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~ 4. The PlalntlH I. on'lUed I. roco,,, domIgoo lot 01 ki- which .ho
Defendants' negligence was a Bubstanllal factor In producing. The Defendant's negligence need
not be the sole cause of the InJuries; other causes may have contributed to producing the final
result. The fact that some other factor may haV9 been a contributing cause of an Injury does
not relieve a Defendant of liability, unless you find that such other couse would have produced
the Injury complained of Independenlly of his negllgenca, Even though prior condlllons or
concurrent causes may have contributed to an Injury, if Defendants' negligence was a
substanllal factor In producing the injury, Defendant is liable for the full amount of damages
Bustalned, without any apportionment or diminution for the other conditions or causes,
\ 1lllllltriCIl, 11 111'111111 \J1It5~yetJ..Heve-thllt"fDfal"llff.hedll'medlOftt'condltIOr1 Wl'lltl'l'l1,ade Itbll,l'I1tlre
'., vulneUlbls"ta' a"bBck'lfi)urv:1Iill'1M'dtbn'CG 'of .thl3'prIF8X111l1rtg '" l:l1tttlllrtm170lft "Mt"Tetltve the
,Defendant of liability, provided that 'tM'Oefendants'''negllgenoe,w8s '8- 8ub8tantfll~1m:toMr1''''
,... causing Plaintiff'a -harm.. Pa.S.S,J:I,'(Clv,} 6,30,
e; .,^J.,... 5"-.. A Rllho'al'ltllll fa.., Irall llM\lal,..laaIJactQl'_~WfII't.the"f'elUll.may be
Ij!J.8l.ar.unellPectaQ....bu1..llJ1.uqt..!Q...Im.t)\.or..tancltul.taC!Of Qf II ,faq!Qr ,having no
connection ,Or 'only .nlnllgnlflcsnt connectIClI1'Wlth'the'1!oclderlt,..p..ai,J,I...(Clv.) 3,26.
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6. The damages recoverable by the Plaintiff In this case and the Items that go
to make them up, each of which I will discuss seperately, are as follows:
a. Past lost earnings and lost earning capacity;
b. Future lost earnings and lost earning capacity;
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o. Past pain and Buffering;
d. Future pain and suffering;
e. Embarrassment and/or humiliation;
f. Loss of enjoyment of life; and
g. Incidental costs.
7. The Plaintiff Is entitled to be compensated for the amount of earnings that
he has lost up to the time of the trial as a result of his InJuries. This amount Is the difference
between what he probably could have earned but for the harm and any less sum which he
actually earned In any employment. Pa,S.S,J,1. (Clv.) 6.01C.
8. The Plaintiff Is entitled to be compensated for any loss or reduction of future
earning capacity that he will suffer as a result of the Injuries sustained In this accident. In
determining this amount, you must ascertain the difference between the yearly amounts which
the Plaintiff probably would or could have earned for the period during which he will be disabled
by his InJuries, and the amounts he will probably be able to earn during such period, In
determining this amount, you may consider the type of work that the Plaintiff has done, the type
of work which, In vlaw of his physical condition, education, experience and age, he would have
been doing and will be doing In the future, the extent and duration of the Plaintiff's Injuries,
together will all other matters reasonably relevant. The amount of lost future earning capacity
which you determine to have been sustained by the Plaintiff should be expressed by you In a
dollar amount. Pa,S.S.J,1. (Clv.) 6.010.
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9. Plaintiff I. entitled to be compensated for any 1088 or reduction of future
earning capacity that he will auffer as a result of a decreale In or 1018 of future productivity,
Future productivity Is the Increase In wages or compensation which Plaintiff would
have received had he not sustained the Injury, Plaintiff has submitted evidence through a
vocational rehabilitation expert, who has computed his loss 01 earnings adding a productivity
lactor, II you believe that Plaintiff has sustained a loss 01 productivity, you may use this evidence
as a gulda In reaching your decision as to the amount 01 Plaintiff's loss of future earning
capacity, Pa,S,S,J.I. (Clv,) 6,22,
10, The Plaintiff Is entitled to be fairly and adequately compensated for such
physical pain, mental anguish, discomfort, Inconvenience and distress as you find he has
endured, Irom the time 01 the IIccldent until today, Pa,S,S.J,I, (elv,) 6,Q1E,
11 , The Plaintiff Is entitled to be lalrly and adequately compensated lor such
physical pain, mental anguish, dlscomlort, Inconvenience and distress as you believe he will
endure In theluture as a result 01 his Injuries, Pa,S,S,J,1. (Clv,) 6,01F.
12, The Plelntll1 Is entitled to be fairly and adequately compensated for such
embarrassment and humiliation as you believe he has endured and will continue to endure In
the future as a result 01 his InJuries, Pa,S,S,J,I, (Clv,) 6,01G,
13, The Plain till Is entitled to be lalrly and adequately compensated lor palt,
prosent and luture lOBI 01 hla ability to enjoy any of the pleasures of IIle as a reault of hla Injurlea
Pa,S,S,J,I, (Clv,) 6,011.
4
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3 WITNESS
4 Robert B. Dahmu8, M.D.
II By Mr. sto1arlki
Ii By Mr. Flower
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INDEX
DIRECT CROSS REDIRECT RECROSS
3/6 U
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Q
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14 NO, DESCRIPTION
111 1 Curriculum Vita.
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RXH1B1TI
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STIPULATION
It ie hereby stipulated by and between the
respective parties that signing, sealing, certification
and filing are waived,
ROBERT R. DAHMUS, M.D., called as a witness,
7 being duly sworn, was examined and testified as follow,.
9 DIRECT EXAMINATION
9 (As to Qualifications)
10 BY MR. STOLARSKI I
11
Doctor, good evening. Doctor, can you tell the
Q
12 members of the jury, first of all, where your practice is
13 located?
14
A
The practice is located in Harrisburg,
15 Hummelstown, Hershey area, Pennsylvania.
16
Q
And, Doctor, do you confine your practice to
17 any specialty?
19
A
Orthopedic surgery.
19
Q
Can you tell the members of the jury generally
20 what the specialty of orthopedic surgery is?
21
A
Orthopedic surgery is that field of medicine
22 that deals with basically the musculoekeletal syetem
23 anywhere from spine injuries to fractures to congenital
24 abnormalities that you see in kids to sports medicine,
25 foot eurgery, joint replacement surgery, arthritis
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A Thi8 i8 my curriculum vitae.
MR. STOLARSKI I Thank you, Doctor.
At thie point in timB I would offer the doctor
expert in the field of orthopedic surgery and would
5 offer him for croee-examination on qualifications.
6
MR. FLOWERI I have no queetiono on
7 qualifications, We'll etipulate to Dr. Dahmue'
8 qualificatione as an orthopedic surgeon.
II DIRECT EXAMINATION
10 BY MR. STOLARSKI I
11
Q
Doctor, at my reque8t, did you perform an
12 orthopedic examination of the plaintiff in this case,
',:J
13 Clyde DeHart?
14
A
Yes,
IS
Q
And can you tell the member8 of the jury when
16 that examination took place?
17
A
January 19th, 1995.
18
Q
Now, Doctor, as part of your examination, did
19 you take a history from Mr. DeHart?
20
A
Yes, I did.
21
Q
And generally can you tell the members of the
22 jury what the purpose of tho history i8?
23
A
1~e purpoBe of a hiatory when you're examining
24 a patient is to find out what happened, what the patient
-....)
25 i8 complaining of, what caused the complaints, what he's
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1 done to try to get over tho complaint8, how hi8 complaints
2 have changed with timo, how his complaints are affecting
3 his lifestyle, that sort of thing.
4
Q
And can you tell us what you learned from the
II hi.tory that Mr. DeHart gave you in terms of his
Ii complaints when you saw him on January 19th?
7
A
He told me that he was continuing to have mid
o and low back pain since an injury that he incurred in June
II of' llJ.
10
Q
Now, when you saw Mr. Dellart on January 19th,
11 was he offering any complalntll to you of any leg pain or
12 pain radiati ng into his legs?
,0 13 A No, he had no leg pain or radiation.
14 Q And in evaluating an individual with complaints
15 of back pain, is there significance to the abaence of pain
16 radiating into the legs'l
17
A
The significance of that mean8 that there more
18 than likely Isn't nerve root impingement in the lumbar
19 spine causing sciatica or other nerve root compres8ion
20 di80rders that would manifest them8elves as pain or some
21 other problem with the logs or foot,
22
u
Now, in addition to Lhe history of Mr. DeHart'a
23 complaints, did you review any records concerning Mr.
24 DeHart or hi8 treatment?
...J
25
A
I reviewed the recorda that were sent me which
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1 included an MRI scan of his back.
:I
Q
Now, Doctor, did you conduct an examination of
3 Mr. DeHart?
4
II
A
Yes, I did.
