HomeMy WebLinkAbout95-06807
,t
.
.,
....., ";';'-
,
.-
,
CHRISTINE C. DUNCAN,
PLAINTIFF
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
95-6807 CIVIL TERM
V.
GERALD B. SWANGER,
DEFENDANT
CIVIL ACTION-LAW
NOTICE
You have been sued in court. If you wish to defend against
the claims set forth in the following pages, you must take action
within twenty (20) days after this complaint and notice are
served, by entering a written appearance personally or by an
attorney and filing in writing with the court, your defenses or
objections to the claims set forth against you. You are warned
that if you fail to do so, the case may proceed without you and a
judgment may be entered against you by the court without further
notice for any money claimed in the complaint or for any other
claim or relief requested by the plaintiff. You may lose money
or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF
YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE
THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL
HELP.
Court Administrator
Cumberland County Courthouse
Carlisle, Pennsylvania l70l3
Telephone Number (717) 240-6200
;.*'\'.-!.,...t."....,:.--'-:_:.'.,.,...
.- ;'-'
. ,-......,.,',.
.
CHRISTINE C. DUNCAN,
PLAINTIFF
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
95-6807 CIVIL TERM
V.
GERALD B. SWANGER,
DEFENDANT
CIVIL ACTION-LAW
COMPLAINT
1. Plaintiff, Christine C. Duncan, is an adult individual
residing at 805 Baltimore Road, Shippensburg, Pennsylvania.
2. Defendant, Gerald B. Swanger, is an adult individual
residing at 24 East Orange Street, Shippensburg, Pennsylvania.
3. On December 24, 1993, the Plaintiff was driving her
motor vehicle east on West King Street in Shippensburg,
Pennsylvania. The facts and occurrences in reference to the auto
accident occurred the evening of December 24, 1993.
4. On December 24, 1993 the Defendant was driving his
motor vehicle east on West King Street in Shippensburg,
Pennsylvania.
5. The Plaintiff had stopped her vehicle behind a vehicle
operated by Charles Colley. Both of these vehicles were stopped
for a red light located at the intersection of West King Street
and Earl Street.
6. The Defendant was operating his vehicle at an excessive
rate of speed. Defendant failed to stop in adequate time and
approximately lO feet to the rear of the Plaintiffs vehicle
engaged his brakes. Defendants vehicle struck Plaintiffs vehicle
in the rear driving her vehicle into the rear of Mr. Colley's
.
vehicle which in turn was pushed approximately ten feet from the
original stopped position.
7. As a result of the collision, the Plaintiff was thrown
forward and rebounded and was injured and transported to the
Carlisle Hospital.
8. As a direct consequence of the collision of the
Defendants vehicle with Christine Duncan's vehicle, Christine
suffered the fOllowing severe and painful injuries:
a. cervical disc syndrome
b. cervical hypolordosis
c. left lateral flexion subluxation of C4 and C5
d. cervical brachial radicular syndrome
e. Cervicaygia
9. As a direct result of the aforesaid collision, the
Plaintiff has suffered a 30% range of motion loss in all planes
associated with cervical rotation.
10. As a result of the above injuries, Christine Duncan was
taken to the hospital and has undergone extensive treatment
including medication treatment, physical therapy, chiropractic
treatment and treatment at a pain management clinic.
11. As a result of the injuries caused by the aforesaid
collision Christine has undergone and in the future will undergo
physical and mental pain and suffering, inconvenience and loss of
life's pleasures and claim is made therefore.
.
.
12. As a result of the aforesaid injuries Christine has
been and in the future will be subject to great humiliation and
embarrassment and clAim is made therefore.
13. As a result of the aforesaid injuries Christine
continues to experience pain and physical limitations and
believes her injuries may be of a permanent nature and claim is
made therefore.
COURT I
14. Paragraphs 1 through 13 are incorporated herein by
reference.
15. The foregoing accident and all of the above injuries
and damages sustained by Christine C. Duncan are the direct and
proximate result of the negligent and careless manner in which
the Defendant, Gerald B. Swanger operated his motor vehicle,
including but not limited to the following:
a. failure to maintain proper control of his motor vehicle
b. failure to stop his vehicle within an assured clear
distance of the Plaintiffs vahicle
c. failure to obey the laws of the Commonwealth regarding
operation of his motor vehicle
d. driving his motor vehicle while intoxicated with a BAC
of 0.27%
WHEREFORE, the Plaintiff respectfully requests that she be
granted judgment in her favor and against the Defendant, Gerald
B. Swanger in an amount in excess of $20,000.00 exclusive of
costs and interest.
.
Respectfully submitted,
O'BRIEN, BARIC & SCHERER
I
By ~~~~ ~
Robert L. O'Brien, Esquire
Attorney for Plaintiff
I.D. . 28351
17 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
VERIFICATION
I verify that the statements made in the foregoing
Complaint are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.
C.S. S 4904, relating to unsworn falsification to authorities.
(Jk;,J;;...~ e. I Q~
CHRISTINE C. DUNCAN
DATED: if - /OJ - 94J
.
f.
j
',.c'
ft
,
\"
....
.
CHRISTINE C. DUNCAN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 95-6807 CIVIL TERM
v.
GERALD B. SWANGER,
Defendant
l.l
.11
-,
"--n
f.'!~ ' :r=-
,_: 1_ l"(!j
The Plaintiff, Christine Duncan, believes that the damageS'EIWarded by ;~~l
!"~.',.. ~~ :1~~~
the jury are inadequate in light of the testimony and the Defendant's admission of -;rn
, .. :.::!
." 'J
r" ':<
POST.TRIAL MOTIONS
n ,'I
I ~~
;~ r::.::
1 )
liability. Accordingly, Plaintiff requests that the Court consider the additur.':
2) The Plaintiff believes that the jury verdict is inadequate and requests,a
new trial.
Respectfully submitted,
O'BRIEN, BARIC & SCHERER
BY: ~ fv-V-'
Robert L. O'Brien, Esquire
Attorney for Plaintiff
17 West South Street
Carlisle, PA 17013
(717) 249-6873
Date:~
.
.'
....
CHRISTINE C. DUNCAN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 95-6807 CIVIL TERM
v.
GERALD B. SWANGER,
Defendant
~ERTIFICATE OF SERVICE
I hereby certify that on July ~, 1998, I, Robert L. O'Brien, Esquire, of
O'Brien, Baric & Scherer, did serve a copy of the Post-Trial Motions, by first class U.S.
mail, postage prepaid, to the parties listed below, as follows:
Karen Durkin, Esquire and John J. McNally, III, Esquire
James, Smith & Durkin
P.O. Box 650
Hershey, Pennsylvania 17033-0650
~D($~.
