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HomeMy WebLinkAbout94-00413 'I H , , . ~j , , ';1 , , , " " i f' " . r " II ,I, ,II , " , Ii, " .... , . , 1'1,' , ~ ' I II: , .. , 8 ,. , jI' j t , , , 'e " , " , , ,'I " d, " " H " " , " " ,j , " ,I " " " '! ,;I' i, II' " , , '\ " f,L " I , 'Ii , ' " , , , , j I Ii' ,II " , , i; , '."" r, "jl '/ COURT OF (:OMMON I'LF;AS DAlJl'HIN COUNTY CIVIl~ A(;'flON Sl'I'I'~__I~~~ . __ !Vr.L _ _~JJ J__GJ;)_J_..lj3!L_ =~ 9~,:_~_j-i51-'-oo,-,-- .. -- - _ _ __.. _,_...._, ,__u.._ __ f.lIJ1}'Jh.!lllllllUIIIL-.l. I _,_._ . . _ .... __~~I!)J!'J!!!I"Loo-__,_.j'(__L.....__,.._. _.nI~!,!,~_!!Urr _ _ ~ "t 19f ,_._......_._ I~~.j'-I.!!!JJ _._____.._L_L_..._'____ u....__ __,_._..., _ _ .._.._"._,. _ ._ _u" _-^-JlJ..vnl _.____._____ "I _L.. -- WIll of Exetllllon IUIl,d: Ol!lndy f J ~~______.._,_~__.. ..~._.". ______.,__'.' _., . _.,.. ......,. ..,_ ..,.,. 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'.... ----.. --- ...____~4.'-~--- ,.,..-.--""- .,.--- -- ,_...~~.,----,._- _ ...._________4_._ --- ..... ...._.._.....__... .....,..u__~.__,..-..,~-....~-,..:.,..P--,...-P- ---.-'. ._...-~-..- - ,..~ ....__..'-----_.-.~--. ~-........._-.. ......-..----..------. ._.__._.._-_._-~-_..__.__...------ ---~~. .-.... .. ~,......'.., ...__.._,-_..~..,.._,.... .-.._..-~-_..'._. -~-_._.--- .-. .... ..... ._...~..._. ...~...- '.'~._' - ....... ...--.- --.. -' '-'-- .---.-'- -.' --~--'.'''--' ' .. . RUTN OJ. DAHIlL I Plaintiff IN TNI/COURT or CONNON PLlAI CUMBIRLAND COUNTY, PINN'YLVANIA . . I . . . . NO. 413 CIVIL 1VV4 I . . v. CIVIL ACTION - LAW CHARLa. R. INNIRB, N.D., INNI.. PAVI' AI.oeIATE', tuANNI GRAMM, R.N., and HOLY 8PIRIT HOSPITAL, Defendant. JURY TRIAL DEMANDED f: i PRAIlCIP. To the Prothonotary. Pha.e mark the above-captioned action .etUed, .aU.ti.d, and dhoonUnued. , ( .ubmitted, c. Ol.on, ..qu r. 52 7 ~d03 N 'ront street Harri.bu 9, PA 17110 Attorney. for Plaintiff. \~llqq~ , , , , i I I, '" IOIO'.,~ 1:1 ,. ~;;;,....i,,~:"d' '.,,, " CIRTI~I~TI Qr I.RVICI 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 i.; ~~ ()1(~ . J, A '/:'J/ ItA Can d . Ba II' - D.ted~~ '1, -/1(, " , "4S0/LA~ , , , ~~ C") ~ r (.. re, .. .. ~lf . N "5 ',1:; lI' , ;:,:a _ .11 Ll_ ~'; ''j , ' ,1:;-' f.1' (I:' I" 1.1' l!) .. I ... U. , ." ;i~ -,I r~, l H 'I ~- .i \'. ',.j , ,.J loP (J " " , , , , " ., . , " ".:' " ' " " , 'I " ,I II; ,,' " . . , . .. RUTH J. DANIEL, Plaintiff : IN THE COURT OF CuMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA . . : 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, , . l.,'. ,". I,,', (, II' ":.' J -" - , ~ " ' I, "I, 1,'0:, . ".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 ~4J ,~...L '1/1'1/1.... ",.r, " ' I.,' , ,.j , ' ,,' 'I; I ',' I' , ' " , " ,j .. 'I '11 ., I, " ,I I' , , " ; Ii , , , : , , , 'I, , " , ' , , , RUTH J. DANIEL, . Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMB:iRLAND COUNTY, PENNSYLVANIA . . : 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 2 94.0413 CIVil. TERM I I 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. 3 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. 4 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. 5 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, 6 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. " 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). 7 ,j :1 'I I I, ! I " \ I . . J;'t,.~ ltl'11:.'I:I"'ll ."\ .',",'j 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 19 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. 20 ;" ''''''".1 ~4l 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 . , :IIi """1"104. Def.ndant Holy Spirit Ho.pital, aotinv throuvh it. 