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HomeMy WebLinkAbout94-05887 IIAIUlII.uaG BOI.I'I'AL, .labUff v. I I I I I I I III '1'1. con'l' OP COIIIIOII fLU. CUU.RLAIID COUny, .....IYLVAIIlA CIVIL AC'I'IOII - LAW H....y J. LA'OR'I'., Defendant 110. COM P L A I N T AND NOW comes Plaintitf by and through it. attorney, Arthur A. Xusic, Esquire, and respectfully repre.ents the followinC): 1. Plaintiff, HARRISBURG HOSPITAL, is a hospital facility organized and existing under the laws of the commonwealth of Penneylvania located at South Front Street, Harrisburg, Dauphin County, Pennsylvania. 2. Defendant, HENRY J, LAPORTE, is an adult individual residinC) at 205 E. Clearview Drive, Camp Hill, Cumberland County, Pennsylvania. 3. On or about August 9, 1993 and from time to time ttlrough August 19, 1993, Defendant was admitted to Plaintiff '. facility for treatment. 4. Plaintiff in good faith provided the necessary medical eervices to Defendant, and thereafter billed the Defendant for thoee services and expenses incurred. As evidence whereof, copies of the billing for services rendered to the Defendant are attached hereto, made a part hereof and marked Exhibit "A". 5. Plaintiff's charge. for services rendered to the Defendant are its usual and customary charges. 6. Should the Defendant not be held liable for the necessary medical services provided, he would be unjustly enriched and the Plaintiff unjustly impoverished. 7. The Defendant is indebted to Plaintiff in the amount of Three Thousand Four Hundred and Forty-Five and 08/100 ($3,445.08) Dollars. 8. Demand has been made upon Defendant for prompt payment amount due, which demand has gone unheeded. 9. Plaintiff avers that the amount due and owing does not exceed the jurisdictional amount requiring arbitration referral by local rule. WHEREFORE, Plaintiff prays your Honorable Court to enter Judgment in its favor and against Defendant in the amount of $3,445.08 along with interest at the rate of 6\ per annum and the costs of this proceeding. RESPECTFULLY SUBMITTED: DATED: /0/;0/'1-'1 ) , /~ ~)';:'~~) Arthur A. ~u.ie,lEequire 4201 Crume Mill Road Post Cffice Box 11585 Harrisburg, PA 11108 (717) 540-5610 Supreme Court No. 07207 Attorney for the Plaintiff TYI'I 01' .u, DISCH OUT'. -,-- -----_..___....h_._......_ .1JJ~lJ OATI 08,16,94 "I.UNQ "1"00 ----t--- -"+--'r--~-- 00,0008,16 -'-- N~_ , -_.~--- ""-'-:j' POI.ICV NO. ---- -1 ......!". "'10'0 VII NO VI. NO VII NO INIU"ANCI COVI.IUOI ~N9_ 0/0 5 --~- ---.. I , L L T o L HENRY J LAPORTE 205 EAST CLEARVIEW DR CAHPHILL PA 17011 GARHANS rn HARRISBURG HOSPITAL HARRISBURG. PA. 17101 717 - 782-3680 __J 1-1"11I ~ 08,09,931 2NO COV.~QI ~o CO\II"AQI r -'-'---r ..nINT ..wOUNT LAPORTE OI'C~""ON r' .00" N iO'l'.41" CM.ulGI --'.....,-- 60,50 44: 00 82, 50 121: 00 2' 00 , ------r-- 310: 00 , , .......,... , , 08,09 08;09 08'09 08;09 08'09 , ACCID REL HOSP VISIT 02 KNEE IMHOBILIZER- ED 02 ED VISIT II 02 KNEE 20 PHARKACY-EMER DEPT 41 uu. 23-Ot71-330N , ......,... , 60,50 44: 00 82> 50 121; 00 2' 00 , -----r-- 3W 00 , .....