jay on R. Wolfqan~
1 1 Korth Front Stre.t
P. O. Box 5950
Harri.burg! PA 17110-0950
(717) 232-0000
By.
"'+1150
.
ItUTH iI. DANIIL
Plaintiff
IN THI CQURT or COMMON PUM .
CUMBIRLAND COUNTY, PINNIYLVANIA
v.
CIVIL ACTION - LAW
NO. 4l3-civil-1tt4
CiW'UI a. INNIRB, M.D.
INNIRI DAVI' AI80CIA~IS
WAIf OIWDlL R.N., and
HOLY l'IaIT HOSPITAL
D.fend.nt
ilURY TRIAL DIMANDED
PLAINTIFF'S RIPLY TO NEW MATTIR or DlfENDANTS
CHARLa. R. INNalf. M.D. AND I~NIR.-DAVtS ASSOCXAT.,
123. Plaintiff incorporat.. her.in by ref.renoe a. if ..t
forth .t l.ngth paragr.ph. 1-122 of Plaintiff'. Complaint.
123. Plaintiu', Complaint adequately .Ita forth cau... of
aotion reccgni.ld undlr Penn.ylvania law.
124. Paragraph 124 of Defendant'. N.w Matter ia objeoted to a.
b.ing vagu., broad and impo..ibl. of re'pon.e and in violation of
the 'enn.ylvania Rule. of Civil Procedure requiring .peoifio
pl.alUng of .fth:m.tive d.t.n.... By way at further r.,pon..,
Plaintiff, Ruth Daniel wa. in no way contributorily or
oompar.tively nlgligent nor did her aotion. in any way contribut.
to her injuri.. nor did .h. a..uml the ri.k of injurie. wh.n .ha
pr...nt.d her..lf for c.re to the Defendant. and tru.ted that th.y
would p.rfor. that oare in a nonneglig.nt manner. Ruth Dani.l, in
no w.y, a..umed the ri.k of her oar. unl... An.wering D.f.nd.nt.
ar. ....rting that thlir incomp.tlnoe wa. .0 op.n and obviou. that
Ruth Daniel .hoUld not have .ought tr..tment with them.
4006t/IU
131. Th~ allevation. herein con.t1tute conolulion. at law to
which no re.pon.e 1. required. An.werinv Defendantl' negl1vence
w.. a .ubltanUal cau.e and taotor ot the .ubjeot 1nc~dent and
relulted in th. 1njur1.. and 10.... .numerated in PldnUU'1
Ipeo1t1o complaint.
126. The allevation. herein con.titute conclu.ion. ot law to
which no re.pon.e il required. An.werin; Defendant., nevl1gence
w.. . .ub.tential cau.e and factor of the .ubjeot lno1dent and
re.ulted in the 1njurie. and damave. to Plaintiff a. alleved in
Plaintiff'. .peoific Complaint. Interveninq or .uperleding cau.e
doe. not apply.
127. The allevation. herein oon.titute oonolu.ion. of law to
which no re.pon.e i. required. An.wering Defendant.' neqligence
waG a .ub.tanUal oau.e and faotor of the ,ubjeot 1no1dent and
re.ulted in the injurie. and damaqe. to Plaintiff a. alleged in
Plaintlff'. .pecific complaint.
128. The allevation. herein oon.titute oonclu.ion. of law to
which no re.pon.e i. required. suit wa. timely fl1ed.
12P. The allevation. herein oon.titute oonclu.1on. of law to
which no re.pon.e 1. required. Plaintiff ha. .tated a cau.e ot
action upon which relief may be qranted.
130. The alleqation. herein oon.titute oonclu.ion. of law to
which no re.pon.e i. required. Plaintiff ha. oomplied with the
.peoifioity requirem.nt. of Pa. R.C.P. 1019.
WHIUrORI, P~dnUtt re.pecttully reque.ta thi. Honorable
Court to d18mb. the New MaUer of An.wer:1nq Defendanta and to
.trike paraqraph. 123, 124, 125, 126, 127, 128, 129 and 130 of the
,,~ 'd
AnIWe~ with New M.tte~.
R'I~ectfully lubaitted,
ANOINO . RO,~IR,
DATlDif J.f'Jej lSl 1C19 Y
.0 Ion,
5287
th Front 8t~e.t
Harri r9, PA, 17110
(717) 238-1I7t1
Coun.el for Plaintiff
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C'R~I.IC~~. o. ...V!C,
X her.by oertify that I, Sand.-- r... RieheU, an e.ploy.. of
Anvino 'Rovne~, P.C., thi. 11th d.y of F.bruary, lee4, have ..rv.
a tNe and oo~r.ct copy of PLAINTIrr's RIPLY TO NEW NAT1IR 0'
DI'INDANT. CHARLlS R. INNIRS, M.D. AND INNIRS-DAVIS A8S0CIATI. by
..ndin9 lam. Unit.d Stat.. tint cla.. Imail, pOlt'g. p~.pdd,
.ddr....d .. folloWl1
Micha.l W. McGuckin, I.quir.
1850 William P.nn Way
Suit. 20e
P.O. Box 101lU
Lanca.ter, PA, l71105
Attorney for Def.ndant.,
Ch.~le. R. Inn.r., M.D. and
Inner. Davi. A'lociate.
Ja.on R. Wolfgang, .Iquire
MITTI, IVANS . WOODSIDE
3401 North 'rant Street
Harr1.burg, PA, 17110
Attorney tor D.fendant.
l"u.n Gr.am R.N. and
Holy Spirit Ho.pital
~r~'t.
I4ml'~'
, "
IlUTM ~. ~IIL
plaintiff
IN THI COURT or COMMON PLlAI
CUMIIR~D COUNTY, '!INNIYLVANIA
r.IVIL ACTION - ~w
NO. 413-clvil-1tt.
v.
C~LI' R. INNlal, M.D.
INNIIlI DAVII ASIOCIATIS
LUAN GRAHHL a.N.t and'
HOLY IPIRIT HOSPITAL
Defendant
JURY TRIAL DIMANDID
PLAINTIff'S RlPLY TO PRILIMINARY OBJICTIONI Of DI'INDANTI
WAN OIWlM, R.N. AND HOLY SPIRIT HOfJPITAL TO
PLAINTI'.'S ~.ND.D CO~PLAIN~
1. A true and oorreot copy of the plaintiff" bend.d
Complaint. i. attaohed hereto a. Ixhibit "A".
Id1urrICIIKT .PICIr~CIT1 or THI PLBADtNO
:a. The aUeqation herein .tat.. ~ oonolul1on of law to which
no re.pon.e i. neoe..ary. To the extent that an .n.wer may ba
required, it i. denied that paragraph :a of Defendantl' preliminary
Objection. .ocurately and oompletely .et. forth the full provilion.
of pa. R.C.P. 101'.
3. The Plaintiff'. complaint i. a written dooument whioh
.p.ak. for itaelf. By way of further re.pon.e, it i. .paoifioally
4enied that paragraph 3 of Defendant'. PreUminary Objeotion.
acourately and completely ..epre.ent. the allegation. ..t fortb in
Plaintiff' 1 bended Complaint.
.. The plaintiff" complaint i. a written document wbioh
.peak. for ii.elf. By way of further ..e.pon.e, it i. .pacifioally
40u"n.
denied that pua9raph 4 of Defendante' PreliJIllnuy Objeotion.
aoouratel~ and oompletely repre.ent. the alleqation. ..t forth in
co~nt I of Plaintiff'. Amended complaint.
5. The Pldnt1ff'. compldnt i. a Wl'Uten dooument whioh
.p.ak. for iteelf. By wa~ of further re.pon.e, it i. .p.cifioally
d.nied that puagraph II of Defendanh' PreUminuy Objeot1on.,
aoouratel~ and oompletely repre.ent. the allegation. .et forth in
Plaintiff'. Amended Complaint aqain.t Defendant. Luan Gra.., R.N.
and Holy Spirit Ho.pital.
6. The Pldnt1ff', complaint i. a written dooument whioh
.peak. for it..lf. By way of further r..pon.e, it i. .peoificallY
denied that panqnph 6 of Defendant.' preliminary Objeot1on.
.ocurately and oompletely repre.ent. the alleqAtion. .et forth in
Count III of Plaintiff'. Amended Complaint aqain.t Defendant Luan
Gra.., R.N.
7. The Pldnt1ff', Complaint i. a written document which
.peak. for it.eU. By way of fux'ther r..pon.e, it 11 .pacificallY
denied that puaqnph 7 of Defendante' Preliminary Objeot1on.
aoc~rately and completely repr..ent. the alleqation. .et forth in
count IV of Plaintiff'. Amended Complaint aqain.t Defendant Holy
spirit Ho.pital.
I. The Plaintiff" Complaint i. a written document which
.peak. tor it.elf. By way of further re.pon.e, it i. .pecitioally
denied that puaqraph 8 of Defendant.' Preliminary Objeotion.
aocurately and oompletely repre.ent. the alleqation. .et forth in
count V of PldntUf" Amended Complaint aqain.t Defendant Holy
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'pi~it Ho.pital.
t. The aU'liJaUon. herdn .tate a oonelu.ion of law to which
no ~e.pon'e 18 nae...ary. By way of further re.pon.a, it h
.paeifieally denied that parsgraph. '3(q) (t) (v) (I) (liJliJ) and "(h),
Count IV in it. entirety, ineludinliJ paraqraph. 84, 8S, lOa, 104,
10', 10', 117, 12l(a) (b) (0) and (e) of Plaintiff'. Amended
Complaint eontain un.peeifie or boilerplate allegation. of
nagUgenee. Rather, the above reterenced paragraph., .ubparaliJraph.
and Count IV, in fact, earefuUy reeite. factually .paeUic
allegation. of .pecifie conduot of all named Defendant. in
eomplianee with Pa. R.C.P. 1019(a). Plaintiff. filed a 27-paqe,
ua.pangraph Amended Complaint replete with faotual aUegation. of
the Defendant.' .pecific conduct and neqligenoe. It i.
.pecUically danied that the lanquaqe contained in the above
referencad paragraph., .ubparaqraph. and Count IV merely .et. fo~th
a recital of ','boilarplate lanquagen applicable to any Complaint.
Rather, eaoh of the alleqation. in Plaintiff'. Amended Complaint
.et. forth clear, oonai.e and .pecific aota of conduct for eaoh
Defandant a. required by Pa, R.C.P. lOlg(a).
10. The aU.qation. herein .tate a conoluaion of law to which
no re.pon.e i. neea..ary. To the extent that an an.wa~ i.
requi~ed, it i. .pecificallY daniad that Plaintiff ha. failad to
.et fo~th .pecifio act. or omi..ion. of allegad neqligence with .
deqree of partioularity and .peciticity required by the
Penn.ylvania Rula. of Civil Procedure .0 aa to give adequate notice
to Defandant. Orallllll and Holy spirit Ho.pital AI to Plaintiff"
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olai.. of ne91igenoe. Plaintiff ref.r. thi. Honorabla court to
.laintiff', 37-page, 122-paragraph Aaended complaint attached
hereto a. Ixhibit "A" to iUu.trate that each of the above
referenced para9raph. ccntain clear, oonci.e and .peoific faotual
allevation. of nevlivenoe with regard to each .pecific Defendant
lncludinv the An.werinv Defendant.. It i. .pecificaUy denied that
'ldntitf', Aaended Clompldnt containa general or boUerplata
aue9aUon. of nevliV~lftoe in violation of Pa. R.C.P. 10U(a).
Clearly, the allegation. in Plaintiff" Aaended complaint includinv
the above ref.renoed paravraph., .ubparaqraph. and count IV more
than adequately appriee all oppodng partie. of prloi.ely what
'ldntitf', intend to e.tabli.h at trial. To .u9ve.t that
Plaintiff" Aaendld complaint, .peoifically the above reterenced
paragraph., .ubparagraph. and Count IV, faile to meet the
.pecificity requirement. of Pa, R.C.P. 1019(a) i. a mookery to thl.
court and to the Rule. of Civil Procedure.
WHIRlrORI, plaintiff re.pectfuUy reque.t. thi. Honorable
Court to diemi.. Defendant Luann Grau, R.N. and Holy spirit
Ho.pital', Preliminary Objection. aUevinq in.ufficient .peoificity
ot the pleading in paragraph. 83(q) (t)(v) (1)(gV), 89(h), count IV,
paragraph. 94, 95, 102, 104, 108, 109, 117, 121(a)(b)(c) and (e)
and direot that Defendant. Luan Gramm, R.N. and Holy Spirit
Ho.pital provide an an.wer to Plaintiff" Aaended complaint within
twenty (20) day. of thi. court'. ORDER.
4
LaOAL INSQ,.ICIZNCY QP TN. PL.ADtN08 IDIMORA..'
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11. The Plaintiff'. CmDplaint 11 a written dooument which
.peak. tor it.elt. By way of further re.pon.e, it i. .pecitioally
denied that paragraph 11 of Defendant.' praUminary ObjeoUon.
aoourately and oompletely repre.ent. the alleqation. .et torth in
Count V of Plaintiff" Amended Complaint.
U. Any .uqge.tJ.on that Defendant Holy Spirit Ho.pital had no
duty impo.ed upon it to be aooredited by tha Joint Commi..ion for
Aocreditation of Ho.pital. a. the ba.b for it. reUef from
liability, i. .paoifically denied. Defendant Holy Spirit Ho.pital
failed to parform varioul and di.creet undertaking. enumerat.d in
Plaintiff'. Amendld Complaint. Defendant Holy Spirlt Ho.pltal h..
no ba.i. by which to object to Plaintiff'. well-pled and faotually
.pecific Complaint. Defendant Holy Spirit Ho.pital mu.t either
admit or dlny the alleqationl in Plaintiff'. Amended Complaint and
ha. no bad. to preliminarily Object to Plaintiff'. taotuaUy
.pecifio alleqation. of Defendant., neqliqanoe.
13. The allegation. herdn .tate a oonolu.ion at law to
wbioh no rl.pon.e i. neca..ary. To the extent that an an.wer .ay
be required, Plaintiff ha. filed a 'Uffioiently .pecifio Complaint
for whlch Defendant Holy Spirit Ho.pital muet provide an an.War.
Defendant Holy spirit Ho.pltal'. Preliminary Objeotion ha. no ba.b
what.oever. Defendant Holy Spirit Ho.pital remaln. jointly and
.everaUy liable, along with the othar namld Defendant. tor the
injurie. and damaqe. to the Plaintiff a. .et forth in the Amended
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RUTH J. DANIIL I It! THI COURT or COMMON I'LlAS
I DAUPHIN COUNTY, PENNSYLVANIA
Plaintiff I
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V. I CIVIL ACTION - LAW
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CllAJl,LZI R. INNIItS, M. D. , I NO. 371l4-S-113
INNIItS DAVIS ASSOCIATES, I
.WAN OJWIM, R.N'i I
HOLY SPIRIT H08P TAL I
I
Defendant. I JURY TRIAL DBMANDID
AMENDED COMPLAINT
1. Ruth J. Daniel i. an adult individual residinq ln Harrl.butq,
Dauphin county! penn.ylvania.
2. Defendant Chad'. R. Innere, M.D., an adult indivldual, is
lioensed to practice medicine 1n the commonwealth of penn.ylvania, who, in
1"2 engaved in the practioe of Internal Medicine in camp Hill, cumberland
county, penn.ylvania.
3. Inner. Davi. A..cciate., i. a profe..ional proflt-makinq
corporation, which pr()vide. medioal s.rvioe. in cumberland county,
penn.ylvania.
4. Defendant Luan Gramm, R.N., an adult individual, i. a regl.tered
nurae, who ln Ut:! praotioed nureinq in camp Hill, cumberland county,
.penneylvanb.
II. Defendant Holy spirit Ho.pital, 1. a oorporate medioal
institutlon with offioe. and medioal fa01litie. in camp Hill, CUlberlar.d
county, penn.ylvania.
6. Defendant Charl.. R. Inner., M.D. w.. at all relevant time.
hereinafter, aoting a. an avent, apparent aqent, .ervant and/or e.ployee
of Defendant Inner. Davit A..coiate..
j;d
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? . Defenlt,nt Charla. R. Inneu, M. D. wa. at ,11 relevant U.e.
hereinafter, aotira; AI an aqent, appaunt aqent, ..rvant anlt/or eJDplo~.e
of Defenltant Hol~ spirit Ho.pital.
I. Defendant Gramm we. at all relevant time. hereinafter aotinv a.
,an agent, apparent agent, .ervant anlt/or employ.e of D.fenltant Holy .plrlt
Hoepital.
t. On AU9u.t IS, 1992, Dr. stephen J. Davia adllitted hia lonv-
etancUn\J patiant, Plail)tiff, Ruth Daniel, to D4Ifend.nt. Hol~ 'pirit
Hoepital for orthopedio evaluation of foot pain.
10. upon her admiaeion to Defendant Hol~ spirit Hoapital, plaintiff,
Ruth Daniel wu .tnted on in.ulin Cloveraql with a maximulIltaUy allot.ent
of 20 unit. NPH in.ulin.
11. Plaintiff's daughter, Debra Niooltlmu., advieelt the ho.pital'l
nurse. and phy.ioian. oaring for Ruth Daniel that her mother was allervio
to Regular in.ulin.
12. Plaintiff, Ruth Daniel'l nur.ing care reoord, ltat.d Augu.t e,
1992, noted her allerqic reaction to Rlqular inlulin AI foUows. IIdau9hter
states patient ha. never been able to be controllelt with Regular inSUlin.
.tate. ~hat they have had problem. in the pa.t with her eugar fluotuating
when ue1ng Regular in.ulin. II
13. Moreover, attaohed to Plaintiff, Ruth Daniel'a ..ltioine Kardex
were warnin9 stioker. advi.ing the ho.pital's nur.e. anlt ph~lioian. of
Mr.. Daniel'. allerqio reaotion to Regular insulin.
14. On Augu.t 7, 1092, at approximately 7130 a.II., Plaintiff, Ruth
Daniel reoeivelt in.ulin caveraqe of 20 unit. of NPH in.ulin.
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15. Plaintiff, Ruth Daniel'_ receipt of 20 unit. ef NPH in.ulih a'
0730 hu on Augu.t 7, 19112 wa. .igned off on hell' mediQine JUdex ~)'
Defendant Holy spirit Ho.pital', .taff nUr.e, .n LPN with the abbrevia'ed
initial., "P"".
16. six hour. lat.r at 1330 hr. on August 7, 1992, Def.ndant Inner.
vave 'TAT order. for plaintiff, Ruth Daniel, to receive additional in.ulin
I.euntinq to 40 unit. of NPH in.ulin and 2S unit. of Regular inlulin.
17. siqnificlntlY, Defendant Inner. ordered the everdOl. of 1n.ulin
without ever examining hi. patient.
18. Defendant Inner. ordered the overdo.e of in~ulin by tllephene.
1'. Defendant Inner. ordered the overdo.e of in.ulin at 1330 hr. en
Augu.t 7, 1992, de.pite plaintiff, Ruth Daniel'. prior ceveraVI with 20
unit. of NPH in.ulin at 0730 hr..
20. An oVlrde.e of in.ulin cau.e. blood Vluco.e level. te lower
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drllllltically, re.ultinv in hypoqlycemia with .eizure. and .hock.