Q
All right. Tell the members of the jury what
6 the exam consisted of and what you were looking for when
7 you conducted this examination?
8
A
Basically the exam consisted of finding out
II where he was tender, where his pain was coming from, if he
10 had any weakness anywhere, if he had any numbness
11 anywhere, if he had any evidence of what we call radicular
12 symptoms, meaning signs showing numbness or weakness
13 because of a specific nerve root that's involved or a
14 epecific disc level that's involved, whether he had any
15 evidence of significant motor, meaning muscle, or sensory
16 loss, basically.
17
Q
And, Doctor, what were your findings at the
10 conclusion of your examination?
111
A
Basically I thought Clyde had mid and upper
20 lower back pain that I thought was real. But I couldn't
21 find any radiation type symptoms or signs going down his
22 legs into his feet, which basically ruled out a lumbar
23 spine type problem.
24 Q Doctor, in addi lion to the history records
,
..J
25 reviewed, did you take any x-rays?
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1 endplates, which, as I said, sounded to be the same as
:I from his original x-rays. But without seeing the
J originals, I couldn't say that for sure.
4
The rest of the spine looked good. The
5 posterior elements look good. The facet joints looked
6 good. Bo basically what appeared on his x-rays agreed
with his MRI scan, that is degeneration in the discs that
you would always Bee between irregular endplates like he
had at TO, T9 and TI0,
Q Okay. Now, the degeneration that you mentioned
that you say the x-rays agreed with the MRI reports, what
i8 that caused from?
A It can be caused from a condition that we call
14 Scheuermann's kyphosio. That's something that happens in
15 psop1e that we have no idea the cause but you see three
16 vertebral bodies in a row that are abnormal with disc
17 8paces in between that are abnormal. And this can lead to
19 pain down the road.
19 You could have a bad enough trauma in the past,
20 and I mean as in sevoral years in the paot, to have caused
:II this kind of problem but it would have had to have been a
22 tremendous trauma in the T spine, in the thoracic spine.
23 'rho nt/Ulon helng III that your ribs protect your thoracic
24 spine very well, In your thoracic spine you can get
25 compression fractures, eopecially older women with
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CROSS-EXAMINATION
:I BY MR. FLOWER I
J 0 Doctor, I'd llko to ask you a couple questions
4 about some of the terms that you used in the report that
!l was kindly supplied to me by Mr. Btolarski.
6 When looking Ilt the kinds of pllln thllt Mr.
7 DsHart 18 experlencl ng, in your tesUmony you indicated it
8 was a real pain. In the report you also used I think the
9 word chronic. Can you tell what the -- the court what you
10 mean by the term chronic in this context?
11
A
Chronic in this context means it's been going
12 on for a long time. It hasn't basically stopped. lie told
C>
13 me it was there all the time. It had been there since
14 June of '93, he said. Acute -- there's basically two
15 types of -- well, thera's lots of different kinds of pain
16 but al far as acute versus chronic, acute is short lived,
17 short time of duration, versus chronic that's been going
18 on for a 10llg Ume. And his, obviously, aCGording to what
19 he told me, had been going on since June of '93.
:10 0 Doctor, you also used the term significant back
21 pain. Would you -- can you explain what you meant by
22 8ignificant back pain III the context of your report?
23
A
Dasically what I milan 111 hll told me he hurt
J
:14 badly Ilnough that he was having trouble doing most any of
25 hla acllvitlol that he wanted to do, Bspecially tho heavy
C,(>,C,Il.Il, ('/17)2511-16~7
(IIUU)1I6] 1657
17
(1
1 lifting. That's the best I can answer that.
2
Pain io a subjective comment. And when I say
3 significant pain, it's because that's what the patient
4 tells me. Tenderness, spasm, that'o something that I can
5 evaluate, but pain is something that the patient has to
6 tell me.
7
o
Dr. Dahmus, I want to ask you just a couple of
8 questions to clarify your role here so the jury
II understands that. You were hired in this case by the
10 defendant. Is that right?
11 A Yes.
12 0 And you were to examine Mr. DeHart and give
o
13 your evaluation of his condition?
14
A
Correct.
15
o
And any compensation you received, you received
16 from the defendant. Is that right?
17
A
Correct.
18
o
Now, you have not actually been a treating
19 physician for Mr. DeHart. Is that right?
20 A
21 0
22 expressing
23 enough?
24 A
\ 25
\..;) 0
Correct.
Your role is solely for the purpose of
an opinion to aid in this litigation. Fair
That's true.
I want to go back to something that you said
C.P.C.R.S. (717)258-3657
(800)863-3657
2:1
~ 1 qU88t1ons.
'._.J.
2 MR. FLOWER I No further cross.
3 (Whereupon, the deposition was concluded at
4 5136 p.rn.)
5
6
7
8
9
10
11
12
0 13
14
15
l6
17
18
19
:10
:II
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23
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~ 25
C.P.C.R.S. (717):158-3657
(800)863-3657
,
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\ ,
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-,
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.
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Again at another portion of the deposition, the following
question was objected tOI
QI And, Doctor, do you have an opinion as to
whether or not, given the condition that you found Mr.
DeHart in, whether he could have continued that
occupation as a dock worker indefinitely.
MR. FLOWER I Objection. Once again, the
opinion that is being asked -- the question that being
asked of the doctor goes beyond the scope of what was
supplied in the expert report of January 19, 1995.
Deposition at page 14, lines 5-12, attached hereto as Exhibit
"A".
As is indicated by the second objection of Mr. Flower, Dr.
Dahmus' expert roport was prepared on Jar.uary 19, 1995 and provided
to counsel shortly thereafter. As indicated by Exhibit "A", Or.
Dahmus' testimony was presented on February 24, 1995.
The sole basis for the objection by the plaintiff in this case
is that the testimony of Dr. Dahmus in the two instances goes
beyond the exact wording of his report.
Pa.R.C,I'. 4003.5 governs the discovery of expert material and
the use of that material at trial. More specificallY, 4003.5(c)
indicates thatl
To the extent that the facts known or opinions
held by an expert have been developed in
discovery proceedings under SUbdivision (a) (1)
or (2) of this rule, his direct testimony at
the trial may not be inconsistent with or go
beyond the fair scope of hie teetlmony in the
discovery proceedings as sot forth In hi.
- 2 "
deposition, answer to an interrogatory,
separate report, or supplement thereto.
However, he sha 11 not be prevented from
testifying ae to facts or opinions on matters
on which he has not been interrogated in the
discovery proceedings. Pa.R.C.P. 4003.5(c).
The relsvant inquiry under the subdivision ie whether there
has been any unfair surpr lEe or prejudice to an opposing party
based upon any alleged deviation between the matters disclosed by
the expert during discovery and those disclosed during the expert's
testimony at tria!. lIickman v. Fruehauf Corporation, 386 Pa. Super.
455, 563 A.2d 155 (1989). In the absence of a showing of unfair
eurprise or prejudice, however, relief pursuant to this sUbdivision
cannot be granted. As was noted in Millard v. Naole, 581 A.2d 10
(Pa,Super. 1991), citing Wilks-Barre Iron v. Paroas of Wilks-Barre,
348 Pa.super. 285, 290, 502 A.2d 210, 212-13 (1985):
In deciding whether an expert trial testimony
is within the fair scope of his report, the
accent is on the word "fair", The question to
be answered is whether, under the particular
facts and circumstances of the case, the
discrepancy between the expert's pre-trial
report and his trial testimony i. of a nature
whiob would prevent the allvenarv fro.
DreDarlna a .eaninqful re.Don.e. or whiob
woulll ai.l.ad tbe allver.ary al to the nature
of the aDDroprlate r..pon...
"Fair scope" contemplates a reasonable explanation and even in
an enlargement of the expert's written words. ~illard, supra. at
23.
- 3 -
Dr. Dahmus rendered an opinion as to whether the plaintiff's
spasm would eventually disa1pate and whether the plaintiff would be
relieved of that pain.
As indicated by Exhibit "B" of this Motion, Dr. Dahmus
discusses his finding of spasm in ths plaintiff when he examined
the plaintiff. The question to t.he doctor IS to whether he would
expect this spasm and the pain which might be anoctated with it to
continue is, the defense would argue, within the fair scope of hi.
report.
Likewise, the BBcond question which was objected to, that
being whether the plaintiff could have continued his occupation as
a dock worker, is within ths fair scope of the doctor's report.
Dr. Dahmus mentions not only in his report but in his previous
testimony that the plaintiff advised him as to his occupation.
(Bee Exhibit "A" at page 14, line 2-4.) Dr. Dahmue also indicated
in his report and in his testimony that he suffered from endp1ate
disorders (page 9, line 8) and identified this degenerative
condition as a Scheuermann's kyphosis (page 10, line 13-14). The
specific diagnosis of Scheuermann's kyphosis was not mentioned in
the doctor's report and his testimony as to the same was not
objected to during the doctor's videotape depoeition.