~.. CHARGIS , , , ------r-- ------r-- ------r-- TOTAL , , .....~.. , , , , , , , , .......... -.- '. ...~ O"r;" .0. 11""'011 Ill. "'Ie 0 OU., you W'Ll. JIIIc IVI AOOI O~1. .I.LJNQ -.-.-- .J..___ ---!.....--.. --~~.- TOTALS. : : : L...___-J...___ --'~--I.____l.__,_~,-_____,,_ S.. ".v.r.. SId. I' You Hav. Hot Furnl.htd U. Your H.aHh Inauranc. In'ormatlon and/or Forma 7~~-3~~Q . ----~...~ .717.-: 'OfIIMfMM 1(111'" r~I' ilO"ITION "0'" YOu~ i11ICQiIIOIJ - - - 'OIr.eM "NO iIIir~~N rlo!IS ~o'-"r!o";' ''''';It~ ""f-Ma:/ljT- :::: ;": r ;t.,~:.,i;4e~:'~'O~;8::;ff 5 r .QJSq1,~,.q~,'~,"~1_-J IlARRI SI\JRG HOS' IT At I. Ql. c. .~,J'l ~~:29 I LAPORf[. ....K. CHICK' "AYAILI TO: __.--.1. , ii"C ."F""2tiii!t5IiL'J'. ., fq~~!~,& r' ~M_'1J_l.l~r. :~lQ. "-"--"~,,-,,-,,-,-, OIICIIlIIITION TOTA~ CHAlItGi 1ST COVIAAQI 2ND eOl/lMGI ~AO C:;OV'MGI ROOK K416 S 525: 00 QUICK TlIIE-PROTH 10 22: 50 PTT 10 22' 50 CBC AUTO DIFF STAT 10 30: 00 PTT STAT 10 2S' 00 PRO-TIKE STAT 10 2S: 00 BUN STAT 10 27' 00 , CREATllfINE STAT 10 34, 50 GLUCOSE STAT 10 27: 00 ORAL KIDS 40 16, 00 ORAL KIDS 40 2: 79 INJICTAlLI KED 41 146' 52 INJICTAlLI KED 41 5: 49 INJICTAlLI KED 41 29' 70 , IV A.DI'lINISTRATlON 80 43, 00 ANGIOSET SO 9: 00 CLINIC VISIT ROUTINE S6 44, 00 ROOK 11416 S 525: 00 P11 10 22' 50 PIT 10 22: 50 P11 10 22' 50 P11 10 22:50 SCHED DRUGS-FLOOR ST 40 7' 00 seHED DRUGS-FLOOR ST 40 21: 00 ORAL KiDS 40 2: 00 INJECTABLE KED 41 10, 9S INJECl'AlU liED 41 29: 70 INJECTABLE liED 41 29' 70 IV CONnOLLER-RENTAL 70 32: 50 SET UP CONnOLLER 70 17' 50 , IV SOL GENEUL 0931 70 45, 00 IVAC 60DRP 3706 70 5: 00 STEil. WATER 1000.'4003 70 6, 00 STU WATER 1000-4003 70 6' 00 , IV CONTIOII U-:IF.NTA.I __.'-_ IP !.Art CltIAPtclfl 1'011I SI"'Vtcn I I QNOlfllllO oecl.!.~J VOIJ WIL.l. TOTALS'" , "'CINI A00lT10~1. 1I1.L.INCi .. __.s.E.1- J.AGE..~ ---1 .__--......L See Reverae Side If You Have Not Furnlahed Ua Your Heahh Inauranee Information and/or Forma ..... OIl .u. DISCH INP. IINI'ITI AIO'o Vlt ... Vlt "0 5 OATI OS,17 08 :17 08'17 OS :17 08' 17 08 :17 08'17 I 08,17 08 :17 08, 17 08 :17 08' 17 08 :17 08 '17 08 :17 08 :17 08,17 08: IS OS'lS 08: IS 08' IS 08 :IS 08: IS 08 ,IS 08 'IS 08 IS 08 IS 08 IS 08 IS 08 IS 08 IS 08 IS 08 IS 08 :18 I IJdIIIM"H4A 00 00 00 IIWNCI OATI IIL.LINQ "111II00 .. : 16 :" ";00 c ~- -----"j '~~"'Cl OOVI"'G~. G".~~,~,,-,-. _._.~WOV 00 ._ GAP.HANS l..~i I I , t I HENRY J LAPORTE 205 E CLEARVIEW DR CANP HILL PA 17011 HARRISBURG HOSPITAL HARRISBURG, fA. 17101 717 - 7S2-36S0 T o L _I PlOOM NO. I.R.S. a3.ot7ll.330H ..nINT AMOUNT 525,00 22: 50 22' 50 30: 00 28' 00 2S: 00 27' 00 , 34, 5(1 27: 00 16, 00 2' 79 , 146' 52 5: 49 29' 70 , 43,00 9: 00 44,00 525: 00 22, 50 22: 50 22' 50 22: 50 7' 00 I 21, 00 2: 00 10, 98 29: 70 29' 70 32: 50 17' 50 , 45, 00 5: 00 6, 00 6' 00 , ~~,~~ NO KlIIPtfoll!l II0Pl'trON "Oil! VQUIII P111r:OIllOS - -oiT~c":; ANa llIiTG/llN rHIS ~O~IO"" WITM "-Ay'MIINT . - IIATIJtNt NAMIl If:::'~."