21. Hur.e Gramm did net properly review or relay the infermatien
noted in plaintiff Ruth Daniel'_ medicine Rerdex on Auqu.t 7, leg2.
aa. Nurae Gramm did not report Coafendent Inner.' overde.e of 1n.uUn
te hie paUent, plaintiff Ruth Dani..l te her .upervieor or ether ef
Plaintiff'. treating phy.ician..
23. Nur.e Gramm failed to under.tend that any additional in.ulin at
lUO hra en Augu.t 7, 19112 oould re.ult in Plaintiff patient, Ruth
Daniel'. experiencing hypoglyoemic .hook and .eizure.
24. Fellewing Defendant Inner.' STAT order overde.ing hi. patient
with in.uUn, Plaintiff Ruth Daniel wa. tran.ported to the racUolo9Y
department fer an ultra.ound relatinq ,to her orthopedic evaluation.
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U. U9nUioantly, neither Nune Oralllm or any of Defendant Holy
.pirit Ho.pital', nur.inq .taff monitored Plaintiff Ruth oaniel'. blQod
91uoo.e level. tollowing Defendant Innen' STAT order overdo.i.ng hi.
patient with in,ulin.
26. Plaintiff, Ruth Daniel wa. returned to her room fol10win9 an
ultra.ound examination at app~oximately l~OO hr..
n. At that Ume, Plaintiff" daughter, Debra NioocSelllu" w.. pn..nt
in her mother'. room.
~.. Not .urprieinq, following Defendant Inner.' STAT order
overdo.inq hi. patient with in.ulin a few hour. earlier, Mr.. Kioodemu.
ob.erved her mother thra.hinq and eonvul.inq in her bed unoontrollably.
ago Plaintiff" dauqhter, Mr.. Nicedemu., ran to the nur.e. .tation
to get help for her mother.
30. Nur.e. note. documented Plaintiff, Ruth Daniel, .hakin9 from a
.eilure, unre.pon.ive to .timuli and pupil. unr..pon.ive to livht.
31. A. plaintiff, Ruth Daniel'. primary treating phy.ioian,
Defendant Innen WAl contacted by Defendant Holy Spirit Ho.pital'. nuning
.taff and re.ponded by qivinq orders by telephone for blood .ugar .tudie.
to be drawn and that Plaintiff, Ruth Daniel, r.oeive an ampule of vluoo.e
and water (D~O).
32. Nur.e. note. document that Plaintiff, Ruth Daniel'. blood .uvar
wa. un.uooe..fully drawn.
33. Nur.e. note. al.o dooumented that the failure to draw blood. on
the fir.t attempt was not reported to staff.
34. Bivniticantly, be fora Plaintiff, Ruth panial'. blood .uvar wa.
drawn, .he received an ampule of vluco.e and water (D50).
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U. The overdo.e of in.uUn ordered by Defendant InneU va. .0
exoellive, that by ~'OO p.m. on the evenin9 of AuqU.t 7, liea, Plaint~'"
Ruth Daniel" blood .uljJu Wal down to :l8 m9/dl and a .eoond ampule of DOt
gluoo.e and wat~r wa. admini.tered.
3e. Bn.in funotion depend. on an adequate .upply of 91uClo.e froa tbl
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blood end e blood .ugar .. low a. as i. oon.i.tent with hYPolillyce.ic ehook
whioh Clan re.ult in .evere brain damage, .eilure., ooma, and neurologio
deficit.
37. Approximately one hour after Defendant Holy spirit Ho.pit'l'l
nur.inq .taff ob.erved Plaintiff, Ruth Daniel'. hypoglyoemio oonvul.inlil
.ei.ure. and .hock, Plaintiff'. complaint. of right .houlder pain w.r.
dooumented and reported to Defendant Inner..
3S. Defendant Inner. failed to respond to call. or to oome into the
ho.pital to examine hi. patient.
3t. Over the next .everal hour. Plaintiff, Ruth Daniel wal
dOClulllented to be moaninq in pain with noted quardinq of her ri9ht upper
.houlder.
40. Plaintiff, Ruth Daniel waB DQt taken to the radiology department
for x-ray evaluation of her riqht .houlder un~il approximately 1t40 hr. or
well over five hour. after her convul.in9 hypoqlyoemio .eilure wa. not.d.
41. At that time X-ray examination of Plaintiff, Ruth Daniel'. right
.houlder docUllllnted a fracture of the neok of the right humeru. with eo..
rotation of the humeral head.
42. Following the x-ray examination an orthopedio evaluation by Dr.
Band. noted Plaintiff, Ruth Daniel'. unre.pon.ivene.. to ~erbal Itimuli,
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right .houlder edem. and l(~ny tindinqB ccmlliBtent with a fraotur!ld and
di.loolted riiht .houlde~.
U. Dr. Bande further noted that Plaint!!f, Ruth Daniel required
.edation before Iny attempt at reduction 8urqery for her .houlder frecture
,Ind di.looltion,
44. By 10100 p.m. or 9 hour8 after hi. telephone order overdoa1nV
hie patient with in.ulin Detendant Innen finally came in to aee hi.
paUent.
4e. At that time, Defendant Inners recorded in the progre.. note.
that he ordered an overdoee of insulin at 1330 hr..
46. At that time Defendant Innen also documented Plaintiff patient,
Ruth Daniel'. .eizure following his order overdo8ing her in,ulin.
47. Defendant Inners further documented that Plaintiff patient, Ruth
Daniel received one ampule of Deo prior to her blood sugar. beini drawn
whioh aooounted for her reported blood sugar of 433.
48. At that time, Defendant Inners also documented Plaintiff
patient, Ruth Daniel's fraotured and dislocated right .houlder followinv
her .eilure .eoondary to hypoglycemia.
49. At that time Defendant Innors also documented review of hi.
patient'. ~edicine Xardel( only after he ordered the overdo.e of 1n.ul1n.
eo. In the early morning hours of August 8, 1992, Defendant Inner.
documented Plaintiff patient, Ruth Daniel'. inability to move her rivht
arm .eoondary to her fraoture.
el, In light of Plaintiff patient, Ruth Daniel'. failUre to "eapond
to external atimuli, a neurologic consult was ordered.
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n. Neuroloqiet, Dr. Todd Samuela, examined Plaintiff Ruth Daniel on
Augu.t 8, 1992 and documented her seizure activity, and per.i.tent llok 01
nspon.ivene.. as .econdArY to an overdo.e ot in.ulin oludnv
hypoglyoemia.
83. Neurologi.t, Dr. Samuels further documentsd Plaintitf patient,
Ruth Daniel'. encephalopathy a. seoondArY to hypoglycemio ahook and
.eieure, and, oon.equently recommended that orthopedio intervention for
her fraotured and dislooated right .houlder be delayed until her
neurologio .tatu. improved.
84. On Augu.t 10, 1992, orthopedio surge~n, Dr. Ban~., documented
Plaintitt patient, Ruth Dani..l' s persistent riqht .houlder pain and
cautioned that her prognosis tor closed reduction was guarded.
88. On Augu.t 12, 1992, Dr. Bands, attempted olo.ed reduction of
Plaintitt Ruth Daniel'. traotured and dislooated riqht .houlder under XV
.edation.
86. The attempt to treat Plaintiff Ruth Daniel'. traotured and
dielooated right .houlder secondary to hypoglycemic edzure by olo.ed
reduction tailed.
8? aeneral aneethe.ia wae considered prohibitiVe in Plaintiff
patient, Ruth Daniel and her right arm was immobilized in a Sling.
88. At that time it was Dr. Band's opinion that Plaintiff patient,
Ruth Daniel'. progno.i. for her right .houlder was poor.
89. Throughout her August and september, 1992 ho.pitalhation,
Plaintitf, Ruth Daniel'. traotured and di.looated right .houlder remained
.wollen, edematou., tender and extremely paintul to the touch.
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60. Ar:tr:titionally, P11l1ntitt Ruth Daniel also complainer:t of left knee.
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pain following her hypoglycemic e.izure for which x-ray. were not taken
until september 11, 1992 or 3~ days after the convulsinq seizure caused by
Defendant Inner.' orr:ter overr:to.ing insulin.
61. Rar:tioqraphio examination of Plaintiff, Ruth Daniel'. left knee
taken on September 11, 1992 revealer:t a fracture of the left tibial
plateau.
62. followinq the unsuccessful attempt at clo.er:t rer:tuotion .urgery
for Plaintiff Ruth Daniel'e fractured and dislocated right shoulder,
physical therapy and rehabilitative programs were instituted.
63. However, plaintiff, Ruth Daniel'. rehabilitation wa. very .low.
64. Acoordinq to the physical therapy progrese reoord., Plaintiff,
Ruth Daniel wa. found to be of questionable rehab pot$ntial until such
ti.e a. .he had aoquired better use of h8r right upper extre.ity.
65. In her many attempts to ambulate, the phy.ioal therapy reoord.
oon.i.tently dooumented Plaintiff, Ruth Daniel a. eorea.ing in pain.
66. Finally, it was the physical therapi.t'. reoommendation that
plaintiff, Ruth Daniel utilize a wheelchair for ambulating rather than.
walker becau.e the weight-bearing required in ueinq a walker, causecS
tre.endous pain to her fraotured and di.located right .houlcSer.
67. On September 23, 1992, Defendant Innere' a..ooiate, Dr. Davi.
noted in his cSi.charge .ummary that Plaintiff, Ruth Daniel was glven an
overcSo.e of insulin which resulted in severe hypoqlyce.ia and .ellure ancS
.ub.equlnt fracture and di.location of her right .houlder.
U. Since Defendant Innen' order overdoeinq hb patient with
in.uUn and her .ub.equent hypoglycemic seizure and .hock, Plaintiff, Ruth
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Daniel's fractured and d1l1ccated rilj/ht .houlder oODlpounded hell' oto.l'.
.edical problem. including pulmonary congestion for which she oannot ~.
adequately turned becau.e of her rilj/ht .houlder pain and ha. rendered'bew
entirely dependent on her dau\Jhter for even her mo.t b..lc and rudi.ental')'
ne.d..
.
6'. In an etfort to a.si.t in the tull-time ta.k ot carin9 tor her
motber, Plaintift, Ruth Daniel'. daughter, Mr.. NiocdeDlus, had to prooure
the a.si.tanoe ot at-home nur.in\J servioe..
70. Plaintiff, Ruth Daniel, remain. entirely dependent on her
dau9hter sinoe the overdo.. of insulin ordered by Detendant Inners.
71. Plaintiff, Ruth Daniel, has no US8 ot her right arll.
72. Plaintiff, Ruth Daniel, will never recover full function ot her
right arm and .houlder to the extent she w.. able prioX' to Detendant
Inner.' order overdo.in\J hi. patient with insulin.
73. A. the direct and proximate rotsult of the Defendant'. negUgenoe
as alleged herein and incorporated by reterence, plaintiff, Ruth Daniel,
ha. .uffered permanent and severe injuries and claim i. made therefore.
74. Defendant. Charles R. Inners, M.D., Innere Davi. A.sociate.,
Luan GralDlll, ~.N., and Holy spirit Hospital are jointly and severely Uable
tor injurie. and damaqe. AI set torth herein and inoorporatad by
reference.
715. As the direct and proximate re.ult of the Defendant'. ne9Ugenoe
.. .lleged herein and inoorporated by reterence, Plaintiff, Ruth Daniel
bas suftered . permanent di.figurinq and di.abling injury and olai. is
..de therefore.
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76. As the direct and proxim.te result of the Defendant'. n.9livena.
.. all.g.d h.rein .nd inco~porated by referenoe, Plaintiff, Ruth Daniel'_
riqht .hould.r injury will oause residual problems for the r.mainder of
her lif. and .inca she continues to have severe right should.r pain, the
probability of her requiring additional tre.tment and th.rapie. in
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inorea.ed and olaim is m.de therefore.
77. A. the direct .nd prcxim.te result of the Defendant'. n.qlig.nQ.
I' aU.ged h.rein and inoorporated by referenoe, Plaintiff, ,Ruth Dlni.l'.
right .hould.r injury will oause residu.l problems .ffeotinq her g.n.ral
h.alth, includinq the inability to .dequately turn or lay on her right
aide which oompromises her pulmonary status and the probability of
inor....d congestion, pneumonia .nd other medioal condition. i. inor....d
requiring additional treatment .nd therapies .nd claim i. made th.r.for~.
78. A. the direot .nd proximate reeult of the Defendant'. n.gUqenoe
a. alleged h.rein and inoorporated by reference, Pl.intiff, Ruth Dani.l
wa. foroed to inour liability for medical treatment., medicine.,
hospit.liz.tions, physio.l therapy and similar miscellaneous .xp.n.e., in
and about an effort to attempt to restore herself to health and claim i.
mad. therefore.
711. A. the direot and proxim.te result of the Def.ndant'. n.qligenoe
a. alleq.d herein .nd incorporated by referenoe, Plaintiff, Ruth Dani.l
will b. foroed to incur liability for medioal treatment., m.dioine.,
ho.pitalizations, phy.ic.l therapy and similar mi.oellaneou. expen... in
the future and claim is made therefore.
80. A. the direct and proximate result of the Def.ndant'. neqliqence
a. all.ged herein and incorporated by referenoe, Plaintiff, Ruth Daniel
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ha. und.r\Jon. and in the futun will under90 qnat m.ntal and ph~.lo~l
plin and .ufferin9, qreat inconveni.noe in caring out her d.U~
activitJ..., 10.. of lif.', pl.a.ure. and olaim i. mad. therefore.
11. Plaintiff, Ruth Daniel, hag been advi..d and therefore aVlr.
, that the dama\Je. and injuri.. AI aUeged h.nin and inoorpolratld by
r.ferenoe are perman.nt and olaim i. mad. th.refor..
l;QUNT I
Ruth Daniel v. Charl.. R. Inner.. M.D.
82. Para\Jraph. 1 throu\Jh 81 of thll complaint an incorpcratld
h.r.in by r.f.r.nce a. if .et forth at len9th.
13. Def.ndant charl.. R. Inn.re, M. D. 11 liable to Plaintiff for hi.
n.gUq.nce inl
(a) failinq to examine Ruth Daniel prior to ordering
in.ulin on Augu.t 7, 1992,
(b) tailing to properly...... Ruth Daniel an1 the
contradiction. associated with ord.rin\J
additional in,ulin on Augu.t 7, 1992/
(c) tailin\J to prop.rly r.vi.w and in.p.ot Ruth
Dani.l'. medicine ~ard.x prior to ord.rinq
in.ulin on Auqu.t 7, 1992,
(d) improperly everdosing Ruth Daniel with
.xc...ive in.ulin on AU\Ju.t 7, 1992 cau.ing
hypoglyo.mio ..izur. and .hook,
(e) failinq to d.termine or to a.k a qualified
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per.on to d.te~ine, the exaot amount ot
inlulin Ruth Danlel had reooived on Augu.t 7,
19i2 prior to hl. order Qv.rdo.ing in.ulin
on Augu.t 7, lee2'
(f) purpo.ely and knowingly orderinq Reqular
in.ulin de.pite Ruth Daniel'. known allerqio
reaotion to Regular in.ulin,
(g) failinv to attend to hi. patient and provid~
medioal oare to Ruth Danlel on Augu.t 7, lIla,
(h) faUinq to properly obtain a careful hiatol')'
of Ruth Danlel" in,ulin ooveraqe on AugU.t 7,
lil92'
(i) failinv to monitor Ruth Daniel .ub.equent to
hi. order overdo.inq in.ulin on Auqu.t 1, 1,.21
(j) inappropriately delayinq radioqraphio evaluation
of Ruth Daniel" Ihoulder followinq the hypoqlyoemio
.ellure oau.ed by the overdo.e of in.ulin ordered
on Auqu.t 7, 1992,
(k) failinq to order and obtain blood qluco.e
mea.urement. followinq the overdo.e of inlulin
ordered on Auqu.t 7, 1992,
(1) improper manavement of in.ulin coveraqe in an
in.ulin-dependent labile diabetic,
(m) failinq to properly inquire into the .tatuI of
in.ulin ooveraqe on Ruth Daniel'l .edicine ~ard'X
prior to ordering additional inlulin at 1330 hrl
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an Auquat 7, leea,
Cn) failinq to under.tand and aooordinqly .anage
hi. patient ba.ed on the in,ulin Coverage
dooumented on Ruth Daniel'. medicine Kardex
on Auquat 7, leea,
Co) tailinq to phy.ioally examine, evaluate,
...... and monitor Ruth Daniel on Auguat 7, ltea,
CP) tailing to prop.rly revi.w, int.rpret ~nd
re.pond to the information contained in Ruth
Daniel'. m.dioine Kardex whioh dooumented
in,ulin Ooveraqe in the early morning hour. of
Auqu.t 7, 1992 /
(q) violatinq the prinoiple of patient-phy.ioian
care whioh required Defendant Inner. to .ake
every Po..ible effort for the benefit ot hi.
patient, Ruth Daniel,
Cr) tal.ely and erroneou.ly a..uminq that Ruth Daniel
did not reoeive in.ulin ooveraqe in the morning
hour. of Auqu.t 7, 1992/
Ca) failing to minimi.e the ri.k and/or prevent
hypoglyoemic aeiaure and .hook,
Ct) inappropriately permitting Ruth Daniel'a blood
qluooa. to drop to ,uoh low level. aa to re.ult
in hypoqlyoemic .eiaure, .hock, re.Ultinq in
aonvul.ion., neurologio oompromi.e, 10..
of oonaaiou.ne..,injury to her lett knee and
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~~aoture and di.looation at he~ right .houlde~I
(u) inappro~riat.ly permitting hi. patient, Ruth
Daniel to .ei.e and convul.e in hypoglycemio
.hook without any effort to intervene,
(v) in oontravention of hi. fiduciary duty,
abandoning hi. patient, Ruth Daniel,
(w) tailing to order blood .tudie. to be drawn
prior to the administration of DeOW,
(x) p~ecipitatin9 Ruth Daniel'. labile diabetic
oondition by overdo.ing her with in.ulin
to the point where she succumb.d to hypoglyoemio
.eilure and .hook,
(y) failinq to notify other phy.icians or to
en.ure that another physician wa. pre.ent
and prepared to care tor Ruth Daniel at the
time Defendant Inner. ordered the overdo.e of
in.ulin by tel.phone on AU9u.t 7, 1992,
(I) inappropriately enqaging in a medioal praotice
that was too d.mandinq tor one person in order
to maximize volume and tharetote revenue,
precluding D.fendant Inn.r. from properly
attending to hi. patient, Ruth Daniel on
AU9U.t 7, 1ge2,
(aa) tailing to inform Ruth Daniel a. to the material
risk., con..qu.nce. and contraindication.
~..ooiated with administering exce.. in.ulin,
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(bb) f.ilinq to inform Ruth D.niel .. to the .ateri.l
ri.k., co~.equence. and cont~aind!cation.