'vent., 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 I 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 22 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. 23 113. 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. '1'1 , , , I ' I' " ' ,', , , I 116 " 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 , . , ' I, I: . !~,; , ' ", ,:1 \ " 'II , , I I, , , 'I' I .1 " ia? I , o ~ , ,. 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,' , ,," , e. DATI. "..1(''' 'J LJkw'1&04+ ~ 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 " ,'I -il, , " , " ,I " , , , , , Iii " " 'I , \ I ,I JI I, " ' ': :1 " , I , , (l ", " ;1 I " ',' , I (;) ~ 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 ....,.... >" c,:~ (\ .. I 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 ,/) " ~ 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 ( \, C~ ~ . , (4) 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.. / , (' . 4 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. ~ r'~ ~ , . 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 *** (.) f.ilinv to properly inveativ.t. Ruth D.ni.l', medicine k.rde., *** , , " r~ , , . (b) (~ ( ) , 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! ..* 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/ ..* (m) rlilinv to initilte and maintli" the proce.. of onvoin; .hlred information in the care provided to Ruth Olniel/ (q) .** 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/ *.. (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 ... " ('~ ~ , . (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 r" ! ( , . 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 "P+143~ I' , i I I I " ') r'. RUTH J. DANIIL I IN THI COURT 01 COMMON PLIU I DAUPHIN COUNTY, PINNSYLVANIA I I I CIVIL ACTION - LAW I : NO. 3';SV- S-'?) I I I 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 ii, , , " , , 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 ! ') I" " I ,I 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. : I , I I , . I 3 ,""') I ,I i :1 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). " i 4 , 1,1 I , ( , ~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, 5 I' ." ~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 I 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. 6 ( .~ (.,~ , 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. : ) 1,1 11 ;, 1 1"',\ , 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 8 I '\ 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. t I"" ( .'0" Ii I I I 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. " " " Ii ':1 " I {j 10 (--.. ,I ., 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 I~ (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 tr" (.", 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 ) (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 ( , (1,"- 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, 11!l '" ('I '1 (~l 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 , ' r~ 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 , ,I ..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 ) , ,;, 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 (~, (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, 20 :1 I II ,I 'I 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 .'~ 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 . ) " 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 f "t' "'~ 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. , ' , ii, .. , " " (J , . . . 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 \\ ,- 'J' " , , ,I J ' , " , I j' rll , I , " i-I " , , , , , . 