~~ij~'::r=::F..6;'.T~_f.,'<l;<;.a.~JC'f~=~~r-~..~o."~ '>_n_'.__ ._'".---...-_.. -'r.--~~.~~t~a(9~~L'~" ---~--- AMQUN'I'.!,,!!Q,_ 1._" ,oo..., 'moo.____ __,___.___ I MAKE CHICKS 'AYAILI TO: TV" o,t ~u. DISCH INP, IINIJlT" A'O'D VII NO VII NO VII NO -f-'--'-'-- -. IIWNQ CATI IlLUNQ 111"100 08,16,94 OO~lOi(I6' ;..:.. ok-..; r;;; :~ GARHANS ~ ..~i l "0 5 i' t HENRY J LAPORTE t 20S E CLEARYIEW DR 6 CAIIP HILL PA 17011 L - ~"---'J--- lI01.ICY NO -~ .-- -- -- .---"-- I HARRISBURG HOSPITAL HARRISBURG, PA. 17101 717 - 782-3680 ..--J "O~ .o...~ 01.0_ "ale I.R.S. a3.oe75-330H LAPORTE HENRY J 11416-02. ~17,93 08,19,93 "AflINT OATI OIlCIIIII'TION fOrAl. CHAFlGI 1 ST COVIPlAG& 2ND COVIIll.AQI 3PtO COVIIllAGI AMOUNT , , ---, 08,18 HEAT THERAPY-RENTAL 70 7, SO , 7,50 08: 18 IRP CONSULT/STRAIGHT 85 83: 00 , 83: 00 08' 19 PTT 10 220 50 22' 50 08: 19 PTT 10 22: 50 22: 50 08' 19 PTT 10 22' 50 22' 50 08: 19 OUP EXT VEINS LIII 12 355: 00 355: 00 08' 19 INJECTABLE KED 41 29' 70 29' 70 , , , 08,19 IV CONTROLLER-RENTAL 70 32, 50 32. 50 08 :19 IV COITROLLER-RENTAL 70 32: 50 32: 50 08, 19 HEAT THERAPY-RENTAL 70 7, 50 7,50 08 :19 HEAT THERAPY-RENTAL 70 7: 50 7: 50 08'19 SET UP HEAT UNIT 70 44' 50 44' 50 08: 19 CONSULT FLU-BRIEF 85 42: 00 42: 00 08 '20 CBC 'ROP AUTO DIPP 10 24' SO 24' 50 I 24: 50 24: 50 08,20 CBC PROP AUTO DIP' 10 08: 19 PII DISCHARGE 00 S25' 00 , 525' 00 , , , ------r--- ------1'""-- ------r--- ------/'"'-- ------,..-- TOtAL CHARGES 3135: 08 , , 3135: 08 , , I ......... .--....... .......... ....--... ......... III LA'. Cl'lAfIIGI. lIOfllll""'CIUI "1'01"10 000"", YO" WILl. 1II1ollVI AOL'lITlONAI. .II..WNG --------.. .-_.._~ ._.~---------!...---..-.. , TOTALS'" ' _.sE.t..LAS .I'AGf...,.._ ,_".... ..__.L..,. ..___..,..L...._,_ S.. R.v.ra. Sid. It You Hav. Not Furnlah.d Ua Your H.alth Inaurane. Information and/or Forma _.__...-'--__ __..--L.... , , I ~~l'Il~t NO I MAKI CHICKS '''V''IU TO: ~I!III' rHI~ "OATION "a~ vOulll ~IICaPlDS oliTACH "NO ~irrUAN fHI!I IfOfllnoN. WI'T'~ pA,-i""lIl1l;' .AI'.,,' "OJ; li:,o",,""..OA,i(' r~O.M.'IS.. ~'CNiii,Av......ii;.:a...'.r~~:-:-~::'~--'~r'~~J:N';:.fl,i!..-: 1 t,' Q!(~~~~!l.~-$A"('. -. ,. ---.p-.. "_-.~~~gli~!j~IQ.~-'j' , , +--.-...-- .-. ... ..... '.-..--.-~..--.,..---.- 110MI' .,...A , . j'.' u~' '. ,..;.' "~ ~ .. .;. 0 ;;' :1' - " .'~' - 0 - - ,'....: - c o __i." -':,., .-: ... ~ " -; I~ i-;'- ,,' "',' E';:'~ :. '_:~ ..~ ,. ,.'- 7 ,~:: r.-. ~ I I " ~ ;.; ~'I , I, , ~~':T ,i. _ ," ,,"_",~' ;t.. CO'~i~ ~..r:~T~,.o 'r': ,.I' . '.:,.11 .'f"- PRAECIPE FOR WRJ'f OF EXECUTION - (MONEY JUDGMENTS) P,R.C.P. 3101 10 3J.t9 ElC. ' IN THE COURT OF COM~fON PLEAS OF .~.~.~~ .1.~.~.~~9...I!~~~.~:~M'.J....... CIJMSERL.~ND COUNTY. PENNSYLVANIA () PLAINTIF.' ... Writ So. ..........._........................__............ T~nn. 19............. 