The question 8S to whether the plaintiff could be expect.ed to
continue in his occupation as a dock worker with the presence of
- 4 -
this condition when he was examined by Dr. Dahmus is also within
the fair ecope of the doctor's report.
More importantly, however, the requisite surpl"lse or prejudice
which would require the Court to sustain the instant objections,
will not be found to exist where the complaining party has full
knowledge of the expert's anticipated testimony based on the pre-
trial diuclosures, has had the opportunity to investigate further
the expert theories, and has had the ability to cure any surprise
or prejudice but fails to seek a continuance or to take other steps
to prevent such surprise or prejudice. AYg~Btine v. Delgadg, JJ2
l'a.Buper. 194, 481 A.2d 319 (1984).
That element is clearly
lacking in the instant case. Dr. Oahmus' testimony was recorded on
February 24, 1995.
The testimony of the plaintiff'S treating
physician, who will testify via videotape, is scheduled for March
16, 199!>. Plaintiff thull has adequate opportunity to not only
investigate the opinions held by Dr. OahmuI but also to have hls
expert refute the same.
WHEREFORE, the defendants respectfully requ..t that this
Honorable Court overrule the objectionl of plaintiff'S counsel in
the videotape deposition of Robert R. DahmuB, M.D.
Ruspecttu11y lubmitted,
( .,(1 14/
'r1!~'- (~~; ,_/ /'
DW II .l.~~" 1
Attorney for Defendant,
IfORB1' MILK 'I'JlANBI'l':It, INC. and
J<ENNETH KIM J<J1;J,UY
llate. Hlrch 10. 1995
- !i -
.
OUTHOPAEDIC SUI10EI1Y CENTEI1
t-
"
Qfi45 North Third SlIccl. 51111c 4\IO^ .lInIl1511111~, P^ 17110. (717) 78Q-07l0
MClhnnlnhory Ullb'. 5 Willow Mill Pnrllllond. (717) 78H710
IImhl'Y Olllec. 18711whcy llond. (717) 500-(;1f>2
January 19, 1995
nobert n,l>ohlllUI, M,IJ,
Uobllrt J, Mourer, M,IJ,
And, l.4wheod. 11A-C
Edward J. stolarBki, EBquire
2005 Market street
suite 20~0
i'hiladl!lphirl, PA 1\')03
ReI Clyde E. Oel/art, Jr.
Filel 1786
Dear Mr. stolarski I
clyde is a twenty-four year old man who comes in today for an
Independent Medical Evaluation regarding his continued back pain.
Clyde originally injured himself back in June of 1993 when he was
sitting in his car and stopped at a stop 1.ight. 'I'here \\'as a mini-
van stopped behind him. lie SflYS il larglJ truck came find Emackod the
mini-van whidl then sln1lc)led illto his car. lie Raid he hus had back
p,lln ever since. I nsked him ilbout the people in the mlni-vnn and
ho thinks the~' are n]l o.k" but he is not sure. 110 says he never
had trouble with his back before, Uinee that time, he has had
continued mid 1Ind low back pain. lie does not have radiation down
his ]ogs and did not before either. lie denies any bowel or bladder
complaints now or in the past. nflsically what he has is continued
J[)W back pain.
lie has seen several difforent physicians for this, including a
physiatdst and has had numorDUS bouts of physical therapy and
phys I atry typo modi ci IH! to try to got bottoI'. lie is presently
wead ng a 'rNE; un i t and he had that on when he came in today. He
basically Is stuck with a chronIc mid and 10H back (laIn that gets
worse vlhnn he J I f Is tuo hard. Because of I:hi 13 he haa not boen able
to gut IJf\l:)( tD hlH prulnjury :lob, thaI: is or a dock worker. At the
present time he io I.aklng IJDxcpin at nigh\:, but he is being
'Irllduu11y chall'led to llox\lox to tilke ilt nJqht, lie lEI nDW pnwently
tllklnl] ),oIJilH' dllrllltl Ihe d.l)'.
lIu Ill-1IHIE\ .~ep()J'I:B uf 11111 Henns H 1 I:h 111m that llhU'.,' dl1qlweral: t VP. d I E1C
d llHl(Hl~1 fit tlw Tll-9 Ilwl'l alld the '1'9 --II) Jove 1. 'l'lle UIll!: nJ1ml't aaYfl
there j 13 (Wine illl1t:>ntllUon but tlw otlwr report Hays thele lu nonE!.
lie did not br illg tho BCIlII pel' Be and thel-efDre I have IlDl berm able
Edward J. stolarski, Esquiro
Re: Clyde E. DeHert, ,lL'.
January 19, 1995
Page 'l'wo
to look at it myself. Neither report, however, says it look. new.
Iloth reports say it looks degenerati ve and, Blnce it was taken lellB
than a month or ratheL' approximatelY a month after his injury,
there is no way that the degenerative changes could have come from
the accident.
Clyde seems to be a vary nica person. 110 is very agreeable, very
easy going and seems to be a very honost person when he is sitting
on the examination table today. lie has answered every question
that I have asked very completely without hesitation.
At the present time, Clyde complaina of pain in his low back and
mid back. He has no leg trouble, no shoulder trouble, no Brm
trouble and no foot trouble. Ilasically it is just pain in his
lower back. lie haa presently gotten back to work full time as a
car salesman. lie said lw went through vocational rehab but every
job they got him involved more lifting than he was doing before and
therefore he was not able to do anything. lie got the car salesman
job on his own. lie would like to get a better job but this is the
best he could find at the present ti me.
On physical exam, he has Ij/Ij strength throughout his lower extremi-
ties. His sensory exam ill intact and hill deep tendon reflexes are
+2/4 bilaterally at the knees antI ankles. lie has a negative
straight leg raising test bilaterally and basically his lego are
perfectly normal as far as neurovascular exam is concerned. lie has
very much trouble bending forwartI. lIis flexibility is very poor in
his back. When he bends forward at about 30 degrees, his back
straightens up and spasms at the lower thonlcic level. 'l'his is
definitely lower thoracic and now down fit his LS spine aroa. lIis
aide to side bending is the same. It 1 stabiliw the thoracic
spine then he moves much nicer find therefore 1 am sure his pain is
coming from the mid thoracic area, that is the '1'-0 through 1'-10
area. lie has no pain to pnlpfltion over the Bl joints, the sciatic
notches or his LS juncU ot!.
Based on the hilltory he hnB IjlVlln me, the examlnnt:inn ] have lione
IInd the reports 1 havo reild that he brnulJht with him or WlJl'e sent
to us, he""lJasi CBl] Y" h/HJ"dnqonerBti VB" joint"..ctiseae~ .f.1fftt....fll"
degenerBti VIr-tHee .cti SCHlIlO, at -thll~'l'lJ-9. IInd..J1'9"1 O'IIL"Blh,. IIe..hllll..no.
radicular. symptoms" no abnorllllll.reC lexes-lInd- no,'l onq~traok~slgnB't
'I'herefore'he' does" not '1lIlVe cord or' nerve'. L'oot..impi t1qomllnt"rrotlf"111 Il'
injury.,..,but. rather. " just. degeneratlve-disc'"ctisBasl!I. 1 have rox-
rayed his 'r-spine today since it ha6 been over a year since he has
Ellwllrd .J. fltollll'skl, Eaquhe
Ile: Clyde I~. IJellart, .11'.
January 19, 1995
Puge 'I'hroc.
hlld It find vou 'cnn dofll1it.ely BIlO th8"'abnormal1t1es" of"the..ent\r
plates nt. tho '1'0-9' 11IId tho '1'9-10 HIVol"'. 'rhls does not seem to be
wonlH from t1\l1 l"opurtu thnt 1 hove read, bul: obviouely without
soolng Ida orlglnnl x-roya, I clln't soy for Buro.