Robert L. O'Brien
~
..
"
..
"
.',. .",-~,.
- C'-'. -7 ".. .~. . '''. ",.~ "".
CHRISTINE C. DUNCAN, I IN THE COURT OF COMMON PLEAS OP
Plaintiff I CUMBERLAND COUNTY, PENNSYLVANIA
I
V. I
I
GERALD B. SWANGER/ I NO. 95-6007 CIVIL TERM
Defendant I
I
AND NOW, this
ORDER OF COURT
"'7~
V day of JULY, 1990, upon consideration
of Plaintiff's Post Trial Motions it is ordered and directed that
Plaintiff file a brief in support thereof on or before Priday,
August 7, 1990, with Defendant's reply brief to be filed on or
before Monday, August 17, 1990. Argument to be held in Chambers
of Judge Guido on Wednesdav. Auqust 19. 1990. at 0:30 a.m.
BY~
Edward E. Guido, J.
Robert L. O'Brien, Esquire
For the Plaintiff
_ ~f.<-.J.~ '7/~f1'/9i.
.)o<l.~
John J. McNally, III, Esquire
For the Defendant
:dd
OF JJ_TNly
98 JU/. 27 PH 4: IS
CUMEJERL/N!J COUI'lTY
PENNSrivANIA
.,
~
/'
..,
tt.~'..
.j(
, ~spital
eaIth Services
, " ,kerSt,eeto P.O. Box 310 0 Carlille, Pennlylvania 17013-03100(717) 249-1212
DEPARTMENT OF RADIOLOGY
'cARLISLB IMAGING ASSOCIATBS, P.C.
DUNCAN, CHRISTINE C. 49Y
805 BALTIMORB ROAD
SHIPPENSBURG, PA 17257
07/09/1996
X-RAY 11104440
MED, REC, .555410
DR. KOSENSKE TBD
C-SPINE SERIES
Five views of the cervical spine were obtained prior to MRI
evaluation, and demonstrate gross preservation of bony alignment, disc
spacing, and bony integrity in the cervical distribution. There is
subtle sclerosis extending from the C2 through the C5 level in the
posterior elements, suggesting a degree of facet degeneration. Facet
joints remain "open", however. Neural foramina appear grossly patent
bilaterally. There is no evidence of deep soft tissue swelling.
IMPRESSION:
Negatlve'study for plain film evidence of acute
cervical pathology.
~J. CUTHBERTSON,
H,D.
RJC/nb
T: 07/09/1996 02:04 pm
RADIOLOGY FILE
: .,j -: -::__~_ . :.- -=--=--=-- ~___-=~~__.....w
,~
:~' t~'J ..: ,"
, ~ . '
~.
" ."\J.,,"';' ',';""'~'-,"', .'*-~';.'.'" '~~~~:Ii1~.%.l,lI..io.ir-.,.c'~.'<;V.""'ot:,::..",'
I ."''-. (y ,.t ," ' '~!rtP.'V;':"t".. I :~r . -.',:"t , ,
. ":"t:;:;:"l;;'~ :' ,1" DEPARTMENT OF RADIOLOGY
OSpl a ,,'
ealth Services
6 Parker Street 0 P,Q. Box 3100 Corli,le, Pennsylvania 17013.03100(7171249.1212
"
I
IMAGING ASSOCIATBS, P.C.
.' -;'~";'ir~"'f"I""'1
'ii.. ~. :L.l.>,. '_'~ ' , :
1"", " -,' "",' I.Ll '
'\>.;.'i!!~t,t~:l' I~'" .-
~.,..... :.11_..~. ..,:IV~'_'''' .
t'; ,','" ,\",- ~''! ,
.......,. .,;,.; ":'I"""'':;''' ';'. "\'"
;,.->f:- ',",.'~' ,. '(!,:,....t.-, ", '(
."" ",,,'~', j.J:..,.,;).tt,i}
, ".-- "''';''.'1''-"_:'0,,,
rj,_:",~~':~;.:::.C:.C,~~
DUNCAN, CHRISTINB C.
805 BALTIMORB ROAD
SHIPPENSBURG, PA 17257
49Y
07/09/1996
X-RAY #104440
MBD. RBC. .555410
DR. KOSBNSKB, T.
NON-CONTRAST HRI OF THB CBRVICAL SPINB
This study consists of sagittal sequences with T1, intermediate, T2*
weighted fast spin echo technique and relatively T2 weighted gradient
echo technique, followed by axial gradient echo, T2 weighted images
from the C2 through the T1 level.
Visualized portions of the posterior fossa appear grossly normal. The
cervical spinal cord is normal in signal characteristics and overall
size throughout, The central canal appears somewhat narrowed in
sagittal images at the C4 and C5 levels, and very subtle dorsal disc
prominence centrally at those levels may actually abut the anterior
cord with neck flexion. The magnitude of findings does not suggest
focal disc protrusion or extrusion, however. Very subtle dorsal disc
prominence centrally and eccentric left at the C5-6 level may
represent a very small disc bulge, Axial images otherwise show no
localized pathology.
IMPRBSSION:
There is central spinal stenosis, localized to the C4-5
and C5-6 levels, with a mild disc bulge contributing to
narrowing at the C5-6 level centrally and eccentric
left, Disc disease only contributes Slightly to this
predominantly congenital configuration. There is no
evidence of myelomalacia or other pathology at this
time.
Gl
RAND J. CUTHBBRTSON, H.D,
RJC/je
T: 07/09/1996 02:48 pm
RADIOLOGY FILE
@tCarlis1e ~
240 Parker Strllt
, P,O. Box 310
Cernlll. Plnnlylvlnla 1701~10
1~788 · 17m 2.801212
.,\
.
..
,
I
PHILOSOPHY AND GOAlS
The objective of the pain Dlllll&en1ent program Is to reduce pain to a tolerable level/
maximlzo optimal functioning and to minimize or eradicate analgesic' dependcncy. Ii.
multid1scipUnary approach Is utlllzcd In which nerve blocks medl~don, physical therapy,
occupational therapy, TENS Instruction, psychiatry and outside consultation Is re:adl1y available.