'i " , " " , ';,' YZR!'ICA'1'ION ..", ( . ) , . " 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 . " " Ii, ~/I I:' 'II .tau...;,.., 21, 1'1'13 , II, , ' " , 'I'i I;' I, 'i " " 'I>! II, I '1'1 , , t" l' , it, ,', ',l,"(j\ "!,,.I ~Iyjl '."1 .74111Ll (;;'\ ([J , . . ~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 , " , , ' IYI -- I.quir. 1801 N r h 'ront Str.et P. o. x !U&O Karr~aburv, PA 17110-09&0 (717) :13:1-&000 ",.un 'I r " , , , . I =c._~~~.'.':!I~JlI.l~ fllao ~_. ,j' , ' , " " " , " , " " , I, " ., , "; " '! " ;". ;1? r" ffj " "-' II t I '. ' '.. :"t.,I, :;j '1' 1,li ~ ~,J ", f') " /, !~A, ;," .,'J Q" (~ '" I. I I, , ., , , i)' , , ,/ " " , " , " , I" I, " " , ' I,' I " " ), ., " \I" I, L"\' , ., .... " ,I " " , " :" ,'I " II -1'1 " ',d ,\ I, ", , , , , .. . '1\ . 'W . ';1 II (..., ...; (i I DANIIL ;1ainUU "U'l'H J. I IN THI COURT or COKNON 'LIA. I DAU,HIN COUNTY 'INHSYLVANIA I I CIVIL ACTION - LAW I I NO. 3754-S-93 . . I . 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, , ,,' , , () (", 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 ',,,I,. ,I.' ( , C'"') "", 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 -cr-"'- / : , .1 REGUVEO OFFI\:F of t>N"':' '1:IHM1Y OIUC! Now 3 .zp rK '9J 'I lllll) , \! ,IN l ~ PENIIA " " , , , \' II Jl'! 'I, , , " .\1 , " , " !' " " , " I, I, " " i' , il,' " 1',\ I Ii , , , ' " 'II ~ ,I ., W" . . /~ (""", , I , ,~ . , , . RUTH J. DAN X IlIp I IN TUB COURT or COKHON PLIAS . la1ntiU I DAUPHIN COUNTY PINNSYLVA"IA I 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! , ' DATIl U/5/93 ~ (.~) , . TABLI 0' CONTINT. . I 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 . . . . . 3 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 . . . . . . . . . . . . . . . . . . . . . . · . . .. " !,. 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. ",I 'J i C. "\' -i- Q Q , 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 . , . . .,. . ',~ . . . . . . . . . . " ,f . I '.' , , 13,14 "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) . t. . , . . . II . . . . -11.. ~') ~ , 8TA.,UTI. 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 24 pa. R.C.P. 1028(a) (1) . '. " I P..R.C.P. 2179(a) . .-11J.-. , , 5 \' 'I " , , ,i , ' '".) "., ., " " , " " " , , "I " 'I I " '>I , ('" ~ , I ... ' . . , 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 (:::', (~ , . ... .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. .2- (') ("" , . I . ... 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? \' 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. ,,I -3- , . (~ /p., , . , . 1. 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 -5- ',' (j (' , , 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. I -7- (-') .., e , , 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 -8- (-") I' ,I 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. , -9- ... (1 . I ,I ~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 -10- ~) q I I " .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 ..11.. f'~ ~ 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 -12- r:) e 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 -13- () e 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, -14- , , t ." ~\ , (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. " I , i- f., 1 , 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, /' \ ~i , i *** , Ii " i :Ii I', (g) 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 \\, -15- , . I,~'d'i:,,;~l,' :(,; "L, (-~ , , 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) ... -115-' I k;JI;;i~'''1r''i,jq' I , I I (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. , i' ! lu Complaint, paragraph" 94(a), (b), (k), (m), (q), (n), (bb) and (e.). -17- (:~ ~ , , 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 -18- '"..., , . 