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HomeMy WebLinkAbout95-04211 ~ ~ ~ ~ I ~ " ~ ~ . ~ J - - ~ ~ 1 ,\1 \~ ~ %: ~ Q.: ~ ~ d tx, & ", ~ Ul~ rn <' ~ "I:: p:--:-, - ll.t3 '+' " \' 0 <5 ~ ~ ,8 \... 3' ~ (J) l1i U '\'Y.j -f.. -- ~--. ~ ~'~ -~ I,""; k, ~ / " \ ! I ...L" \ ' \~~ ~ 'Y'\ M 1'-...::;-. .........." ."f'\ ~ ...." ,,--; \.;, r\ v. . "i ~!:: - ~........- '--~' '0 .1 t I ~~ , ~ll: j ,~ :> .. .. ... , ...... .:::~'~.~ I>~.." '.(1)..,",. PI... . J.,_",.\,),.."".. .. .. . U 8 p.; E , < a3.:i~ 5 ~ ~ ~~ H :p.~~~! ctl~zeo~: a~g~p.;~ Q '" II III !!l ~ " ~ ~ , ... .. .... " . .. ,/ . .' \.i~ u- ' '-<'1/ () .... ~ .1 H F" ALISON J. KOTZMOYER, A MINOR CHILD, BY HER FATHER AND NATURAL GUARDIAN, HARRY KOTZMOYER IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY PENNSYLVANIA NO, r:~j 4) (/ (Ii tl~ ~ "Jt L1-"'- PLAINTIFF V. CHARLES F. RATCLIFFE JR. DEFENDANT : CIVIL ACTION - LAW AND NOW, this /1"1 \ ') day ORDER ,-- T\ \,)\ of 1i\.~\J , 1995, on consideration of the foregoing petition, it is ORDERED that the settlement in compromise of this action for the gross sum of $12,000,00 is approved. Counsel fees and expenses are also approved as set forth below, This dietribution is directed as follows: 1. To be paid to Petitioner, Harry Kotzmoyer, guardian of minor/Plaintiff and to be placed in an insured savings account, to be marked "Not to be withdrawn until minor/Plaintiff reaches her majority, or without the Order of a Court of competent juriediction" the sum of $8,630,00. 2. To Richard S, Friedman, Esquire and Friedman & Friedman, PC for counsel fees, the sum of $3,000,00. 3. To Friedman & Friedman, PC for coets as set forth in the Petition, the sum of $370,00, By the Court: lfcl,~\\ ~ ,K{~ /' ,.//'..- J. pleading\kotzmoyer,or ALISON J, KOTZMOYER, A MINOR CHILD, BY HER FATHER AND NATURAL GUARDIAN, HARRY KOTZMOYER I IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY PENNSYLVANIA PLAINTIFF NO'95_ '1-,,// ~'y,"L V, CHARLES F. RATCLIFFE JR. DEFENDANT CIVIL ACTION - LAW ORDER AND NOW, this ~ day ofAu'a~~995, on consideration of the foregoing Petition, it is hereby ORDERED that a hearing be held in the above matter before the Honorable #A~/d L SAu.J~ Judge, on the I~ay ofA~d-1995 at 3 ; {)() /l.rn., in Court Room~ of the Cumberland county Courthouee. By the Court: )J (-w! I~ J1: J. , 55. n' Lr: '] 01 :~; gS ,I ~)~~ (fX ,J,'-RcP- .. Q5l)tr'\) j\UJ1' A I ALISON J. KOTZMOYER, A MINOR CHILD, BY HER FATHER AND NATURAL GUARDIAN, HARRY KOTZMOYER : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY PENNSYLVANIA PLAINTIFF : NO, : : V, CHARLES F, RATCLIFFE JR. DEFENDANT CIVIL ACTION - LAW PETITION FOR LEAVE TO COMPROMISE MINOR'S ACTION AND NOW COMES the Petitioner, Harry Kotzmoyer, the parent and natural guardian of the minor child, Alison J. Kotzmoyer, by his attorney, Richard S. Friedman, Esquire, of Friedman & Friedman, PC, and petitions this Court to enter an Order permitting settlement in compromise of this action and in support avers the following: 1, Harry Kotzmoyer is the parent and natural guardian of the minor child/Plaintiff, Alison J. Kotzmoyer, who was born on December 2, 1977 and who is preeently 17 years of age. 2. Minor/Plaintiff was injured on October 18, 1994 on State Route 83 South in Lemoyne Borough, Cumberland County, when she was eouthbound on eaid highway and was obliged to corne to a full stop because of traffic conditione, at which time a second car driven by Guyles Whitney and travelling immediately behind minor/Plaintiff likewise carne to a stop, but was thereafter forcibly struck in the rear by a vehicle driven by Defendant, Charles F, Ratcliffe Jr" thus puehing the Whitney vehicle forcibly into the vehicle driven by minor/Plaintiff. J Minor/Plaintiff was injured as a result of the accident with Defendant. 3. The injuriee suetained by Minor/Plaintiff were cervical strain, swelling of many of the musclee in the shoulders and thoracic area, bilateral arm pain, lumbar strain, and muscle contraction type headaches created by a cervical myofaecial injury. Minor/Plaintiff had been recovering well from said injuries when she was re-injured in an incident on January 28, 1995, which is not the subject of this Petition and which incident forms a second action, stopping the damages of the accident which is the subject of this Petition. 4. Petitioner has incurred the following medical expenses for treatment of the minor/Plaintiff: Dr. Richard Seldow Dr. Emily Matlin Pennsylvania MRI Associates Osteopathic Hospital $1,707.00 $ 360.00 $ 992.00 $ 266.75 $3,325.75 TOTAL All bills were paid by the first party carrier for minor/Plaintiff, 5, Counsel, Richard S. Friedman, Esquire, was retained by the Petitioner to represent the minor/Plaintiff on a contingency basis. A copy of the fee agreement is attached ae Exhibit A. Upon settlement of the personal injury action of minor/Plaintiff, counsel, Richard S. Friedman, Esquire, unilaterally offered to reduce his fee from 33 1/3% ae set forth in Exhibit A to 25%, which offer was accepted by Petitioner. Counsel therefore seeks approval of counsel fees in the amount of $3,000.00, ........ -.". - -- A , In prosecuting this action on behalf of minor/plaintiff, counsel has incurred the following expenseel Commonwealth of Pennaylvania Richard M. Seldow, MD Emily W. Matlin, DO Tristan Aesociatee Lower Allen Township Emily W. Matlin, DO pennCorp Service Group, Inc, Filing of within Petition TOTAL $ 8,00 $175.00 $ 75.00 $ 20.00 $ 5,00 $ 25,00 $ 16.50 $ 45.50 $370,00 6, Petitioner and counsel seek approval of the settlement on behalf of minor/Plaintiff in the amount of $12,000.00 negotiated with Defendant because they believe that it represents a full and fair settlement of the caee, equal to or greater than that which may be obtained should the matter be fully litigated. No issue of liability was raised by Defendant. Minor/Plaintiff had substantially recovered from her injuries by the date of her second trauma, to wit, January 28, 1995. 7, Petitioner approves the proposed settlement because he considers it fair and reasonable and it adequately compensates minor/Plaintiff for the injuriee eustained and expenses incurred. 8. Petitioner further approves the proposed distribution contained in the order form attached, 9, A copy of the medical reports of the treating physicians, Richard M, Seldow, DC and Emily W. Matlin, DO, as well as a copy of the report of Pennsylvania MRI Associates are attached and collectively marked Exhibit B. ... WHEREFORE Petitioner requests that this Court enter an Order approving the settlement and compromise allowing counsel fees and ordering distribution as set forth in the attached Order, ( ~ ;' (/t't 1: )1- "'--...... P ti~ne~~ry Kotzmoyer Respectfully submitted, .c-...