Attention will be liven to the Individuality of p,ain each patient pr=cnts rccopizlng special
needs and abilities of each patient. Most Importantly, it Is Imperative to educate tho patient in
unduslalldini the lmportanco In becoming actively Involved In treatment, which Is the most,
essential core of change and improvement. The program does not offer a cure for any liven
affliction but hopes to live the patient a positive outlook in managing their pain ,and regaining
control of their lives.
When patients are seen on the initial visit a number of general philosop~cal goals are
sought.
1,
2.
~
,.
0,
.
4,
5.
These goals are as follows: '
To provide an overview of treatment modallties available.
To cIiIcct tho patients focus towards a fwIctioaal rather than slnlctural
lmprovOlDCllt.
To diminlsh anxiety and diffuse fears of accusations of p,tychosomatic pain by
establishing trust and rapport with the patient.
To guide, educate Jnd assist Ihe patient to take an active 1010 in treatment and to
be aware of the therapeutic vs. counterproductive behaviors.
To foster realistic expectations of treatment.
ORIGINAL
~
IN THE COURT OP COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
CHRISTINE C. DUNCAN,
PLAINTIFF
V
NO. 95-6807 CIVIL TERM
GERALD B. SWANGER,
DEFENDANT
DEPOSITION OP: PAUL H. McCABE, M.D.
TAKEN BY: DEFENDANT
BEFORE: JAMIE P. HACKMAN, RPR/RMR
NOTARY PUBLIC
>>0
DATE:
SEPTEMBER 29, 1997, 9:03 A.M.
HERSHEY MEDICAL CENTER
500 UNIVERSITY DRIVE
HERSHEY, PENNSYLVANIA
PLACE:
APPEARANCES:
O'BRIEN, BARIC & SCHERER
BY: DAVID A. BARIC, ESQUIRE
FOR - PLAINTIFF
JAMES, SMITH & DURKIN
BY: JOHN J. McNALLY, ESQUIRE
FOR - DEFENDANT
ALSO PRESENT:
DOUGLAS MacINTYRE / VIDEOGRAPHER
, 41'
,.. ,,''--
'.;.:...;
Hups, 7l1briekt,1=olh irJlaf4le ~ &ma, 8""
115 PINE STREET. HARRISBURG. PA 17101
Harrisburg 717.232.5&44 Fax 717.232.9637 Lancaaler 717.393-5101
:J
1
2 NAME
3 PAUL H. McCABE, M.D.
4 BY: MR. McNALLY
5 BY: MR. BARIC
6
7
8
9
o
:.:;
WITNESS INDEX
EXHIBIT INDEX
10 McCABE DEPOSITION EXHIBIT NO.
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
PRODUCED AND MARI<ED
13
13
15
1.
2.
REPORT OF DR. BAKER
ELECTROMYOGRAPHY NERVE CONDUCTIONS
5/30/95 LETTER FROM JURGENSEN TO RELY
DEPARTMENT OF RADIOLOGY C-SPINE SERIES BY
CUTHBERTSON
DEPARTMENT OF RADIOLOGY NON-CONTRAST MRI OF
THE CERVICAL SPINE BY CUTHBERTSON
3.
4.
5.
2
EXAMINATION
3
24
17
18
')
o
,,,.--
J
3
1
THE VIDEOGRAPHER: My name is Douglas MacIntyre,
2 and I represent VideoImages, 3004 Black Oak Drive, Red Lion,
3 Pennsylvania. Today's date is September 29th, 1997. The
4 time of day is 9103 a.m. This deposition is being
5 videotaped at the Hershey Medical Center, 500 University
6 Drive, Kershey, Pennsylvania. The caption of this case is
7 Christine C. Duncan versus Gerald B. Swanger. The name of
8 the witness is Paul K. McCabe, M.D. This deposition is
9 being videotaped on behalf of the Defendant. Counsel will
10 now please introduce themselves.
11
MR. McNALLY: John McNally, here on behalf of the
12 Defendant.
13 MR. BARIC: David Baric, here on behalf of
14 Plaintiff, Christine Duncan.
15
TKE VIDEOGRAPHER: The court reporter will now
16 please identify herself and swear in the witness.
17
TKE COURT REPORTER: Jamie Hackman.
18 PAUL H. McCABE, M.D., called as a witness, being
19 duly sworn, testified as follows:
20 DIRECT EXAMINATION
21 BY MR. McNALLY:
22
Doctor, if you could please introduce yourself to
Q
23 the members of our jury.
24
A
I'm Paul McCabe.
25
Dr. McCabe, what is your profession?
Q
,
~
1
2
3
4
5
6
, \,..'-.5;__...
4
A Neurologist here at the Hershey Medical Center.
Q And your business address here?
A 500 University Drive, Hershey, Pennsylvania.
Q Doctor, if you could briefly describe for us your
educational background, beginning with college.
A My college was Wilkes University that I received
7 my Bachelor of Science degree in biology. From there I
8 proceeded on to medical school, Thomas Jefferson University
9 for four years, received an M.D. degree, and then following
10 that was my residency in neurology, which I started at the
11 Medical College of Pennsylvania in Philadelphia and then
0 12 completed here in Hershey. Since that time I've been on the
staff a neurologist at the Hershey Medical Center.
13 as
14 Q Doctor, what is neurology?
15 A Essentially, it deals with disorders of the brain
-...-)
16 and nerves. So it includes the brain, the spinal cord, and
17 peripheral nerves.
18 Q Dr. McCabe, could you summarize for us your
19 professional experience.
20 A I've been certified or on staff here in neurology
21 for approximately the last five years, of which we see
22 numerous neurologic diseases. We spend time in the
23 outpatient clinics, seeing outpatients with various
24 neurologic disorders, as well as time on the inpatient and
25 consult services, where we see, again, patients with
1
,
, ,
, '~
,!
. ' ..~
5
1 neurologic disorders. And also a fair amount is for
2 education, educating new neurologists as they're coming
3 through their training, as well as medical students and
4 other doctors that are training in other fields.
5
Q
Are you licensed by the Commonwealth of
6 Pennsylvania?
7 A Yes.
8 Q When did you receive your license?
9 A I believe that was in 1988.
10 Q Do you have any additional board certifications?
11 A Yes, I'm certified in neurology and psychiatry
0 12 from the American board, as well as added qualifications in
13 clinical neurophysiology.
14
Q
Are you a member of any professional associations
15 or societies?
16
A
Yes, the American Academy of Neurology, the
17 American Epilepsy Society, and Pennsylvania Medical Society
18 up until, I guess, just a few months ago.
19
Q
Have you ever lectured in the field of neurology?
20
A
Yes.
21
Q
All right. If you could briefly describe some of
22 the topics that you've lectured on in the field of
23 neurology?