...ociat.d with orderinv medication. to whioh
Ruth Daniel wa. dooumented a. being allerqie,
(co) d..pite hi. awar.ne.. that Ruth Daniel h.d
labile diabete., and that .he wa. .en.itive
to the adju.tment of in,ulin, neverthele..,
failinq to be phyeically pre.ent to ......, .
monitor and evaluate hie patient, ineludinv
review of her medicine Rardex before order in; .n
overdo.. of in,ulin oh Auqu.t 7, 1992,
(dd) de.pite hie awarene.. that hi. patient wa. a
labile diabetic and wa. .en.itive to the
.dju.tment Of ineulin,neverthele.., f.ilinq
to .ummon any phyeician to be pre.ent .t the
time he ordered the overdo.e of in,ulin on
Augu.t 7, 1992,
(ee) failing to enBure prop.r do.aqe .nd
admini.tration of insulin in a labile di.betiel
(ff) failing to plan, arranqe, and en.ur. proper
in,ulin coverav. for hi. patient, Ruth Daniel
on Augu.t 7, 1992, and
(VV) in.ppropriately abando~inq hi. p.ti.nt, Ruth
Daniel by permittinq her to .ei.., eonvul..,
fraotur. and di.locate her riqht .houlder,
fraoture her left knee, .u.tain neuroloqie
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defioit and 101. of conlcioulne.. al a re.ult
of orderinq an overdole of inlulin on AuWU.t 7,
1992.
14. A. a direct and proximate re.ult of the Defendant'. negligenoe,
. Plaintiff Ruth D.nial .uetained injuria. and damage. a. .et fo"th in
pa"a9raph. 28 throu9h 81 above which are incorporated herein by refarenoa
a. it .et forth at length and olaim i. made therefore.
WHIRlrORl, plaintiff, Ruth Daniel, demand. jUdlJ1llent aqdnet Defandant
Charle. R. Inner., M.D. for compen.atory damaqe. in an amount in exoe.. of
Twanty Thou.and ($20,000.00) Dollar. exclu.ive of intare.t and co.t. and
in axcea. of any juri.dictional amount requirin9 compul.ory arbitration.
COQNT II
Ruth Daniel v. Inner. Dav!. A..Dclat..
1&. Paragraph. 1 throuqh 81 alld Count I of thi. Complaint are
incorporated herein by reference a. it let forth at len9th.
Ie. At all relevant time. herein, Defendant Inner. we. acting a. the
aqent, apparent aqent, lervant and/or employee of Inner. Cavi. Aa.ooiat..,
a prote..ional profit-maki1l9 medical corporation and wa. actinv within the
.oope of .aid employment.
17. Defendant Innar. Davia Aa.ociate., acting throuqh it. avent.,
apparent agent., .arvant. and/or employee., i. liable to the Plaintiff for
the injurie. and damave. alleqed herein whioh we"e direotly and
proximately cau.ed by tha Defendant'. negligenoe a. eet forth in
paragraph. 21 throU9h 81 above which are incorporated herein by referenoe
aa if aet forth at lenqth and claim i. made therefore.
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WHIRlrORI, Plaintiff, Ruth Daniel, demand. judgoment a,ain.t Inn.r.
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Dav1. A..ociate. for oompan.atory damaqe. in an amount in eXo... of TW.ntv
Thou.and (UO, 000.00) DoUan exolu.ive of intere.t and oo.t. and in
exoe.. of any juri.diotional amount requiring oompul.ory arb1trltion.
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COUtjT II I
Ruth n,ni.l v. Luan arammr R.N.
'e. paraqraph. 1 throu9h el and count. I and II of thi. Co.plaint
are inoorporated herein by referenoe a. if .et forth at lenvth.
eg. Defendant Luan Gramm, R.N. i. liable to the Plaintiff fo~ hlr
neq11genoe in I
(a) failing to properly inve.tigate and relay the
information oontained in Ruth D.niel'.
medioine ~ardex/
(b) failinq to properly read the information oontainld
in Ruth Daniel'. medioine ~.rdex,
(0) failing to appreciate the .ignificenca whioh
additional in.ulin would hive on a labile diabetio
patient .uch a. Ruth Daniel, partioularly .,t.r
her reoe1pt of in,ulin cover.,e in the .arly .ornin,
hour. of Augu.t 7, 1992/
(d) failing to notify .upervi.or., departm.nt head.,
medical direotor., phy.ician. or ho.pital
admini.trator. of Dafendant Inner.' overdo.e of
in.ulin on Augu.t 7, 1992/
(e) failing to appreoiate that Dafendant Innar.' orde~
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overdo.in9 hi. patient Ruth Daniel w1th 1n.uli"
on Auqu.t 7, lee3 could re.ult in a dra.tio
drop in blood gluco.e cau.in9 hypoglyo.mia .hook
and .e!lure,
f.iling to attend, monitor and provide for proper
nur.inq car. to Ruth Daniel followin9 Def.ndant
Inn.r.' order overdo.inq hi. pati.nt with in.ulin
on AU9U.t 7, lee3,
improp.rly a.oertainin9 the .tatu. of Ruth
Daniel'. in,ulin coverage on Auqu.t 7, 1..a,
abandoninq her patient, Ruth Danial by fai1in9
to properly monitor, evaluate and ...... Ruth Daniel
followin9 Defendant Inner.'order overdo.ing the
patient with in,ulin,
failing to minimize the ri.k and/or prev.nt
hypoqlycemio .hock and .eieura,
failing to r.port Defendant Inner.' order
ov.rdo.ing hi. patient, Ruth Dani.l with In.ulin
on Auqu.t 7, 1993,
inappropri.tely monitorinq Ruth Dani.l'. blood
gluoo.. l.v.la on luqu.t 7, 1992, and
failinq to remain with her pati.nt ruth Daniel
followinq her hypoqlyoemic .eilure and .hock to
monitor, ...... and evaluate her traumatic injurie.
and n.urologic damaqe.
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eo. A. the direot and proximate re.ult of the Defendant'.
naVliganoe, Plaintiff, Ruth Daniel .u.tained injurie. and d..aga. .. ..t
forth in paragr.ph. 28 through 81 above which are inoorporated herein by
ref.rence a. if .et forth at lenqth and claim i. mad. therefore.
WHEREFORI, Plaintiff Ruth Daniel, d.mand. judqment .gain.t Defendant
Luan Or..., R.N. for oompen.atory damaqe. in an amount in exo... of Tw.nty
Thou.and ($20,000.00) Dollan excludve of intere.t .nd oo.t. and in
exo... of any juri.dictional amount requirinq compul.ory arbitration.
COUNT IV
Ruth Dan~el v. Holy Spirit HoaDital
81. Paraqraph. 1 through 81 and Clount. I through III of thil
Complaint are inoorporated herein by reterenoe a. if aet forth at length.
82. At all relevant time. herein, Defendant Charle. R. Inner., M.D.,
Defendant Luan oramm, R.N., and all medical penonnel includinq .t.rt
nur.e. who provided care to Ruth Daniel in Auqu.t, 1992, were the .qent.,
apparent agente, .ervant. and/or employee. of Defendant Holy spirit
Ho.pit.l.
u. Defendant Holy Spirit Hospital, acting throuqh it. agent.,
.pparent agent., .ervant. and/or employee., i. li.ble to Plaintiff for
injuria. and damage. a. .et forth in paragraph. 28 throuqh 81 abOVe Whioh
are inoorporated h.rein by ref.rence a. if a.t forth at lenqth and ol.i.
i. .ade therefor..
u. Defendant Holy Spirit Hoapital, aoting throuqh it. .gantl,
apparent .qent., .ervant. and/or employee., failed to t.ke the n.o....ry
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.tep. in order to en.ure the .afety of Mr.. Daniel, knowing that 'he W"
dependent upon Defendant Holy spirit Ho.pital and it. .tatt, and i. liable
tor ita failure to intervene ell,d prevent the improper Idlllini.tration of In
oVlrdo.e ot in.ulin to plaintiff, Ruth Daniel.
115. Deten4ant Holy spirit Ho.pital, loting through it. agent.,
apparent avent., .erv.nt. In4/or employee. i. liebla to the plaintiff,
Ruth Daniel for ita failur. to provide quideline., protoool', pOlioie.,
and prooedure. for intervention when a phy.ician order. an overdo.e of
in.ulin in a lftbile diabetic patient, resultinq in hypoqlyce.io .hook and
.eilure.
ll6. ~. a direct and proximate re.ult at Defendant Holy spirit
Ho.pital', neqUqence .. alleged herein, plaintiff, Ruth Daniel, ha.
.u.tained injurie. and damaqel al let forth in paraVraph. a. throuvh Ii
above which are incorporated herein by reterenoe a. if .et forth at lenvth
and a claim i. made therefore.
WHEREFOR!, Plaintiff demand I judqment aqainlt Defendant, Holy spirit'
Ho.pital, in an amount in exce.s of Twenty Thousand ($20,000.00) Dollar.
exclueive of intere.t and cost. and in exce.1 of any juri.dictional amount
requirinv compullory arbitration.
.
COUNT V
Ruth Daniel v. Holv spirit Ho.oital
116. Paraqraph. 1 throuqh 81 and count. I throuqh IV of thb
complaint Ire inoorporated herein by referenoe a. if eet forth at lenvth.
20'
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17. All nurae., phyaioian. .nd anoillary ho.pital pe~.onnel,
providing oare for Plaintiff, Ruth Daniel, in 1992, wer. at all r.l.v.n~
I
ti..., agent., apparent sqent., .ervant. and/or employ.e. of Defendant
Holy 8pirit Ho.pital and aoting within the .oope of ..id employaent.
II. In 1192, all medical .tatf, oommittee ..mb.r., ho.pital
oOlDlllitt.e .emben, and board member. wen agent., apparent agent.,
.er/ant. and/or employ... of Dd.ndant Holy Spirit Ho.pital, aoUng in the
.cope of their employm.nt and authority a. ve.tad in the.. by Def.ndant
Holy Spirit Ho.pital.
II. Defendant Holy Spirit Ho.pital'. nGgliq.noe, a. alleged h.rein
and incorporated by ret.rence, wa. a .ub.tantial tactor in bringing about
the harD .u.tained by Plaintift, Ruth Daniel.
100. Defendant Holy Spirit Ho.pital had a nond.leqable duty ow.d
direotly to it. patient, Ruth Daniel.
101. In 1992, Defendant Holy spirit Hoapital, through it. ag.nt.,
apparent aqent., ..rvante and/or employeea had a duty to over... IU
p.non. who praotioed medicine within ita wall. II to paUent care,
including Defendant. Inner. and Gramm.
102. Defendant Holy spirit Ho.pital i. liable for tailing to ov.r..e
Defendant Inner.' and Detendant Gramm'. practic. of ..dicine within it.
wall. a. to patient oar. and in partiCUlar, a. to Plaintiff patient, Ruth
Daniel.
103. In 1992, Det.ndant Holy Spirit Ho.pital had a duty to U.e
rea.onable oare in the provilion at .ate and adequate equip.ent Ind
per.onnel.
,
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104. D.fend.nt Holy 8pil'it Ho.pit.l, ,0Unv thl'oUVh it. .,.nt.,
.".r.nt .vent., ..rv.nt. and/or emplo~ee. i. li.bl. for it. Ililu~. ,.
u.. ~el.on.ble o.re in the provi.ion and mainten.noe Of 'IIe Ind ad. quit.
,er.onnel 101' the aare of Plaintiff pati.nt, Ruth D.niel.
101. In lPP3, Defendant Hol~ 'pirit Ho.pital h.d . duty to ..1eot Ind
.
I'etlin only comp.t.nt phy.ioian. .nd nur....
loe. In lP'3, Defendant Hol~ Spirit Ho.pitll h.d notio. thlt
Defendant Gr.mm wa. not a qualilied nur...
107. 8pecificall~, Defendant Holy spil'it Ho.pital', culp'bl. oonduot
wa..
Ca) it. failure to tormulate, adopt and .ntorc.
polioie. and prooedure. to en.ure quality
monitoring and managing of a labile inlulin
dependent diabeUo .uch AI Plaintiff
patient, Ruth Daniel,
Cb) improperly proce..ing and evaluating
Defendant Gramm'. oredential.,
(c) tailing to verity Defendant Gramm'. .kill
a. a nur.e before allowing her to ...... .
labile in.ulin dependent diabetio patient
.uch a. Plaintift patient, Ruth Daniel,
Cd) tailing to te.t Defendant OrallUll'.
profioiency and competenoy in monitoring
and managing an ineulin dependent di.b.tio
patient to en.ure that her nureing .kill.
wen current with .tate of the .rt
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dev.lopment. in the management and care of
an in,ulln dependent diabetio patient, and
(e) failinq to limit, su.pend or r.voke
Defendant Gramm'. nurdnq privUege. ln
. monitoring and manaqing patient. at it.
faoility.
101. Det.ndant Holy spirit Ho.pital, aoting through it. ag.nt.,
appar.nt aq.nt., .ervant. and/or employee., i. liable for it. ..l.ction
and ret.ntion of D.fendant. Inner. and Gramm and it. failure to .up.rvi..
and .onitor the praotice of Defendant. Inner. and Gramm within it. w.ll..
1011. Defendant Holy Spirit Ho.pital, actinq throuqh It. ag.nt.,
appar.nt aq.nt., ..rvant. and/or employee., i. liable for it. f.ilur. to
formulat., .dopt, and enforoe adequate rule. and polloie. to .n.ur.
quaUty of care for it. patient., inclucUnq plaintiff patient, Rutb
Daniel.
110. D.fendant Holy spirit Ho.pital had a duty to formul.t., adopt,
and .nforce adequat. rul.. and policie. to en.ure quality of o.re for it.
p.ti.nt., includinq Plaintiff patient, Ruth Daniel.
111. In 1'112, Def.ndant Holy Spirit Ho.pital wa. aocr.dit.d by the
Joint commi..ion tor Aooreditation of Ho.pitala (herein JCAH).
112. In 111112, ho.pital. acoredited by JCAH were required to ..tabli.h
and .alht.ln variou. committe.. to review .peoific a.pect. of the pr.ctlc.
of ..dlcine within it. in.titution, inoludinq the proc...inq .nd ......1nt
of pby.icl.n and nur.e oredential. and the r.view, analy.i. and evalu.tion
of phy.ician'a and nur.e'. ollnical p.rformance.
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lU. xn holding it.elf out t,o the publio a. "'CAB aOOl'ldU:ld/,
Defendant Holy spirit Ho.pitlll wa. proo1aimin9 that it tonulatld and
enforoed procedure. and pOlioie. for the .atety and proteotion of patient.
1n loeordanoe with the minimum .tandard. .et torth by "'CAB.
114. Xn 1992, Detendant Holy spirit HOlpital had a duty to
inve.tigate, monitor, and it n,ol..ary, revoke, limit or .u.pend Defendant
Inner. IndIaI' Gramm" privilege. in the taoe of que.tionlbll Or
eub.tandard oare.
I' 115. Defendant Holy spirit Ho.pital b liable for it. failure to
comply with the requirement. of ",eAl!, with ngard to enforoinv polleie. and
protledun. for the quality and .afety of ho.pital-ba.ed patient care,
inoluding care provided to Ruth Daniel in 1992.
116. Defendant Holy spirit Ho.pital b liable tor it. failure to
provid. any .Ub.tantive te.t1nq or eoncnte evaluation of Defendant
Inner" andlor Gramm'. .kill, before pemittinq them to evaluate and
monitor patient'_ inoludin9 plaintiff patient, Ruth Daniel within it. four
waU..
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117. Detendant Holy spirit Ho.pital failed to lupervi.e Defendant.
Innere and Gramm properly, and AI a n.ult of their failure to do .0,
Defendant Holy spirit Ho.pitlll breaClhed it. duty to it. patient, Ruth
Daniel.
118. Thi. breaoh of duty by Defendant Holy spirit HOlpital wa. the
direot and proximate re.ult of the injurie. alleged herein and
inoorporated by reterenoe.
119. Defendant Holy spirit Ho.pital, throu'lh it. aVent., includinv
medioal Itatf oommittee member., ho.pital committee melllbar., and board of
at
.
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r
tl'u.tee .elllbu., tI.. the r19ht and duty to control .taU pdvU.,e. .~
praotioe. within it. in.titution, inoludinq the privile,.. and pl'aotio..
ot D.tendant. Inn.r. and Gramm.
110. N.v.rth.le.., Defendant Holy spirit HClpital did not inve.Ugate
. Defendant. Inn.u or Gramm, nor take any Itep. to limit, ,ulp.nd, 01'
....vok. thei... privileg.. or t..t theJ.r profioi.ncy and Clo.petenoy in
ou.......nt ..na,...nt and oare of in,ulin diabetio patient., or limit and
di.olpline the. for inappropriate or .ub.tandard patient oal'e.
121. Additionally, Defendant Holy spirit Hospital i. liable to....
(a) failinq to .elect and retain only comp.t.nt
phyaloian.,
(b) failing to ovenea all penons who practic.
..dicin. within it. wall. .. to pati.nt
care,
(c) failin9 to formulate, adopt, and .nforce
adequate rule. and POliOJ,88 to en.ur.
quality care to itr. patient, Ruth Oaniel,
(d) failin9 to report condition. and que.tion
Defendant Inner.' practio. and proo.dur..
wh.n not in aocordanc. with the .tania...d.
of medioal practice,
(e) failing to en.ur. pati.nt .af.ty and well-
b.ing while at the ho.pital,
(f) fdlinq to revi.w, analyze and evaluate
Defendant Inn.r.' olinioal performanoe,
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(g) faiUnq to proaes. and ...... Defend.nt
Inner.' ar.dentialing and reappointm.nt
properly,
(h) failing to properly delineate Defendant
Inner.' privilege. and limit hi. practice
at Defendant Holy Spirit Ho.pital,
(1) faiUng to revoke, limit or .u.pend
Defendant Inn.r.' privilege. de.pite .
.ub.tandard oar., and
(j) faiUng to verify updated knowledge and
.kill to en.ure that Defendant Inner.'
.kill and knowledge oomported with
oontemporary standards of medical praotice.
122. Defendant Holy Spirit Hospital, aoting throu9h ita avent.,'
apparent agente, .ervant. and/or employ.e. i. liable to the Plaintiff,
Ruth Daniel, for injuri.. and dama'le. alleged herein whioh were direotly
and proximately oaused by it. negli'lence a. .et forth in paragraph. 2.
through 11 above which are incorporated herein by reference a. it ..t
forth at length and claim i. made therefore.
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WHI~.rORI, Plaintiff demand. judqment a9ain.t Defendant Hol~ .pir&'
HOlpital for compel)eatlOry damage. in an amount in exc.., of Tw.n',
Thoullnd (tao,ooo.OO) Dollan exclueive of interelt. and oOltl and 1n
.xoe.. 'of any juri.dictional .mount requirin9 aompul.or~ arbitration.
,
Re.pectfully .ubmitted,
ANGINO . ROVNIR,
N 0
I.D.
~eo rth Front Street
Harri.burg, PA, 17110
(717) :U8-67U
ooun.el for Plaintiff
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I her.by certify that 1, S.ndra L. ~i.h.ll, an ..ploy.. of
.
An;ino , Rovner, P.c., thi. 8th day of Novemb.r, 1883, hav.'..rv.
a true an4 correct copy of AMINDID COMPLAINT by .eneUn; .allle Unite4
Itet.. fir.t ela.. ..ail, po.taqe pr.paid, .ddr....d a. fo~low.1
Micha.l W. McGuokin, I.quire
1850 William Penn way
suite 209
P.O. Box 10696
Lanca.t.r, PA, 17605
Attorn.y for D.fendant.,
Charle. R. Inn.r., M.D. and
Inner. Davi. A..ooiate.
Ja.on R. Wolfgonq, I.quire
MITTI, EVANS , WOODSIDE
3401 North Front str.et
~arri.burg, PA, 17110
Attorn.y for Def.ndant.