- S. Friedman, Esquire 6 0 N. Second Street Penthouse Suite P.O. Box 984 Harrisburg, PA 17108 (717) 236-8000 pleading\kotzmoyer.pfl ~ VERIFICATION I, Harry Kotzmoyer, hereby acknowledge that I am the Petitioner in the within action; that I have read the foregoing Petition for Leave to Compromise Minor'e Action; and the facts contained therein are true and correct to the best of my knowledge, information and belief, I understand that false statements herein are made subject to the penalties of 18 Pa,C.S, S 4904, relating to unsworn falsification to authorities. {/~~ /\~ Harry tzmpyer ' ---..-- '- '.. -'- ( exhibit A , * --- .,_~.-o_'" \ I ! ''''/''-:'''b':~'':1C~1''''''t;!,-"~ft,~~~~,,t~_.~. . . ';~~~~~~1'\ltr~''-'',~T~'r~~rt:';~i!o''''i!~~~it!~rf1'11~~t~~i~~_j." ."".f '-.,..--.~.- i' 1 i1(~~~ . 'G) .~I~' II""" ""'.-'&'11""" ( POWER OF ATTORNEY AND CONTINGENT FEE AGREEMENT KNOW ALL MEN BY THESE PRESENTS, That I, Harry Kotzmoyer, father and natural guardian of Alison J, Kotzmoyer, acting on my daughter's behalf, do hereby retain Friedman & Friedman, P.C" of Harrisburg, Pennsylvania, as my daughter's attorneys to negotiate for an adjustment, or to institute for her and in her name or my name any legal actions or proceedings that in their judgment are necessary, in connection with her claim for damages as a result of injuries or damages sustained by her on october 18, 1994 in an auto accident. NOW THEREFORE, in consideration of the services so to be rendered by our said attorneys, Friedman & Friedman, I hereby covenant, promise and agree to pay to my said attorneys for their professional services rendered, thirty-three and one third percent (33 1/3%) of whatever sum is recovered, whether from the party responsible for my daughter's damages, his insurance carrier, or any other third party carrier, if the case settles or forty percent (40%) if it is necessary to institute legal proceedings, I further agree to be responsible for all costs advanced by Friedman and Friedman, P,C, on my daughter's behalf. I understand that my attorneys will secure reports from all my daughter's medical providers, as well as a copy of the accident report if applicable, and that the majority of medical providers charge fees for written reports and/or copies of medical records. These fees will be payable by me at the time of settlement of our accident case or at such time as it becomes necessary to institute legal proceedings. I will also be responsible for costs of proceeding in court if applicable, such costs to include filing fees and costs of service by Sheriff or private process server, In the event no recovery is made, or in the event I substitute attorneys prior to completion of the accident case, I agree to pay for all costs upon presentment of a bill. This Contingent Fee Agreement and Power of Attorney has been read, approved and understood by me and the receipt of a copy thereof acknowledged. The terms set forth are agreeable, f'~ ~ ( IN WITNESS WHEREOF, I have hereunto set my hand and seal this day of October, 1994, I~ ^,,,^,, !k accidwil:kotzmoye.fee '" I Exhibit B -'.' ,---- -c-- , ;. --.. *.. O~ .".,. ...... , v L, I October I ~, 199~ REI ALISON KOTZMOYER HISTOleY AND I:XAMINATIDN AII.on Willi Involvlld In I motor vehicle Iccldent on 10/18/94 et 2115 In the Ifternoon. She wa. the drlvlr of II vehicle proceeding Bouth on Rt. B3 It the York Ipllt with 581. There woe In accident In the rlaht lene and trlffle wn diverted Into the left 18no. A car cut In f..ont of hera end .toppad and then procaeded on, She .Iammed on her brakes to ml.. the clr thet Will cutting hiI' off Ind the person behind hcr hit hll brakel and litopped In I eufflclent dlatlnce not to Impact her car, howDver, the car behind that hit ttnl ellr behind here which Impaotod hor car, Sht> wall wearing D seat bolt. Sh.. felt hilI' nllck hit tho headrest, but not her "p.nd, Immedlatelv upon impact, she W8I thrown beck ward, forward and then bDckwlrd Bgllln. Aftor thl Iccldent, Ihe felt bacK pilln throughout her onUre blck. She donl'l any 1011 of ~on8clou&ncss. Sho wall eble to move ull body plrte. A police report wall medo, ShA had 8 very reallou 11m. t"Vlng to IIle.p le.t night Ind today she hlls headache, back pain In bl.th tho uppor and IowaI' baCk,: She also mentions that as soon III sne stopped, her bock left the seat beck and she wos forwurd of the le.t whcn Impact occurred, Therefore, there wal II doublo Impact pa.terlorly ',Ith her bock hlttlnO the .~pt and riding uj) tile eBet lInd then her neck "vper"xtendlnll over the headrest, She donies Iny plln In the low.,r extremities, however, hila .walllng and IIchlllg In the 11'011 of her prior eplnel frocture at approxlmetely l.3, She Coon fool pelpabl. .welllng In the erlll as well as spasm, She Is unllware of any particular motion which hurts it more becauso she hasn't moved much since tho accident. There II IncreBsed pressure liven with breathing deeply. There 111'. no ...dlot1ona Into tho lower 8xtremlllAli from this. The .copulllr 111"" or. al.o very pelnful. This includoli the medial Ilcapular region as well as the scapular areas end superollcllpular reglone, She hasn't moved this arll much Ilnce the eccldent 50 ~he 18 unowpre of any pain which may be caused by mot/on, She mEontlona peln In tho lntoral aspect of the orm to tho olbow end then thft medial i1spect of the llrm oil the way down to the lateral aspect of the hand, Shc hilS tho limo pein on the right OS the left, howftver, It is more Intonse on the loft, There are no paIns beyond the wrlllts Into the hllnd,. 5ho h:ls Intonl. pain In the area of the right pOlterlor cervlclll region, Sho also has pain in thc "ntorior ncck In the arell of thc llttachmente In the upper chcst wall of the scolenos, She hasn't movlld her neck becauso of the poln, She IItates thot It f..oll lomewnat boltar when ~he lies down. howcver, sho still h811 poln and was unable to sleep htllt night becauso of potn. Her Borg Pain Scale Is filled out ancJ sho ratlll hel' pain III .. 9, 'the Rlinsford Pitln Drowlng find' dull echo In th" back of her head, She h.1 pins and noodles In tha Icapular re~lons bilaterally al well 09 lltabbing end burning In the cervlcothoraclc Junction lInd the upper lumbar regIon. Therc Is also numbnllu In the enterlor lower up pCI' itrm r..glon bllllto....llv, Examlnotlon finds a Ceu"R~lan fpOInill who Is 69" tell end welgha 160 ., I ~ I \..... ~ Paga 2 REI ALISON KOTZMOYIlR HISTORY AND eXAMINAIION CONTINUt:O 10/1."4 Blood prcnure 10 11O/02mm of me..cu..y In tho ..Ight Il..m ea.tod. Pulao "lite 10 !5 beoll pe.. mlnuto, C..o.. tondon ...f111xeo e' the bl..opo, t..lcepl. brachial "adlalll, patella and Achilles ar.. all ralnd 00 Z'/4 IInd equal bUaterally. "on .Iltlng Iltl'Oloht 'ell "0110 l:IIUIOIl pain lit L.3, Th.... II IlIght weakness of the extonlor hDllucls longus on full hip f1elllon and lhere I. 01.0 minima' weakno.. o( Iho flexorl 0' the toel on the loft. Thoro II a q-/5 woaknoclI ef tho Ian quod..lc.pl, howovo.., thlt hamst..lnga and hip flJxors are normal. The .eme tOil on the right ere negative, Pin p"lck exam to tho Iowa.. Clxtreml"oo ,. normal. Thoro 10 a po.IUvo at..alght lag ..01110 on