U",-.,
24
A
It's really a whole variety, including things
'-..,)
25 from headache to seizures to lecturing on general anatomy of
6
.,
'-..-"
1 neurology, covering various disorders in neurology, aB well
2 as individual patient cases always being discussed with
3 residents or medical students.
4
Q
Have you ever posed as an expert witness in the
S field of neurology?
6
A
Yes, I have.
7
Q
Have you had the opportunity to review any
8 medical records of the Plaintiff, Christine Duncan?
9 A Yes.
10 Q What records have you had the opportunity to
11 review?
0 12 A The records regarding her accident on December
13 24th of 1993, including the records from Dr. Baker, Dr.
14 Carey, Dr. VanBoskirk, Dr. Jurgensen, Dr. Hely, Shippensburg
lS Health Services, Alexander Spring Rehab, emergency room
16 visit from the accident, and several others, and Dr.
17 Kosenske.
18
Q
Have you also had the opportunity to examine Ms.
19 Duncan?
20 A Yes/ I did.
21 Q As a result of your review of the medical records
22 and your examination of Ms. Duncan, have you been able to
23 provide a diagnosis of her condition and/or its causes?
24 A Yes, I did have the chance to perform a detailed
.J
2S neurologic history and examination on her, and essentially,
7
')
_/
1 going over her full examination, was unable to come up with
2 any evidence of any neurologic disease at this time.
3
Q
Doctor, do you believe that as a result of your
4 examination and review of the records that you'll be able to
5 testify within a reasonable degree of medical certainty as
6 to her condition and its causes?
7
A
Yes.
8
MR. McNALLY: At this point in time, I'd like to
9 offer Dr. McCabe as a medical expert in the field of
10 neurology.
11 MR. BARIC: Neurology only?
0 12 MR. McNALLY: Actually, neurology and
13 psychology.
14 MR. BARIC: I'm going to express an objection, to
15 the extent that Dr. McCabe may be offered for psychological
16 reasons, to psychologies, since I don't believe he's really
17 expressed an opinion as to any psychological components of
18 Christine Duncan's condition he's expressed in at least the
19 May 5th, 1997, report that was provided to us. I think we
20 can go ahead with him offering his testimony, although I
21 would ask that you break the two, I think, for purposes of
22 this videotape deposition so that we could, if necessary,
23 approach the judge in terms of whether this is within the
I
..J
24 fair scope of his report.
25 MR. McNALLY: Certainly. In response, I'd just
8
~
...~
1 like to point out that Dr. McCabe has found that there is a
2 significant anxiety component to her presentation, and that
3 is included in his May 5th report. with that, we will
4 continue.
5 BY MR. McNALLY:
6
Q
Dr. McCabe, I am going to ask you a series of
7 questions today for your explanation to the jury/ and in
8 providing those answers, I ask that all answers that you
9 provide are within a reasonable degree of medical
10 certainty.
11
A
Yes.
o
12
Q Is that okay, Doctor? Doctor, from your review
13
of the medical records, were you able to learn of
14 Christine's medical condition before the auto accident of
15 December 24th, 1994?
16
A
Yes/ I was. There were some medical records that
17 were provided a year or so before the actual accident, and
18 her main medical problem at the time seemed to be regarding
19 her pulmonary history in that she had even gotten to the
20 point of going to see if she was a candidate for a pulmonary
21 transplant. There is also some other notes from the past
22 that aren't given in detail, but she did have a history of
~
23 carpal tunnel that was operated on in 1980, and also there
24 had been mention of a fair amount of things such as anxiety
25 in terms of some of her other medical conditions.
'-'-"''''''i~
:H
9
;,
~
""","
1
Q
Doctor, do any of these current medical
2 conditions have a neurological component or otherwise factor
3 into your assessment of Christine Duncan?
4
A
The main one that would be neurologic would be
5 carpal tunnel syndrome. It may have some degree, but I
6 don't think it's really directly related to this current
7 case.
8 Q Is she taking any medication, Doctor?
9 A At the time I had seen her, she was taking
o
10 medication. I'm not sure what she may be on now, but when I
11 evaluated her in April of '97, she was on several different
12 medications, including Tylenol, Darvocet, and had also tried
13 Neurontin and Amitriptyline, or Elavil, which is the other
14 name.
15
Q
Do you know what condition she was taking these
16 medications for?
17
A
Well, for the pain that she was feeling in the
18 back of her neck and going down her left arm.
19
Q
Do you know whether she was taking a drug called
20 Prednisone?
21
A
She was also on Prednisone for her pulmonary
22 conditions, yes, and she had been on that chronically. And
23 I believe she's also using several types of inhalers for her
:..)
24
respiratory condition.
25
Q Doctor, do you know whether she had any prior
~
~
o
-J
10
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
complaints of neck pain?
A There had been some remarks in older records
about her having neck paint mainly associated with her
breathing, particularly if her breathing would become
worse.
Q How are these factors pertinent to your analysis
of the injury that she suffered as a result of the collision
of December 24/ 1993?
A Well, there is some overlap of the conditions,
and at some times it may be difficult to pertain the
division between some of her complaints. so, for example,
her breathing condition, it's stated on several different
records that she must maintain a somewhat forward posture of
the head and neck, which is going to cause some strain on
the muscles in the neck.
Q Dr. McCabe, what medical attention did Christine
receive immediately after the accident?
A I believe right after the accident she was seen
in the emergency room that same day for which she had an
evaluation by the physician in the emergency room as well as
a cervical spine X-ray.
Q X-rays were taken at that time?
A Yes.
Q What were the results of those X-rays?
A Essentially normal cervical spine X-ray.
11
')
'">~~
1
Q
What were her chief complaints at the time of her
2 admission?
3 A Her main complaint at the time in the emergency
4 room I'll just pull the records -- were some left knee
5 discomfort and slight neck discomfort.
6
Q
Was she prescribed a course of treatment after
7 that?
8
A
Well, she did return to her, I believe, family
9 doctor or general internist, Dr. Hely, for her continuing
10 care, but no -- no specific medicines or treatments were
11 given aside from, again, one of the inhalers for her
o
12 breathing condition.
13
Q
Did Dr. Hely make any findings?
14
A
He did describe her pain and her symptoms but on
15 exam was not really able to find a substantial amount of
16 abnormality.
17
Q
Did Dr. Hely himself perform any diagnostic tests
18 or examinations?