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). -l9- I , , I, I' I I {) ,~ 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 -20- () ~~ , . 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 ... -21- /~), ',', ~ 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. -23- ~ , . .' '~ , .,"" '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 , I:' jl '{ I -24- o IIld'1AIlA Alj"A"I"I~I~',r'1'LlI '.lOm<Jl'~ fill' ~11't.!Ul @' ~ . i" " 'I, I , I , I " ,. Ii I , , , " " " r, , ' ('" ~ t" 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; I' I I I 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, , I I 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. '! I 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"'" ~ . ~.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 , ' . -, ~" 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 " , " , I . , . ../1 (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., " . I 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 ~~ 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 . I ~I~ "_'~~J<l~~"","r':ll 1....lIIlltlQ IUI' 'l'l:'l'''' (i) . " , ' " " 1\ 'II " ,,' "" ," " ", " " I ," , q \' ,II I 'I 'I , j) I I , ", " , " , " I" , , \ " " , , , , , , ,". " " " ., " , , " I', " " .' " , , 'I , , " , " , , , " !, I " I " "1" I I \ " I " '1' .1 " I'i a 1" A " , 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 I " ~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 I . i , , 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.. , \ I 16 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 ! " 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 , I I " , 1'\1 ,..!' ~l'!' ,""-- 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. " 18 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 4/. 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. " 23 , . 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 , . 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 " " I' 1 1 ,) ') ,I,; ,\J ..', q I !i , " 'I , ,\ " , i', I' .,1 " i il , , , ' " , ',i I' , 'I, , " , , , 'I" '\ 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 :z '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" 3 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..' I 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 t I i I' ! f, ,I, I I' \ \, 'I ~: " I " , , \] II! f, IS I L: ,,,/,,, "~'.;I, " , {I I " ;'1 ," p' , , 1 II " ,I .i I, " , , , , , 'I " I, ,i i I' u " ' , I 1 " " , , I, 'I " , " ;! ::1' I , 'IiI I, 1 ' I ,. -' (~ ",," ' RUTH J. DANIIL I It! THI COURT or COMMON I'LlAS I DAUPHIN COUNTY, PENNSYLVANIA Plaintiff I I V. I CIVIL ACTION - LAW I 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 ",\,,' '. ,.','.',' ~'_L"'" "... ,.. .., ".,,'" r r ? . 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. 2 I:, ( (- . 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 I 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. :I r (" 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). 4 (- 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 . 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, 5 ( r 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. 6 ( ( 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. 7 '. 'I" " .., . r~ '. .." '. " " '.. , (~ r- 60. Ar:tr:titionally, P11l1ntitt Ruth Daniel also complainer:t of left knee. I 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 B ~ .' ( 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. " r' r " 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 , 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 10 ( 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 11 r r ....'1'..'