tho len at abollt eOD with . vo..y IIt..ona'y posItIve Dowltrlng'. Msneuver. Onnslen's Manauve.. CIIU." L3 pllln .1 wall. Fabo..e Pat..ick'. Tellt caue.. pDln In tho bllck at LIon tho loft o. woll, St..olght 1110 rlllae on the right lit 20. cause I L3 pain which Is not relieved by knee flaxlun, Oaon.len'l Maneuve.. ond Fobe..e Patrick'" T08t on the right a..o nogltlv., Thoro 15 mo..kud pain on palpatllln of t"O spinous procell 0' L3, The,.e III phYllcel swelling o..ound thllt region. There In Inc..eased plln on palplltlon of the ..Ight ca..alumba,.s. howevor. thoro 15 .p..m throug"llut tho pll..elumbar .....gl"n bl 1lt...III1V. The..p Is also marked pain on palpetlon or the ..I~ht PSIS, L.umb.r nn!lcI of motion rind rlexlon to 300, eKtenllun t. 10, ..Ight Ilte..ol flcK'on 10 60, left lot...al f1oKlon I, qo, right rotltlon II 80, loft ..otfttlrm Is lUo, llllate..al Kemp'. Sign Cause. pain Ilt 1.3. Toe walk Bnd hvel w..lk ..... perfo..med adoqualely, Palpation or the ..Igk( ocopul... ..eglon rlnde ma..ked aw.lllnO 0' tho ..h"""bold mlno.. and the rhomboid malar II wall us Vlllbla Ilnd palpllble ~w"llIng of the Io:vlltor IClpullr, The..e 10 1100 algnlflcent swelling of tho In(....plnatu5. All of th... ..oglons are oqullly plllnful to Il/llplltlon, There Is mll..ked pain on palpation at TB Ilnd 9 IPlnous proc:esSl:', There II also 10C:IUzed tluue swelling of the lOft tiOOUOD a..ound thot ...glon. Th.... I, loft t'uu. 5pasm 0' the uppe.. trap on the left and aenerally thrDUl1hout the medial IIC1lpulllr muselel on tho left. Thll Is not al .onlltlvc II. the Iwelllng and painful roglon. of tho ..Ight BCllpul... o..ea, Palpetlon of the ce..vical spine finds large mlues 0' swelllnl1 In the mid ce..vh:ol ..aglon anteriorly, lhe t..achal Is f..eely mov..ble end tho thyroid. palp.ta no..molly, howny...., the..e Is la..o. ma..el of swelling beneath the thy..oldl In the IrCII of the Icalllnes, These Ire exqulahely ten de.. to polpotlon, All of the aplnoul p..ocon", In tho co..vlca' ..oglon o..n tonde.. to palpatllln, how.vo~, C6 and 7 0..8 flxqulsltp,ly tender to palpotlon, Ce..vlcal ranges or motion flndl flexIon to 180, \:xtl:nalon I. qo with mo.t of It occur..lng In the uppe.. co..vlC:DI comploJ<, Right laterlll flulan 19 100. Left loteral flexion I, 50. Rloht cervical !'otetlon Is q50 IInd left ce..vlelll roh.tlon II Sq", Shoulder ranges o( motion o..e compl"te, however, cau.. ..ching, C..lp Ilt..ength a. mOllllu..od with D Jaymor Dynnmometllr Is 35" rIght ilnd 26" Inrt, plltlont I, right domln.nt. X-..ave were t.ken of tho ILlmbllr spine InCludIng AP, laterlll IInd lotornl SPOt, tho..aclc .plna Including AP Dnd 18tarol end ce..vlcal view., Aft... thelo arc revlewod, I dl.cull5od th.. "Ignlflcllne" of tno .....ults of Alison's 'n)u,,'es with hath Alllon IInd he.. 'alher, I IIlau prl:5c..lbl:d D cou..se of treotml:llt conal'ting of lupport end Ice fo.. 72 hOI..... Sho I.. tll keep thlt ~ -- . u ~ I I I I I I Plloe 3 AE: AI.ISON KOT1MOVER HISTORY AND EXAMINATION CONTINUED. 10/19/'" lupport on uxcept when Ihe Is Ileeplng, The support II e loft cerylcal collar, She II to Ice her neck both onte,.lorly and posteriorly while she Is awoko. She I, put on . 10' IIfllno IImll IInd II not \0 tak.. Phy Ed for two Wilko, On Frldoy, we will begin plcslv. ,..ngo of motion \0 beoln to ol'Ollnlle the extravII.ted tlnues In her neck. Addltlonolly. we will u.e po,itlye HVeS. Then. btl ullng paulve rellltlve ond Ihen Ictlve exercl'e and active resistive. She will also be using e)(crclles at home for hel' baCk liS hilI' condition warrant., RMS/cml OCT 2 1 1994 Alllon Is no better, This II not at all lurprl,lng. She Is treated today with po,'Uve IIVOS ond poulYI rango of mGtlon eXlrclsos, I then In&tl'ueted her '.thAr In the prop.,. method of pClrformlng passive rMge of motion exerclsol It home and give them strategies for thll. I 1m Instructing them to continue Icing her neCk for ten mlnutOI out Of each hour and to perform paulye range of motion three times II day wIth fillo I'...potltlons pOI' I.t, If they h811e anv problems or question., they are to call me Immediately. RMS/cml OCT 2 4 1994 Alison" falher followed our Inlitruetlonll and applied lI;e to her nock and also did the panlve rongo of motion GUl'erlel 011 weekend. She Is feeling impl'ollAd today, We are removing her collar today and she Is to keep It with her in tase she has any ruumptlon of her Iymptoms, If she does, IIhe Is to put It blck on. She II treated tOday with liMP lInd mild manage to tho upper beck, neck pOltol'lol'ly and neck .nterlorly, Wodnolldoy, "'. will begin aetlve range of motion exercises using the coller. RMS/cml teru_ I om beginning Alicon on .ellve I'ehllbllllallvc elll'lrclses loday, These are thn NerklUS type using Ihe Necksus prooreullle rllhabllltatlon and resistance system. She Is going to do forward push, backWard pUBh. right IInd left lalerol pushes u~ln\1 the week..st rulslenco and utlllr.1nO her Cullar, She 10 to do thl. fol' flfteon ..eond~ In elle-h dll'ectlon using only minimal reslstRnee Rnd to rut between each set, Before this Ihe Is un liMP to relax her mUlcles, Today she Is treated with HMP and massage to the neck both antoriorly and posteriorly and tllen we went Into tne exercise room for th" Nuckllus progl'em, I domonstr"tlld thl' prooram for her end hOd her domonltl'HIA It for me, After I milde corl'lIctl'lns and dl~cuSSOd It with her I had her do ono SIt on hor Own, She soems to be quite comfortable with thl" We will be prO!}rlll&lng Into flexion both anteriorly ond posteriorly unll IlItt:ro!llly end rotation llnd then and up with puuurel corrClctlYl! exorel.OI. She will bA wearIng her Collar when she porCnl'ms thp. Initial set of exercises, RMS/ue ~ I I i I .. . . .... ''''''.~' ...J .V>J' r .IJCJ ~ ~ Page " RE: ALISON KOTZMOVER ~CT 2 . 1894 at' VO'/M4 We are beginning vel' V mild cervlcll mllnlpulatlon, She Is treated with P to A adJustm.nt of tho mid corvlool oplno whoro palpablo rllttr'ct'an I. neted, Afterwards, reltrlctlon I. leu, FollowIng thll, HMP ra applied and following thll she II performing her exercises. I observed her while Ihe Willi doing them end ahe leeml to hive them well under control. RMS/cml IV 0 4 199. AII50n II slightly Improved, HMP II admlnlatered IIgaln and aftor tnll Iha do.. hor prelcrlbod ",x"'rolle.. RMS/cml I~OY Ci 1 19Vt ~ MOV 0 9 lQQ4 ,. Alillon has noted development of headaches, ConcomItant with these ore pulna In the paracervlcal rogion end the letel'lll Olpoolo pnd Into tho upper chut. This Is conslstont with the Involvement of the IClllenes, She had Initial complaint of headllches with a component of antorlor scalene Involvement Inltlallv after the IIccldent which Will reported In aUI' chart notes at that lima, Since Sunday, .he ha. noticed thet thl. 1'101 worlened and, Indeod, she w..n't able to go to .r.hool either MondllV 01' TUlllday bRclluse of this, The neck pain Ind headaches dovelored slmultaneoully, She has been up all night