19
A
He had several times that he had seen her in the
20 office throughout the course of her history after the
21 accident and had made comment of not being able to find any
22 abnormalities on her neurologic exam that he performed as
23 well as not having anything on the neck X-ray that was
24 performed in the emergency room that day.
.....J
25
Q
Are Dr. Hely's findings pertinent to your ability
,
o
.:J
12
1 to assess her condition?
2 A Yes, I believe they are. They do, again, make
3 comment of him not being able to find any focal neurologic
4 abnormalities back at that time.
5 Q Did Dr. Hely prescribe any course of treatment or
6 therapy?
7 A He prescribed physical therapy for the most part,
S and that was at both Alexander Spring and also at
9 Shippensburg Hospital, and from what I could gather from the
10 records, mainly consisted of treatment with hot packs,
11 ultrasound and range of motion exercises. On top of that,
12 she had also undergone a brief psychological evaluation.
13 Q Did she receive any results from this course of
14 treatment?
15 A Several of the notes from the physical therapy
16 patients do comment about them being able to increase her
17 mObility and decrease the pain. On top of that, Dr. Hely
10 also has in his notes from August of '94 that he believed
19 that her problems had been resolved with the physical
20 therapy.
21 Q Have you had the opportunity to review any
22 treatment records of Dr. Carey?
23 A Yes/ I did, and Dr. carey, again, appears to be
24 either a family physician, a general practitioner, and had
25 made various comments about different disorders, including
')
,--,
o
...)
13
1 her pulmonary disease, some GI complaints that she had for a
2 while, as well as her current neck pain.
3
Q
Did Dr. Carey seek the input ot any specialists
4 that you know ot?
5
A
I'm not exactly sure if it's Dr. Carey who had
6 asked tor it, but Dr. Jurgensen had been asked to qive his
7 opinion, and he is a neurologist.
8 (Report ot Dr. Baker and Electromyography Nerve
9 Conductions produced and marked McCabe Deposition Exhibit
10 Nos. 1 and 2/ respectively.)
11 BY MR. McNALLY:
12
Q Doctor, I'm goinq to present to you -- betore
you/ you will find what is shown as Exhibit No.1. Can you
13
14 identify Exhibit No.1?
15
A
It is an evaluation by Dr. David D. Baker --
16 David C. Baker, sorry.
17 Q I'm sorry / I have the wrong exhibit before you.
18 A Oh, okay.
19 Q If you can reter to Exhibit No. 2 there.
20 A 2?
21 Q Yes.
22 A Okay. Okay. That is a report on nerve
23 conduction tests and electromyoqram performed by Dr. Craiq
24 Jurqensen.
25
Q
Describe that test for us if you could, Dr.
14
~
1 McCabe.
2 A The test consists of two parts. The first is the
3 nerve conduction test where the time it takes for a signal
4 to travel down the nerve is measured, typically done by
5 simulating the nerve at various points along its pathway.
6 That tends to look mainly at the covering around the nerve,
7 called the myelin sheath, to see if it's been disrupted. It
8 also looks at the central part of the nerve, what's called
9 the axon, to see if there's any disorder. The second part,
10 or the EMG, involves evaluating various muscles that are
11 innervated by different nerves to see if their input has
12 been disrupted in any way, as well as also evaluating if
13 there's any primary muscle disease.
14 Q What were the results of these tests?
15 A Both the EMG and nerve conduction tests were
16 within normal limits.
17 Q Is that significant to your ability to provide
18 testimony regarding her condition at that time?
19 A Yes/ it is. Essentially what it tells me is that
20 there's no evidence of any ongoing nerve or muscle disease
21 at this time.
22 Q Did Dr. Jurgensen reach any conclusions with
23 regard to her condition?
24 A He had raised some suspicion that there may have
25 been some cervical disc disease as the cause of her pain,
o
Q
15
')
........"
1 but was unable to actually show any evidence of that when he
2 performed the nerve conduction test and the EMG.
3 (5/30/95 letter from Jurgensen to Hely produced
4 and marked McCabe Deposition Exhibit No.3.)
5 BY MR. McNALLY:
6
Q
Okay, Doctor, now I'm going to refer you to what
7 we have marked as Exhibit No.3. If you can simply refer to
8 Exhibit No.3.
9
A
Okay.
Are you able to identify Exhibit No.3?
10
Q
11
A
Yes, that's a clinical note by Dr. Jurgensen
o
12
regarding Christine Duncan.
13
Q And to whom is it addressed?
14
A
It's addressed to Dr. Hely, Daniel P. Hely.
15
Q
What were you able to learn from this report?
16
A
Again, Dr. Jurgensen, being a neurologist, is
17 unable to find any actual abnormalities of the nervous
18 system, based on her evaluation of har muscles and nerves,
19 and again he raises the question at that time of some
20 cervical disc disease. However, there is no clinical
21 evidence to support any nerve root damage.
22
Q
Dr. McCabe, at any point in time are you aware of
23 whether a second opinion was sought?
24
A
I believe she did have a second opinion by Dr.
,....}
25 Baker.
1 Q Now, Dr. McCabe, I'd like you to refer to what
2 we've marked as Exhibit No. 1/ if you could.
3 A Okay.
4 Q What is Exhibit No.1?
5 A That is the evaluation by Dr. David C. Baker.
6 Q Do you know whether Dr. Baker performed any
7 independent diagnostic tests?
8 A He did perform an examination of her, according
9 to the note I have here, and on that he states, again, that,
10 similar to Dr. Jurgensen or Dr. Hely, he's unable to find
11 any abnormalities on her examination.
Q Would you expect to find any abnormalities?
A If there were muscle or nerve damage, yes, that
can be picked up on an examination in terms of focal
weaknesses, focal sensory loss or chronic changes in the
muscle, such as atrophy, which is just shrinking of the
muscle, or fascicu1ations, which is a quivering of the
muscle.
Q Did she receive any further medical treatment?
A For a brief period she did undergo a chiropractic
evaluation by a Dr. VanBoskirk and, from what I could tell,
did not really receive any significant relief or changes in
23 her symptoms. And I believe it was at that point that she
24 then was either referred or referred herself to The Pain
~
25 Clinic and Dr. Kosenske.
)
0 12
13
14
15
16
17
18
19
20
21
22
16
'\
,
o
--'
17
1
What type of treatment did she seek froM Dr.
Q
2 Kosenske?
3
Dr. Kosenske had several modes of treatment he
A
4 had tried, including a TENS unitt steroid injections, and
5 also some trials of medication for her pain. He also had
6 her undergo an MRI scan of the cervical spine.