... ~.. " . "" L.u, .' .' " ," '. . " 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 12 C' (, , 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 I, u , , . ... ~ ." '" 'I" .... '"" , I r ,-1 . ~~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, 14 ( ( I I I , I (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 ! '" 15 , I i r f 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. 16 t ,.... f c WHIRlrORI, Plaintiff, Ruth Daniel, demand. judgoment a,ain.t Inn.r. I 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. , 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~ 17 II< ~ .." .. '.... .. ~....' ,'" ... . (f) (9) (h) I 'I (i) (j) (k) " (1) I, , , I , : I l' r r 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. I, 18 (~ r I . 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 15 ( r ,I .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' ( 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. , 21 , I r 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 23 , , r f' 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. 23 r . 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.. I , ' 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 . ,f'h 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, 215 . ( ., ( (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. . 'I' ,2$ r ,.. 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 " , ' I" 'Iii \'i ,I " , " " , ' II, , , ' , t,'". , , , I,,,,; I 'II Ii , , " '" ia1 1"1, I' ",I, , . (" (- CIlR~n'JQA'l'll OJ' SIl~ICJl 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 " ~~~~~ Sandra L. Rl.helf , ' , Ii, 'I I' ,I' ,I' ""'/lLR ,L I " , , , , , , " , ' " I' 'It ;;<<:f ,,' " .':J .- ......., "" ~... .....' m I..... I'" ., ~:.., ''I' i' ':., ", \, " ,I " : , 'I 1/ , , " 'j , ,'I <, 'I; '" I" , ' " 1:1 \' t , , i' " ,I .., I I " , I', " , " " " " I ,,[ 'I, I, ' , , " ',I 'I, , , , I' " ,L 'I 1,1 I, I' . . 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: ,- P:.. rn~ ,o\llum.n: .: ~~n - - 'J.; ,o\lJllm.nr C~ur: -----------------------------------.,-----------~.-----~--~~-~--- CAnlON 0' CAoSI (,nllrt ~apllon mllll b. mild In lull) lltml J. DAllIIL -,t ~ (Ptallln/f) ,',fj:, .' , I " ~I. 1" , u:I F=;,; $.l VI, CWLIB It. IJIIIIU, M.D., IJIIII18 DAVIS ABSOCtATIS, WAll ClItAllM, 1.11., AllD HOL~ S.lllT HOSPITAL , .' I.' I 'i"''1 .,' , J t; , J' '., t ~ I" ",I," , ..~ ,. ..... ,..,,-, :;if:. ':I. (D.i.ndaJIl) VI. s~, 413 CLvll --121L- :9_ 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 I,,~tto .~ (or and ..... ->>. Calld: ii' I'r Q ~ .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 .' 'I: \1 , J' ,LI ., , Sl04.m_ . o e 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 I , , II , , , o ~ 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... o ~ 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. Z ". ~ 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 , 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. 3 " . ."," i ,., ~. -., ( , 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). 4 /) c 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, II a e I' 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.. , 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. , " r '. I , .~ 1, ,I " " r I I, I! t: i' I 'I" \ ~! I 6 ~'''' I" ..... ,,-;;, , ! ! r I /, 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 , 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. 7 r'~ ~ 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 , in,ulin and her aub.equent hypoqlycemic aeilure and ahock, plaintiff, Ruth 8 ".",,\ .) e 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. II '~ 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. 