I om ut II losa to BOY \vhy 1m I fl still hav llltJ flU much pllin based on
hia x-roy fitudloa and his OXOIII. He dOBs'nol: hAve Any'herniations,.
at'lenat ncconlllig to tho Mill n'IHlrtB lliiIt'! hnve seen,'and,there"
fore, he, daBS' not hilve nny truo IlCrve'i mpl ngementJ... 110 seems to
truly have significant Imd, 11I11n, however, to exam In that he
deCinitolYllpasms up whon 1 hnve him bend forwArd.- I am sure this
i6 because uf tho I'robll!lII thot Ill' IIiIB at t.hQ 'I'U-9 and '1'9-10 inter-
splices, but thl a doe13n' t make BOIIIH' I rom Id II injury. I don' t know
if he hllLl something brewing IlOrl! olld the illjury just aggravated
this nllti eaulled tho ploblem, but it is doflltlt(.ly abnormal as you
can tell IJY lookln'J at IIII! ellllplill "ll Oil hlu 18<Julal' x-lllya. This
is defillltely whore his pain 18 1101l11n'1 from, I think if he would
have had a bone scan ,ludn'l hie; orllJlnal Injury time, perhaps
something could hllva )JrH'n told abou\: tho <IiBC problem, T~ou'lt:t
havo !Jean /ui info(:\:lon back tht!ll. It could have been many
difloronl: thin'JB bul !linca only iln HHI (wan WilS done, there is
relllly nothing O!flO I l1iln nilY about why IdH discs lire so
degenllrllled, lIownver, nu Ill'. Hol hll1iln hns noted in hi 13 Mill reading,
thes8 urn del'lnltely old and do DOl: 'JO illollq with the type of
injury IIf; had, 1I0wevrn, if hI. did have nn nbnonna 1 di sc space
becauBll Df il prl or Inf ecti on ilnd then hu WleJnt IInd had this
signiflcnnUy jolted, then ho lI1ilY hUVll caused this entire area to
be very nggrilvated, Ill! drd InJtely urwms 10 hilvo I:rue spasm by exam
ami I dolinllely think il ifl,:omilllJ froln thilt [Iron. lis stated, it
didn't COll1e 11'0111 tho iled donI, hut tlw ace! d(!nt may hllve aggravated
it, I illl1 ill n joun to !Jay olnee I don'l know what he was like
priur to thot ilnd J ,lon'l: I',now what he WilB IH,e IJXilcl:1y at the time
of Injury.
At the plOllent tJlIIU I .Iul inlll1ly Ihink I'lydu ':iln work full timo,
'I'he ffWI IhilllllJ hnu nlll)il,ly Ill!Un doinq it nhowB Ihnt.l'think-hlJ'
shouid not be llIUn'J lI10rllthiln plohllbJy Ihilly-Ilvu pounds beCaU8l!
I Ihlnll il hn d'HJB hln hill'k II; 1111,1 <Join'J 10 dl jvn hill1 urll~Y. lie
III no\ ill rink, 1111 lIel VI' I'Ollll'lolII,lrll! 01 thin puint, but ho defl-
nl tel y lulU ui~lld I ICiHlt puill nllll fJlHlIJIII flU pt!1 eXilm alltl thereforo 1
d,dinilrdy IIrlu Ill! In 1"01 IlIld I woulll Ilm!p Ilia IIIUI1\l to ft
IIIlnllllulII, lIowover, II lIIi!11 hill BizI' flI1t1 BITon'l1 h nhoulrl easily'be-
uhle tu lilt thiny-f lve 1"1\I1IdH wit h oct'IIBionnl hand lrlfJ I' stooping,.
crawling, etc. without ci\uHillll him /'lny In".-ellaillt) prohlems,
/~ 1 CLYDE E. DEHART, JIL,
Plaintiff ,
2
vs.
3 I
HORST MILK TRANSFER, INc.1
4 and KENNETH KIM KELBY, :
Defendants, 1
5
6
7
8
9 Videotaped
10 Deposition of 1
11 Taken bYI
12 Before:
0 13
Date I
14
15 Plaoel
16
17
18
19 APPEARANCEBI
I
IN THE cOUHT OF COMMON PLEAS
CUMBEIU,AND COUN1'Y, PENNSYLVANIA
CIVIL ACTION - I,AW
NO. 94-3399 CIVIL TERM
JURY TRIAL DEMANDED
. f
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MARK P. LUTNEBS, M.D.
plaintiff
Jan L. Bucher
court Reporter-Notary
Thursday, March 16, 1995
at 3:29 p.m.
175 Lancaster BOUlevard
Mechanicsburg, Pennsylvania
20 FLOWER, MOROENTIlAL, FLOWER , LINDSAY
BY: JAMEB D. FLOWER, JR., ~SOUIRE
21 FOR - I'LAINTH"F
22 LAW OFI'ICES OF EDWARD J. S'roLARSKI
BY I EDWARD J. ll'I'OI,ARBKI, EBQUIRE
23 FOR - IJEt'EtWAN1'S
24
ALSO I'HESENT:
.....)
25
CHAlG ASIlWAV - VlIlEOOIlAPHEH
centrlll 1'I!IInaylvllnill Court Ileporting
(717) 2f,ll-lb!'>7
flervic88
ORIGINAL
"" ,__ _....-1_
"""'
1
2 WITNESS
3 Mark P. Lutnes8
4
5
6
7
9
9
I N 0 E X
DIREC1'
CROSS
REDIIUtCT
JtECROSS
3
31
41
47
'-"
10
11
12
13 NO.
14 1
15
16
17
18
19
20
21
22
23
24
25
EXHIBIT'
o
DESCIUPTION
PAOE
2-pq. curriculum Vita.
of Mark P. Lutn..., M.P,
:I
~..~~_~~__~.~~~___~T'~.'__"
Cent fA 1 l'unnlV 1 Va" I" courtiiepo'rtTnci Burv 1 OUB
('11 'I) 2llU~ trill'!
,..-,
1
2
3
4
5
6
7
8
9
10
11
12
3
STIPULATION
It is hereby stipulated by and between the
respective parties that signing, sealing, certification
and filing are waived; and that all objections except as
to the form of the question are reserved until the time of
trial.
(Dr. Lutness Deposition Exhibit No. 1 was
marked. )
MARK P. LUTNESS, M.D., called as a witness,
being duly sworn, was examined and testified as followsl
DIRECT EXAMINATION
0 13 BY MR. FLOWER:
14 Q Dr. Lutness, would you give your full name,
15 please?
16 A Mark Philip Lutness.
11 Q And where is your office located, Dr. Lutness?
18 A It's here. It's Physicians of Rehabilitation
'-'
19 Medicine, P.C., 175 Lancaster Boulevard, Mechanicsburg,
20 PA.
21
Are you a medical doctor?
Q
22
A
Yes, I am.
23
Would you review for us your education?
Q
24
college degree in English Literature; college
A
25 degree in a -- woll, a degree thereafter in radiologic
central Pennsylvania Court Reporting services
(117) 258-3651
,-
5
6
7
8
9
10
11
12
0 13
14
>.....d'-
5
1 hospital. I have a -- a group of hospital patients. We
2 see patients who havo sufferod some kind of usually an
3 illness or catastrophe, stroke, fracture of the spine or a
4 neurologic disease as multiple sclerosis, myopathies or --
after orthopedic procedures, hip replacement, knee
replacement or multiple trauma, brain injury and then deal
with patients as they recover and try to help them with
their physical therapy and other therapy needs and their
medical needs and then eventually help them get back to
living in the community, if possible.
In the outpatient setting, we usually deal with
people who have either a~ orthopedic or a neurologic
problem or people that have pain and have gone through the
usual initial stages of treatment for pain or management
15 for pain and still haven't been able to do well.
16 Q Dr. Lutness, are you board certified?
11 A Yes, I am.
18 Q What -- what board are you certified by, first
19 of all?
20 A The American Board of Physical Medicine and
21 Rehabilitation.
22
Will you tell the jury what it means to be
Q
23 board certified?
24
Firstly, you have to have completed a residency
A
25 program in the specialty. Then you have to pass the
Central Pennsylvania Court Reporting Services
(111) 258-)651
6
,f"''''
1 written examinations for board certification. You have to
2 work as a practitioner doing your clinical work within the
3 community for a period of one year or more.
4 You have to rDceive tho support of three
5 members of the board indicating that your work is
6 satisfactory and that your moral character Is
7 satisfactory. Then you have to pass a -- an oral
8 eKamination that Involves examination by throe individual
9 boarded members of the specialty dealing with the varioua
10 aspects for which we are responsible.
11
Q
Do you belong to any professional societiee,
12 Dr. Lutness?
o
13
A
American Medical Association, Pennsylvania
14 Medical Association, American Academy of Physical Medicine
15 and Rehabilitation.
16
MR. FWWEIO Mr. stolarski, do you have any
17 questions on qualifications?
18
MR. STOLARSKI I I have no questions of the
19 doctor,
20 BY MR. FLOWERI
'.~---
21 Q Dr. Lutness, when did you first have contact
22 with Mr. Clyde DeHart?
23 A 1 first saw Mr. DeHart on December loth, 199].
24 Q And what brought him to your RUentl on? Old he
26 come to Bee you or was he referred?
_._n~__~"_'_..~_.'.~_>>"'~ , _~_.~_."".._ ....
central l'ennsy1vanla Court Reporting Hervlcee
(717) 2'>Il-H,r,7
10
1 pain. I felt that he probably had a hornlated disc at
2 around 1'-0.
J
Q
Defore you go on with the courso of treatment,
4 Doctor, you mentioned a number of factors that you think
6 may have contributed to -- to his symptoms, Were there
6 any other factors contributing to the initiation of theBe
7 symptoms? Did he date the onset of -- the onset of his
8 symptoms to any particular event?