LUan Gramm R.N. and
Holy spirit Hospital
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Sandra L. Rl.helf
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PRt4,1CIPI FOR LI5n:-lO C.4!! FOR ,4/lCl:~IENT
I ~'uu bf ryp.wrin.n JIId submln,d In <Juplll:QIt'
Ttll THE 'ROTHONOT.o\RY OF CI.'MBERl.o\.'iO COl::'in':
PlUM :111 til. wiwn m~lter (~r :1\. n'.'I:
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CWLIB It. IJIIIIU, M.D.,
IJIIII18 DAVIS ABSOCtATIS,
WAll ClItAllM, 1.11., AllD
HOL~ S.lllT HOSPITAL
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I, Sra.. malllr 10 b' ul'I'dll..oo plllillwl'l motion (or n.w :nlll.
d,I"lIdanl" dtmurr.r to ~omplQ.lrtl. tIC.):
Dafandants' Holy Spirit Ho.pital and Clra..'s 'raliainary Objactiona
.
.,
ld,nllty ~IlW\.l,1 wl\ll will ulU' ~~.:
(~) (Ilr plalllrll'{; Ilijola C. Olaan, Isquire
Addr...t 4503 Ilorth Front Straat, Harri.burl,'A 17110
Ib) (Ilr ~'(.ndaJIl; Jayso" I. "oUlana, Isquire
Addr"'1 3401 II. Front. St., '.0. Box 5950, Rarrisburl, PA
17110-0950
J, I will nOllfy all punts In wnrill, 'V\::-Jn two j~YI :h~1 :tus .3.1, I\~ :..n
U"'d (or 3.llum.nl._
4. Arlumlnt Court Datil March 30, 1994
C.1l of Arlumlnt L1.t Datil
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.RUTH J. DANIIL
IN THI COURT or COMMON 'LIAS
DAUPHIN COUNTY, PINNSYLVANIA
PlainUff
v.
CIVIL ACTION - LAW
No.;II ') S' Y .51. ?y
CHAaLlS R. INNIRS, M.D.,
INNIII DAVIS ASSOCIATES,
WAN GI'AMM R. N. Land
HOLY SPIRIT HOSPITAL
Defendant.
JURY TRIAL DEMAN DID
N9T1C1
YOU HAVE BIIN SUED IN COURT. It you wi.h to detend aqain.t .
the claim. ..t forth in ttie followinq paqe., you mu.t take action
within twenty (20) day. atter thil COlllplaint and Notioe are .erved,
by enter1nq a written appearanoe peraonally or by attorney and
fU1nq in wriUnq with the court your deten.e. or objeoUon. to the
ola1m. .et forth aqain.t you. You are warned that if you fail to
do 110 the o..e may prooeed without you and a jud9lllent .ay be
entered .gain.t you by the Court without further not1oe for any
money claimed in the complaint or for any other ola1m or rel1et
reque.ted by the Plaintiff. You ",ay 10.. money or property or
other riiht. important to you.
YOU SHOULD TARE THIS PAPER TO YOUR LAWYER AT ONCI. IF YOU DO
NO'l' HAVI A LAWYIlR OR CANNOT AfFORD ONI, 00 TO OR TILlPHONI THI
OfrICI BIT fORTH BELOW TO rIND OUT WHERE YOU CAN GET LlGAL HILP.
Court Admini.trator
Dauphin County Courthou.e
Front and Market Street
Harrieburq, PA, 17101
2157-11599
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PlainU U
IN THE COURT or COMMON PLlA.
DAUPHIN COUNTY, PENNSYLVANIA
RUTH J. DANIIL
v.
CIVIL ACTION - LAW
NO.J?fr- S-7J
CHARr~s R. INNERS, M.D.,
INNIRS DAVIS ASSOCIATES,
WAN GRAMM, R.N.,
HOLY SPIRIT HOSPITAL
Defandant:.
JURY TRIAL DEMANDED
NO~ACIA
Le han damandado a u.tad an la oorta. 8i u.tad qu1are 'datandar.a da
..ta. damand.. axpua.ta. .n la. pa91na. .1qu1ant.., u.ted t1ana v1ant.
(30) dia. da plalo al partir da la taoha da la damanda y 1. not1t1oaoion.
U.tad daba pra.antar una aparlancla ..cr1ta 0 en par.ona 0 pOr abo9ado y
archival' an la corta an torma aIel' ita IUI datan.a. 0 IU' objact1ona. ala.
damanda. an contra da .u par.ona. Saa avilado qua .1 u.tad no ..
d.t1anda, la corta tomara madlda. y puada antral' una orden oontra Ia.tad
lin prev10 avho 0 notitioaoion y pOl' cUdqu1ar quaja 0 aUvio qua a.
pad1llo a., 1& peUc10n de demanda. U.tact puede pardar 1l1naro 0 'u,
prop1.dad.~ 0 otros daracho. important.. para u.t.d.
LLlVI IlIJTA I)IlMANDA A UN ABODAGO INMEDIATAMIlNTA. SI NO TIINI ABODAGO
o 81 NO TIIlNI ilL DINIlRO sUrICIENT! DE PAGAR TAL SERVICIO, VAYA IN PERSONA
o LLAMI fOR TIlLIPONO A LA OFICINA CUYA DIRICCION 81 INCUINTRA .SGRtTA
ADAJO PARA AVIRIGUAR DONDE SIl PUEDE CONIJIlGUIR A818TENCIA LlGAL.
I
Court Admininatrator
Dauphin county Courthou.a
Front , Markat str.ata
Harriabur9, PA. 17101
2117-11199
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RUTH J. DANULo
IN THI COURT or COMMON 'LIlA'
DAUPHIN CQUNTY, PINNSYLVANIA
Plaint! U
v.
CIVIL ACTION - LAW
NO.~ ;JJ't/- S -?~
~HAaLll8 a. INNIRSt M.D.,
INNIRS DAVIS ASSOCIATIS,
WAN GRAMM, R.N.,
HOLY SPIRIT HOSPITAL
Defendant:.
JURY TRIAL DIMANOID
COMPLAINT
1. Ruth J. Daniel i. an adult individual r..1dinq in Harri.burv,
Dauphin county, Penn'Ylvania.
2. Detendant Chub. R. Inner., M.D., an adult lnd1v1dual, i.
l1cen.ed to practio. medic in. in the cOl\llllonwaalth ot Penn.ylvania, who, in
11192 enqaged in the practice of Internal Medicine in camp H11l, CWIlberland ,
county, penn.ylvania.
3. Inner. Davi. A..ociat.., 1. a prote..tonal protit-aak1n9
corporation, which provide. medical ..rvic.. in cumberland county,
Penn.ylvanh.
.. . Defendant Luan Gramlll, R. N., an adult lndi vidual, 1. a re.,1.t.r.d
nun., who in 19112 practiced nunin9 in Camp Hill, cumberland county,
p.nn.ylvanh.
II. Detendant Holy spirit H08pital, 1. a corporat. .edical
1n.t1tut1on with ott1ce. and medical tacilltie. in Harr1.burq, Dauphin
county, Penn.ylvanil.
6. Defendant Chub. R. Innen, M.D. wa. at an relevant ti.e.
hereinatter, actin., a. an aqent, apparent aqent, .ervant and/or ..ploy..
of D.fendant Inner. Davl. A..oclat...
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7. Detendant Charl.. a. Innan, M.D. Waa at all relevant ti...
he~einatter, actinq ae an a.,ant, apparent agent, eervant and/or e.ploye.
ot Defendant Holy splr1t Hoapltal.
I. Detendant Oral\llll wal at all ralavant t1mee hereinafte~ lotin9 a.
I" agent, apparent a9ant, earvant and/or employee of Defendant Holy spirit
Ho.p1tal.
t. On AU9uat II, 11111Z, Dr. Stephen J. Davia admitted hi. 10n.,-
Itand1nq patlant, Plalntltf, Ruth Danial, to Detendant Hol~ .pirit
Hoepital for orthopadic evaluation ot toot pain.
10. Upon hor adml..ion to Detandant Holy spirit HOlp1tal, plaintiff,
Ruth Daniel waa atartad on lnaulin cove raga with a maximum daily allot.ent
of zo unite NPH 1neulin.
11. Plalntiff'e daughtar, Dabra Nicodemue, advieed the hoepital'1
nu~eal and phyaician. c6ring tor Ruth Danial that her mothe~ wae al1ergio
to Ragular inlulin.
1Z. Pla1ntlft, Ruth Daniel'. nurlinq care racord, dated Auquet 6,
1UZ, noted har allerqlc raaction to Regular inlulin .. followa, "dau9hte~
.tateM patiant ha~ navar baan able to be controllad with ae.,ular ineulin.
.tata. that they hava had problema ln the paat with her .uqar fluotuatinq
whan ulin., Ra9ular lnaulin."
13. Moraover, attached to Plaintitf, Ruth Daniel'. medicine Xardex
WIre warnin9 .ticken advillinq tha ho.pital'e nunee and phyeioian. ot
Mre. Daniel'. allarqic reaction to Ragular ineulin.
14. on AU9uet 7, 11111Z, at approximataly '130 a.m., Plaintift, Ruth
Daniel reoeived ineulin coverage ot ZO unite ot NPH in.ul1n.
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lS. pla1ntift, Ruth Daniel'. reoe1pt ot 20 unit. of NPH in.~lin at
0730 hn on AU9u1t ", 111U wae .i9ned ott on her med1Cline hrdex by
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Defendant Holy spirit HOlpital" .tatf nur.a, an LPN with the abbreviated
in.t.Uala, "PH".
16. 8ix houre later at 1330 hrl on AU9U.t 7, 111V2, Defendant Inner.
9ave 'TAT nrdere for Plaintiff, Ruth Danial, to receive additional ineulin.
amountinq to 40 unlt. ot NPH inlulin an~ 211 unit. ot Ra9ular ineulin.
17. s19nlt1cantly, Datandant InnGr. ordered the overdoea of 1neulin
without ever exam1nin9 hi. patiant.
11. Defendant Innar. ordared the overdo.e of in.ulin by telephone,
111. Datendant Jnner. ordere~ tha overdoe. ot in.ul1n at 1330 hr. On
Auqu.t 7, 111112, de.plt. Plalntitt, Ruth Dani.l'. prior ooverage with 20
unit. ot NPH in.ulin at 0730 hr..
20. An overdo.a of inlulin cause. blood qluco.. level1 to lower
dramatlcal1y, ra,ultinq ln hypoqlycemia with seizure. and .hook.
U. Nur.. Grall\lll did not properly reviaw or relay the 1nformaUon
noted in Plaintiff Ruth Daniel'. medioine Kardax on AU9U.t 7, 11182.
22. Nurea Gramm did not report Datandant Innar.' overdol' of 1neulin
to hb patient, Plaintift Ruth Daniel to her .upervbor or other c>f
Plaintiff" treatin9 phy.icians.
23. Hure. Gramm tailed to understand that any additional inlulin at
1330 hre on AUqust 7, 111U could ra.ult ln plaintiff paUent, Ruth
Daniel'e experiancin9 hypoqlycemio .hock an~ .ei.ure.
24. Follow1n9 Datendant Jnnar.' STAT order overdoein; hi. patient
with lnlulin, Phlntift Ruth Danial wa. tran.ported to the rad101o9Y
dapartment tor an ultra.ound relatinq to har orthopedio evaluation.
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all. 819niUoantly, neither Nur.. Gramm or any ot Defendant Holy
8pirit Hoepital'e nurlin9 etaff monitored Plaintiff Ruth Daniel'. ~lood
.,luco.. levale tollowlnq Datendant Innen' STAT order overdo.in., hi.
patient with inlulin.
U. Plaintift, Ruth Daniel wn raturnad to har roo. tollowinv an
ultra.ound examination at approximately 11100 hr..
27. At that time, Plaintiff'. dauqhter, Debra Nloodamul, w.. pn.ent
in her mother'e room.
28. Not .urpr1alnq, tollowin9 Detandant Innen' ITA'l' order
overdoe1n9 hl. patient with insulln a tew houre aarl1er, Mre. N1code.ue
obaerved har mothar thrashing and convul.lnq in her bad uncontrollably.
211. Plaintift'. dauqhtar, Mr.. Nicodemu., ran to the nureee etatlon
to .,et halp tor her mother.
30. Nurea. note. documented Plaintitf, Ruth Daniel, .hak1n9 fro. a
.ehure, unraeponlive to .Umuli and pupils unraeponaive to 119ht.
31. Ae Plaintiff, Ruth Danial'. primary treat1nq phy.1oian,
Defendant Inner. wn contacted by Defendant Holy spirit HOlpltal'. nurdn~
etatt and re.ponded by qivin9 ordar. by telaphone tor blood IU9ar Itudie.
to be drawn and that Plaintift, Ruth Danial, recaiva an ampule ot "luoole
and water (DIIO).
32. Nur.a. notas dooument that plaintift, Ruth Daniel'l blood .Uqar
wa. uneuccee.tully drawn,
33. Nuree. nota. al.o documanted that the tailure to draw blood on
tha f1ret attempt wa. not reported to .taft.
34. 8l9nlfioantly, befors Plaintitf, Ruth Daniel'. blooll eu.,ar Wae
drawn, .ha received an ampule of qluco.a and water (D50).
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3D. The overdo.e of inouUn or4ereel by Defendant Innera wa. .0
exo,eeive, that by 81QO p.m. on the ev.nlnq ot AU~U.t 7, ltta, Plaintiff,
Ruth Daniel'e blood .u9ar wa. 40wn to 28 mq/dl and a ..coneS ampule of 50'
.,luoo.e and wat.r waf admini.ter.d.
36. Brain tunot1on dapande on an adaquat. .upply of .,luco.e froll the.
blood and a blood .u9ar a. low a. 28 i. oon.i.tent with hYP091yca.io .hook
which can ra.ult in .avera brain dama9a, .eizuree, coma, and neuroloqio,
deUcit.
37. Approxlmataly one hour atter Detandant Holy spirit Ho.pital"
nur.in9 .taft ob.erved Plalntitt, Ruth Daniel'. hYP091yce.ic convuleinq
.ailur..and .hock, Plaintiff'. complaint. of riqht ehoulder pain were
dooumanted and raported to Dafendant Innere.
38.
Dat.ndant Inner. tail.d tu re.pond to call. or to co.e into the
to .xamina hl. patient.
ov.r the next several hour. Plaintitt, Ruth Daniel wa.
hoepital
311.
document ad to ba moaning in pain with not ad guardin9 ot her r19ht upper
ehoulder.
40. plaintiff, Ruth Daniel was n.g.t taklln to the radiol09Y department
tor x-ray avaluation of ha~ right shouldar until approximately 11140 hre or
well over tive hour. atter her convul.in9 hypoglyce.lc .eizura wa. noted.
U. At that tima x-ray axamination ot Plaintiff, Ruth Daniel'. r19ht
ahoulder documented a fracture of tha neck of the right hu.erue with .o.e
rotation of tha humeral head,
42. rollowlnq the x-ray examination an orthopedic evaluation by Dr.
Band. note4 Plainti~t, Ruth Daniel'e unre.pon.ivene.e to verbal stimuli,
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r~ght .houldar edema and x-ray tindln9. con.iatent with a fraot~red and
dialooated right ahouldar.
43. Dr. Banda furthar not.d that Plaintitt, Ruth Daniel required
.edation bafore any attempt at reductlon .urg8ry for her .houlder fraotur.
and d1'looation.
44. By 10100 p.m. or II hour. attar h1a telephone order overdo.in.,
hi. paUent with In.ul1n Detendant Innen finally oame in tc .ee hi.
patient.
411. At that time, Detendant Inner. racordad in the pr09re.. not..
that he ordered an overdo.e of in,ulin at 1330 hr..
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46. At that time Defandant Inner. a1l0 documented PlaintUf paUent,
Ruth Dan1al'. .e1lura tOllowing hi. ordar overdoaln9 her in.ul1n.
47. Defendant Innen turther dooumanted that Plaintiff paUent, Ruth
Dan1al recelvad one ampule ot D~O prior to her blood .u9ar. being drawn
whioh accountad for her raported blood .ugar ot 433.
48. At that tima, Dafendant Innera al.o documanted Plaintiff
patient, Ruth Daniel'. fraotured and di.located right ahoulder. fOllowing
har .ellura .econdary to hypoglycemia,
49. At that tima Detendant Inner. al.o documented review of hie
patiant'. mediclne Kardex only atter he ordared the ovardo.e of 1naulin.
110. In the aarly morning hour. of Auqu.t 8, 1911Z, Dafendant Inner.
dooumented Plaintiff patient, Ruth Daniel'. inability to move her riqht
arm .econdary to har frauture,
Ill. In liqht ot Plaintiff patient, Ruth Dan1el'e tailure to re.pond
to axternal etimull, a neuroloqic con.ult wa. ordered.
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53. Neurol091at, Dr. Todd samuela, examined Plaintiff Ruth Danial on
Auquat I, 189Z and documented her .eilure activity, and per.i.tent laok ot
re.pon.ivene.e aa ..oondary to an overdo.e of in.ul1n gauain,
hypo.,lyoemh.
53. Neurql091at, Dr. Samuela turther dooumented Pla1nt1tt patient I
Ruth Daniell. enoephalopathy a. .eoondary to hypoqlyoamio ehook and
.ellure, and, oon..quantly reoommended that orthopadio intervention for
her fractured and di.1Qcated ri9ht ahouldar be delayed until her
neuroloqlo .tatua lmproved.
54. On AU9U.t 10, l1111Z, orthopadic .urqaon, Dr. Band., dooumented
Plaintiff patiant, Ruth Daniella pard.tent riqht ahoulder pain and
oautloned that her pr09no.ie tor clo.ed raduot1on waa quarded.
55. On AU9U.t 12, 1119Z, Dr. Band., attemptad clo.ed reduotion of
Pla1nt1ft Ruth Danial'. fracturad and di.located rlqht .houlder under XV
aedation.
56. The attempt to treat Plaintiff Ruth Daniell. frectured and
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dialocated ri9ht .houlder .econdary to hYP091ycemio .ebure by oloaed
reduot1on tailed.
57. Ganeral anOlthada waa oon.iderad prohib1Uve in Pldnt1tf
patlant, Ruth Daniel and har riqht arm wa. immobili.ed in a elinq.
58. At that time lt wau Dr. Band'. o~inion that Pla1nt1tt patient,
Ruth Danial'a proqno.l. tor her r1qht .houldar waG poor.
119. Throu9hout her Auquet and September, 111112 ho.pitIl1laUon,
Plaint1tt, Ruth Danial'. fractured and di.looated ri9ht .houlder remained
.wollen., edematou., tender and oxtremely painful to the touch.
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60. Additionally, plaintUf Ruth Daniel al.o oomplained of 1.ft knee
pain tollow1nq her hYP091yoemic .ellure tor whioh x-rey. we~e not taken
until september 11, UllZ or 315 day. after the convulain9 ae!lure cau.ed by
Defendant Inner.' order overdo.lnq In.ulln.
61. Radio9raph1c examination ot Plalntift, Ruth Daniel'. left kne.
taken on september 11, 111112 revealed a fracture ot the left tibial
platuu.
62. rollowiJ\9 the un.ucce..tul attempt at olo..d reduction aurvery
to~ PlaintUt Ruth Danial'. tractured and d1alocated d9ht .houldu,
phy.loal therapy and rehabilitative pro9ram' were inatituted.