IIlnce SUnday. Thev ore I' around the clock. She doesn't notice If they Ire effected by phVslcal exertion or position of her head or neck. Pain Increases with cou!lhlng or Gnooalng. There III'. no .ymptom. elCtendlng Into the shouldel's. al'ml or honds, There Is also Increased aching in the lower cervical and upper thoracic region, She Is ,Iso noticing an increase In blurring of hor vIsion. She had one episode 01 double Vision Which IlIIted a few $"cond., She denies any dysphnla, dysorthrlo or tlnnltull. Sho alao notlc:os II oeneral wftllknesl, She 1'111 difficulty standing for long periods. Cross tendon rotlexes of the biceps, triceps, brachial radlllli5, plltelle end Achillea arB all ratod 81 2+/q and equal bllatel'lIl1V, Grip "renght 118 mOOsul'ad with a JaV1ller Dynamometer Is qO ppound5 left and q3 pounds right, pationl Is right dominant. Pupll8 rllct normally to light .s well os nellr ond far vlson. Occulor motion Is normal. The 80ft plllete raises normallv and tho uvula III In the midline, Tongue pl'otl'ude. normallv, Her trops heve nOl'mll1 tone, Weber's Tese Is normal, Finger to nose test Is normal, Romberg Teat is normal 80 In tandom Ramberg, Toc wolk and haol wlllk .re "Iso norll1l1l. There II It III marked sposm of the neck flexors bilaterally all the WilY down to the Insertion in to the upper ribs, This Is even throughout the muscles and even bilaterally, She h8S slgnlllcant poln un polpatlon of lublul<otlons at Cq and C2 Ilnd I on the loft. Prossul'a on Ihllle causn. 1I10nlflcllnt IncrBllle In her poln. She II tllken into 0 treatment room ana HMP I, applied lu the anterior neck flexors, Atter the sa are romoved In ton mlnutn5, eh" 14 ndJultCtd for LPCS, LPCI Rnrf LPC2, After this, sho feols much more relaxed and 0 greatly incrl!8&cd rllnge of motion In her neck, Following thla, .ho Is given positive lives to the postol'lor artlculllr (Ql:ctl end the pOltel'lor I I I I I I I I I . I I I .::-......... ( ( Page 5 RE: ALISON KOTZMOYER 11/9/94 Con't. cervical region, Afterwards, nature of her headaches and be present, she Is being consultation, RMS/cml she does Ceel much better, Because of the to rule out any Intercranlal lesion which may referred to Dr, Matlin for neurological Nav I I 1994 Alison Is Ceellng significantly better than she was on Wednesday, She Is treated again with positive IIGVS and then does her exercise regime under my supervision and then I adjust her Cor LPC1, LPC2 and LPCS as well as anterior thoracic adjustment, RMS/cml NOV 1 4 1994 Alison Is Ceellng a bit beUer, She had one episode of dizziness on Sunday, but this Is only brleC and transient, She Is treated today with positive HVeS followed by LPC1, LPC2 and LPCS and this Is followed by her exercise therapy, RMS/n'/, tlDV 1 6 1994 Alison Is stili having a lot of posterior cervical pain, Her low back feels much better. She now has a negative straight leg raise and although there Is stili tenderness at L3, It Is not nelJrly as profound as before nor Is there any spasm or swelling, Kemp's sign Is negative as well. She Is treated with liMP Additionally, we are giving her theory behind this and let her comfortable with It, RMS/cml and she does her cervical exercises, a cervical pillow to use, I explained the try this In the oUlce and she seems quite Nav I 8 1994 Alison Is unchanged, She is treated again with liMP and Collows this with her cervical exercises, RMS 1 cml 'tIDV .3 0 1994 Alison Is unchanged, She was using the exercise tubing protocol at home while the oUlce was closed temporarily. Now she Is back on the system O and performs It today In the orrtce, RMS/cml EC a 2, /994 Alison Is slightly beUer. We are starting to have her exercise without the collar and we are adding rotation as well as anterior and posterior translation, She is also treated today with liMP and upper cervical adjustment. RMS Icml DfC 0 5 /99 ADDEI'mtM: Alison has he unahle to wnrl\ at her regular job since her accident, She Is a produce clerk at a supermarl\et. This requires her ~ ,..__':t.,- ( Page 6 RE: ALISON KOTZMOYER December 5, 199q "continued" to pick up cases and carry them around, Because of her current status she Is unable to do that, Ilowever, letting her work one day a week where she just has to move Individual produce Items. RMSlbaa DEe 0 5 1994 Alison Is doing better, regime, RMS/cml She Is treated with liMP followed by her exercise DEe 0 9 1994 Alison continues to Improve. She Is treated today with 11MI' and this Is followed by her performing her kinetic activities, We will re-evaluate her next week. RMS/mh ,DEe p~eW~lr 12, 1m RE-EV ALUA nON RE: ALISON KOTZMOYER Alison fills out her Oswestry questionnaire which Is graded 22 out of 90. This Is slightly worse than It was the lost time at 19 out of 90, Her Borg pain scale has her rating her pain as a 6 this time, The last time, It was a 9, She stili notes the same areas as before as to the areas of her pain. Palpation finds spasm of the scalenes still present, however, It Is not as rock like as It had been, There Is still significant spasm In the left upper trap and In the parathoraclcs but these arc much less than they were when last we checlted, Iler anterior head carriage has Improved remarkedly, Cervical ranges of motion find flexion to 220, extension Is 100, right lateral flexion Is 180, left lateral flexion Is 200, right cervical rotation Is 700 and left Is 710. Iler motions are far more fluid than last time we re-evaluated her, Shoulder ranges of motion are normal, however, bilateral extension causes thoracic aching. Grip strength as measured with a Jaymar Dynamomoter Is 70# right and 60# left, patient Is right dominant, Discussing this with her. I find that she has frequent pain In the anterior neck fiexors 011 the way into the upper chest wall. Occasionally, there Is recruitment of muscles In the mid chest at'ea as well. The pain In the back Is In the area of the medial scapular and scapular muscles and Is more diffuse pain than that In the front. The lumbar region only bothers her occasionally, Posterior plumb line exam is normal, Palpation of the lumbar spine finds spasm of the left paralumbars and the right hutloclts. Ranges of motion of the lumbar spine ore eull and complete and without restriction, Toe wallt and heel walk are normal, Straight leg raise Is normal, ( Page 7 RE: ALISON KOTZMOYER Rfter the evaluation. Alslon Is token luto a treatment room and placed supine and hot packs ore put on her neck nnd upper chest. After this, I reviewed her exercises with her, Currently, she Is doing flexion, extension, right lateral flexion, left lateral flexion as well as bilateral rotation and anterior and posterior translation of the cervical region. She Is doing these quite freely and therefore we are Increasing the reslstence on the Nexsys Device by approximately 25~, She Is to lower the number of repetitions and she will begin this today, I observed that she did this and she seemed to be able to do this relatively