7
Did he also perform X-rays or have X-rays
Q
8 performed?
9
He did repeat cervical spine X-rays.
A
10 (Department of Radiology C-Spine Series by
11 Cuthbertson produced and marked McCabe Deposition Exhibit
12 No.4.)
13 BY MR. McNALLY:
14
Doctor, I/d like you to refer to what we've
Q
15 Marked as Exhibit No.4.
16
A
Okay.
17
Can you identify Exhibit No.4?
Q
18
Yes/ it is a cervical spine series performed on
A
19 7/9/96 on Christine Duncan.
20
Okay. What were the results of those X-rays?
Again, nothing was found, and they reported as
Q
21
A
22 being negative.
23
Is that significant to your ability to diagnose
Q
24 her condition?
25
Yes. It tells me that there are no significant
A
')
o
.J
18
1 changes in the bone that may be possibly impinging on nerve
2 roots or the spinal cord itself.
3 (Department of Radiology Non-Contrast Mal of the
4 Cervical Spine by Cuthbertson produced and marked McCabe
5 Deposition Exhibit No.5.)
6 BY Ma. McNALLY:
7 Q Doctor, you also indicated that an Mal was done.
8 What is an Mal?
9 A Mal stands for Magnetic Resonance Imaging. It's
10 one of the newer techniques for viewing various systems in
13 the body, brain, spinal cord, joints, thoracic cavity, and
12 essentially has a much higher resolution than any other
13 currently available imaging technique.
14 Q In the situation with Christine Duncan, why was
15 an Mal ordered?
16 A It was done to look at her cervical spine, the
17 spinal cord itself, and also the nerve roots on the spine,
18 and that takes into account anything that may be impinging
19 on those, such as the bones or nerve roots or, rather,
20 discs.
21 Q If the report revealed impingement of that
22 nature, what type of symptoms would Christine show?
23 A Well, if a nerve was being pinched at its area of
24 origin or near that area, she could have focal weakness,
25 focal sensory changes or radiation of pain. It would be in
, :)
,
o
v
19
1 a specific what we call dermatomal pattern/ however.
2
What did her Mal show?
Q
3
Essentially, it just showed some mild spinal
A
4 stenosis at the levels of C4-C5 and CS-C6 and a mild disc
5 bulge at CS-C6. There was no evidence, however, of any
6 impingement on the spinal cord or on the nerve roots
7 themselves.
8
To your knowledge, has Dr. Kosenske been able to
Q
9 diagnose her condition?
10
He did give her a diagnosis, after these tests
A
11 came back as being normal or negative, and his diagnosis, I
12
believe, was myofascial pain as well as fibromyalgia.
13
Q What is myofascial pain and fibromyalgia?
14
CUrrently, at this time, they appear to be a
A
15 diagnosis essentially to fit in patients that have not
16 really been able to fall under other specific categories,
17 and they're mainly used for people that may be describing a
18 type of muscular pain, but there's really no diagnostic
19 tests for proving their existence.
20
Doctor, is there any indication in the medical
Q
21 records of Christine/s hyper-exaggeration of her symptoms?
22
There are some. There are a few times that she
A
23 was seen in the emergency room with her breathing problems,
24 and notes are made by the physician that there were a
25 significant anxiety component to her presentation. The
-"-~
1_
20
.')
"..,.",
"
1 other area that points along the similar lines was an
2 extensive workup she had for some gastrointestinal systems,
3 and no specific abnormality was ever able to be found to
4 explain those symptoms.
5
Q
How was Dr. Kosenske treating Christine?
6
A
Currently, at this time, I believe still with
7 some steroid injections and had tried medications. I'm not
8 sure if she's now still on those medications or if they've
9 been discontinued.
10
Q
Are you able to reconcile Dr. Kosenske's
()
11 diagnosis with the findings of all the previous physicians
12 that she had seen?
13
A
Well, from what I could see by the records and my
14 examination, I could not find anything suggesting muscle or
15 nerve disorder or spinal cord disorder. So I really could
16 not find any sign of any ongoing neurologic disease at the
17 time.
18
Q
Do you know whether Dr. Kosenske has sought the
19 input of any other practitioners?
20
A
I'm not aware of any other people being asked for
21 opinions aside from those we've talked about today.
22
Q
Do you know how Christine is currently being
23 treated?
24
A
Only from when I had seen her in April. I know I
J
25 had records of further steroid injections, but they were the
:)
()
o
21
1 main thing I had seen.
2 Q Describe your visit with Christine in April.
3 A I found her to be a very pleasant woman. She was
4 in some mild respiratory distress because of her chronic
5 lung disease. She was able to give me a full history of
6 everything that had happened. She did not appear to be in
7 any other type of distress, appear, as opposed to her
8 respiratory prob1em, and I was able to perform a full
9 evaluation on her.
10 Q Describe your evaluation of her.
11 A Well, it involved taking a history, which pretty
12 much had followed all the records of the pain and how it has
13 become a major part of her life right now, and also included
14 a full physica1, or I should say neurological evaluation,
15 including examination of her cranial nerves/ her muscles,
strength, her sensation, her coordination, and her
16 her motor
17 reflexes.
18 Q
19 A
20 did not.
21 Q
22 A
Did you perform any diagnostic tests?
Not aside from the actual physical examination, I
What were your findings, Dr. McCabe?
I had really found no evidence of any ongoing
23 neurologic disease. There was nothing indicating nerve
24 roots at any particular level being impinged, nothing
25 showing any current muscle cramps or tightness, and nothing
22
)
1 to support any evidence of central disease, such as the
2 spinal cord or the brain.
3
Q
What were her chief complaints when you examined
4 her?
5 A Her chief complaint was really, I guess/ two main
6 ones. The first was the neck pain that would radiate down
7 her arm. The other one, complaint she had, involved what
8 she was describing as Charlie horses in her left arm and her
9 left hand, and essentially she described these as involving
10 all of the fingers and the top portion of her forearm, that
11 they could occur at any time, but mainly while she was using
0 12 her arm, and would last up to about five minutes. They were
13 usually separate or independent from the pain by her
14 history.
15 Q Are you able to verify the cause of these
16 symptoms through any objective tests that had been performed
17 on Christine?
18 A There really could -- I could not find any
19 cause. Some cramps of the muscles can occur in diseases of
22
23
".... 24
--..)
25
cramps can just occur from extensive use of certain muscles
20 nerves or muscles, but again, no studies to this point have
21 found any evidence of such. And sometimes such types of
over and over again, the best example I can give being
writer's cramp for people who may spent several hours at a
time writing and typically have to put their pencil or pen
23
~
~
1 down to loosen up their muscles.