10 ":) ~ 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, 11 o = (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 12 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 (:) ~ 13 o ~ 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. I 'I fi' i II': ' 14 o . ~ 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, 111 f") @ 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, lllll:ll 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 16 /J " c 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., 17 ~ ~ ~ ~ , , h I, . II . ~ 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 ~ fh ,t . I I I' 1 I I ~ 18 o Q 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 , I' 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 I' ! III (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, ~ I~ 20 . h d.., ' c ~ " " , 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 I ),i , HI I , I; , " , i " At :'1 "~I ,'I i'" , 1;1 I' I': I I 1 1 21 ~ ~ 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 22 ~ ~~~} ~ 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 J' 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., 23 o Q (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, ," " IU ,> o ~ 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 \ " , ' 'I, ' II I ", I 1(1' . 1,\; ,_1,1 ) , ' , I II 1', , ' , ',I: " , " "I II 'I , , 1 , ,I () ~ 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 .'-'---' -- fft/; ~k'...kv' t7, I qq 3 1 ' ') \1 , "I., 1 ' ,'. I !' I 1 ,. ,II' '.111 'II , .141/m II f,~ .f' \ '! (:,0 'f-" . f',' :,.,(': 'H" I~ '.' 1 ' .)If' 1 1 'I.. v>> (It '~J ',/111'1 It \ I 'I h.iHfA I' " , , , " ,II " 'I I, " , , , , '! ,', , , I, oi, " " I' 'i I' 'I " , , , ' " " " " II " , 'i , , 1 , , , ' .il " ,'I-I " -I 'I I' ~- d I': };l i) " ,I., ;jl -' ~ 4j . . RUTH J. DANIIL, plaintiff VS. CHARLIS R. INNIRS, M.D., INNlaS DAVIS ASSOCIATBS, LUAN GRAMM, n.N., Ind HOLY SPIRIT HOSPITAL, Defandl'ltl ~ I IN THI COURT or COMMON P~IAI I DAUPHIN COUNTY PINNIYLVANIA I I CIVIL ACTION - LAW I I NO, 37&4-S-g3 I I I 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 / ~';~1l~' 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 ~, '-'j ........ ,--.....",' (. ............ '.~ , , ., ,....,-.- W1Q , , ,I, "i I, > .~ 0: ~t.~..: .;e 1,.Ic,: ',J' ,., I ." ',I I" I,' .1. ..;J .1 - - I' , , .\1' I, I' I I " " d , I I, " , " I, " I ,I, q " , () ~ 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. 'YQ\ ( t ~ .N' \,') \' , ") ~ I: ,;)1'1/\ \.{I ( t C"" J.. I .,-- I'! '. '" ,,-....... .....,' , , _. ' ., , , ',' I , , iy,", <,'" "l'h:~:.\ 11""'1 " "', .i." "1 ~ " . I ~.", (" ',. (, ... .......... " , <..: t .\. ...>".g\~.r.l 0 '''1' {j ~,\, J (', .<J, Crl)i)y;9 (",i\ ')!/I' :'. '1 . ;':...\ l' I "'], j ~, C~Qj) f(\ ,f) I) Q V\ V\.f0 ("~ Qov9 \ r-- \ . .\' I" . ,,' 'I'" I (\ ,)l: , '. '.' I f-'-i . 'I:... 1 .); \ '.' .j"{ ~. ' \() r ;"~ I\, 1" t.IL,,\ . 't I ,) I' G ;.7'\.A 1)11 ,),' '1.'\ . '.. , ' , \'. .1 J .. , I (i (' Y 'Ie f ('Y'I{ /" If) 0;.1 In: 'v:" t r>- ,i' ~"'I,I ,Jnv ~/I, ," '--', ~ II) ~:~,.(~)i /'/J;\ \j} ~\ '1 \! 'ty '.,,' 'to 2, I, ~...h } 0 .,~, , '\', ':' ," 'iV, . ' .J).~ (/1. ,(,.\~~ . . . . ~ ~/' ,.:10.,,, ,\\(\\ l ",,,).'lI.:,--,,.I'..~ "),, [. , r (. ~ t I .'1 , , " !" , I; I' , , " ,It RUTH J. DAHilL I IN THI COURT or COIIICOJf PLIAI I DAUPHIN COUNTY, PINlfIYLVAIIIA PldntUf I I 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 ,:' , )j 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 '\'... . (;Ill '; DAT.D~Y"W.../ II I Iv{ , I'"~ " , I ! ',>I '\ Ii /, , I 'I \ ' \,,' " w , iH) '1 "' .) f /,,0"/ t, rt' "il iJu; ;. z " tli '~~ J f.".) C't) ~ ~ ~ ~ , t V ~ 1 it, 1L ~ '-.J ~ ~. ~ ~. :a , ~ >. " \. ~ , ~, , } . ., '::) ~ 4':> cO 111 '. Ii) 'I.';.) ~. Cl ..... \.r) In -. ~ h ., ,. l~~,! 