9
A
Oh, well, yos. Thia all occurred following a
10 motor vehicle accident, He -- he had reported no problems
11 with back pain prior to July 23rd, 1993 I'm just
12 reading from my ewam on the first visit when he was
-.
W 13 involved in a motor vehicle acd dent. lie was stopped at a
14 stop siqn when his vehicle was rear-ended by a Dodge
15 Caravan that had been rammed from behind.
16 He was wearing a seatbelt with a Bhoulder
17 harness. 1'he impact was immediate I\nd ewplosive. It
18 caused his seat to slide forward from Its locked position
19 hurling Mr. DeHart forward causing his chest to impact on
20 the steering whoel, The impact was severe enough to bend
21 the frame 01 his pickup car. And the car behind him had a
22 little ehlld who was thrown against the daohbOl\rd.
23 He lirat Instinctively went: to holp the child.
24 And then once thin was taken care of, he nJted that he had
25 ReVere ll/wk pain. Ill! pornlived it more In the mid sal'ral
",1
Cent rill l'ul1l1l1ylvilllla Court lIeport till) Harvlcan
(I) 1) 2ljR-lhb"
14
c~,
1 he extended to the upright position.
2 He was trimmer, the weight loss was obvious.
3 At that point I felt that he had reduced the lumbar
4 lordosis. When I first saw him, I felt he looked like he
5 was almost swaybacked. He certainly had an increased
6 lumbar lordosis at that time. This seemed to be
7 improved.
8
His reflexes were symmetrical. I tested his
9 muscles at the hip flexors, hip abductors and adductors
10 and the knee extensors. And at that point testing these
11 muscles did not increase his back pain; whereas, formerly
12 that had caused an increase in back pain. He also had
"...,
V
13 paraspinal muscles which were no longer in spasm while he
14 stood comfortably. They weren't as tender when I palpated
15 them.
16
Q
Where are paraspinal muscles?
17
A
They're on either side of the spinal column.
18 Again, with this model, the paraspinal muscles would be
19 the muscle mass that's on either side. I should mention
20 with mechanical low back pain, these joints are the facet
.J
21 joints. These are the joints that Dr. Momin injected.
22 And when there's a lot of curve in the back, that curve
23 causee these joints to impinge and just caUses them to
24 hurt. They have many pain fibers. So these joints can
25 cause a lot of pai n.
Central Pennsylvania Court Reporting Services
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2
3
4
and both maneuvers aggravated the mid sacral pain. He wae
wearing the TENS unit with the electrodes ovor the
paraspinal muscles at the level of the sacral dimples each
midway between the sacral dimple and the dorsal spinous
6 process.
6 He didn't have any point tenderness over the
7 dorsal spinous processes or the interspinous ligaments.
8 And he -- he didn't really demonstrate any spasm of the
9 paraspinals. So it just appeared to me that he had some
10 refractory low back pain.
11 Q Refractory meaning?
12 A It wasn't relieved by all the treatment
o
13 measures that were attempted. We discussed the options.
14 I noted that sleep disturbance is very harmful and he
15 would do better with a good night's sleep. And he could
16 probably tolerate an increased dose of Doxepin; he's a
17 large man.
18 So we doubled the dose of Doxepin to 100
19 milligrams every night. I suggested he try that for a
20 week and if it made him too sleepy, cut back. But if he
21 tolerated it, keep it up and try some extra strength
22 Tylenol at bedtime to see if he could get some
23 uninterrupted sleep. I did recommend that he go ahead and
~-_.'
24 take the OED as soon as possible, if you don't pass it, do
26 it again. And I recommended that he look into the
central Pennsylvania Court Reporting Services
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"'\
1 extends up the parasplnal muscles, they will exert
2 pressuro on the base of the skull. And often that will
3 cause a headache. 60 he had begun to notice that sort of
4 dynamic. And that was basically the history and the
5 changes as he described It.
6 On examination at that time, it seemed -- by
7 the exam, seemed about the same to me. I felt he had
8 mechanical low back pain. I felt he had a component of a
9 mild sensory lower lumbar radiculopathy. We added a
10 nonsteroidal medication, Tylox, a mild narcotic, if the
11 pain became worse. I was glad that he was going to see a
12 neurologist, and that was for the end of the week. And if
0 13
14
15
16
11
18
I was missing a diagnosis, I thought It would be excellent
to have an independent opinion.
And then I suggested that we could certainly
try some things in therapy including physical therapy,
lumbar traction, medium frequency current to the lumbar
region, aquatics, maybe some dynamic lumbar stabilization
19 exercises. nut I had not ordered them because he had
20 already been through a similar program. And I didn't feel
21 it would be appropriate just to prescribe another
22 go-around simply becauso he had soma worsening symptoms.
23 I did see the patient one other time on
24 February 24th, 1995,
.....-/
25
MIL 61'OLAIlSKll
Objection. I've not be~ ~.
.. - -------.--- - - -- 11- __ - ----
Court Iloport inq nervlces"nJ,I'
250-3&57 ~ y
\ T(\
Central I'ennsylvania
(111)
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\
1 in the future with this condition?
2
A
Yes. I believe that this will continue to
3 trouble him. I bolieve this for two reasons; one of them
4 is because he has the radicular signs. He's had
5 injeotions, medications to attempt to rolieve these and
6 they remain present. And he's had several specialists
7 look at the cond i lion from a fresh point of view trying to
8 come up with new ways to treat it. And there are no new
9 ways in the offing. So I believe that this condition will
10 continue.
11 The second thing is he has had reduced activity
12 and chronic pain for a long time. The accident was in
o
13 July of '93. So this is almost two years. By this point,
14 people with chronic pain from whatever reason will have
15 had changes to the muscles and ligaments if they've had
16 abnormal postures, which this patient has exhibited. And
17 they will also have developed a proclivity towards pain.
18 If pain exists for that long, it tends to be very
19 difficult to eradicate.
20
Q
Doctor, have you reached an opinion as to
21 whether Clyde will have the physical capacity at some
22 point to return to work as a dockworker?
23
A
No, I don't believe that would be advisable at
24 all. I told him that on the first visit, as a matter of
25 fact. If he has already shown evidence of a herniated
~--
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Central Pennsylvania Court Reporting Services
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._,
1 burly. He was a little heavy, but he wan doing that kind
2 of work. And he wasn't having difficulty with it. So I
3 would expect that he would continue that pattern.
4 Everybody gets older. Everybody runs into arthritis or
5 degenerative diseases or, you know. So I'm sure he would
6 have fallen prey to the usual diseases of age or
7 whatever.
8 But based on his performance prior to the
9 accident, I would have expected his performance to be
10 similar had the accident not occurred.
11
MR. FLOWER: Cross-examine.
12
CROSS EXAMINATION
o
13 BY MR. STOLARSKI:
14
Q
Doctor, I wonder if we could go off the record
16 if 1 could review your tile before we start?
16 A Sure.
17 (Off the record. )
18 BY MR. STOLARSKI:
19 Q Doctor, good afternoon.
20 A Good afternoon.
21 Q Ooctor, I'm going to refer to your records
22 which you do have marked by date. And I'll give you the
23 date on the records as we go through. Now, you first saw
24 Mr. Dellart on December 30th, '93, correct?
--./
26
A
Yes.
central Pennsylvania Court Reporting Services
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1
Q
And that was as a result of a referral by Dr.
2 Lippo, correct?
3 A Correct.
4 Q And in Dr. Lippe's opinion In that referral, he
6 found Mr. DeHart's back pain to be mechanical, con'sct?
6 A I can't romember what he said. I'd have to
7 look at the referral letter. (Perusing document.)
8 Well, now, did you find the reforral letter in
9 there? Okay. I have noted in my report that it doesn't
10 require surgical Intervention and It's mid sacral. And
11 usually mid sacral low back pain that doesn't require
12 surgical intervention Is mechanical. Hut I didn't -- I
,)
I.,.
13 didn't state that In my report.
14
Q
Hut you felt and you testified to Hr. Flower's
15 question that you felt hla back pain had a number of
16 components, correct?
17 A Correct.
18 Q He was obese?
19 A Correct.
20 Q He had tight hamstring.?
21 A Correct.
22 Q He had mechanical low baok pain?
23 A Correct,
24 Q And then, finally, you mentioned he wu
,
""-"
25 Involved In this automobile accident, correct?
Central PennsylvaniA Court Heportlnq /lnrvlcea
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A
Con"ect.
33
4 meohanical low back pain prior to the sutomobile accident.
5
Q
And you've also testified that --
Except 1 did mention that he denied having
A
Q
nut you do mention in your report of December
6 30th, Doctor, that indivldun1s of the body type that you
7 saw on Mr. DeBut often have thie type of pain without any
8 precipitating trauma?