94-5887 94 No. ....--............._.... ......._......................... Term, .,........._.. .~",Il duo -..-.._._... , .~.d.~.~:.9.L... In...... lrom .~L~~-!m!!.]9LUt'..\._~J.11.SD ......................................... ........................... HENRY J, LAPORTE ................... ........ ................,..._-..... -.. .......... 1 ....tt.y'. Com. -...............--.........................--.................-.... .~!l.~.~!!~~~.:.............._........... Co... ...__......._..., _........._.._.......... T.1llo '~ry oIl1id CoUll' ISSUE WRIT 0' IXECI.'TION IN TIlE ABOVE MATI'IR. (I) 01....... 10 IlIO Ih.rill 01 .~~...........Cou",y. P.nna.; (I) .......1 ....~!!'.~.~..~:...~.'!p.~!".~.~........ ..... ................. .. .... ........ .............. (I) .... ...w, ........................................................._.............. Oam/"'n (0) : ..,............ ....... .......................-... .......-........- ""'''''' DoI.ndo.. (.) : (t) .... ~ .=..~.. ....~!!!I.!".L~:...~.'!P.9.!". ~J!... ""'" .__ "_""" _ .__. '. ._................. -............. ..........-........-.. ....-........................ Dolmelonl (0) .nd (') opIBlI ................_..._............ ,..... ...._....... _ _.......... _.. '''' .............. . ......... ............... .......-.....-... ......... ......-... ... .-.... O.m/"'.. (.). ......... opWIIlIO,..I,.....IIyol II,. d.l.adan. (.) la IlIO a....., ,h. O.,ai.hn (.) ..1.110...: (-'p..m.ally ...... ,..,.ny) Pleae. levy on all personal property located at 205 E, Clearview Drive, Camp Hill, Cumberland County, PA 17011. --.- - .,- ,/ /', /) C') Iua(tlloa IIOoCIIOI) .... WIlwol / .....'" " . , /,/' ........................................-.. '.?i~-.._.~_(-:~ ' (' ""....y for 'iIll') Arthur A. Kusic, Esquire Norl ..:::: ::t:'e~~ IIIe WrilI.I d........ .. Ill. _11I01 ,.0Ul.. '0Ul\1~ .. .u....1.I14 '" II.... JIOGC'l. tr..l.. ""NCI) · ..11....14 .. . lr_nl4!u d.....I...~ .. dl...lOd onl~ Ia 1lI.1II..1J1 ., Ill. _~ .. ..,..,.,..... .......... '" alloYa IIIoldd" ....~ oaJ~ II. .....d "'.111I.. I.lIa .. Inollld.d la Ill. ..Il ~'~f It'I_~"-.-O!II7I1Iao1"'Ia'''''. ....ulIo. ...1/1......17 .,_-.." -..... Ib I HC.,. . II. ",11 .... Ia .. .tIln .....17 laollJda. ,. 'lqU.d .. of _.. iii WI ....., Ill.". _II",. 'If .... Jllf'.,. -.....1.) (,,) 11I0"'4" tomDJ'I~ oaJ:r II...' 'lOlI""" h. "'. nlm, 0' ~ '"dJ.h... f. ........ Incl..."... ".. ,"4.1,. it"" ""Of F.. ....<I,......t ..... If,,f..1flf..,,., .. i .. I , ""< - I I .:!. , ~~ , t: .' , J - I od , 1 . G.I I- I 0: . I I 1<1< - C'l ~I , . I".Q Q - - , , !f I i: . I ~ ~ ~ 1 , " .! 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Ii ~;~\'!'~~ 1/" 'if r,...:?,' .~.1 r:>-~1, "'?cl' "1~:.;,.....~".... ,'~ .~".4;~" .' - ,,~,,~,.Ll.."'.J. ... t,., ....'''.. .-- ,.:) ;.\.... ,. ,~ . t'.. ',.. -','" .J . R. THOMAS KLINE Sheriff HORACE A., JOHNSON Sollollor OFFICE OF THE SHERIFF Court House Carlisle. Pennsylvania 17013 November 27. 