'J.\' 'I iJ /1 i'l i'L,j;.A 11\1 ,,' , , Ii' , I I'.' ,il , \ \ I " ", , I e. ~UTH J. UANXlr. I IN TNI COURT or COMMON PLIAS 0' CUKBIRLAND COUNTY, PINNIYLVAHIA v I I I I I CIVIL ACTION - LAW I I I I I 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 c...~ ,~.(, ,IAI.jM' >8, f. 'lil,~I." S~II)d ^) 'I. "', '1" ,~, \ ~ lH~!\ ,': Ill' , U ~~\ " ,,111'.' . \ \jt1 ':.....:JI" I, i. ~~ ~o t, G I H1\f RUTH J. D~~~~tiff 6 I IN THI CQURT or COMMON PLIAS or I CUMIIRLAND COUNTY, PINNSYLVANIA I I I I I I 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 V1JO' l ~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 I i. ~ '!rr-'IH. vf '. ,I '1<10'; ,'.\IIY ClJNI.'f;'l.A"jl) /JI,lllt,rt n'/~~f/';'\'II.\ , , " , I 'I " " ..., , " " 'I " " I , I I H I" , , ,., " , " " '!, i'l liP 'Ii " " , '" i,l " I, , , Ii " I, I, iI' "I 'I I' , , I)' , ' I!, " I, I' " " . I P~t'!CIPlt 'QR USTtNG CAS! '2.!..I!!4!r, (Mull be lYpewrtl"n ,,/ld .ubmlll.11 in dupIlCfI') '" No. ~13 <:1,\1_ _ ".ll-. 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 ( ) ( ) ( ) ( X ) ,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. ,'I 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. tIIIt .... II "11I)' fOI IrllII, Sllnld: Es uire 'j 'f ".~L ~()I ~~~ ( 'riM S.ml: Allorn.y for: Plaintiff 1 I "' , , \ 'Ii oj' , " , " ,I I' 'I " , , I' " " I 'I " ;i, " , ~ e ~ !::::I ?i r;: r- T,..., "j':)I. 'A" C. "r> /,l..l ~;. \~ l!\ ~. J ~.\ I' ,I":~- ~f "1-) I !r. I,;, ,::i~ I,. Ill,... ' I',:.t; 'n.' .....,...;- ~, - N -- ./ I 'II 'I 'I " , 'I , , .. " I' ., . 0,."'10.'. O. ...VIO, 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 ,I I, \' 'I I" I I' I, I , " , ','I, j' " , , IIN,.... " >It , ,I , " II'" '..I I. I" r" o ~ " , , ", " \1 ,'I -, '"I," ,- ,"I, " -I I 'I,' " 'I I I." .1111' , ",I I, " I' , " 'I i I , \lR !! lit !::l 1'1 c:::i -~ ~. f: 'j\. . .,. ul 'J, -,',.1: c.:: 1I ~'.~ '.l :~; ? I:~;.' ~I~~ , '.I'lIl o i,;r. I. "':;' J1:JII.j , " I'" .t:l ' 0.- l~~ r.' oil I, '" i" -I I, " .,' " " r!A1Cl'I-!2" LJSTlNQ CAJll.9" l"IA~. (MUll'" typfwriu.n ,'1111 .lIbmlll.1I In dllpU.,It) I1I.iIIll1l) The t~1al li.t w11l be calle4 OQ 6/1 ~/95 and' · \ . . 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". ( ) fOI IrIIl w111101l1 I jilt)'. - - CAPTlON 0' CMI (InwI 1I,1I0n .111111 ~I 1I11,d 11\ C\lU) (c/llck onl) Ruth J.Danle1 ( ) ( ) ( ) ( X) Mllm,IU T'II,'" 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 . :'! , (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, j'; Iii ',' 'I',' No. 413 CMI Ita- 1 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, 'L" I I, I" I , DIIII /' 51In.d: 'riAl :O;lm': AIIOlrl.y fOl: P1 a 1 nt 1ff Olson, Esquire 1\ "I , Ii .1 " '1-' I, 'I " qt' -1/ I , " , I, , , 'I " " , I' '" .1 ' " lIA "",.. _.It ,,~ .. .. ,1 ., , e ., ., ," ~ " ,-..j " '" - , ~ \ I ;,'1 U"l :11\ ;.:) .m " ~:. ';,' I I Iii, 1'1 " , ' I' '\II , ' " ;-1 " '1'1 .. .. ~ ~ 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.) a .., , . '1 "-.,, 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. 'I . . ~ ~~ "'"'" ,,-, 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 I I v. , , 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. 'I , I, , I 1:1 "......- . , f",r'II""j"'I" ." \ I' , ,.,........' ':.. -............."..,- fWO " il ',' j" 'I (1; i"1 IJj" (r:\1 :(,\j I')',; (,W, , , Ilk' nill! ! I {i"" \'~I' ' "'\ 'I ,^,' ji'l ~~j " I ~f " ,I,"', "'11,: l~i,L (,Ol " " 'I, , ., " , , , ") " l" I " I I II " I " , ',. I I, 'I. " , 'I , " , , 'I' :'. ,~ ,'" , I... ":l':'.' 