easily. I told her not to force It and If she has any problems to contact us Immediately. RMS/cml DEe I 4 1904 Alison continues to Improve, She Is treated with liMP and she perfol'ms her therapeutic exercises, RMS/cml JAN 0 ~I~n has been vel'Y busy due to the holidays. however, has had Incl'eased aching because of her absence fl'OIn the office, She Is treated with liMP and ultl'asound to the shouldel's and back as well as neck and this Is followed by TPT to the Infl'aspinatus bilatel'ally and she thereupon does her exercises, RNS/cml JAIl 1 J l~nf. Alison is feeling Impl'oved, She felt belleI' after we saw her the other day. She has more flexibility In the muscles and less spasm In the region. She Is treated with liMP and TPT as well as CMT to the area. She, thel'eupon, proceeded to pel'fol'm her exercises, RMS/cml 1/13/95 Alison Is much belleI', She can notice that hel' condition Is impl'oving since she has been back under care, She is tl'eated with liMP and soft tissue manipulation followed by vel'Y mild manipulation and her exercises. RMS 1 cml JAN I ~ 1995 Alison continues to Impl'ove, exercise pl'otocol. RMS/cml Today. she Is receiving liMP and does hel' 'JAN , 8 1995 Alison Is continuing to improve, We are Increasing the resistance on her exercise device to a 3 from a 2, This Is certainly an excellent progression, She Is treated with liMP and then following this she performs hel' exercises, Next time. we will schedule her for are-evaluation. RMS/cml tIN4 ~ 0 19l1) Alison Is continuing to show grndunl progressive improvement, tl'eated todny with liMP nnd performs her exercises as prescl'lbed, be re-evaluatlng her next time, RMS/ncs She Is We will . ---, '< ~ ( Pone 1\ RE: All SON KOTZMOVER JAN 1 ~ 19m) RE-EVALUATION RE: ALISON KOllMOYER Alison rates her pain as a 3 and a half on the scale of 0 to 10, (Borg pain scale), The Ransford pain drawing reveals that she has pins and needles In the lower anterior cervical region and dull ache In the upper chest wall anteriorly, She also has stabbing and pins and needles In the shoulders and upper traps as well as the scapular regions bilaterally, lIer neck appears to be Improving however the shoulders arc not. We going to be giving her exercise tubing for shoulder rehabilitation, She has avoided lifting because she states that It clluses her shoulders to Increase In aching, She still has pain along the cervical parasplnals posteriorly, Its unaffected by position, Neck position docs not llHeet her shoulder aching, There Is no change \'11th coughing or sneezing, Pain docs not \'lake her up at night, There arc no radiations Into the upper extremities of pain, weakness, numbness, Examination finds that her spasm In the neclt has diminished. There Is stili focal spasm In the left and mid cervical I'eglon both anteriorly and posteriorly. There Is tenderness to palpation on the transverse process em the left of Cq and 5 as well as 6, There Is also pain on palpation of the spinous processes of these as well as C2, There Is mild tenderness of the peck major and minor bilaterally, There Is spasm In the upper traps and low to moderate of the Infraspinatus and thoracic parasplnals, There Is tenderness on palpation of the scapular and medial scapular muscles as \'Iell as the upper traps, Cervical ranges of motion find flexion to 20 degrees. extension is 8 degrees. right lateral flexion is 10 degrees and left lateral flexion Is 15 degrees. right cervical rotation Is 50 degrees and left Is 56 degrees, Shoulder ranges of motion m'e normal however cause aching In shoulder joints and upper traps, Muscle testing at the rotator cuff finds It to be strong, Gross strength Is mellsured with a Jaymar Dynamometer as 55 pounds on the right and 119 pounds on the lefl. patient is right dominant. Posterior plumb line exam is normal, Lumbar ranges of motion are full and completc with flexion to 100 degl'ees, Kcmp's sign is negative, Toe walk and heel \'Ialk arc normal, "Gross tendon reflexes of the biceps. triceps, brachial radialis, I'atellll--and- Achilles aI'e ell '1"Ot- 5 2./Q and cqual bilaterally, SiUing straight leg raises arc normal and there Is good extensor hallucls longus strcngth bilaterally, It appears as though the cervical spl'ain/straln is resolving nicely, She has developed a sccondary strain of the upper traps and shoulders, This may be primary hOl'levcl' duc to the scvel'ity of the neck injury it \'/as never full Investigated before this, She is therefol'c going to be given excrclsc tubing for the shoulders today, She is going to pcrform a Zlnovleff Technlquc protocol. She Is to perf 01"111 these 3 days a weelt, I reviewed the thr.ory behind thc r.xcrcise tubing and ho\'l it is to be performed, I demonstrllted it fOl' her IInd had hOl' demonstrate it for me, She is to start out with light rcslstance ami pro~JI'ess as she is able, She is also to continue liMP and exercise hcre so long as shc notices improvement. She is treatr.u in the orrlce with II~'P and C~1T followed by her perfol'minCJ her exC'rr.lsos, RMS/scw ;.~'"' . ( ( .. ....... ............."....~..................~~~.rJ.!...!....!I.L..t -~ ....~.~" 'l","".'-"~ I fir tL &..,. .. __...........................................,.,........,r.. ...:...:.., ...:.'. o;................"I,..:rt'~..I.. ~ ~I I . ~..,~L liP .~ ~. --... ............. ..............................................o;Ji'...............IO...........!.!,~,!:~:'t~.".~ I'oge 0 RE: ALISON KOTZMOYER JAN 2 7 1995 Alison had a follow-up consult with Dr, Mallin yesterday, states that she has started her exercise tubing, She states that she Is getllng the hang of It. We will treat her today her cervical exercises, RMS/cml She further that she feels with liMP and RICHARD M; SELDOW, DC TEL:I-717-774-5386 Dee 12.94 ( 12:52 No,004 P,02 December 1, 1DDq RICHARD M. SELDOW, D.C., C.C.S.P. Ms. Kimberly S. Acrl FRIEDMAN & FRIEDMAN, P. C. soo N. Socond Streot Penthouse Suite, P.O. Box 98q Harrisburg, PI. 17108 BY FAX TRANSMISSION 230-8000 RE: ALISON KOTZMOYER Dear Ms. Acrl: Alison Will flr.t selin In our office on February 11. 