63. However, plaintift, Ruth Daniel'. rehabilitation waa very alow.
64. Accordinq to the phy.ioal therapy pr09re.. recorda, Pla1ntift,
Ruth Danlel wa. found to be ot que.tlonable rehab potential until .uch
tlme ae .he had acquired ~~tter u.e ot her riqht uppe~ extremity.
6~. In her many attempte to ambulate, the Phy.lcal therapy recorde
oon.1atently dooumented Plalntitt, Ruth Danlel aa .cream1n9 in pain.
66. rinally, it waa the physical therap1at'e recommendaUon that
Plaintiff, Ruth Daniel utili.e a wheelohair for ambulat1nq rather than a
walker beoau.e t.he wei9ht-bearin9 required in uainq a walker:, oauaed
tremendoua pain to her fraotured and dielocated ri9ht .houlder.
67. On september 23, l1111Z, Detendant Inner.' a..ociate, Dr. Davia
noted in hi. diaoharq. eummary that Plaintlff, Ruth Daniel waa .,iven an
overdoa. of in.ulln which r..ultod in ,evere hypoqlycem1a and .e1lure and
eub..quent fracture and di.location ot her riqht ehould.r.
68. Since Detandant Innera' order ovardoain9 hilt patient with
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in,ulin and her aub.equent hypoqlycemic aeilure and ahock, plaintiff, Ruth
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Oant.el'. fraoturecl ancl clhlooata'1 ri9ht .hould.r oompounded her other
..dloal problam. 1nclucl1nq pulmonary conge.tion for which .he cannot be
adequately turnecl bacau.. ot har r19ht .houlder pain and ha. rendered her
entirely dependent on her dau9hter for avan her mo.t baa1c and rUdi.entary
need..
6i. In an .ftort to ...i.t in the full-tlma ta.k ot car1nq for her
mothar, Plaintitt, Ruth Danial'. dau9hter, Mr.. N1oodamu., had to prOQure
the ...1.tanoe of at-home nur.in9 .ervioa..
70. Plaintiff, Ruth Daniel, remain. antirely. dapendent on her
dau9htar .inoe the overdo.e of lnsulln ordared by Dafendant Innar..
71. Plaintitf, Ruth Daniel, ha. no u.e ot her ri9ht arm.
72. Plaintift, Ruth Daniel, wlll naver recover tull function of her
r19ht arm and .houlder to the extent .he waa able prior to Detanclant
Inner.' ordar ovardo.inq hi. patient with lnsul1n.
73. A. the d1reot and proximate ra.ult of the Detendant'. ne9Uqance
and/or qro.. ne91lqenoa a. alleqed hare in and lnoorporatecl by reference,
Plaint1tf, Ruth Daniel, ha. .uttered permanant and .evare lnjuriea and
claim 1. made there tore ,
74. Detendant. Charle. R, Inners, M.D" Innar. Davl. A..oc1ate.,
Luan Gnu, R.N., and Holy spirit Hospital are jointly and .everely Uable
for injurie. and damaqa. .. let forth herdn and inoorporat.d by
reterenca.
711. Aa tha direct and proximata re.ult ot the atore.a1cl evenl:a,
Plaint1ft, Ruth Daniel has sutfered a permanent di.f19urinq and di.ablinq
injury and olaim i. made therefore.
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76. Aa the direct and proximate reault of the afor..dd event.,
Plaintitt, Ruth Daniel'. ri9ht .houlder injury will cau.. reaidual
problema for the remainder ot her lite and .ince .he oontinuea to hlv.
.evere ri9ht ahoulder pain, the probability of her requir1nq additional
treatment and theraple. in increa.ed and olalm 1. made therefore.
77. A. the direct and proximate r..ult ot the atoremenUoned event.,
Plaintiff, Ruth Daniel'a riqht .houlder injury will cauae reeidual
problem. affeoting her general health, includin9 the inab111t~ to
adequately turn or lay on her right .ide whloh compromi.e. her pul.onary
.tatu. and the probabl1ity ot lncrea.ed conqeBtion, pneumonia and other
medical oondltlon. ie inorea.ed requiring addltional treatment and
therap1e. and olaim i. made theretore,
78. A. the dlrect and proximate r..ult ot the atore..1d evant.,
Plaintltt, Ruth Daniel wa. forced to incur 11ab111ty for .edical
treatmenta, medicln.., ho.pitalhationa, phydcal therapy and dmUar
miaceUaneoua expen..., ln and about an .ftort to attempt to natoI.'.
her.elf to health and claim 1. made theretore.
711. A. the direot llnd proximate n.ult ot the aton...1d event.,
PldnUtf, Ruth Daniel will be foroed to incur liability for .edical
treatment., medicinea, ho.pltal1zaUon., physical therapy and d.Uar
ml.cellaneou. expen.e. in the tuture and claim 1. made therefore.
80, A. the direct and proximate n.ult of the afore.aid event.,
Plaint1tf, Ruth Daniel ha. undergone and in the tuture will under90 qreat
mental and phy.ical pain and Buftering, great inconvenience in caring out
her daily actlvltie., 10.. ot 11fe'. plea.ur.. and claim 1. .ad.
therefore.
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11. plaintitf, Ruth Daniel, ha. been advi..d and therefor. aVer.
that the damaqa. and injurie. a. alleqed hlrein are permanent an4 elai_ i.
.ade therefore.
IZ. A. the direot an4 proximate re.ult ot tha Defendant" reokle..
d1.rl9ar4 and complete indltterenol tor Pla1nt1tt, Ruth Daniel" wel,arl,
Pla1ntift, Ruth Daniel ha. .utt.red injurie. tor whioh .h. .ay reoovar
punitive dalDaqea and olaim i. made theretore.
COUNT I
~uth Dani.~ v. Chari.. R. Inn.r.. M.D.
83. para9raph. 1 throu9h 8Z ot thi. complaint are inQorporated
h.rein by ret.renoe a. it .et torth at 1.n9th.
84. Detendant charle. R. Inner., M,D. i. liable to Plaint1ft, for
lnjurl.. an4 damaq.. a. alleqed her. in whioh w.r. dir.ctly and proximataly
cau.ed by hi. n.91iqenc. and/or qro.. nlqliqenoe inl
(a) tailinq to examine Ruth Daniel prior to order1nq
in.ulin on AU9u8t 7, l1111Z,
(b) taiHn9 to properly...... Ruth Daniel and the
contradiction. a..oclat.d with order1nq
adctitional in.ulin on AU9U1t 7, 1911Z,
(c) tailin9 to properly review and in.pect Ruth
D$nill'l ..4icine Rardex prior to orderinq
in.ulin on Auqu.t 7, l1111Z,
(d) improp.rly overdo.inq Ruth Dani.l with
exoa..lv. in,ulin on Auqust 7, l1111Z oaulinq
hypoqlycemio ..ilur. and .hock,
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(e) ta11in9 to determine or to aak a qual1t1e4
peraon to determine, the exact amount of
~n.ul1n Ruth ~aniel had reoeived on Auqu.t 7,
lVII3 prior to hia order overdo.inq inaul1n
on Auquat 7, 11192'
(f) purpo.ely and knowinqly orderin9 Re9ular
lnaulin deaplte Ruth Daniel'a known aller9ic
reaction to Reqular 1naulin,
(q) tailing to attend to hi. patient and prov1d~
medical oare to Ruth Daniel on AU9uat 7, lVi2,
(h) tail1n9 to properly obtain a caretul hiatory
ot Ruth Daniel'a inaulin ooverage on Auquet 7,
111112,
(1) tal11ng to monitor Ruth Daniel aubaequent to
hi. order overdoalng in8ulin on Auguat 7, leV2,
(j) lnappropriately delayinq radl09raphic evaluatlon
ot Ruth Daniel's ahoulder tollowing the hypoqlyoe.io
aellure c~u.ed by the overdoa. ot lnaulln ordered
on Auquat 7, 11192,
(k) failing to order and ob~ain blood qluoo.e
meaaurements tollowlnq the overdoae ot 1n,ulin
orllered on AU9uat 7, 111112'
(1) improper management ot lnaul1n coverage in an
lnaulln-dependent labl1e diabetlo,
<m) failinq to properly inquire lnto the atatua of
in,ulin ooverage on Ruth Danlel'a medicine Kardex
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prior to ordarin9 addltional inaulin at 1~30 h~.
on AU9U.tI7, 19112,
(n) failinq to und.~atan4 and aooord1nvly ..nave
hi. patient baa.d on the inaul1n cova~ava
documented on Ruth 'Daniel" madicina ~arde~
on AU9uat 7, 19112,
(0) failin9 to phyaical1y examlne, .valuate,
...... and monitor Ruth Daniel on AU9U.t 7, leila,
(p) failinq to prop.rlY r.view, int.rp~.t and
n.pond to the information contained in Ruth
Daniel'a medicine ~a~dex whioh documantad
in,ulln cov.raqe in the early morninq hour. ot
Auqu.t ", 19112,
_"" (q) violatinq the ~r1ncipla of patbnt-phy.iclan
cara which required Defendant Inn.r. to .ake
every po.aible ettort tor the benefit of h1a
patient, Ruth Daniel,
(I.') falaely and erroneoualy a..uminq that Ruth Daniel
did not reoeive in.ul1n ooveraqa in the mornin9
hour. ot Auqu.t 7, 111112,
(a) tail1nq to minilni.... the ri.k and/or prevent
hypoqlyoemic .eizure and .hook,
" (t) lnappropr1atelY permittinq Ruth Daniel" blood
qlucoa. to drop to .uah low lev.l. a. to raault
in hYP091ycemia .aizure, ahock, re.ultinq in
convulaiona, neuroloqia compromi.e, 10.a
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of con.c1ouane.a, injury to h.r left kn.e and
fractura and dialocation of her r1qht .houlder,
(u) inappropriat.ly permittinq hi. patient, Ruth
Daniel to a.i.a and convul.e in hYP091ycemio
ahook without any .ftort to 1nterv.na,
(v) in contravention of hi. fiduciary duty,
abandonin9 hi. pati.nt, Ruth Dani.ll
(w) tailinq to ordar blood .tudl.. to ba drawn
Drior to tha admlni.tration ot DIIOWI
(x) pr.oipitatinq Ruth Danial'. labile diabetic
condition by overdo.in9 har wlth 1naulin
to the point where she aucoumbed to hYP091yoe.io
.eilura and ,hock,
(y) failinq to notity other phy.ic1ana or to
.n.ura that another phyaioian wa. preaent
and prepar.d to oare tor Ruth Dan1al at the
time Der.endant Innar. ord.red the ov.rdoae of
1n.ulln by telephone on Auqu.t 7, 191121
(I) inappropriatdy enqa9inq in a lII.dical practice
that wa. too d.mandinq tor on. p.raon in ord.~
to maximi.a volume and tharetor. rev.nu.,
precludinq Datendant Innera trom properly
attendinq to hi. pati.nt, Ruth Daniel on
AU9U.t 7, 111112,
(aa) tailinq to lntorm'Ruth Daniel a. to the material
rlaka, coneequenca. and contraindication.
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a..ooiated with Mdmini.terinq exoe.. in.ul1n,
(bb) failinq to inform Ruth Daniel a. to the material
rl.k., con.aquanoe. and contra1nd1oation.
a..ociatad with ordarln~ medioat1on. to whioh
Ruth Daniel wa. documented a. be1n9 aller.,1o,
(co) de.pit. hi. awaran... that Ruth Daniel had
lab11a diabata., and that .he wa. ..n.it1ve
to the adju.tm.nt of in.ulin, neverthel...,
tailin9 to be phy.ically pre.ant to a.....,
monltor and evaluate hl. patient, 1noludinq
review of har medioine ~ardax before order1n9 an
ovardos. of insulin on Auqu.t 7, 111112,
(dd) da.plta hi. awarenaa. that hi. ~atlent wa. a
labila diabetic and wa. .en.it1ve to the
adju.tment of inlulin,neverthele.., tailin.,
to .ummon any physlclan to ba pre.ant at the
tima he ordered the overdo.a of In.ul1n on
AU9U.t 7, 111112,
(ee) taillnq to ansure proper do.aqe and
admini.tration of inlulln in a labl1e diabetio,
(ft) failinq to plan, arranqe, and an.ure prop.r
in.ulin covera9' tor hi. patient, Ruth Daniel
on Auqu.t 7, 111112, and
(q9) inapproprlately abandoninq hi. patient, Ruth
Daniel by permittln9 har to .aiz., convul..,
fracture and di.locata her riqht shoulder,
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fractura har l.tt kne., .u.tain n.urolo9ic
deticlt and 10.. ot con.oiou.ne.. a. a r..ult
ot ordlrin9 an ov.rdo.. of 1n,ulin on AU9U.t 7,
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n. A. tha direct and proximate r..ult of the atore.enUoned
neqli9.no. and/or 9ro.. nagliganoe, D.fandant Inner. i. liable to
Pla1ntitt for 1njur1.. and damage. a. .et torth in paragraph. 21 throU9h
82 above whlch are lncorporatad hlraln by retaranc. a. it .at forth at
lan.,th.
WHIRlroRll, Plaintitt, Ruth Danlel, d.mand. judgmant aqaJ.n.t Defandant
charl.. R. Innar., M.D. for compenaatory dama9a. in an amount in exoe.. of
tw.nty thou.and ($20,000.00) dollare exclu.iva ot int.re.t. and co.t. and
ln exca.. ot any juriedictional amount requirin9 compul.ory arbitration.
COUNT II
Ruth Daniel v. Inn.r. Davi. A..oclat..
86. Paragraph. 1 through 82 and Count I of thi. Complaint ara
incorporat.d h.rein by raterenca a. it ,et torth at len9th.
87. At all relevant tim.. harein, Defendant Inn.n wa. acUn9 a. the
agent, apparent agant, .ervant and/or employea ot Innar. Davil A..ooiate.,
a prota.a1onal profit-making medioal oorporation and wa. aotin9 w1thln the
.copa ot .ald .mploymant,
88. Datandant Innar. Davi. A..octatea, actin9 through it, a9ant.,
appar.nt aqente, .arvant. and/or employ..., 1. liable to the Pla1ntift for
the 1njurle. and damage. allaged h.rain whioh wer. directly and
proximat.ly cau.ed by the Dafendant'. nagllganoa and/or qro.. ne.,11genoe
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a. aat torth in paravuph. :18 through 8:1 abova wh10h are inoorpontecS
herein by raterenc. .. it ..t torth at lal\9th.
WHIRlrORl, Pla1ntift, Ruth Dani.l, demanda jUdqement a.,ainat Inner..
Davia Aa.ociata. for oompan.atory damage. in an amount in .xoaaa of twenty
thouaand "20,000.00) dollan axclua1ve ot intere.t. and ooat. and in
axoe.a of any juriad1otional amount raqu1rin9 ccmpul.ory arbitration.
COUNT II I
Ruth Daniel v. Luan Gramm. R.N.
811. Para9raph. 1 through 82 and Count. I and II ot thia complaint
ara 1ncorporatad herain by reterance a. it .et torth at lan9th.
110. Datendant Luan Gramm, R,N, is liable to the Detendant for the
injur1e. and damage. alleved harein which were directly and proximately
cau.ed by har naVllganc8 and/or vro.. naglivenoe inl
(a) taillnq to properly inve.tlgate Ruth Danlel'a
medicine RardexI
(b) failing to properly read Ruth Daniel'. med101na
I<ardax 1
(0) tal1ing to properly relay tha intormat1on oonta1ned
in Ruth Danlel's madioine RardexI
(d) failinq to appreoiata the 8i9nitioanoe that
additional In.ulin would hava on a labile diabetic
.uoh a. Ruth Danial, particularly atter reoeipt
ot in.ulin coverage in tha aarly morning hour. of
Auquat 7, 1111121
(e) tailing to notlfy .uparviaor., dapartment head.,
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medical dir.ctor., phy.io1ana or ho.pital
Idmin1.trator. ot Det.ndant Inn.r.' overdo.e of
inaulin on AU9U.t 7, 1~g2/
(f) failin9 to appreciate that Def.ndant Inner.' order
oVlrdo.1ng hl. patient Ruth Danl.1 with inaulin
on Auqu.t 7, 111112 oould r..ult in a dr..tl~
drop in blood 91uco.. oau.1n9 hyp091ycemic .hock
and ..ilur./
(9) tal1lng to provld. tor proper nur.1n9 car. to
Ruth Daniel tollowlng Defendant Inn.r.' order
overdo.inq hi.,patl.nt with lnaulin on AU9U.t
7, 111112/
(h) improp.rly a.certainin9 the Itatu. of Ruth
Danl.1'. inlul1n ooveraqe on AU9U.t 7, 111112/
(1) abandonlng hor patient, Ruth Danlel by faillnq
to properly monitor, evaluate and a..... Ruth
tollowin9 Defendant Inner.' ord.r overdo.in9
hi. pati.nt wlth in.ulin/
(j) failing to remain wlth Ruth Dan1.1 to a.....
h.r traumatic in1urie. and neurol09ic damage
following h.r hypo~lyoemlo .elzure and .hock on
Augu.t 7, 111112/
(k) falling to report Defendant Innerl' ord.r
overdoainq hi. patient, Ruth Daniel wlth 1naulin
on Augult 7, 111112/
(1) failing to mlnimile the riak and/or prevent
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Ruth Dan1el'l hypoglyoamio .hook and .ailu~e on
AU9uat 7, 11192/ and
(m) 1napproprlataly mon1torln9 Ruth Daniel'a blood
91uco.e lavel. on AU9u.t 7, 1992.
Ill. AI the diraot and proximata ra.ult ot the aforellentionld
nlqUgenoe and/or 91'0" na.,119ance, Dafendant Gnu 18 Uable to plaintiff
for lnjuria. and dama9a. a. lat forth ln paragraphl 31 th~ough 13 above
which ara inoorporated herein by ratarance .. Jf ..t forth at lanqth.
WHIlRIFORIl, Plaintitt Ruth Danial, demand. judvment a9a1n.t Defendant
Luan Gramm, R.N. tor compan.atory damaqel ln an amount ln exoe.. of twenty
thouland ($20,000.00) dollau exclulive ot 1ntareate and ooate and in
excaa. ot any juri.dictional amount requirin9 oompullory arbitration.
COUNT .lY
Ruth Daniel v. Holy spirit HOIDital
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112. Paragraph. 1 through 82 and Count. I, n AND In of thia
complaint are incorporated hare in by reterance a. it .et forth at llngth.
113. At all ralevant times harein, Defendant Charlie R. Innlr., M.D.,
Defandant Luan Gramm, R.N" and all madioal perlonnal includinq .taU
nur.e. who providad oare to Ruth Danial in Augult, 19112, were the a.,lnt.,
apparent IIglnta, .arvant. and/or amploy... of Defendant Holy spirit
Hoapital.