1995 ~ ;:?, I t.\ 1\ -:. ~l t';..r4 tjl.-~: ,..~t.) '- ; -;(') ..--<f<r) _'"c_: -. ~ -... Harrisburg Hospital vs. Henry J. Laporte No. 94-5887 Civil Term Property Claim Determination ,/ Dear Sir: Reference is made to Property Claim dated November 27. 1995. entered by Geraldine L. Purdue and pertaining to Writ of Execution No. 94-58&7 Civil Tenn. Harrisburg Hospital vs. Henry Laporte. Sheriff R. Thomas Kline. has determined that the claimant Geraldine L. Purdue in the above mlentioned property claim is prima facie the owner o(the property set forth therei1't. So Answers: r"~::-~ ~t' R. Thomas Kline. Sheriff By M,;;~- d./-.#- Deputy Sheriff cc: Arthur Kusic atty pllf lIenry Laporte deft Kent H. Patterson ally for c1aimanl RONNY R. ANDERSON Chle' Depul1 AUDREY O. ADAMS Reel Elle.e Depul1 ,,(') ~ (Jl ~ ml rTl ,"1 I ~ -.J .., 6 :;.; ~ .(' ~ (J' ~ r-.) -' " .r.- '..J In the Court of co.-on .1.... of Cumb.r1.nd county, ..nnay1vani. Writ No. 5887 CIVIL 1"4 .1O.lan CLAIM ua'.I.BURG HOBPITAL ~ Pl.intiff v.. ~NIlY J, LAPORTE D.f.nd.nt TO THI BHIRIrr or CUKBIRLAND COUNTY, 'INNA, The property li.t.d b.low .nd 1.vied upon in thi. c... i. not the prop.rty of the d.fend.nt but i. the property of the und.r.igned. A li.t of the cl.i..d prop.rty .nd the valu.. th.r.of. .r.: LIlT or PROPIRn VALUI VALUE La KI'l'C1DN ct on. Bofa 40 Ut.n.U. Pot. 10 0 .. Ind Tabl.. 5 , .an. ~c~ rurnitur. lfi Iron , Ironinq 2 20 Board trror. 8 R.frigerator 10 .k 20 Electric Stove 5 r~a (buUt in) tra.her , 50 10 Dryer I f. 30 Toa.t.r 5 C~.ira 8 De. Gr.ndf.th.r Clock 200 BIDROOII 1 Dr....r , Bur.au 50 DiNING IlOCIIl $5 ~bl. . Chair. VAWI BIDROOII 2 Dr....r , Bur..u GA.~I H.n Tool. l' "IICILLAlllOUII sw..p.r 8 All oth.r it.m. .t 205 la.t Cl.arvi.w Drive ar. prop.rty of Claim.nt .xc.pt a. .ter.o, drum ..t, Ford F190, t.1.vi.ion, microw.v. and bicycl.. Th. Claim.nt Obt.in.d Titl. to the Prop.rty .. Follow.: Rich.rd w, Crum i. Admini.trator of the latat. of Ro.. I. Crum, Jr.. d.c....d. h.ving b..n qranted Lett.r. of Admini.tr.tion by the R.qi.t.r of !Jll. of CuMber1.nd County, docketed at No, 373 of 1995. Prior to hi. d..th. d.e.dent acquir.d the furni.hinq. .nd other item. l.vi.d upon in thi. c... while living at the r..idence at 205 Za.t C1e.rvie.., Driv., H.mpd'n Town.hip. Cuab.r1.nd County, PennaYlvania. Th. property li.t.d on thi. Prop.rty C1.im .r. ....t. of the e.tat., )L(,;:)'/O: 1/ ('I.- /// CLAIMANT P. '..~~ ~ _ ~ W. Crulll, Adllinl.u.tor 1/0 Ro.. I. Crum, Jr. 101 Lanc..t.r Boul.vard Mech.nicaburg, 'A 1'055 being duly .worn .ccordin, D.t. l/J~/~ /?~ Co-.onw..l th~:. ~?..y::ani. County of cJ/. to l.w, d.po.e. .nd ..y that the above liat in the property clailll .r. corr.ct and true, lworn and aub.cribed to before me thi. d.y of 1995 /) ~.L' AI... . I, u.. __' ~;(fL--- Clai_nt AL 51At. f"I~IUIOM.. I.UNGA. lIoury 'u~lt( Ml ~~l.to,.n U, o.,.Ol\ln trJ'.n~, '/ r.~mml UIOM I,Ol.'U M'!1 I, t1'lij