9
10
A
Right. Mechanical low back pain.
Q
And when you saw him then he had no radicular
11 symptoms, correct?
12
o
13
A
I didn't identify any.
Q
Now, you Bay In your report, Doctor, of
14 December 30th in the impression section, that you've been
15 aeked to comment on the relationship of this pain to the
16 motor vehicle accident.
17
18
19
A
Om hum.
o
Who asked you to comment on that?
A
I don't remember unless 1 wrote it down.
20 Sometimes the -- sometimes the secretaries
in fact I
21 guess I should note this from now on. nut sometimee the
22 secretaries will hand me a patient to see. And then
23 they'll say, You've been asked to comment on causal
24 relationship.
25
L~
And so I'll do It. nut sometlmee I don't even
Centrll I Pennsy I viln j it COllrt Hepol"t I ng Borv I cos
(71'1) 2!JIl-lb")'1
35
.~
1 the mechanical low back pain, right.
2
o
Now, Doctor, when you saw him neKt on February
3 24th, you emphasiud that he needed weight lase, correct?
4 A correct.
II 0 And you fe It that by losing weight, Ilome of his
6 symptoms in terms oC the back pain that he was having
7 would be alleviated, correct?
B A correct,
9 0 And he began to lose weight at that point?
10 A Corroct.
11 0 Began following your advice ae to your
12 treatment, correct?
o
13
A
Correct.
14
o
Now, when you saw him again, Doctor, and you
15 reported on March 11th, you note there that he
16 discontinued his program of weight 10s..
17
A
(Nodding head up and down.)
18
o
Is that correet?
19
A
Which -- which date?
20
o
On your report of March 11th to Mr. Capp, the
21 rehabilitation counselor. Do you note there, Doctor, that
22 he Is discontinuing a program of weight loss?
23
A
'I'hat' 6 a -- that' 6 a mllipr I nt by the Iiecretllry
24 that 1 missed because] had statad in the prior visit that
-J
25 he was losing weight. And In the newt vlalt attar that I
-
central I'ennaylvanla Court Heport tnl] flarvicaR
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1-..,
1 was also stating that he had lost evon more weight. So
2 she -- that's II misprint thBt I missed.
J Q Well, the next sentence, Ooctor, where you say,
4 "He has not completed the treatment .oegime thBt I
5 BU'iI'ilBBtBd, II is that also a misprint?
6
A
No. See, In other words, he hllsn't completed
7 the treatment regimen. Out it looked like he was doing
8 the physical therapy. And that is a misprint. He was
9 continuing with the prog."llm of weight loss, yeah.
10
Q
So you don't mean by that sentence that by not
11 continuing with the program of weight loss that he wasn't
12 continuing with your suggested treatment?
o
13
1\
No. I meant thllt -- like I say, thllt is a
14 mhprint. I meant that he wall continuing weight loss. lie
15 had loat weight In the prior visit and he lost more weight
16 on the next visit. Bo that should have been he was
1'/ undergoing a program of continuing -- or and continuing a
18 program of weight loss. And then I Bald, "He has not
19 comploted the treatment regimen that] suggested," moaning
20 that thero was stili more to go, yeah.
21
Q
Iloutor, there wo."e on other oucas Ions, though,
22 Mr, Ilellart did 1101: do I:hll1cJs that you had asked him to do
23 with respect to trying to alleviate his symptoms, did he?
24
A
]']1 have to go -- quite likuly.
. I
-
25
Q
Let mil refer YOIl to your report oj ,lune Oth.
~ --.- ---. ----- -.-
CentrA] I'ennuylvanla COllrt: lleportinCj fJurviGos
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38
1 him 130 that ho could start to uso thsm.
2
Q
And you IIdvlaed him on that visit that he
3 shouldn't expect Improvement in a day or so?
4
A
Rightl becauee he was just starting that and it
5 takee a while.
6 Q Now, whon you next SIlW him on August of 1994 --
7 A Okay.
8 Q -- he did have the added weight gain?
9 A Correct.
10 Q So at some point he did go oft of your
11 suggestion that he koep the weight off?
12
o
13
A
Well, he failed in his attempts, ysah.
Q
Did you have any discussion with him about it
14 being important that he keep the weight off?
15
16
A
Surely.
Q
Now, on that visit, Doctor, you also discus8ed
17 with him the importance of his vocational rehabilitation,
18 did you not?
19
20
A
Urn hum.
Q
And it was suggested that he might do dBlk work
21 or sedentary activity, correct?
22
23
A
Right.
Q
And Mr. lJultllrt told you lit that point that he
24 found sedentary work or desk work distasteful?
.J
25
A
Right. He's an outdoors, physical sort of
centrlll Pennsylvania Court HeportlnQ DurvlcoB
(717) 2511-]6!J7
39
!,
1 person.
2
Q
Doctor, as working in the field of physical
3 medicine and rehabilitation, you often have to give
4 individuals advice about their vocational outlook, don't
Ii you?
6
A
Correct.
7
Q
And In terms of changing their vocational
o
8 position, looking for another job --
II A Right.
10 Q -- obtaining more education?
11 A /tight. Sure.
12 Q And you certainly felt that Mr. DeHart could
13 work at eomething, did you not?
14 A Sure. And that's u initially we tried with
15 the Offloe of Vocational Rehab. And, like he said, their
16 advice was basically move to Arizona. And he telt that
17 that waen't helptul. But then he went out and did it on
18 his own. lie got a job selling shoes and then later he got
19 a job doing something else. I target.
20
Q
And you also advised him though that he should
21 obtain his OED, correct?
22
A
It would be helpful, yeah.
23
o
And Mr. Ilellut ePfJllntlally told you that he
24 thought that that type of test was just too tough?
...1
25
A
At that time, yeah. 1 think he -- it sounds
Central Pennsylvania Court /teporting uervicos
('/1'1) 2'\8-16'.7
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1
43
Q
And the neurologist indicated to you that he
2 conducted what he found to be a normal neurologic exam,
3 isn't that true?
4
5
A
Yes.
o
And that he said that he could not explain the
6 progression of symptoms that Mr. DeHart had in this case.
7 A
8
9 I have.
10
11 moment?
12
.~
V 13
Ves.
MR. STOLARSKI: Thank you, Doctor. That's all
MR. FLOWER: Could we go off the record for a
(A discussion was held off the record.)
REDIRECT EXAMINATION
14 BY MR. FLOWER:
15 Q Dr. Lutness, let me refer you, first, to the
16 report from Dr. Heck which you have provided to us today.
17 What's the date of this report?
18 A January loth, 1995.
19 Q And Dr. lIeck is the neurologist that you
20 referred Mr. DeHart to?
21
22
A
Yes, that's correct.
Q
Now, in the course of preparing this report,
23 does Dr. Heck appear to have taken a history from Clyde?
24
A
Well, he mentions
he mentions several
-J
25 items. lie refers to my history and then he mentions
Central I'ennsylvania Court Reporting services
(117) 258-3651
44
~
1 several items.
2
Q
Did he maks any obssrvation as to, in the first
3 paragraph, the back pain and whether or not it radiated in
4 either of the legs? to '''d!".~jJ
6 MR. STOI.ARSI<I: Objection as
6 MIL FLOWElll I'll rephrase.
7 Does he make any observations in his history
8 concerning the nature of the back pain?
II
TilE WI'rHESSI Il1s report states, "lie tells me
10 that the back pain continually is getting worse and now
11 spreads down both of his legs to an equal degree over the
12 past two months."
~)
13 BY MR. FWWERI
14
Q
Dr. Ileck was apparently aware that Mr -- that
16 Clyde was working selling cars. Does he make any
16 observations as to any problems he had with that,
11 performing that work?
18
A
(Perusing document.) lie says, "He is now
19 working a desk job selling cars but frequently has to
20 leave work early and go home and take pills for his back."
21
Q
And, now, Doctor, 1 beliove on the aecond page
22 he makes reference to an Mill scan? Would you roview his
23 comments with respect to tho results of the Mill scan of
24 the thoracic spine?
~
25
A
The letter states, "Mill sean of the thol"adc
Central Pennsylvania Court Ileportlng HervieBs
( 'll"l) 2 flll-)(, f) '/
45
~
1 spine in the region of where he complaine of pain shows a
2 right paracentral disc protrusion at the T8-9 level which
3 could not be clearly related to hie back pain and was
4 certainly not felt to be a surgical lesion."
5 Q Now, with respect to Dr. Heck's conclusions, I
6 believe Mr. Stolarski paraphrased a portion of Dr. Heck's
7 letter to the effect that he was at a loss to understand
B the symptoms. Would you -- would you refer directly to
9 that section of the letter and indicate what Dr. Heck
10 actually said to you in this letter?
11
A
The letter states, "I am unable to explain on a
12 neurologic basis his persistent localized pain at this
o
13 point in time nor would 1 be able to explain the
14 progression of his symptoms involving pain radiating both
15 up and down his back except on the basis of deconditioning
16 and disuse."