2 Q Did Christine discuss with you any hobbies that
3 she had or any activities that she pertormed?
4 A Yes/ she does describe doing a tair number ot
5 cratts and that she has been doing those for several years.
6 Q Did she describe her symptoms following doinq
7 those crafts?
8 A Well, the crafts were one of the thinqs that
9 could brinq them on because she did complain about, at
10 times, not being able to do as many or as much of the crafts
11 as she would like because of having these symptoms.
12 Q Doctor, did the auto accident ot December 24th,
13 1993, cause the condition which she complained of at the
14 time you had the opportunity to examine her?
15 A There was really nothing on her examination that
16 I could find that showed any evidence ot any permanent or
17 chronic disorder related to that accident.
18 Q Do you believe that the accident was a
19 substantial factor in brinqing about that injury, her
20 injuries?
21 A It played some role. She did, by records, appear
22 to have some symptoms at the time of the accident that
23 qradually worsened over a few weeks, but they did appear to
24 have resolution or improvement with her physical therapy,
25 and it may just be that her current complaints now resemble
o
')
-'
o
~
24
1 what those were 1ike, and therefore it has just been
2 connected to the accident.
3
Q
Doctor, has all your testimony been today within
4 a reasonable degree of medical certainty?
5
A
Yes/ it has.
6
MR. McNALLY: At this time I'd like to offer the
7 Exhibits 1 through 5 into evidence and offer Dr. McCabe for
8 cross-examination.
9
MR. BARIC: Let me make sure I have the numbers
10 correct. No. 4 starts out as C spine series, correct?
11
12
13
14
THE WITNESS: (Nods head up and down.)
MR. BARIC: And 5 then is the non-contrast MRI?
MR. McNALLY: That's correct.
MR. BARIC: Cervical spine. I have no objection
15 to the exhibits.
16 CROSS-EXAMINATION
17 BY MR. BARIC:
10
Q
Dr. McCabe, my name is Dave Baric, and I'm here
19 representing Christine Duncan in this matter. For what
20 period of time did you examine Christine the day you
21 indicated that you saw her, took her history and examined
22 her?
23
A
I believe it was somewhere in the range of an
24 hour to an hour and a half.
25
Q
Was that the only direct contact you have had
J
o
-~"',
\
---.)
.......j....l'';'.f..,;:.;...." '/:',i""P"-','
25
1 with Christine Duncan in relation to rendering an opinion in
2 this case?
3
4
A
Yes, it is.
Q
Doctor, are you being compensated for your time
5 that you spent on this matter? Are you being paid?
6
7
8
A
Yes.
Q
And how much are you paid?
Well, my current fee, at the time of her
A
9 evaluation, was $300 per hour.
10
Q
Your testimony was that you spent, you believe,
11 an hour to an hour and a half, was it --
12
13
A
Yes.
Q
on that day? Likewise, were you compensated
14 for rendering a report in this matter?
15
16
17 that report?
10
A
Yes/ I was.
Q
Do you recall how much time you spent drafting
A
The actual preparation of the report itself was
19 probably about one hour or so. The record review, I don't
20 remember exactly, but that was two or three hours.
21
Q
Would that record review have taken place before
22 or after your independent evaluation of Christine?
23
24
A
I believe it was before.
Q
And, likewise, Doctor, are you being compensated
25 for appearing here tOday, providing your testimony?
~
o
J
26
1 A Yes.
2 Q The same hourly rate?
3 A Um-hum.
4 Q Now/ I believe your testimony, based upon the
5 last few moments of your direct examination of Mr. McNally,
6 you indicated that you have no reason to doubt that
7 Christine experienced some pain immediately after the
8 accident, is that correct?
9 A That's correct.
10 Q Likewise, do you have any reason to doubt that
11 she experienced pain a week after the accident?
12 A No, I don't.
13 Q A month after the accident? Same question.
14 A No.
15 Q What report of any of the treating physicians did
16 you rely upon then to conclude at the point in time -- or
17 what point in time she actually no longer experienced any
18 pain associated with the accident?
19 A I believe it was in August under Dr. Hely's
20 notes.
21 Q It's Dr. Hely.
22 A He1y. There is the note, I think it is 8/24/94,
23 that states pain relief has been achieved with PT. She had
24 been going three times weekly, has very little pain except
25 at direct posterior aspect of the neck, and due to that had
27
::>
1 cut back her physical therapy to just once a week and had
2 planned on discontinuing it.
3
Q
So, approximately nine months after the accident,
4 you're relying upon the note of Dr. He1y then to conclude
5 that her pain had sUbstantially resolved itself?
6
A
Yes.
7
Q
Does Dr. He1y indicate that it had absolutely
8 resolved and there was no longer any pain?
9
A
Well, he says pain relief has been achieved, but
10 then also in the next sentence says that there is very
11 little pain except at one particular aspect of the neck,
o
12
direct posterior aspect.
Q Doctor, in your practice here at Hershey Medical
13
14 Center -- I believe you indicated you've been here for five
15 years have you worked with victims of whiplash injuries?
16 A Yes, I have.
17 Q Have you worked with -- well, tell me, what
18 percentage of your practice would you estimate relates to
19 working with people who have experienced whiplash-type
20 accidents or injuries in car accidents?
21
A
I'd say, since the time I have been here,
22 including some of my training, probably about 5 to 10
23 percent.
~."""~
24
Q Have you always found that in working with -- and
now I'm limiting my question to the 5 to 10 percent of your
.....J
25
28
~
~
1 practice that relates to folks who have been involved in
2 whiplash-related injuries. For those people, have you
3 always been able to ascertain an objective finding that
4 relates to their subjective complaint of pain?
5 A Well, I'd say for the majority of them we
6 typically cannot find objective findings. The exceptions
7 would come along when we have people that, due to such an
8 injury, have pertained actual nerve damage or, in some case,
9 blood vessel damage.
10 Q So, more often than not, you're not finding
11 you're not coming up with an objective finding through an
12 X-ray or an Mal that would relate to the subjective
13 complaints of pain?
14 A Right.
15 Q Now, you offered, in concluding your direct
16 examination, that Dr. Kosenske has indicated that Ms. Duncan
17 is SUffering from fibromyalgia. Are you familiar with that
18 term and that condition?