1991. She W88 In an accident the Sunday before Christmas of 1990. Her mother wes driving a car that WIIS proceeding through an Intersection and was struck In tha front left. Alison wa. sitting In the right rear. The car spun around end tipped over with the right Ilde down. Sho folt a jorklng at tho tlmo and had pain ever since. The pain was elong the posterior longitUdinal ligament from C7 to the occipital base. There was also pain In the entire upper back, lower thoracic Ind upper lumbar regions, She had Increased ncck poln with ony motion of her ncc:k, She had some tronlllent numbnelll In the volar aspect of the arm, forcarm ond hondo however. this subsided quite quickly. She denied any loss of grip strength. Since the accident, she had constant headacho.. Examlnetlon at that time found ep..m to the left of C3 through T1 Inclusive which was painful to palpation. There was also swelling present end .pasm of the anterior scalenes bilaterally, slightly more on the left than the right with spasm of the left sternocleldomBStold. The left upper trop exhibited rock like hardnen and there WDS moderate spasm on the rlcht. The rhomboid meJor on the left exhibited orAllt IIJlIISm end the one on the right lesser spasm. Croll tendon reflexes were normal. Cervfcal ranges of motion found flexion to 180, extension to 190, right lateral flexion to 210, left lateral flexion 28", which caused homolateral upper trap pain. Right cervical rotation Is 7qO and left I. 750. Rang.. of motion nf the shoulder Joints were within normal limits and grip strength was adequate at 2S pounds bllaterelly, Ocular motion was normal and the eyes converge normally, There was a slightly positive Weber's Test laterallzlng to the right, The remainder of the cranial nervea teated normally. Examination of the lumhar spIne revealed spllsm In the left flank from Lq to LI. Lumbar range. of motion werll 50. of flexion with paIn at L3, right lateral bending normal less 10% and slightly more restriction In left lateral bending. Rotetlon was normal bilaterally. X-rays taken on that date revealed "flattening of the normal cervical curve with restriction of flexion and extension secondary to a severe soft tissue trauma" . Her diagnosis wag OU7,O, 723.2 (cervIcal sprain/strain, cervical cranial syndrome) , .5' BRIDOE STREET NEW CUMoeRLAND, P&NNGVLVANIA 17070.1 DaD TIL.~"ONI 17171 7.,..1I37a r'^,.. Nu. ("7 t 7) '7.,.04 :J:tOD .............. RICHARD HI SELDOW, DC TEL:1-717-~74-5~86 ( Dee 12,94 ( 12:54 No,004 P,03 Paoe 2 MS. KIMBERLY ACRI RE: ALISON KOT2MOVER Her treatment consisted of ultrasound after the application of HMP and eMT as well as ROM exarclses. Alllon was .een on a taperad basis until Auguot 21, 1991. At that time, she had full range of motion of her low back and cer\(lcal ....Ine. H.I' grIp atl'ength WOI 40 poundl on the right and 30 pounds on the left, patient I. right dominant. She was completely pain free with no palpable .paam In her neck and back. She wal doing her exercises regularly. Shoulders were void of any spasm. She was deemed completely rocovel'ed from her accident of 12/23190. She returned the next week (August 20, 1991) after I received an emergency call from her mother stating that her daughter was In school end had her erms wreppod around herself In a hugging appearance and someone grabbed her from behind and Jorkod hor ceullng her to lurch. She had severe pain to the area JUlt left of L2 and 3. She olio had Immediate pain In both legs. I took x-rays at that time and found a fracture of the spinous process at L2. She was referred for orthopedic consult.tlon which wel performed on Septcmber 13, 1991. Or. Greene, the orthopedic surgeon. reviewed the films, examined Alison and concurrod with my diagnoses. He referred her back to me for follow-up care. She was treated In the office with a braca, HMP and ultrasound. Sha was tl'eatcd with ancillary modalities exclusive of manIpulation. She continued to Improve until May whon she had an elCacel'batlon of her back pain which took about two weeks to resolve. She was not seen aoaln until December of 1992, when she had an exacerbation of back pain with no sIgn of any additional fracture. She was troated with HMP. ultrasound and traction and Bho waB given e"ercIBos. She was not seen again until Septembar 23. 1993. when she was playlno tennis and axacllrbatlld he.. back pain. X-rays taken of the low back were normal. She was diagnosed as having a lumbar spraln/straln and was seen from Soptember 23 through the end of October at which time she was allowed to return to Phys Ed and r",sume her normal actlvltlos. I did not see Alison after November 3, 1993, until she entered our office on October 19, 199q after becoming Involved In the motor vehicle eccldent of Octobol' 10, 1994. Alison entered our office on October 19, 199Q, stating that she was tho driver of a vehicle heading south on Rt. 03 at the York Split with SR501, Thore woa an accident In the right lane and trufflc was diverted to tho loft lone. A cer cut In front of her8 and IOtopplld Gnd then proceeded on. She slammed on her brakos to miss thllt car and the person behind her hit his brakes and stopped In sufficient distance not to Impact her car, however, the car behind that hit the car behind hers which Impacted her cor. She felt her neck hit the headrest but not her head. Immediately upon Impoct, sh", WAll thrown backward And thon forward and then backward again. She states that as she stopped suddenly, her back left the scot end she was thrown forward of the soat and then the Impact :""': RICHARD M.' SELDOW. DC TEL:1-717-774-5386 ( Dee 12,94 ,,1-2: 54 No, 004 P, 04 ( Paga 3 MS. KIMBERLY ACRI RE; ALISON KOTZMOYER occurred forcing her back agalnlt the leat caullng II double Impact pOlterlorly with her back hitting the .ellt. riding up the seat with her nel:k hyperextendlng over the headrelt. After the accident, Ihe wal able to mova all body parta, howav.r, Iha h.d a very ruUa.. tlm. trying to sleep t"'at night and entered our office with a profound headache and back peln In both the upper end lower beck. She denied any pain In the extremities, however, had swelling and IIchlng In the area of her prior spinal frecture at L3. She was unaware of any partlculer motion which would hurt her beck end neck because she tried not to move et ell. There wes Increased prenure even with breethlng deeply, There were no radiations Into the extremltlflll, The acapular .reAI were very pnlnful Including the medlnl scnpulllr and lIuperollcapular areas. She elso had pain In the leterel aspect of the erm to the elbow end the medlel aspect of the arm all the way down to the lateral aspect of the hand. She had the BlIme pain on the right liS the left, however, It wel moro Intonllo on the left. There wnl no pain that extended beyond the wrist Into the hands. She had Intense pain In the area of the right posterior cervical region and also pain In the anterior neck flexors from their attachment on the opine to the upper chest wall. She hadn't moved her neck beclIuse of the pain, however, atates thDt she would have some mild relief when 8he would lie down resting her neck. Even when she was lying down, 8he had that much pain that she was unable to sleep thlt night. She rated her Pllln as a 9 on a sCDle of 0 to 10 with 0 being no pain and 10 being a severe emargency type pain. Examination found grollll tendon reflexes to be z+/q and equal bilaterally. Thoro was IlIght weakn... of the extenRor hallucls lonous on full hip flexion and minimal weakness of the flexors of the toes on the left. There was II 11+/5 weakness of the left quadriceps femoris over the hamstrlnga and hip flexors lire normal. The seme tests on the right werfl negative_ Pinprick exomlnatlon of the lower extremltlos Will normlll, There was II positive Itraight leg raise on the left at about 600 with II very strongly positive Bowstring's Maneuver. Cacn,len's Moneuver and Fabere Patrlck'a Test all caused pain at 1.3. Straight leg raise on the right at 200 cau8ed 1.3 pilln whIch wos not relieved by knee flexion. There was morked pain on plllpetlon of the spinous pI'OCf!9!l of 1.3 with nbsorvable swelling around It, Lumbar rangos of motion were flexion to 300, extension to 10, right lIteral flexion 60, left latoral flexion 110, right rotation 80, left rotation 100. Kemp's Sign cDused pain at 1.3, Toe walk nnd heel walk were performed odequetoly. Palpation of the right scopular regIon found marked 8welllng of the rhomboid minor ond major as well a8 visible and palpable swelling of the levetor scapula. There was 01110 Ilgnlflcont swelling of tho Infl'allplnlltus. RICHRRD M, SELDOW, DC TEL:l-?1?