1'/
Q
How do you interpret that, Dr. Lutness?
18
A
When he states on a neurologic basis, he's
19 referring to the nerves and nerve roots. And in his
20 capacity as a neurologist, that's one of the areas that
21 I'm seeking his expertiae. When he states eKcept on the
22 basis of decondltioning and disuse, that would refer to
23 the phenomenon that ) had 1\) ready menU uned I that iB, if
24 you have pain In one area of the low back or -- well,
~
25 anywhere In the back and spasm Is accompanying the pain,
---..-
centra) /'onnay I van I a Court Hepurt I ng fiarv I cas
(11'1) 2[,11- 16',!
41
~
1 your notes of December 30th, 1993.
2
A
Yes.
3
o
Mr. stolarski read a section in that stating
4 that, "Because the pain is often encountered with people
5 with similar -- similarly body habitus who have no
6 identified precipitating trauma, it cannot
7 unequivocally -" be unequivocally blamed on the accident."
8 He stopped there. Would you read the next sentence?
9
A
"However, because he had no such problems prior
10 to the accident which had considerable force of impact and
11 trauma is known to hasten or aggravate changes of
12 osteoarthritis, I am convinced that the traumatic injury
o
13 is implicated to some extent."
14
MR. FLOWER: No further questions.
16 RECROSS EXAMINA'rlON
16 BY MR. STOLARSKI:
11
o
Doctor, just a few more on recross. You
18 mention in that sentence again, and we talked about this
19 before, the term considerable force of impact. The
20 description of the force of the impact factors into your
21 opinions and diagnosis, does it not?
22 A 1'0 some degreel although, people can have
23 problems with relatively minor precipitating trauma.
24
o
Doctor, finally going once again to Dr. Heck's
~
25 report. One of the things that he mentions In his history
---,~ ._,.__._--_._--"._---.._.~...... ,------- ---
Central I'ennsylvania Court Reporting Services
("117) 25U-)(,f,7
!
I
. I ~
~
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..
8 Itoffer
V,
HORST MILK TRANSI'ER. INC,
and KENNETH KIM HELBY,
Oefandants
IN THE COURT 01' COMMON PLEAS Of
CUMBfllLANIl COUNTY, PINNSYl VANIA
CIVIl IICTION - LIIW
NO, 9/j-3399 CIVIL TERM
IN TlHSPIISS (M.V,)
C L YIlE f. lJeliART, JR,.
Plaintiff
IN HE; PRETRIAL CONfERENCE
A pretrial conference was held before the
Honoroble George E. lioffer, Judge, on Wednesday. March I,
1995,
In this auto occident case. James D, Flower. Jr,.
Esquire. represents the plaintiff; and Edward J, Stolarski,
Esquire, represents both defendants,
Plaintiff was stopped for 0 traffic signal on
Route II at a point approximately across from the All
American Truck Stop in Middlesex Township, Defendant Helby
is 0 driver for Horst Milk Transfer, Inc, and approached
plaintiff from the rear. Defendant struck a car stopped
behind the plaintiff, pushing that vehicle into plaintiff's
vehicle. Plaintiff's injuries consist mostly of soft tissue
variety, and his claim is that he cannot return to work as a
dock worker and that he will lose substantial future income
in 0 lesser paying Job,
This Is 0 Jury case estimated to take two days to
try with four Challenges each, Each party has examined the
witness l15t of the other party nnd tIll! I!xhiblt list. and no
problems hnve been raised,
In reviewing plaintiff's witnesses. the only
medical witness to be called will be Doctor Lutness. whose
clelJOslt1otl 1s III Ill> tO~l'tl Murch 16.
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amount and severity of damages sustained by the plaintiff. The
defendants' contention at the time of Trial will bs that the
plaintiff suffered from pre-existing conditions and that the only
injuries sustained by the plaintiff in this accident were soft
tissue injuries.
It is also the defendants' position that plaintiff is oapable
of employment.
4. SUMMARY at' J,EGAJ, I !laUES I
None anticipatsd.
5. IDENTITY OF WITNESSES TO DE CALLED I
1. Kenneth Kelby.
2. Robert H. Dahmus,
videotape) ,
4. Rs[!n....J._ l".;ulILuUlan DI "lal\Dllda.. lJp..ll1\j1l .u,nab.
5. Records custodian of Mechllnicsburg Rehab.
6. Hecords custod iIln of Hoadway J~xprese.
7. JlecordlJ custodian of Carislo Hospital.
B. Irene c, Mendelsohn, M.S.
6. LI flT OF I'HO'I'OGHAPHfll
Estimate from Jlaillh Auto Uody of Cariele, Pa. detailinq
estimate of damage to plaintiff's vehicle.
Medical records from Carisle Hospital pertaining to the
plaintiff.
Medical records from Dr. uruaw pertaining to the
plaintiff.
ReCOl"ds from Alexander Sprinq Hehab pertaininIJ to the
plaintiff.
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No. ...!~..:..~!~~_.~.i.Yi.t.. 1.'1 em
....................................
Clyde B. DeHart. Jr.
'"
Horst Hilk Transfer, Inc..
IInd Kenneth Kim Kelby
~_.......-~-----~._._----_..........
8WlU110111 In
............~vJl1.~aut........_..
Jllmes D. Plower, Jr., Esq.
11 Bllet High Rtreat
Cllrlisle. P^ 17013
(717) 243-5513
I. D. '27742
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o:\"",I'jt\MIrI_ f\Io, ...9-91-01
CLYDE E. DIHART, JR.,
PI,lntl"
IN THe COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION. LAW
NO. 84.3388 CIVIL TERM
JURY TRIAL DEMANDED
v.
HORST MilK TRANSFER, INC.,
.nd KENNETH KIM KELBY,
Delend.nt
COMPI.AI.NI
COUNT I . PLAINTIFF v. KENNETH KIM KELBY
1. Plaintiff Is Clyde E, DeHart, Jr., an adult Individual, rasldlng at 393 Sherwood Drive,
Carlllle, Cumberland County, Pennsylvania 17013.
2. Delendant Kenneth Kim Kelby Is an adult Individual I residing all0471 Buchanan Trail,
Waynelboro, Franklin County, Pennsylvania 17268.
3, Delendant Horsl Milk Transler, Inc. Is a corporation wllh offices al 1050 Florida
Avenue, Hagerstown, Maryland 21740.
4. On or aboul June 23, 1993, al or aboul3:08 p,m., Plaintiff was operating a 1993 Ford
motor vehicle northbound on U.S. Aoule 11 In Middlesex Township, Cumberland County,
Pennsylvania, and was slopped In a line ollralflc In Ihe lelt-hand lane allhe Intersection 01 U.S.
Roula 11 wllh Clinton Drive to Ihe north and Narth Middlesex Aoad to tho south.
5. AI the aloresald time, lheoa Verow, al1829 Rldgevlew Drive, Carllsle, Pennsylvania,
was operaling a motor vehicle that was stationary Immedlalely behind Plalntlll's motor vehicle.
6. At the same time, Kenneth Kim Kelby was operating a 1986 Freight Une Truck
northbound on U.S, Route 11 behind Plalnllll's vehicle and Ihe Verow vehlcla approaching the
alorelald Intersection,
c:\wpll~_ 11Io'.""'1-01
7, Def.ndant K.nn.th Klm K.lbV allow.d th. front of hi. motor v.hlcl. to .trlke the rear
of the Verow motor vehicle, driving the Verow v.hlcl. Into the rear of Plalntlff'l vehicle.
S, Th. 101. caule of the accident In queltlon wal the negligent oper.tlon of the mator
vehicle driven by Defendant Kenneth Kim Kelby In the following rellpectl:
a) operating hili vehicle at an excessive speed under the circumstances;
b) failing to operate his vehicle In such a mantler as to be able to stop within the
assured clear dlslance ahead;
c) following the vehicle driven by Theall E. Verow too closely;
d) failing to maintain proper contral of his vehicle;
e) failing to operate his vehicle in an allentlve end careful manner, and failing to
carefully observe the vehicle ahead;
f) operating hll vehicle without due regard to lIs size and welght, the momentum of
the vehicle when In motion I and the extent of the deltructlon which It could cauls
In a colllllon with smaller vehicles.
9. AI a result of the accident In question, Plaintiff suffered InJurlel to hll Iplne and/or
spinal cord, Ipeclflcally Including but not limited to, a disc hernlallon at the T-S level al wellal soft
tissue spralnl or strains In hll back and neck, which Injuries have In the past, and will continue In
the future. to cause him considerable pain, sulferlng, discomfort and Inconvenience.
10. As a relult of Plalnllff's InJuries, he has In the past, and will In the future, continue to
sustain substantial blllll for medical treatment of his Injuries.