114. Defandant Holy Spirit Ho.pital, acting throu9h ita a.,enta,
appallent a9lnt., 'Brvant. and/or employa.., i. Uable for it. nlgUq.nol
with rea~.ct to Ruth Danial bYI
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(a) fa11in9 to provi4e 9uidelinea and proce4urel
for the t~eatment and oa~a of inlul1n-dapendent
labile diabetioa,
(b) fal1in9 to properly .elact and .upervi.e
phyaiolanl and other per.onnal to whom
they entrult tha care ot patient. with
Ruth Daniel'a condition,
(0) ta11in9 to appraolate and reoo9nile the
riak. of a patient known to be allarqio to
Re9ular inlulin and, navarthele.., parmittinq
the adminiltration ot RI9ular inlulin in Auqult,
19112,
(d) althouqh aware that Ruth Daniel had labile
diabate. and waa aen.itive to adjuetment
of in.ulin, nevarthelell, fai.linq to notify
.uparvilor., department haadl, .adioal diractora
or hoapital admini.tratora whan Defendant Inner.
ordered an overdose of in.ulin on AU9uat 7, 111112,
(e) failinq to under.tand that additional in.ulin
admini.tratlon in the afternoon hour. of Auquet
7, 111112 in a patient who already recaived inaulin
oovaraql at 0730 hr. on Auqu.t 7, 111112 oould
ra.ult in hYP091ycemic .ailura, .hook and it.
attandant oon.equancel'
(f) failinq to appreoiata that Defandant Innarl'
order tor an ovardo.a ot inaulin in AU9u1t 7,
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18113 oould r..ult in a dr.atic drop in Ruth
Daniel'a blood .,lucoae r.aultln9 in hypo.,lyoe.1o
ahock and ..1Iure,
(q) failin9 to provld. tor proper nuraing oare to
Ruth Daniel following Def.ndant Inner.' order
for an overdo.. of in.ulin on Auquat 7, 1"2,
(h) tal1ing to properly review all of Ruth Daniel'.
..dical r.cord. inoluding her med101ne ~.r4ex
on AU9U.t 7, 111112 to aloertain the atatua of
her in.ulin coverage,
(i) inappro~riately abandcninq the patlent, Ruth
Dani.l by tailing to properly monitor, .valuate
and a..... Ruth Danl.1 followlnq De~.ndant
Inner.' order ov.rdo.in9 hi. patient wlth In.ul1n
on Auqu.t 7, 11192,
(j) failin9 to plan, arrange, and r.main with Ruth
Daniel to a.eeee for n.urological deficit or
tral1matio injuri.. followinq h.r hYP091yoe.ic
.eilure and Shook,
(k) falling to have peraon. prop.rly train.d in
nur.inq a.....inq a labile diabetic patient
for oompromi.inq aign. and aymptom. fOllowinq
Def.ndant Inners' order overdoslnq his patient
with insulin on Auquet 7, 111112,
(1) failin9 to .n.ure that Ruth Danlel rec.1ved
prop.r examlnation and follow-up care atter
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her hYP091yc.mic .eilure and .hook/
(m) failin9 to initiate and maintain the prooe..
ot on901nq .hared information ln the ClU.
provided to Ruth Danl.1/
(n) failin9 to properly r.vi.w and re.pond to
the informatlon oontained in Ruth Deniel'.
medioin. ~ard.x on AU9Ult 7, 111112/
(0) tailin9 to prop.rly re.pond to the neurolo.,1o
deticit and traumatic lnjury to Ruth Daniel
followinq her hYP091yc.mic .hock and .ebure/
(p) fail1n9 to draw a blood .ample trom Ruth
Daniel prlor to the admini.tration of the
bolu. ot DIIOW on AU9U.t 7, 111112/
(q) fal1in9 to minimize the r1.k and/or prev.nt
,
hYP091ycem1o I.ilur. and .hock by qu..tion1nq
D.f.ndant Inn.r.' ord.r. tor an additional
40 unit. of NPH and 211 unit. of Reqular 1n.ulin
at 1330 hr. when Ruth Danl.1 already received
20 unlt. of NPH In.ulln at 0730 hr. on Auqu.t 7, 1"2/
(I.') 1napproprlately abandonln9 the patl.nt by
permittinq Ruth Daniel to aqoni.e in hypoqlycemlo
..ilur. and Ihock tor hourI without further
a.....m.nt ot h.r oondltion/
(.) inapproprlat.ly mi.r.adin9 Ruth Danlel'.
medicine ~ard.x on AU9ult 7, 111112/
(t) fail1nq to comply wlth Detendant Holy Spirit
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Hoapital'a policy on monitorln9 and mana9inq
labile inaulin-dependent diabetic.,
(u) tailin9 to notity a .uperv1.or, med10al
dlractor, department head, ho.pltal
adminiatrator or othar phy.1c1an to monitor
and evaluate Ruth Oaniel tollowin; Oetendant
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Inner.' order overdoein9 hi. patient with '
lneulin on AU9U.t 7, 111112,
(v) inappropriataly adminiatar1nq DIIOW pr~or to
draw1nq a blood auqar aa orderad by Defendant
Innar. on Auqu.t 7, 111112,
(w) inappropriately holdin9 It..lf out to the
public a. havinq all the nece..ary faoilitie.
and aervic.. to cara tor Ruth Daniel in a
.ate and approprlate mannar,
(x) inappropriatelY repre.antinq to the pUblio,
and Ruth Danial, in particular, that it wa.
able to provido madical .ervlce. in an adequate
taahion,
(y) failinq to properly ratar Ruth Danlel'a caae to
a phy.ician more familiar and batter able to
handle Ruth Daniel'. medical oondition durin; her
ho.pltalizatlon in AU9U.t, 11192,
(I) inappropriatalY rapre.entinq that R~th Daniel
waa not in danqer by lack of taoilitie., equip.ent,
and/or .ervloe.,
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(aa) failinq to minimi.. the riak and/or avoid injury
to Ruth Danlal,
(bb) fai1in9 to proparly provide for careful planninq
and mon1tor1n9 ot 1n.ul1n oovera9a throuqhout
Ruth Dan1al'a AU9uat, 111~2 hoapltalilation,
(00) 1napproprlately monitor1nq Ruth Daniel'. blood
qluco.e levela durin9 har Auquet, 111112
ho.pitalization,
(dd) fa111nq to provida adequate order. tor the
ho.pital nurainq .tatt, nur.. olln1c1ana and
other ho.pital per.onnel in charqa of monitorinq
Mr.. Daniel' II in.ulin ooverage, and
(ea) tailinq to minimize tha ri.k and/or pravent
Mr. Danial'. hypoqlycamio aelzure and ahock
on Auqu.t 7, 111112.
1111. Datendant Holy spirlt Hoepital, aotinq throuqh It. a.,ante,
apparant agenta, aervanta and/or employaea ie liable to the Plaintiff, for
the lnjuriaa and damagee .. alle9acS herein which we/;'e directly and
proxlmately cau.ed by the Defendant'. neqllqanoe ae .et forth in
paraqrapha 28 throuqh 82 above whloh ara incorporated herein by referenoe
ae lt aet forth at lenqth,
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WHIRI.ORI, plaintitt, Ruth D.ni.1, dem.nd. jUdva.nt aqalnat D.ten4.n~
Holy 8pirit Hoapital for co~penaatory d..aq.a in an .mount in exoe.. 01
twenty thou, and (.20,000.00) dollar. exolu.1ve ot inter.at. and cOlt. and
in .xcea. ot any jur1adictional amount requlrinq oompul.ory ar~ltration.
Ra.paott~lly .ubm1tt.d,
ANGINO . ROVNER, P.C.
DATID. September 27, 1993
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VIlRIJ'I9ATIQN
I, Ruth Daniel hereby varity that the taot. .et torth in the
in the tore9oin9 COMPLAINT are true and correct to
the ba.t of my knowledqe, information and bel1at.
I uncSer.tand that any talaa .tatement. therein are lIacSe
aubjeot to the penaltiaa ot 18 Pa.C.S.A. I 41104, relaUn9 to
unaworn folaitication to authoritie..
WITNESS I
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RUTH J. DANIIL,
plaintiff
VS.
CHARLIS R. INNIRS, M.D.,
INNlaS DAVIS ASSOCIATBS,
LUAN GRAMM, n.N., Ind
HOLY SPIRIT HOSPITAL,
Defandl'ltl
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I IN THI COURT or COMMON P~IAI
I DAUPHIN COUNTY PINNIYLVANIA
I
I CIVIL ACTION - LAW
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I NO, 37&4-S-g3
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I JU~Y TRIAL DlMANDID
UOOLOr .UVIc:a
I heraby certity that I 1m thil dlY .ervinv Interr09atorie.
and Reque.t for Production of Documentl of Dafandant. Luan
Grimm, R.N., .nd Holy Spirit HOlpital tor Anlwer by the
pllintiff Ruth J. Dlniel upon the parlon(.) Ind in the mannar
indlc.tad below, which lervica .ati.fiel the raqUiremant. ot
the Penn.ylvanil Rulel of Civil Procedure, by depolitinv I copy
of the .Ime in the united stlte. mlil, It Harri.burv,
Penn.ylvlnil, with firlt-clall pOltlVa, prepaid, a. folloWl1
Nijola C. allan, Ilquire
Anvino .. Rovner
4&03 North Front Street
H.rrilburv, PA 17110
DATil \\I\~f\~
BYI
Michlel W, McGuckin, laquire
18&0 Wil1ilm Penn Way
Suite 20g
P.O. Bolt 10U6
Llncalter, PA 17605-06g6
METTIl, EVANS .. WooDSIDB
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Koy .~f~~;;;~" ...,....t t.
Crliv ' tone, B.quire
3401 North Front Street
p, 0, Bolt 5g50
Harrilbur9, PA 17110-0950
(717) 232-5000
Attorneys for Defendant.
Luan Gramm, a.N, Ind Holy Spirit
Hospital
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IW'JIH iJ. DAHilL
1N THI ~OUIlT or COMllON PUM
DAUPHIN COUNTY, PINN.YLVAlfIA
Pla1ntUf
v.
CIVIL ACTION - LAW
NO. 31114-.-13
CHULlI a. IlQIla, II.D.
INN'" DAVII AlIOCIATI.
LUAN QIlAIIIIL a.N'L and
HOLY ..lalT HOIP1TAL
Defendant
JURY TRIAL DIllANDID
QRDIR 1..' /
AND NOW, thb ....i.~ day of . .1.....1(11 llt3, upon
aon.1deration of the Petition to tran.fer oa.. and record. in the
above aaption.d ca.. to the court of coaaon Plea. in cumberland
county, it 1. hereby ORDIRID and DICallDID that the above
oapt1oned oaaa, No. 37114-8-93, will b. tran.ferr.d fro. the court
of Coaaon Plea. of Dauphin county to tha Court of Co..on Pleaa of
cumberland county, Pennaylvan1a.
BY THI COURTI
J.
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RUTH J. DAHilL I IN THI COURT or COIIICOJf PLIAI
I DAUPHIN COUNTY, PINlfIYLVAIIIA
PldntUf I
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v. . CIVIL ACTION - LAW
.
CHAaLlI Il. IIfJII", II.D. I NO. ~7'u-s-n
INNJIlI DAVII AI.OCIATIS I
~AII GRAKIIT Il.N., and .
HOLY IPIIlI HOSPITAL .
.
Defendant I JURY TRIAL DIIlANDID
PITITION TO TRAM"IR CAlI TO COURT or COMMON 'LlAI
IN CUN..R'~D OO~Y. P.NN8YLVAHI&
Plaintiff, Ruth J. Daniel, by har attorneya, Anv1no . Rovner,
P.c., hereby petitiona leave ot court to voluntarily tranafer the
above capUon.c1 cae. frolll tha Court of CODon Pleaa of Dauphin
County to the Court of Common Plea. of CUmberland County,
Pennaylvan1a. In .upport of her p.UUon, PlaintUf aven aa
foUon.
1. Plaintiff fl1.d a Complalnt in the above captlonec1 caa.
on or about September 27, 111113 in tha Court of Common Plea.,
Dauphin County, P.nnaylvania.
2. Plaintiff, Ruth J. Daniel, 1. ae.k1n9 tranafer of thia
ca.e troa Dauphin County to Cumbarland County, Pennaylvania. All
Defendant. in the above captioned caae, prov1c1ed m_~ical a.rv1ce.
and aaintdned corporate .ec1ical 1natituUona in Cullberland County,
P.nnaylvanla rathar than Dauphin County, Penn.ylvania.
3. By SUpulation of counaal, all parUe. to the above
captioned ca.e a9r.e with the tranafer of thi. ca.e from the court
Of Common Plea. ot Dauphin county to the Court of Co..on piea. ot
UOlS/ll.t
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cuuel'land county, pennaylvania. (ba, e.eouted .UpulaUon of
coun.el, attaohed hereto .1 I.hibit "A" and incorporated herein ~y
ratel'ence) .
,wa...,o.., '~aint1ff, Ruth J. Daniel, re.peotful1y re~e.t.
thi. Honora~le COUl't to qrant the herein Petition and thet the
'rot.honotary trend.X' aU noorda in the above oaption~d .atter
tro. the court ot coaaon 'leae in Dauphin county to the court of
co..on .lea. in Cuaberland ccunty, pennaylvania.
Re.peotful1y .ub.itted,
. ROWla, P.C.
. 0
. . ssal?
4110 orth 'ront street
Hal' .burq, PA, 171iO
(717) 23'-1711
coun.el for plaintiff
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~UTH J. UANXlr.
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IN TNI COURT or COMMON PLIAS 0'
CUKBIRLAND COUNTY, PINNIYLVAHIA
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I CIVIL ACTION - LAW
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NO. 94-413 CIVIL TIRM
CBARLIS R. INNIR8, M.D.,
IHNIR8 DAVIS ASIOCIATI8,
LUAH GIWCML R.N., AND
HOLY 8'IRXT NOBPITAL
QIlD.. 0' COUR"
AND NOW, JUNI 14, 1995, at the reque.t at the
defendant, the above-captioned matter i. hereby oontinued from
the JULY, 199', trial term. Coun.el i. diraotad to reli.t for
trial when ready.
By the Court,
l(,( /. J!l
Harold .. Shaely, P.J.
...~~~
Nijole C. 01.on, .aquire J
Mlchael W. McGuokin, .equlre
Crai9 A. Stona, .aquire -
Court Admini.trator
IIld
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RUTH J. D~~~~tiff
6
I IN THI CQURT or COMMON PLIAS or
I CUMIIRLAND COUNTY, PINNSYLVANIA
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I CIVIL ACTION - LAW
I NO. 114-413 CIVIL TERM
IN RII CONTINUANCI
v.
CHARLIS R. INNER8, M.D.,
INNIRI DAVI8 ASSOCIATES,
LUAN GRAMM R.N., and
HOI,Y SPIRIT HOSPITAL,
Defendant.
ORDER or COURT
AND NOW, thl. 13th day ot June, 19911, tha ca.e
not havinq been continued previou.ly and couneel for the
Detandant. havinq reque.tad a contlnuanc. tor variou. raa.on.
statad here today, the Court wl11 9rant ona contlnuance. The
Prothonotary 1. diracted to reli.t the oa.a tor the 8eptamber
tarm ot civil trial.,
By the Court,
1d~1 ;: '. J'h-~~~-.._'
(Harold E, shaely, P,J.
. r Nijole C. Oleon, I.qulre
...1 For the Plaintitt
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~1~14~ Micha.l W. MCGuckln, m.qulra
,~,,\.~ For Dafendant:. Innar. and Innau Davie A..oclate.
cra1q A. stone, m.qulre
For Datendant. Gramm and Holy Spirlt Hoapital
IlIh
JUH ZZ
10 20 11H '95
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P~t'!CIPlt 'QR USTtNG CAS! '2.!..I!!4!r,
(Mull be lYpewrtl"n ,,/ld .ubmlll.11 in dupIlCfI')
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No. ~13
<:1,\1_
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TO THE PROTHONOTARY/OF ClJMBEIlLAl'/D COUNTY
(ell_ell on.)
'lul' III! tII. followln. UU:
( X) rOI JURY lrlll al tII. MXI 111m of 41,\1 ~QUIl.
( ) fOI IIIN wIlhOUI . JUry.
_ T
CAmON 0' C:,UI
(.nlll' clplLon mill! b. Il.lflllll 11I11)
(ell.ell on.)
Ruth J. Oan1el
( )
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,wumplU
Till''''
Till.... (MoIOI V.IllcI'J
CiV1l Act19n " Law
(011111)
0'1'1111111)
(Der.ntlanl)
The t~i&l li.t will be called on
8/15/95 and' .
Tl:ial. COllllUnce on 9/18/95
P1:et:i&1. '1111 b. hald on 8/23/95 "
(B~iaf. &~e due 5 day. before p~..
td&1. . )
(The pa~ty liatinl thi. ca.. fo~ t~i.l
.hall p~ovid. fo~thwitb a copy ~f the
~~a.cip. to all coun.el. pur.uant to
local au1e 214-1.)
n.
Charles R. Innors, M.D., [nners
Davis Associates; Luanne Gramm, R.N.;
and Holy Spirit Hosp1tal
VI.
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Indiult III. morn.)' wllo w1U II)' cu. fOI III. ,lIIlY willi m~. 11\II ,r."lp.:
N1jole C. Olson, Esquire, Angino & Rovner, P.C.
lIIt11c,,~ 11111 c01I1I6I1 fo, 0111I1 ,ulIIl II luIownl Cra i g A. Stone. ~ ra - fo~ DefendAnts
Gramm and Holy Splr1t. Hosp1tal Michael W. McGuckin Es ulr -
[nners and Inners Davis Associates.
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Sllnld:
Es uire
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".~L ~()I ~~~ (
'riM S.ml:
Allorn.y for:
Plaintiff
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J h.I'QY certity that I, Lynn A. John.on, an ..ploy.. of
Anqino. aovn.l', P.O., have thi. day .erv.d a true and OOI'I'.ot oOPY
of .ra.oi,. for Ll.'ia, Ga.. for 'rial upon coun..l of r.oord by
unit.d .tat.. Ur.t cla.. .aU, poata.,. pr.paid, .elelr....d a.
follow..
cl'aiq A. .ton., ,.q.
'401 KOl'tb 'I'ont .tl'..t
P.O. lox 5150
Harri.bul'9, PA 17110-0950
Micha.l W. McGuckin, ..q.
1150 Wil1ia. 'enn Way,
.uita 201
P.O. Box 106116
Lanca.t.1', PA 17605
,J N'u~ nC\~N'~""-
~. JOhn.'o1l'/ -
Dated, Jun. 30, 11115
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The t~1al li.t w11l be calle4 OQ
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TO THI 'll.OTHONOTARYfOf CVM81RL~D COUNTY
pi".. 11I1 1/11 foUowlnl u,,:
(Check onl)
( X) . fOI IlJp.y lrialll "'I n.lII 111m of 4lvU, ~Oll".
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CAPTlON 0' CMI
(InwI 1I,1I0n .111111 ~I 1I11,d 11\ C\lU)
(c/llck onl)
Ruth J.Danle1
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TII''''' (MOIOI VIlIIcl'l
~ Action - lAW
(OI/ler)
n.
Charles R. Inners, M.D., lnners
Davis AssQciates; Luan Gramm, R.N.;
and Holy Spirit Hospital
T:d.al. cOlllll8nce on 7/10/95 .
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(DeC.ndanl)
,ntdal. w1ll be helcl on 1\/:>I/Q"- '.
(B~1ef. a~e clue 5 daye b.fo~e p~e.
tdal. . )
(The pa~ty l1.t1nl thi. ca.. lo~ t~i&l
.hall p~ov1cl. fo~thw1th a copy ~f the
~~a.c1pe to all coun..l. p~.U&ftt to
local aule 214~1.)
VI,
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No. 413
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Indlll'l Ihl .lIorn.y who wlU It)' .... for 1/1. 'OIlY 11'/10 nl~. IiIlI plI.el,l:
Nijo1e C. Olson, Es ulre An Ino & Rovner P.C.