-~?4-5386 ( De c 12,94 ( 12:54 No,004 P,05 Pogo II MS. KIMBERLY ACRI RI!, ALISON KOTZMOYElR All these regions were painful to palpation. There was marked paIn on palpation of TV ond II oplnour prollouor Th.r. 11111 Illn Inr.lh.r1 Inft Ll__u" _",,1111111 III Ll.v.." '''lIluIID. '1'1,,,,,, "aD DI"".,I'. gf Ll\l. U~IH.I' tl'ap '"" the left and generally throughout tho medllll Ilespulsr muscles on the left. This area was not as sensitive "as the swelling and painful region. In the right scapular area. Palpation of the cervical spine found large masses of swelling In the mid cervical region anteriorly. The trachea wes freely movable and the thyroldo palpated normally, however, thoro ware large malles of swelllno beneath the thyroids In the area of thl! scalenas. These were exquisitely tender to palpation. All tho spinous processes In the cervical region were tender to palpation, however, C6 and 7 were exquisitely tender. Cervical ranges of motion were flexion to 100, extonslon to qo. (wIth moat of It occ::urrlno In the upper cervical complexl. right lateral flexion 100, left lateral flex.lon 50, right cervical rotation liSo, left cervical rotation SliD, Shoulder ranges of motion were full and complete, however, caused achIng. Grip strength n measured with e Jeymer Dynemomctor wes 35 pounds right end 28 pounds left. pllthlnt Is right dominant. X-rays were taken of the lumbar and cervical spines. The lumbar spine wes negative for recent trauma, The cervical IIplne was nogatlve for fractura, however, thet'e waa marked restriction of flexion and extension with swelling of the lower cervical soft tissues. She was diagnosed with eQ7.0, e1l7.1, eQ7.2, end 729.1. I discussed the results with Alison and her father. I prescribed a course of treatment consisting of support and Ice for seventy two hours. She WIIS put on a 10' lifting limit and not to take Phy Ed for two weeks, Three days later. she wall begun with passive range of motion to organl:re scar formation. She WIIS IIlso treated with positive HVCS, I Instructed her father In the proper method of performing passive range of motion exercises at home so that he would be able to perform It out of the office. She was also to continue u>>lng Ice on her neck for ton minutes out of caeh hour. She Will then progr'Qued to plt"Rlvl! resistive exercise Rnd then active exercise followed by active resistive exercises. By October 26, I began using IIctlve reslstlvc exercIse with her using a cervical collar and to flex at the waist with the rellstance agelnst her head In a forward push and a bockwlIrd push as wall liS rIght Ilnd loft lateral pushes using the wClIkest roslstllnce. She was given HMP beforehand to relllx her muscles, She started doing this and progressed relatively well. On November 9, she noticed the development of heudsche5 and concomitant wIth theso wer'e pains In the cervical roglon, Thoso were so sovOr'o that sho WIlS unable to IJD to school for two days, They caused paIn all around the clock and were not relieved with rost, They were worse with physical exertion or change of position of her ',ead or neck. Trey alsQ Increasod with coughing or sneezing, Tharo were no radlntlons o paIn Into tne arms or hllnds. She had one episode of double vision whIch losted a few seconds, however, she did notice blurring vision on RICHARD M; SELDOW, DC TEL:I-717-7.74-5~86 Dee 12.94 ( 12:54 No,004 P,06 Pogo 6 MS. KIMBERLY ACRI REI ALISON KOTZMOYER and off. She had no dys/lhasla, dysarthria or tinnitus. She noticed a generalized weakness. She had difficulty standing for long periods. Gross tendon reflelUII weru normal aa waa her grip .trongth. Hor puplle roactod normelly to light ee well .e nul' and far vlelon. Oculllr motion Will normal and' her loft plllte raised normally with her uvula In tho midline. The tongue protruded normally end her upper trap tone Was normal. Weber's' Test was normal as was her finger to noee toet. Rhoumberg'. Teet was normal oe wae tandem Rhoumberg. Toe wlllk and heel walk were normal. There Was marked spasm In the neck f1elCors bilaterally all the way down to their attachmant to the upper ribs. She wes referred to Dr. Matlin for neurological consultation. Dr. Matlin had an MRI parformod which Ie normel and eho aleo hod an EEe performed whIch w.e normlll. ,Her Impreulons were thllt "Alison's history Is suggestive of post traumatic muscle contraction type cephalalgia with cervical myof8&clal paIn on the basis of whiplash type InJury", She wes treated In our office with HMP and eMT, Sho hae progroued well doing har exerclsos, however, It Is of noto that she hRS a reoulllr Job as a produce clerk at a supermarket. She has been unable to do this because of the lifting requirements and the damage to the neck and upper back. She Is only able to work one day a week and then .he Just basIcally move. Individual Items of fruit Ground rather than carrying cu.. of fruit. Alleon Is now doing her exercises quite well, She Is doing them regularly and happily. She Is recuperating well and I expect her to make full recovery within about six months, At that time, I will determIne what Impairment she may have. If you have any further questions regarding this matter, pleese do not hesitate to contact our office at any time. .e; I. .........". ( ( RICHARD M. SELDOW, D.C., C.C,S,P. February 2q, 1995 Kimberly S, Acrl, Office Manager Friedman & Friedman, p.e. 600 N, Second ST, Penthouse Suite P ,0, Box 90Q Harrisburg, PA 17100 Re: Alison Kotzmoyer Dear Ms Acrl: I am going to enclose a copy of our chart notes from December 5, 199Q through and Including January 27, 1995, I performed a complete re-evaluatlon on January 23, 1995, You will note that her pain level was down to a 3 out of a scale of 0 to 10, She was really coming along quite well and we were going to begin goIng full speed Into her rehabilitation and revel In her returning to good health and the normal life of a bright and energetic teenager, I trust that the Information found in these notes will answer your questions. If they do not please feel free to either call or write us and we will comply with your request. Sincerely, 431 BRIDGE STREET NEW CUMBeRLAND. PENNSYLVANIA 17070.1929 TELEPHONE C717) 774.:5376 FAX No. ('17. 