11, All a rellult of the Injurlos which Plaintiff has suffered, he Is permanently dlllabled from
his prevloul employment al a dock workor, 81 wella. from other non.,edentary, end hal,uffered,
and will In the future Buffer, a reduced earning capacity and lOll of Income from unemployment I
fringe benefits and retirement benefits.
2
SHERIFF'S DEPARTMENT
157 LINCOlN WAY EAST, CHAMOEHSBURG, PENNSYLVANIA 17201 (717) 261,3877 ilK" 7 I'l91,
SIlERlFf SEfWICE
PROCESS RECEIPT, and AfFIDAVIT OF I1ETUI1N
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"I<,'1'IlONAS KLlNI':, HIlEIlIFF OF CUHIlEIlLANIJ COUNTY, CO\lIlT~!J\lSE, CAIlLlSLE. PA 17013
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CLYDE E, DeHART, JR.
Plalnllff,
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION. LAW
VS.
HORST MILK TRANSFER, INC"
and KENNETH KIM KELBY,
Defendants.
I .1 . 1 1
NO. (- tl -- ~ 3 'I " (( (H...i'.,HA h./
JURY TRIAL DEMANDED
flWUfSI.FJln~ES.J)tiIAIfMfNlli
TO: TO: HORST MILK TRANSFER, INe,
1050 FLORIDA AVENUE
HAGERSTOWN, MARYLAND 21740
KENNETH KIM KELBY
10471 BUCHANAN TRAIL
WAYNESBORO, PENNSYLVANIA 1726B
Plaintiff requests prompt receipt, at the offices of the undersigned, of a photostallc
copy or like reproduction of any statement concerning this actIon or Its subject matter previously
made by Defendants or any other party or witness, In accordance with Pa, R.C.P. 64003.4.
Please consider this to be a conllnulng request In accordance with Pa, ftC.P, 64007.4.
FLOWER, MORGENTliAL, FLOWER & LINDSAY
A"orneys for Plaintiffs
,
BV , i~i.;; ~;:l~l;,: JtiWu:~ ()'
\ . 11 East High Street
I Carllsle, PA 17013
(717) 243.5513
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FRAIlIILIH 00. 611ERIFF
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CLYDE E, DeHART, JR.
Plaintiff,
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. (/tJ -- 33 'Ii (utU!. l.:lll,-"
JURY TRIAL DEMANDED
VS.
HORST MILK TRANSFER, INC"
and KENNETH KIM KELBY,
Defendants.
REflllESLm
1'01 1I0RST MII.K TllANSI'lm, INC.
1050 n,onmA AVENlJE
IIAGI~RSl'OWN, MAIt\'LAND 217411
KENNln'u KIM KEUIY
104711lUCIIANAN THAlL
WAVNKSIIOHO, I'ENNS\'LVANIA 17268
This Heljuchl for Production of Documents concerns an accident which occurred on
or about June 23, 1993, at or neur Ihe intersection of Iloute II North and Clinton Drive, Middlesex
Townshipl in lumhelland Coonly, PenlH.ylvunia, invnlving thc purtics abovc numcd.
I'I.EASE TAKE NOTICE TIIAT pursuant to puReI'. 411119, you ure reljuired to
furnish ut our ofl'ice,on or hdol!' forty-five (4~) days after service hercof, a photostutlc copy or ilkI'
reprmJuCllon of the lIluterials l'Olll'!'lIling Ihls lll'tion or its suhject mutter which are in your
possession, cUlillldy UI wnl/olund whkh ure not protected by the attorney/client privilege; or, in
the alternative, prudu~'e the suld matter at said time to permit inspectioll und copying thereof:
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County of Cumherland
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AUG 2 :11994
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CLYDE E. DeHART, JR,
Plaintiff,
VS,
IN THE OOURT OF COMMON PLEAS OF
CUMBERLAND COUNlY, PENNSYLVANIA
CIVIL AOTlON . LAW
HORST MILK TRANSFER, INC.,
and KENNETH KIM KELBY I
Defendants.
NO. 94.3399 CIVIL TERM
JURY TRIAL DEMANDED
1. Plaintiff filed a Praecipe for a Writ of Summons In this action on June 23,
1994, and requested that the Writ of Summons be served on Defendants by certified maU, along
with Plalntlff'a Requests for caples of statements, attached hereto as Exhibit 'A', and Request
for Production of Documents, attached hereto as Exhibit "B".
2. According to the return of the Cumberland County Sherlff, the Summons I
along with Requests for Caples of Statements and Requast for Production Documents was
servad upon Defendant I HORST MILK TRANSFER, INC., on June 27, 1994. Edward J.
Stolarski, Esquire, of 2005 Market Street, Suite 2030, Phlladelphla, Pennsylvania, 19103, entered
his appearance on behalf af HORST MILK TRANSFER, INC., on July 13, 1994, and a
Complaint was timely filed against both Defendants on August 9, 1994.
3. Approximately two months hava elapsed since the service of Plaintiff's
Request for Production of Documents and Request for Caples of Statements upon Defendant,
HORST MILK TRANSFER, INC.
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CIVIL ACTION
1. plaintiff, Ford Motor Credit Company, is a corporation duly
organized and exieting under the laws of the state of Delaware
with offices located ilt One American Hoad, Dearborn, Michigan
48122.
2. Defendant(a) Clyde E. Dehart, Jr. ia/are individual(a)
residing at the address(es) contained In the caption of the caae.
3. an or about February 22,1993 Dsfendant(s) (buyer) entered
into a written Automobile Retail Installment Contract
(hereinafter called the Contract) to purchase a "Vehicle" from a
doaler (creditor) as fully described in said contract, said
purchase to be made according to the terms, pricea and conditions
contained within the aforesaid contract, a true and correct copy
of said Contract being attached hereto, made a part hereof, and
Marked Exhibit "A".
4. "Creditor" subsequently assigned the aforesaid Contract to
Plaintiff, Ford Motor Credit company.
5. Subsequently, Defendant(s) did default upon the aforesaid
Contract by failing to make timely installment payment to
Plaintiff and in accordance therewith the entire remaining
balance became due and payable immediately.
6. The aforesaid Contract further provides that in the event of
default, Plaintiff may repossess the "Vehicle" and sell same in
accord with the terms of the aforesaid Contract.
7. The aforesaid Contract further provides that buyer agrees to
pay lawyers fees and legal costs permitted by law.
8. As a consequence of the foregoing, there is currently due and
owing to Plaintiff by the Defendant(s) the following sums:
BALANCE WilEN REPaSSESSED
Leasl Sale Proceeds
Physical Damage Insurance Premium Hefund
Credit Life Insurance Premium Refund
Acoidsnt & Health Insurance Premium Refund
Finance Charge Refund
ADD: Earned but Unpaid credit Charges
Unpaid Late Charges
Repoesession Expense
Balance Owing
Customer Payment a Heceived after
establishment of Deficiency
SUD TaTAL
Interost
Plus Attorney's fees at 20\
TOTAL DUE
$24,893.61
18,200.00
.00
.00
.00
1,436.54
742.03
22.38
969.54
$ 6,991.02
,00
. 6,991.02
. 419.46
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BOB BAISH ~UTO BODY PAINT " GLASS SHOP
1249 HOll Y PIKE, CARLISLE, PA., 17013
PHO'III~t.UU
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nAil ~~. MOil" ~DUV IIIIIA~ ND ~ICINII NO. MI~IAUI
9' ..:- '" 12.- :.)/,,7) 1(;/ >< ~j);" (.. KJ f'Tt:lilY Ur, PAY, ' H" /'11..11.;;, iN 7-,1 II, - .,
'''," HOVIII ~A'OIl 'AlIlI ftllftl FTINIT
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SUP TOTAL
LAIC R '-f-:{ <.JQ
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"-/ U'" .H'.... .., It ..""',... ..,,,. h., .... ''1&' ..,.. .,....... ""," ,.., ",... 'ARn 70.:.. ....y
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TAX "1<\ i!fj
IITIMATI IHEET TOTAL 19b h
-
'-1
. . ...
CLYDE E, DeHART. JR,
Plaintiff.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY. PENNSYLVANIA
CIVIL ACTION - LAW
NO. 94-3399 CIVIL TERM
JURY TRIAL DEMANDED
vs.
HORST MILK TRANSFER, INC.,
and KENNETH KIM KELBY,
Defendants.
f8AE.CleE
TO THE PROTHONOTARY:
Please mark this case settled and discontinued, and Issue a certificate to that
effect, reflecting the docket costs on the certificate,
FLOWER, MORGENTHAL, FLOWER & LINDSAY
Attorneys for the Plaintiff
1
James D. Flower, Jr., Esquire
I 11 East High Street
Carlisle, PA 17013
(717) 243-5513
1.0. #27742
APR /3 IU 114H '95
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