'S " l,lt , j,:J :~ " ,) d( .1 ' I, I II, H' t)' ': .,. 1,1 11.. ,I " '] :. , , , , :j "j ,I " I, I' ;" , , ' " ,11'1 1,1 .,; " , . " '-' -...J "' ... '. 'i' HI I', .. -." 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 ~ .. . Io'(.:nt...;. ". t. .' ~~~H?f H. Liv ng~ 5-16 . ""'" " , , , ,',' ill ,I' 'I. , , I, ." " , , , 'I " .\ " 'I. , , 'I' '1 "I '! :! \ i 'I f" " ~,i J .~ .~ 1 ';I " I" ,\'1 ,i Ii , , I, , I I, I' I' " Dale (rlt"rI10 hv _ ;{:~ '" " " . ~ ,...., ~ 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 t ; !, i I 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. , Ii I,: I Sheriff' . Docketing Service Affidav it COltel 26,00 16.S0 1. 50 44.30 Pd. by Atty. 10-04-93 SO ~~~II r~~~~ R. Thomds Kline. ah riff ---;/ 1'1 t III . , aworn Bnd Subscribed to Before Me I' This /.1 rJ 1993, ^.D, ........... t, I ~ r, : 1I .' " \~^I': I ~,\ \ { , " . " , ,....', ................... r' f: ~' fl, 1/ :'/"',, ):j " ~ ,. .. r: ,--If'' I.IJ" ,". ":! ~ ~ .~ 't.-...,..... , " 'II ", :~\ , . j'! ::l C'l") ~ I' ',,'" " !' . 4) - ,,! \': . ,', .td " :,' II' . I,',' _J: , 'I'. ,".J; t Ii '4' 'Jl' :;,:1 1,\ I (.j. I' ! - , " , II "" I ~ ~ I I , , , lll'l , , , J ( I " , I ~ , " Ii, I \'1' I' ;:~ Ii' ! !. " , , 1,11\ I' i' Ii: ~; , , " II t"'" , I /. i \1 i. i I'll " , , ,i , , I:, " . . "I 1'1' II , , " . ."I'lJ""""'I~ IIt:\.."....r.. ...~ 'H.(ll'II",~"~H Al "nllmy,) "r L.AW 1.I"nI11"''''1I1<1 1'1 nfl'", . ",,^.t7ItU ,'IF\fl . '1 O. lR'llI 'JUI"',.) ,I 1';/ , , I 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 , I I I , , , I , I 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) , ' , .. 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. - 3 . , 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. - 4 - 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 - 5 - 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, - 6 - 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 - , I ,;[.' h I.J.",j.' 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, - 9 - I. 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 - .~ 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. " , I, " ~ 12 - " ~11 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 - 14 - , ' 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 - 15 - I' " , I >Ii ,I 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. ~ .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 - 18 - , . 1t - 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. , ' c:QqII'I' V 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, - 20 - "I; 1 < ("c.i)J .1' . :-'_1,:1, , 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. ~ 21 ~ 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.. - 24 - 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 \ I , \ \ ..- -- , , III' , I 'I 'I ; II' , ".,1 I;,i I, Y.I1UUCAtlOH 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 rlll/I'1 I I.' "I., "1 , I " " " , , , , , "'1 " , I , I, 'I }, I IlUTH ;S. DAN1.IL, ! Plaintiff, IN THI COURT or COIOCON 'LaM CUHBIRLAND COUNTY, PA NO. 413 CIVIL 11le4 CIVI~ ACTION - LAW I I I I I I I I I ~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. " Datl41Auqult 34, ltt' ,I: ,I I " ", , ' I , , , , , , , , \ ' " i" ;\ 'I .,., ',I i I " "I I , " ' " , , I' " "I I I ' " , , , I a..'"IQ.,. O. ...VIO. 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. SI7..,ILO 1.\ /' " , , " , , , Ii " ')\ ,', " I ,",I " 1:1 ,) , " 'I r i' ,',. J'I' " 'I " ,J:",! I'}'" J It Ie m M ~~ r:: .. , 1-, ,.' lil_i1.i,;, <'l.;tt""..,I" ':'l'"lLI", t:~ 'J": ':.'1 ~_'I , 1 ~ ,: r':;. 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