774.5386 4 ....~ __ ~,__......- " , " , ( I DATB OF TEST: 11/29/94 BEOI: 283 EXAMINER: Dr. Emily Matlin RBPORT: Age 16. On 11/29/94 a 16-channel EEG is recorded, and the patient is reported to be alert and drowsy during this recording. The waking background of this recording consists ot a stable Alpha activity at 10.5 cycles per second seen to occur symmetrically between the hemispheres. Amplitudes are maximal posteriorly at 50 microvolts. Eye opening symmetrically attenuates the background. There are episodes of dARynchronl.?l\tion of the background compatible with episodes of physiologic drowsing. There are no asymmetries, focal abnormalities, or specific seizure discharges identified. Hyperventilation demonstrates a generalized gradual buildup of higher slow wave activity which is within normal limits at this age. A simultaneous EKG rhythm strip demonstrates a sinus rhythm with a heart rate of about 72 beats per minute. IMPRESSION: EEG within normal limits in the awake and drowsy states. COMMENTS: The absence of seizure discharges during this recording does not rule out a seizure disorder clinically. Clinical correlation is .....required. EMILY MATLIN, DO Electroencephalographer Dictated: .Transcribed: Filename: 11/30/94 12/01/94 15:58 ak-ee-em, bat cc: Dr. virginia williams Dr. Richard Seldow 431 Bridge street New Cumberland, PA 17070 E E 0 REPORT KOTZMOYER, ALISON MRI: 2011617 PTI: 70074836 ADMISSION: OUTPATNT / COMMUNITY GENERAL OSTEOPATHIC HOSPITAL 4300 LONDON DERRY ROAD HARRISBURG, PENNSYLVANIA 17109 EMILY MATLIN, DO , c I ., , ( r ~"";t.W +/it-7,;D.a E U R 0 LOG v ~24 londondtotry IIood MP 101 HomlbV'9 PA 17109 17171 ~~ 4214 F N c T C E o p R A December 16, 1994 Ms. Kimberly S, Acri Offic. Manager Friedman & Friedman, PC 600 North Second Str.et Penthouse Suite P,O, Box 984 Harrisburg, PA 17108 ReI Alison Kotzmoyer Dear Ms. Acril This letter is in response to your communication dated December 13, 1994 regarding Alison Kotzmoyer. Alison waa referred to this office by Dr. Richard Seldow and was examined on November 28, 1994 regarding complaints of headaches and dizziness following a motor vehicle accident which occurred on 10/18/94. The patient had pain in her neck associated with headaches and dizzy spells following this accident. She had not had these symptoms resolved with chiropractic treatment. Her neurologic examination was benign, Diagnostic studies including an MRI of the brain and EEG were both performed and were within normal limits, Alison was scheduled for a second follow-up examination on 12/7/94 at 3130 p.m. The patient cancelled her appointment on 12/7/94 at 12110 p,m. stating she vas sick and vould reschedule. To my knovledge, she has not rescheduled this appointment as of this time. Folloving my initial examination and review of her diagnostic studies to date my impression is that Alison suffers from muscle contraction type headaches on the basis of a cervical myofascial injury (whiplash). I suspect her symptoms of dizziness and visual disturbance are most likely due to myofascial pain rather than structural CNS pathology, As her myofascial symptoms resolve, I would anticipate improvement in her symptoms of dizziness and visual disturbance. At this point, I do not feel I can advise you regarding a prognosis as I have only seen this patient on one occasion. Please contact me if additional information is required in the future. Sincerely, ~~ l,.wr~\-u,) Emily j' Matlin. 0,0. lranscribed by J,M, Luchi Dictated/Not Read c!l-~~ 'll.r- 't>~ . ,. t ... ( (" n PENNSYLVANIA MRI ASSOCIATES 2645 North Third Street 0 Horrlsburg, PA 17110 (7171762-2900 DATE,,;.t1 December 1, 1994 SOCIAL SECURITY NO, ' IGL-69-9496 NAME KDtzmoye~, Alinon J STREET 9J Pleasant View CITY New Cumbe~land AGE LOCAnON 16y OUTP PHYSICIAN !o:'TI11y W Metl1n, DO PROCEDURE COOES: 7r.\~,~1 TERMINOLOGY: HIH. Bnl1n DATE OF SERVICE: O~~pmbe~ J, 1994 r'II'.ln ~ Te~~ace tafA'tI!;O:..:I:rtl~J FA 17070 Il("TURY. Sixteen yea[' old female involved in an MVA on 10/18/94, Patient now complains of blu~~y vision bilaterally an.j headaches, I MPnnfltlION. Normal HRl of the brain, P"I,SE SEQUENCE, 6a\31ttal Tl, Axial Tl, proton density, T2, MPGR, and SPGR, ,'l.lrIMF:NT. Thp.~e Is no evidence of an int~ecereb~lll hemo~~hage, There 1\[1' ,,: . Kt,rn-axlal fluid collections, maeses, or cerebral edema, The ventrlrLaq PIa or normal size and symmetry, The brain pa~enchyma is no~mal, : l....A).,...--- James W War~en, HD . / .. ~1 Ll-\- " , Richbr~ LogeR, HD ,J\4W/nte Radiology Residp.nt CONSULTATION REPORT PENNSYLVANIA MRI ASSOCIATES ., , January ~7. 1995 Richard H, Seldow, D.C, 431 Bridge Street New Cumberland, PA 17070 Rei Alison Kotzmoyer Date o~ Birthl 12/2/77 Date o~ Examination I 1/26/95 Dear Dr, Seldowl Alison reports she has been !eeling much better, She has very "minor headaches.. These occur approximately twice weekly and last ~or a maximum o! an hour, This usually occurs a!ter she makes some ohange in her cervical exercise regime. She is able to obtain relie~ with one over-the-counter dosage o~ either Ibupro!en or aspirin. She has had no ~urther episodes o! dizziness and her severe headaches have completely resolved. She is haVing no problems with new symptoms. She is tolersting her activities at work and at school. Her EEG and MRI per~ormed in November both were within normal lim1ts. She has no new or additional concerns, On today's examination, Alison weighs 168 pounds, Her blood pressure is 100/70. Funduscopic examination 1S benign, Cranial nerves are intact, Strength and tone o! all tour extremities is normal, There are no sensory or cerebellar de!icits. Deep tendon re~lexes are symmetric. Alison is to continue with her current regime under your auspices. I would be happy to re-evaluate her at any time in the !uture at your request, Thank you ~or allOWing me this opportunity to participate in the care o~ your patient, Sincerely, Emily W, Matlin, D.O. transcribed by J.M, Luchi Dictated/Not Read ~. Richard S. Priedman, Esquire _ ~ ~~ For the Plaintiff ~ 0 g- /~, Ic;J-' ".8p. ALISON J, KOTZMOYER, I A MINOR CHILD, BY HER FATHER I AND NATURAL GUARDIAN, I HARRY KOTZMOYER, I Plaintiff I I V. I I CHARLES P. RATCLIFFE, JR" I Defendant I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 95-4211 CIVIL TERM IN REI FUNDS WITHDRAWN FROM MINOR'S SETTLEMENT ORDER OP COURT AND NOW, this 15th day of August, 1995, after hearing, the Court authorizes Harry Kotzmoyer, the natural father of Alison J. Kotzmoyer, to apply the sum of $1,420.00 to the Arts Magnat School, which will be a tuition payment for Alison, and the Court further directs then that the balance of $8,630.00 less the $1,420.00 then be deposited in an insured savings account as set forth in the original order, By the Court, H mal ~ :c ~ .... ... en ~.l'-' .... .-X.. t.ol~.)J:-J _ Uz~";.r. "::000.( ",-.:::;0.- n'_-__t <:. =i:i; . ~::r: , h).r .:' ,::1 (. ~ . ~ '0. ;] .' - '" ..., => ~