Il\dlnlt utal c01l1UI1 for orller pull.. Illulownl Cra j g A. Stone. ESQuire - fl'll' DefonrtAnts
Gramm and Holy Splr1t Hos 1ta1' Michael W. McGu n
lnners and lnners Dav1s Associates
thIa .... It reldy tOllrio.l,
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AIIOlrl.y fOl: P1 a 1 nt 1ff
Olson, Esquire
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MICHAItL. W, MCClI.JCKIN a AeeQCfATlle, ...c;:,
("'.
ATTO"N.V. AT L~w
'..0 WIUoIAM PItNN WAY
eUITIt IIQ.
",0, 1101< '0...
LANCA.TIt/'l, "A 17.08'0...
(7'7) ~.O'~OIlO
TaLa""",a" (717) ~.0.~01l'
61),143
Octobar 13, lee3
Prothonotary'. Ottice
Dauphin county Court Hou.e
P.o. Box 114&
Harri.bur9, PA 17108
RBI Daniel v. Inner., M.D., et al,
Dau~hin County C.C.P.. No. 375.-8-1093
Daar Slr or Madaml
Enolo.ad plea.e tlnd the oriqlnal and one copy of our Intry
ot Appaaranoe and Demand tor Jury Trial on behalt ot our client.,
Charle. R. Inner., M,D. and Inner.-Davl. A.aooiate., in the
abova-captioned matter,
Kindly tile .ame wlth tha court and return ona oopy to me,
Aa alway., thank you tor your anticipatad oooperation and
courte.1e. in thla regard.
Very truly youra,
/O&~~
~~~EL W, McGUCKIN
MWMlllle9
IInololura
OCI Nijola C. Ol.on, ..quira (w/anol.)
Holy Spirlt Hoapltal (w/ancl.)
Luan Gramm, R.N. (w/encl.)
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MICHAIL W. McGUC~IN , A8S0CIATIS,
BY' Mioha.l W. McGuckln
Idant1tioation No. 411464
Ja... P. Gre.n
Id.ntltJpation No. 411666
18110 William Penn Way
Suita <1011
P.O. Box 10U6
Lanoa.tar, PA 1760~-0696
(717) 3110-3020
P.c. 60,142
Attorney. tor Detendaht.,
Charle. R. Inner., M.D.
Inner.-Dav1. A..ooiate.
RUTH J. DAHIlL ,
,
,
v. ,
,
CHARLIS R, INNERS, M.D. ,
and ,
INNER8-DAVIS ASSOCIATES ,
and I
LUAN GRAMM, R,N. ,
and I
HOLY SPIRIT HOSPITAL I
COURT OF COMHON PLIAS 0'
DAUPHIN COUNTY
NO, 37114-S-93
JURY TRIAL DEMANDED
ENTRY or APPEARANCE
TO THE PROTHONOTARY'
~indly anter my appearanoe on bahalt ot Oatendant., charle.
R. Inner., M.D. and Innera-Oavi. A..ociete., in the above-
captioned matter.
MICHAE W. McGUC~IN , ~OCIATIS,
t.-'C~( :::J
. c
Attorney tor Detendanta,
Charla. R. Inner., M,O.
Innar.-Davi. A..oc1ata.
P.C.
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MICHAIL W. McGUC~IN . ASSOCIATES,
BY' Michael W. McGuckin
Identitication No, 411464
Jalle. p, Graen
Ident1ticatlon Nfl' 411666
11110 WilliaDl Penn Way
8uita aOll
P.O. Box 106116
Lanca.ter, PA 17605-0696
(717) 3110~3020
f--
f.C. 60,14:1
Attornay' tor Defendant.,
Charlea R. Inner., M.D.
Inn.r.-Davia Aa.ociata.
RUTH J. DANIEL I
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,
CHARLIS R. INNIRS, M,D, I
and ,
INNERS-DAVIS ASSOCIATIlS I
anct ,
LUAIf GRAMM, R,N. I
and I
HOLY 8PIRIT HOSPITAL I
COURT or COMMON Pl,IlAS OF
DAUPHIN COUNTY
NO. 37114-S-93
JURY TRIAL DEMANDIlD
DEMAND FOR JURY TRIAL
TO THI PROTIIONOTARY,
Dafendant., Charle. R, Inner., M,D. and Inner.-Davl.
A..ociat.., hereby demand a jury trial in tha above-captionad
matter.
CIATIlS, P.C.
, I,
.
Attorney tor Detendante,
Charle. R. Innera, M,D,
Innar.-Davl. A..ociata.
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-." OI"lllCll 011 ,!'tlll StlllRIIo'F OF UAl1l'llIN COUN'rY. I'ImNt:lYI,VANIiY"'\
~ut.h J. Dani~l
Plalntl ff
No. 3754 S 1993
vs
Charles R. lnners, M.D. &E~AL
lnners Davis Association Defenda'1t Page No. 104.
and
Luan Gremn, R.N. and .
_ Ho~y Spirit Ho8plt~.___.____._... _._...___..____._..____.___._____........,.._,--__
And Now; Sept.anber 27, 1993 I, heruby Duputl1.lI tho Sheriff
of Qxl)berland County, Pennsylv111llil. to serve the within Civil Act.iQn
Complaint uponQJOlarles R. lnners, M.D. alJJfnners Davis Association at. 1863 Cent.er St.
CIIIIlp Hill, PA, and upoltmn GrallJlI, R.N. an~oly Spirit Hospital at 503 North 21st.. ,
4-copies
ADVANCE CXlSTSI.$50.00
Camp Hill, Pa, NOTEl Please leave copy of the complaint with Charles lnners or person in
char8e at. time of service & lnners Davis Assoc. leave copy wit.h person ln charge. Luan
Gramm, R.N. leave copy of the complaint with her & Holy Spirit Hospital with the person
in charge. According to Law.
So ~w,ors JtI. ..
Wllllam~Vlngst;)tl,~
Shllrlff of Diluphln County, Flenna.
~
~-
KINDLY RETURN THIS DEPUTIZATION WITH YOUR RETURN OF SERVICE
- - - - - -
". .. - - - - - - - - - - - - - ,- - - ,- - -. ., - ., - - - - - .. - - - - - - - -
And Now, Oct, 1, 1993 at 2124 pm;T~ed the withln Civil Action Complaint upon
Charles ~, lnners, M.D. & lnners Davis Association by personally handing to Charles ~, lnners,
M.D" personally and as adult in charge at time of service two true copies and making known to
him the contents ther~of at 1863 Center St., Camp Hill, PI!, by the Sheriff of ClJ\lberland Co, psI.'
his affidavit of servlce attached.
And NOWI Oct, 1, 1993 at 2135 r.M, served the within Civil Action C'..omplaint upon
Luan Gramm, R.N, & Holy Spirit Hospital by personally handing to William Holjes, Vice President
of Holy Spirit Hospital two true copies and making known to him the contents thereof at 503 N.
21st Street, Camp Hill, Pa, by the Sheriff of Cumberlend Co. per his affidavit of service
attached,
Shariff's costs $44,00 pd. 9/27/93 Rec, 046016
,. A ,0 Anawers J ~ ..
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COMMONWEALTH OF PENNSYLVANIAI
COUNTY OF CUMBERLAND
Ruth J. Daniel
VS
Charle. R. l/lnerll, M.D., lnners
Davil AIsociation and Luan Gramm,
R.N. and Holy Spirit Hospital
In The Court of Common Pleae of
Dauphin county, Pennsylvania
No. 37"'4 S Term 1993
Civil Action Complaint
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Timotlly Reitz, Deputy Sheriff, who being duly sworn acoording
to law, says that on October 01, 1993 at 2124 o'clook P.M., E,D.S.T., he
lerved a true copy of the within Civil Action Complaint, in the above entitled
aotion, upon one of the within named defendants, to witl Char lee R. lnnera,
M.D., by making known unto Charles R, lnners, M.D. personally, at 18~3 Center
Street, Camp Hill, Cumberland county, Pennsylvania, its contents and at the
Isme time handing to him personally the saId true and attellted copy of the
lame.
Timothy Reitz. Deputy Sheriff, who being duly Iworn according
to law, lIays that on October 01, 1993 at 2124 o'clock P.M., E.D.S.T., he
urved a true copy of the within civil Aotion complaint, in the above entitled
action, upon one of the within named defendants, to witl lnners Davil
Allociation, by making known unto Charles R. lnners, M.D., adult in charge,
at 1863 Center Street, Camp Hill, Cumberland county, Pennsylvania, itl oontentl
and at the lame time handing to him personally the said true and attelted
copy of the lame.
Timothy Reitz, Deputy Sheriff, who being duly Iworn according
to law, says thllt on October 01,1993 at 2135 o'clock P.M., E.D.S.T., he
lerved a true copy of the within Civil Action Complaint, in the above
entitled action, upon the within named defendants, to witl Luan Gramm, R.N.
by makin~ known unto William Holjee, Vice Preeident of Holy Spirit HOlpltal,
at 503 North 21st Street, Camp Hill, Cumberland county, Pennlylvania, itl
content. and at the Bame time handing to him personally the said true and
attelted copy of the same.
Timothy Reitz, Deputy Sheriff, who being duly Iworn aooordlng
to law, saYI that on October' 01,1993 at 2135 o'clock P.M., E.D.S.T., he
served a true copy of the within Civil Action Complaint. in the above entitled
action, upon the wit.hin named defendant, to witl Holy Spirit Halpita1, by
making known unto William Holjes, Vice Prelident of Holy spirit HOlpital,
at 503 North 211t Street, Camp Hill, Cumberland county, Pennlylvania, itl
content. and at the lame time handing to him perlonally the laid true end
attelted copy of the lame.
,
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Sheriff' .
Docketing
Service
Affidav it
COltel
26,00
16.S0
1. 50
44.30
Pd. by Atty.
10-04-93
SO ~~~II
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R. Thomds Kline. ah riff
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,
aworn Bnd Subscribed to Before Me
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This /.1 rJ
1993, ^.D,
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ltUTHJ. PA.NUL,
. Plat.ntUt
v.
CHARLI. R. INNIRI, M.D.,
INNIR8 DAVI8 AI8OCIATIS,
LUAN ORAKML R.N., and
HOLY "IRIT HOSPITAL,
Detendantl
. IN THI COURT or CQKMON PLIAI.
. CUHIIRLAND COUNTY, PA
.
. NO. 413 CIVIL 1994
.
.
. CIVIL ACTION - LAW
.
.
. JURY TRIAL DlMANDIP
tlMICI 'J'O PLIAD
TO.
~ole C, Ol.on, ..qulre
1110 . ROVlQIR, P.C.
.503 North rront Street
Harri.bur9, fA 17110
You are hereby notified to plead to the withln New Matter
within twenty (20) day. aftar ..rvice hereof, or a default
judgment may be entered again.t you.
By.
DATID. 8-lIS-U
CRAIG A. STO ,I QUIR'
Sup, Ct. I, . '15907
3401 North I ont Straet
P. O. Box 5950
Harrlebur9, PA 17110-0950
(717) 232-5000
Attorney. tor Detendanta
Luanne Gramm, R,N, and Holy
Spirit Hoapital
,.
RUTH J. I)ANUL,
plalntLU
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IN THI COURT 0' COKMON P~IAI
CUKBIRLAND COUNTY, PA.
HO. 413 Clvl1 1"4
v.
CHARLI' R. INNIRS, M.D.,
INIIIRI DAVIS AISOCIATII,
LUAIIGRAKKL R.N,t and
HOLY SPIRIT HOIPITAL,
Detendanta
CIVIL ACTION " LAW
JURY TRIA~ DIKANDID
AllnR .ITJI .1. 1IA'l"1'la 0' DI'IIIDAII'l'S
YlUIIIJI ORa_, R... un HOLY SPIRJ'!' HORlII'l'AL
1. Atter raa.onable lnveltlqatlon, Detendant., Luanne
Gramm, R.N. and Holy Splrlt HOlpltat heralnafter lometlme.
referrad to a. Anlwerln9 Defendantl HI, Gramm and HOlpltal, are
wlthout lntormatlon or knowledge lufflclent to form a bel1ef a.
to the truth of the corre.pondin9 Paraqraph of Plalntlff'.
complalnt, the lame 1. therefore denled and Itrlot proof, lf
relevant, 1. demanded at tlme ot trlal,
2.-3. The averment. ot paraqraph 2 are not appllcable to
An.werln9 Detendanta,
4. Admlttad,
5. . Admitted.
" I)
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, .. The avermenU of PUI.,lt'&ph . allle not Ipplicable to
Anawelt'in., Defendanta.
7. Denied, It ia .pecitically denied that at any ti.e
.atelt'ial to Plaintitf'. Complaint, Dr, Innelt'. WI' tho a.,ent,
a.rvant or employee, actuIl or apparent, of Holy Splrit
Hoapital. Rather, Dr. Inner. .aI an independent ataU
phyl1C lan.
B. It i. admitted that M., Gramm waa the Agent, aervant
and employee ot Ho.pltal in connactlon with the oare and
tlt'e.tment It'endered to Ruth Danlel .. aet torth in Plaintitf'a
Cqmplalnt,
9, Denied.. atated. Rather lt 11 averred that Dr. DAVi.
admitted Ruth Daniell to the HOlpltal on AU9u1t 4, 1992 with a
chlat complaint ot .evare pain in helt' leq., e.peclally the
.01ea ot her teat caulln9 her to be unable to walk. Her
hiltory ot pre.ent il1n.11 lncluded brlttle dlabeta. mel11tua,
In.ulin dependent a. .ell a. COPD, .evera kypho.coll0.il,
va.troentelt'oloqy with dehydration and blood .u9ar. out of
oontlt'ol.
- 2 -
10. Denled a. atatld. Accordlnq to the Hoapltal chart,
the ln1tl11 ordara for lnaulln Wire wrltten by Dr. Davla. Dr.
, I
McI,nroy wrote ordera tar lnlul1n on a conlultlng balia the
following day. The dally and coverage doaagea are contained 1n
the chart whlch 1. lncorporated by reterence.
11. Denied al .tated. It i. unknown what Plaintiff'l
daughter, Debra Nicodemu., advi.ad phyaician'. carlng for Ruth
Daniel. It ia apeciflcally danled that Ma, Nlcodlmua advla.d
n~rae. carlnq for Ruth Danial that her mother wa. "al1erglc to
Re9ular In.ulin,'' It la admitted trom tha recorda that Ma.
"
Nicodemul adviaad one of the nuraaa on Auguat 6, 1992 that Mra.
Daniel had never been well controlled with Regular In.ul1n.
The averment. of Para9raph 12 ara lncorpor.r~d by rlferencl,
By way of turther anawar, Regular inaulln waa ordered by the
attendlng and conaultlng phyaiclana treatln9 Mr.. Daniel.
12. Denied a. atatad. It 11 admitted that a note
oontainlnq that quotatlon anet other intormatlon 11 tound on the
Hoapital chart, Said antry i. lncorporated by reference.
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13. Denied" .t.ted. It 11 admitted that warninv
.ticker. curr.ntly appear on Mr., Daniel'. ~arde. purportin9 to
a4vi.e that Mr.. Daniel i. aller9ic to Revular in.ulin. Said
aticker. were ngt atfi.ed to tha chart until Mr.. Daniel went
to the Inten.ive Care Unit on AUQu.t 7, 1992.
14, Danied a. atated. Rather on Au;u.t 7, 1992, It
IPpro.imately 7130 a.m., Ruth Daniel received her previou.ly
ordered, daily doae of 20 unitl of NPH inaulin.
l~. Admitted.
16. Admitted accordinG to Hoapital record..
17. Deniad al atated. It i_ denied thlt Anaw.rin;
Defendant. raco;niled Dr. Innera' order la beinG for I
-overdoae ot inaulin-. It ia admitted that Dr, Innera di4 not
e.lmine Mr.. Dlniel on Au;uat 7, 1992 before preacribinv her
I
inaul1n.
18. Denied for reaaona aet forth in tha precedin;
I
Plragraph. By way ot further an_wer, it ia .dmitted that the
order referrad to in Pari;rapha 16 Ind 17 waa given by phone.
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19. Denied for releone eet torth in Plrl9rlphe 17 and 18.
8y wIY of further anewer, it i. Idmitted th,t LUlnne Gramm
Idvi.ed Dr. Inner. that Ruth Daniel had received her routine
dlily NPH ineulin at 7130 I.m. but had not reo.iv.aher morninQ
"cOVerIQe,"
20. Th. avermente of parlQrlph 20 re~uire In e.pert
medical opinion which ie beyond the e.pertiee of AnlwerinQ
Def~ndente. It il admitted that certain Imountl of inlulin
under certain Circumltlncel cln ClUle hYPoQlycemla with
Iubaequent hYPoQ1ycemic Ihock and leilurel. After I rea_onlble
inveatiQltion, AnlwerinQ Defendantl Ire withQut informltion or
knowledQ. _uf~ici.nt to form a belief a. to whether Plaintiff
.uftered from the Iyndrome referred to in ParaQrlph 20 and
.trict proof, if relevant, i. demanded at time ot trial,
21. Denied, Rather, Nur.. Gramm reviewed the Kard.. and
Ippropriltely rellyed all relevant information to Dr, Innere on
AUQuet 7, 1992,
22. It i_ denied that Nur.e Gramm knew or _hould have
known thlt Ruth Daniel luffered any ill effect a. I re.ult at
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the a4miniltration ot inlulin on Auvult 7, 1992 at the time Ihe
l_ft the HOlpital at the end ot her Ihitt. When Ihe returned
to the HOlpitd lome daye later I ehe hid a dhOUllion with her
Iuperyilore conoerninv the event I whioh lad to the oreation of
the interdep.rtmental memorandum whioh wle m.rked el Bzhibit
"3" du~inQ Luanne Gramm'l depolition,
23. Daniad, Luanne Gra~n contacted Dr, Inner. on
Auvuet 7, 1992 to ..oertain trom hlm tha appropriate amount ot
inlulin to be viyen to the patient under the circumltance..
She lubaequently trlnemitted hie order to the nuree attendinv
Mr.. Daniel, She rea.onlbly relied upon Dr. Inner,' judvment
concerninv the patient'e naed tor in,ulin.
24, Denied tor reaeon. ,et torth in Plrlvraphs 17 throuQh
23. It il Idmitted thlt Mrl, Daniel went to tha Radiolovy
Department tor an ultralound atter 1130 p,m, purluant to
. phYliciln'. orderl,
2&. Denied. Rather, Mr,. Daniel" blood vlucole level1
,
were monitored by mamberl ot the HOlpital nurlinv Itatt and
laboratory tollowinv 1130 p.m. on AUVUlt 7, 19112,
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2.. Atte~ ~ea.on.ble inve.t1Qatlon, Anaw.~inQ Detendant.
a~e wit~out intormat1on or knowledQe .uft1elent to torm a
belie' .a to when Mr.. Danial ~et~rnad to her room follow1n;
he~ ultra.ound. It 1. belleved that Ihe raturned at
approxlmately 3130 p.m.
27, After rea.onable lnve.t19at1on, Anlwer1n9 Defendanta
are without lnformat1on or knowledge luff1cient to form a
bel1et A' to the truth of the eorre.pond1n9 Para9raph ot
'la1nt1tf'. C~mpla1nt, tha I.me 11 tharetore denied and atr1ct
proof, if ralevant, i. demanded at tlme ot trial. It 11
admitted that Mra, N1codemul called member. of the nur.1n;
Itaff to her mother" room at about 3140 p.m.
28, Denled for rea.on. .et forth in Paragraph. 16 throu.,h I
23. Atter realonable 1nve.t19atlon, An.werln9 Defendanta are
wlthout 1nformatlon or knowledge .uff1clent to form a bellef a.
to what Mr.. N1codemul ob.erved, the .ame i. therefora denied
and .tr1ct proot, if relevant, i. damanded at tlme of t~1al.
Ob.ervat1on. made by tha nur.1n9 ataff are recorded In the
Hoap1tal chart whlch 1. lncorporated by reterenee,
- 1 -
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3". It h 14mitt.4 thlt the p~OW WII 9iven before I bloQ4
,u9lr wa. drlwn beclu.. of the e.19.ncie. of the pltient~1
dtuatlon.
3~. Denied for realonl eet forth in Plrl9rlphl 16 throu9h
23. It il Idmittad thlt Mr.. Dlniel', blood IU91r It 8100 p.m.
WII 28. By WIY of furthar Inlwer, it i. Iverred that Iha had
wide variationl in the Pllt.
36, Denied for realonl .et forth in Plra9rlph 20,
37, Danied 01 Itatad, The nurlin; notel are incorporatad
by reference al thou;h fully eet forth,
38, Tha averment. of Plra;rlph 38 Ire not applicable to
Anlw.rin9 Defendantl. Calle made to Dr. Innere are documented
on the chart end in Luanne Gremm Depolition Bahibit "3" which
i. incorpor.ted by reference.
39. Denied'l Iteted. The applioable nur.in; notel are
incorporated by reference ae thQU9h fully let forth,
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40. Denied.. .tlted. Th. raterenoe. to the
tr.n.port.tion of Mrl. Olniel tQ .nd from the x-r.y Dep.rtment,
p.rtioijl.rly with referenoe to her .eilure .ctivity .re .et
forth in tha chart whioh il incorpor.ted by reterenoe .. though
fully .et torth.
41. Deniad I' ,tlted. The appliclble radiology raport
trom the chart 1. incorporlted by raference a. thou9h tully .et
torth.
42, Deniad II Itated. Dr. Bandl' con,ultation report from
t.he chlrt il incorporated by referenoe I. though fully .et
f.orth.
43. Deniad for rellonl .et fOlth i" the preoeding
P.r.graph,
44. Denied for re.lonl let forth in Plragrlphl 16 through
23. It i. .dmitted thlt Or, Innerl ..w Mra. D.niel .t .bbut
91~8 p.m.
45.-49. The Ivermentl ot Paragraphl 45 through 49 do not.
require. re.ponle from Anlwering Defendantl, Dr, Innar.'
- 10 -
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provr.a. not. i. inoorporated by retarenoe and .peaka for
it..lf .
50. Admittad and denied for rea.on. aet forth in the
precedinv Pauvraph..
51. Admitted aocording to the chart.
52.-53. Denied a. .tated. Dr. Samuell' conaultation
report i. incorporated by reterence al thouqh fully .et forth.
54. Daniad a. Itatad, Dr. Bandl' note of Auvu.t 10, 11192
1. incorporated by referance al though fully .et forth,
55.-58. Denied a. Itated. The documentation written on
the chart by Dr. Band. concerninv the.e nletteu 11 incorponted
by reference al thouvh fully let forth.
59. Atter reasoneble inve.tivat10n, Anlwerinv Defendant.
are without information or knQwledve ,ufficient to form a
beliet al to the truth of the corre.pondinv Parevraph ot
Pleintitf'. Complaint, the Inme i. therefore denied and Itriot
proof, if relevant, il demanded at time of trial.
- 11 -
60. It 11 .pecUic.lly 4enied that 'Phintitf complained of
lett knee pain followin9 her .eilur. of AUQu.t 7, 1992.
61. It i. admitted that a. part of . .eri.. of left hip,
pelvi. and knea, a laft knee a-ray W'I taken on Septembar 11,
1992. It il denied that any recent fracture of the tibial
plateau wa. de.cribed in the radioloQY report which i.
incorporatad by reference.
62.-66, Denied I' atated, Plalntiff'. phy.ical therapy
record. a. contained in the Hospital chart are incorporated by
reference al thouQh fully let forth,
67. Deniad al .tated, Dr, Davis' di.charQe .ummary i.
incorporated by refarence as thouQh fully .et forth.
68. -72, After re..onable inve.tiQation, An.worinQ
Defendant. ara without information or knowledQe .ufticient to
form a belief al to the truth of the corre.pondinQ Para9rapha
Of Plaintiff'. Complaint, the ..me i. therefore denied and
.trict proof, if relevant, i. demanded at time of trial.
- 12 -
73.-81. The avermenta ot paragraph. 73 throu9h 81 contein
oonclulionl ot law to whioh no anawer i. raquired. It an
anlwer ia deemed re~uired, atter rea.onable inveltigation,
Anlwering Defendantl are without information or knowledge
autfioient to form a beliet al to the truth ot the
correaponding para9raphl ot Plaintitt's Complaint, the lame 1.
theretore deniad and strict proot, it relavent, il demanded at
time ot trial.
~
puth Daniel Y. Charlea R. Inn_ra, N.D.
82.-84, The averment. ot paragrapha 82 through 84 do not
require a response by Answering Defendants,
MHIIBrOII, Detendants, Luanne Granw, R,N, and Holy Spirit
HOlpital, demand that Plaintitt's Complaint be dllmialad with
co.t. to them.
"
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I>>~b v,~iel v. Jnnar. D,vl, Aa,oa~at..
8~. -87. The .verment. of pauvuphl B& throuvh 87 do not
require. relPQnle by Anlwerinv Defend.ntl.
WKJRIrQRI, Defend.ntl, Luanne Gramm, R,N. .nd Holy spirit
HOlpit.l, damand that Plaintiff" Complaint be di.milsed with
COltl to them,
tDJII'l'lII
Ruth Daniel v. Luan Or.", R._,
BB. The averments of Paravraphs 1 throuvh Bl and count I 1
Ind II of this Anlwer wlth Naw Matter are incorporatad herein
by referance IS thouvh fully set forth,
B9. The Iverment. of Parevraph 89 are conclulion. of l.w
to which no .nlwer il required. To the eatent en anlwer il
daemeeS required, it il .pecifically denied that LUlnne Gr.mm,
R.N, W'I nevlivent or carelell in her care and treatment of the
pl.intitf. To the contrary, Defendant, Luanne Gramm, R,N, wa.
at no time nevlivent or carelesl and provieSed medical care and
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, '
aervicee to the Plaintitt competentl~ and in accordance with
the applicable atendarda ot care and in keeping with the
Itandardl ot the nur.ing profealional within the applioable
community. If In In.wer i. deemed required, it il .peciticIlly
Iverred la tollowal
(e) Denled. It i. denied that Luanne Gramm, R,N.
tilled to properly inva.tlgate and rellY
intormation oontlined in Ruth Daniel'. mediaine
lerde.. Rlthar, it 11 averred that M., Gramm
properly a.certained and relayed appllcable
intormation to other healthcare provider.
including but not limited to Dr, Innarl,
(b) Denied, It il denled that M.. Gramm tailed to
properly read the intormatlon contained in Ruth
Daniel'l medicine larde., The averment. ot the
preceding Paragraph are incorporated by reterenae
aa though tully let forth,
(a) Denied. It i. denied that MI, Gramm tailed to
appreaiata the .ignificance which additional
inaulin would have had on a labeled diabatic
petient .uch a. ~uth Daniel et any tlme on
August 7, 19112. Rather, it il averred that Ma,
Gremm rea.onably relied upon the orderl ot an
attending phylicien concerning inlulin coverage.
(d) Denied. It il denied that MI. Gramm had a duty
to notity otherl concernlnq the adminiltration ot
inlulin to Ruth Daniel on Augult 7, 11192. Atter
ree.onable inve.tigation, MI. Gramm is without
intormation or knowledge lutticient to torm I
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truth ot the oorre.pondin9 Plrlvrlph ot Pllintitt'l Compllint,
the .eme il theretore denied Ind Itriot proot, it relevlnt, i.
demlnded It time ot trill. The Ivermont. ot Plrl9rlph. 28
throu9h 89 ot thil Anlwar with New Matter Ire inoorporlt.d
herein by retaranoe al thouvh tully lat forth, Parlvrlph 110
containl oonolu.ion. of law to which no anlwer il required,
MHlllroll, Defendlnts, LUlnne Gramm, R.N, Ind Holy 8pirit
HOlpitll, dem.nd that Plaintitf's Compllint be di.mi.,edwith
cOlt' to them.
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.uth Daniel Y. Holy 8>>ixjt Holpital
91. The averments ot Parlvraphs 1 throuvh 90 of thi,
An.wer with New Matter are inoorporated herein by reterence I'
though tully .et forth,
92. Denied a. .tated, It i. denied that Dr, Innerl wa.
the Ivent, .ervlnt or employee of Holy Spirit Hospitll II WI'
Iverred more fully in Paragraph 7 Ibove whioh allevationl Ire
,
inoorporated by referenoe, It is admitted thet Luenne Gramm
WIS an employee of HOlpital IS averred in Peregraph 8 which il
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incorporated by reterence. After realonable inveltigltion,
HOlpitll i. without intormation or knowledge lutf1cient to form
I belief II to the idantity of "Ill medicIl per.onnel including
Itltt nur.e." who provided clre to Ruth Daniel. The
Illegationl of their negligenca are t~eretore denied and Itriot
proof, it ralevant, ia demlnded It time of trial.
~3. Atter realonabla inve.tigation, HOlpital il without
information or knowledge lufficient to form a belief al to the
truth of the corre.pondin9 paragraph of Plaintiff'l Complaint,
the lame is therefore denied end strict proof, it relevant, i.
demanded It time of trlal. The averments of Paragraph 92 Ire
incorporated herein by reference a~ though fully .at torth.
paragraph 93 contain. conclusions of law to which no anlwer i.
requirad.
94.-116,
Denled for reasons let forth in Paragrlph 113.
MHlRlroRl, Defendantl, Luanne Gramm, R,N. and Holy Spirit
HOlpital, demand that Plaintiff'l Complaint ba dilmi.led with
cOlte to them.
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Ruth Q.,i.~ v. ~JY 'Dirit Bo.D.~,l
9'/laio) The avermenta of Paravraphl 1 throuvh 9' of thi.
Anawer with New Matter are incorporated herein by reference aa
thouvh fully aet forth.
97. Denied for reaaonl let tor in Paravraphl 7, e and 92.
98. Atter a rellonable inveltivation, HOlpital ie without
intormation or knowledve lufficient to form a bellef a. to the
identiti'l of tha myriad of peraonl reterred to in the
oorrelpondinv paravraph of Plaintiff'l Complaint, the agenoy of
which i. denied, The avermant. ot Paravraphl 7, 8 and 112 Ire
incorporated by reference.
119.-10~. The Iverment. of Paravraph. 1111 throuvh 10~,
inolul!ve, are conclulion. of Uw to which no anlwer 11
required. It an anlwar il deemed required, the Iverment. Ire
,
.peoificelly denied. HOlpitll wa. not nevlivent I. I
oorporation. Tha averment. of Plrlvraph 107 are incorporlted
by reference,
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106. Denied. It ia .pecifio.lly deni.d thlt Hoapit.l hed
-notice th.t petendant Gr.mm WI' not . qUIlitied nurae- .t any
time materi.l to Pl.intift'. compl.int.
107. The averment. of parl9r.ph 107 Ire concluaion. of l.w
to which to .nlwer i. ~equired. If an .n.wer i. deemed
uq'lired, the everment. are .pecitiaally denied, The averment.
of P.rlgr.ph 811 are inaorporeted herein by raference a. thou9~
tully .et forth, By way of further anlwer, it i. Iverred aa
followll
(a) Denled. It i. denied thet HOlpital teiled to
tormul.te, edopt and enforce poliaie. Ind
procedures to ~neure quality moni~oring .nd
managamant of p.tients luah as Ruth Daniel.
R8ther, raa.oneble poliaies were formul.ted,
.dopted and enforced to provide appropri.te care
to such petient.. It i. specif,ic.lly denied
tnat Pl.intiff's injuries, if any, were cauaed
by Hospital's tailure to formulata, adopt .nd
enforce policie. and procedures,
(b) Denied, It i. denied that Ho.pital improperly
proaas.~d and evaluated Luanne Grimm, R.N.'a
credentiall. Rather, Ms. Gramm w.. known by the
Ho.pital to be tully qualitied to render
.ppropriate nursing care to Plaintitf.
(c) Denied, It is denied for the rea.on. set forth
in the praceding sub~parts.
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in.ppropri.te or lub-.t.n4erd p.tient o.re at .ny time m.teri.l
to Pl.intitf'. Complaint,
121. The avermentl of Paragraph 121 are oonclu.ion. of l.w
to which no Inlwar 11 required. The .verment. ot P.u9Uph. n
through 120 of thil Anlwer with New Matt.r are incorporlted by
refarance .. though tully .et forth.
122. The avermentl ot Paragraph 122 are conclulion' of l.w
to which no anlwer i. requlred. Tha Ivarmantl ot p.rlgraphl 28
through 121 of thil Anlwer with New Mltter ara incorpor.ted by
raterence .. though fully .et forth, To the e.tent an an.wer
il requirad, the averment. of Paragraph 122 are .pecificllly
danied,
MHIRIfORI, Defendant., Luanne Grimm, R,N. In4 Holy 8pirit
HOlpit.l, demand that Pllintiff'. Compllint ba di.mil.ed with
COlt. to them,
.... 1IA'l"'l'llIl
1. Pl.intiff'. Complaint faill to state I ol.im upon
,
which reliet can be granted against Anlwering Defendant..
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YUIIICA'I'IC)II
I, Luanne Grimm, hereby ve~ify Ind atlte thlt to the
e.tent thlt the tore90ing dooument conti in. flot. .upplied by
me, th.y Ire true and oorreot to the belt of my knowledge,
informltion Ind beliet/ howev.r, to the eatent thlt the
toregoin9 document Ind/or it~ language i. that of coun.al, I
have relied upon counlel in mlking thil Veriticetlon.
I under.tand that tal.e .tatementl mlde harein Ire
,ubject to the penlltie. of 18 Pa, C,S.A. 84904, relating to
un.worn tlleitioation to authoritie.,
DATIDI 8-115-94
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I, Illen Militi, en authoriled repre..ntetive of Holy
spirit HQ.pitll, hereby acknowladve that 1 have re.d the
forevoinv document Ind that the facti .tated therain are true
and correct to the beat of my knowledve, information and belief.
I underatan4 that any falle .tatement. herein are made
aubject to penaltie. of 18 Pa, C.s. 54904, relltinv to unaworn
fllaification to luthoritie..
HOLY SPIRIT HOSPITAL
f;- .-lihV "1M A~>h- .
_nen Militi
OATIDI
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IlUTH ;S. DAN1.IL,
! Plaintiff,
IN THI COURT or COIOCON 'LaM
CUHBIRLAND COUNTY, PA
NO. 413 CIVIL 11le4
CIVI~ ACTION - LAW
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~URY TRIA~ DIMANDID
v.
ClWtLll' a. INNIRB, N.D.
INNIIlI DAVIS A880CIATI.,
LUANNI GRAMM, R.N., and
HOLY 8PIRIT H08PITAL,
D.fendant.,
_Lalll'lll... UltLY IJO ow JIA"".. O. D....IID&IfIt. LQ~
.~~t' a.lI.. AIm BOLY ..Iar.. .o..r"A~
1. The alleqation hndn ltat.. the conolu.1on of law to
wh10h no r.Dpon.. i. n.o...ary. To the extent that .n anlwer .ay
b. r.quired, it 1. Ipeoitlcally denied that Plaintiff'. oo.plaint
fail. to atate a claim ot action upon which reli.t may b. 9ranted.
2. The .lle9ation hndn .tate. the concludon of law to
wh10h no r.aponl1v. pl.adinq 1. required. To the extent that .n
an.wer .ay b. required, lt 11 apeoifically d.n1ed that the
Pla1ntitt Ruth J. Daniel waa in any way oontr1butorily 01'
comparat1v.ly neqli9.nt. Plaintiff Ruth Daniel pre.ented her aelf
for car. to the Defendant. and trult.d that th.y would pertora that
oar. in a non-ne911g.nt m.nn.r.
3. The alla9ation h.re1n ltate. the concludon of law to
whioh no r.epon.e i. n.c....ry, By way ot turther r'.pon..,
Pla1nt1ft Ruth Daniel in no way a,.umed the rilk ot her care unlea.
Defendanta are alcertdn1ng that thaiI' incompetenoe wa. 10 open and
tlm/.LO
o~vioul that Ruth Daniel .hfluld not have aouqht treat.ent with
t"e..
4. Tha al1.;ati?n herein conat1tute. a conoluaion of law to
which no reapon.. ia r.qu1rad. Buit wa. tim.ly fil.d.
,. Tha el1..,ation heraln con.titut.a a conclu.ion of law to
which no reapona. 11 required. Def.ndant. ne.,Uqence wea a
lubltantial caU" and tactor ot tha aubjeot 1no1dent and reaulted
. in injurie. and damlge. to the Plaintitt.
6. The al1'9ation herein .tata. that a la9al arqum.nt which
il incorreot. Nothin., in the Meetical Malpraotice Act of 111115
,
auqgeat. an abroqation of tha liabilitie. lmpo.ad in common law or
under corporate law of the stata ot Pa"n.ylvania. Defandant. 1e9&1
po.ition hat b.en rej.ct.d by avery court whioh ha. con.idared it,
1nolud1n; but not l1mi t.d to the court ot common Pl.a. of
cumberland county. By way ot furthar r..pon.., the all..,at1on
her. in ia irrelevant and inluttioient a. a matt.r of law to raiae
any affiraative d.f.n....
7. Plaintiff'. damanded a jury trial wh.n the complaint wa.
or19inal1y fil.d.
I. The al1a9at1on herein atata. tha conolu.ion of law to
which no re.pon.iv. pleadln9 1. raquired. To the extent that an
an.w.r may be r.quirad, it 1. ap.citical1Y deni.d that the aotion.
of othara and not tha aotion. or inaotion. of an.werin; Det.ndant.
w.re .uperaacUn; and/or intarvaning cau..a ot pldntitt'. injuriae.
Th. above named Det.ndant. are jointly and .everally Uable for the
1njurie. plaintiff auetainad.
"
Wh.~efore, plalntltf" .re.pecttully requa.t that the New
Mlttlll' of Defendanta x.Ulnne oralUl, R.N. ancl Holy sph'it Hoapital be
di.ai.aed.
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Datl41Auqult 34, ltt'
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I he~eby oe~t1ty that I am th1. day .erv1nq a copy Qf the
fore901nq document upon the peraon(.) and in the manner 1ndioated
below, which .ervica aati.t1ea tha requ1remant. of the penn.ylvania
Rule. for civil procadure, by depo.1t1nq a copy of .ame in the
Un~ted state. Hail, Harr1.burq, Pannaylvanla, rir.t Cla.. Hail,
po.tage prepaid, a. tollowal
Cra19 A. 8tone, laq.
3401 North Front streat
P.O. lox 8180
Harr1abur9, PA 17110-0180
Michael w. McGuckin, laq.
18110 William Penn Way,
Suite 201
P.O. lox 106116
Lanca.ter, PA 11608
BYI
~ ROVNER,
DATIDI Auqu.t 24, 11114.
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