19 A I'm familiar with the term. In terms of familiar
20 with the condition, I guess it depends on exactly what do
21 you mean by the condition. Since there really are no
22 objective tests for making the diagnosis, it really relies
23 on somebody saying they have it or don't have it.
24 Q Um-hum. Well, it relies upon -- as I understand
25 it, it relies upon people continuing to indicate
o
29
1
v
1 subjectively that they're experiencing pain, and yet there
2 is no objective finding to match it. Isn't it true/ Doctor,
3 that as it relates to fibromyalgia, in fact, your practice
4 is to try to rule out other things with tests before coming
5 to a diagnosis of fibromyalgia?
6 A Well, that is how the diagnosis is used by
7 several people. I think one of the major concerns is, is it
8 a true disorder or not.
9 Q And you're aware/ are you not, that support
10 groups have been put in place and whatnot for folks who are
11 sUffering from fibromyalgia?
12 A Yes.
13 Q And there's a syndrome, as I understand it,
14 that's been associated with fibromyalgia and referred to as
15 fibromyalgia syndrome?
16 A Yes, there has been.
17 Q Have you written any articles relating to
18 fibromyalgia?
19 A No.
20 Q Have you given any lectures in regards to
21 fibromya1gia?
22 A Not specifically about that disorder. It's been
23 included, though, in some of the talks that may be about
24 pain in general.
25 Q Does fibromyalgia really fit within the study of
o
30
()
..,-"
1 neuroloqy?
2
A
It will be included in textbooks and the journal
3 articles because it is commonly a diaqnosis that comes up in
4 regard to differential diaqnosis from other neuroloqic
5 disorders, and also muscle disorders are typically covered
6 by neurologists as well, such as muscular dystrophies.
7
Q
Is there another classification or specialty
8 within there has been more of a discussion of fibromyalgia
9 in the medical community?
10
A
There probably have been. My quess/ and it's
11 mainly a guess/ would be rheumatology.
o
12
Q
All riqht. Dr. McCabe, in renderinq your report
13 previously in this matter, you referenced a number of tests
14 that you performed on Christine. The report that you had
15 provided, that, as I understand it, indicated to the
16 exclusion of anythinq else all of the tests that you
17 performed on Christine.
18
A
We1l, I had performed just a physical
19 examination. I was qoing by the reports of other tests.
20
Q
All riqht. Would you have liked to have
21 performed any further testinq in reqards to renderinq an
22 opinion of Christine?
23
A
No. Actua11y, the main test would have been the
24 MRI and the nerve conduction tests in terms of seekinq out
, -...J
25 an actual cause that may have been directly related to the
31
.'l
1 accident.
2 Q And/ as I understand it from the previous
3 testimony, the MRI and the X-rays/ again, you're looking for
4 objective findings?
5 A (Nods head up and down.)
6 Q Physical changes to the body
7 A Yes.
8 Q -- that would relate then to an indication of
9 paint correct?
10 A Correct.
11 MR. BARIC: I have nothing further at this time.
0 12 MR. McNALLY: I have no further questions at this
time. Thank you,
13 Doctor.
18
19 a.m.)
20
21
22
23
,..) 24
25
14 MR. BARIC: Thank you.
15 THE WITNESS: You're welcome.
16 THE VIDEOGRAPHER: This videotape deposition is
17 now concluded. The time of day is 9:48 a.m.
(Whereupon, the deposition was concluded at 9:48
32
,-:)
1 COUNTY OF DAUPHIN
2 SS
3 COMMONWEALTH OF PENNSYLVANIA
4 1/ Jamie F. Hackman, a Notary Public, authorized to
5 administer oaths within and for the Commonwealth of
6 Pennsylvania, do hereby certify that the foregoing is the
7 testimony of PAUL H. McCABE, M.D.
8 I further certify that before the taking of said
9 deposition, the witness was duly sworn; that the questions
10 and answers were taken down stenographically by the said
11 Reporter-Notary Public, and afterwards reduced to
o
12 typewriting under the direction of the said Reporter.
13 I further certify that the said deposition was taken
14 at the time and place specified in the caption sheet hereof.
15 I further certify that I am not a relative or employee
16 or attorney or counsel to any of the parties, or a relative
17 or employee of such attorney or counsel, or financially
18 interested directly or indirectly in this action.
19 I further certify that the said deposition constitutes
20 a true record of the testimony given by the said witness.
21 IN WITNESS WHEREOF, I have hereunto set my hand this
.'
.1-
22 20th day of October, 1997.
23
'~""'.
24
/
"
RPR/RMR
-...J
25
NOTAAALSEAL
JAMIE F, HACKMAN, HoIIIy PIlI*
H"".bYtg. 00upIlIn CeUNy
I.. ~\~.~~.-, J!L:.n E'!,?!~ _~ 15. 1998
Q..
w
o
R
D
I
N
D
I
X
o
to
.
Multi-Pagcl>l
$300 - ccrtlfy
PAUL II, McCAlIIl. M.I).
I
.---
alon,lllJl 14:5 20:1 I based 1'1 15:18 264
-S- -8- 28: beeomol'llII:4 21: Il
5300111 25:9 8n4/94 III 26:22 always 1'1 6:2 27:24 beginning III 4:~
28:3 behalfl'l l,Y 311
.'- -9- American 1'1 5:12 3:1l
5:16 5:17 best III 22:2l
'94111 12:18 95-6807111 1:4 Amitriptyline III 9:ll between III 10: II
'97111 9:11 9:031'1 1:12 3:4 amount fJI 5: I 1:24 biology III 47
9:481'1 31:17 31:18 11:15 Black III 3:2
-I- analysis III 10:6 blood III 21:9
1[71 2:11 13:10 -A- anatomy III 5:25 bosrd fJI 5:10 5:12
1l:13 13:14 16:2 1:12 3:4 answers 1'1 B:B body 1'1 IB:II 31:6
a,m(41 B:8 32:10
16:4 24:7 31:17 31:19 anxiety 1'1 8:2 bone III IB:I
10['1 27:22 27:25 abilitr 1'1 11:25 14:17 8:24
19:25 bones III 18:19
131'1 2:11 2:12 17:2 appear 1'1 19:14 21:6 brain (41 4:15 4:16
15111 2:13 ablclIll 6:22 7:4 21:7 23:21 23:23 18:11 22:2
17111 2:15 8:13 11:15 11:21 APPBARANCES III break III 7:21
12:3 12:16 15:10
18111 2:17 15:15 19:8 19:16 1:16 breathing III 10:4
1980111 8:23 20:3 20:10 21:5 appearing III 25:25 10:4 10:12 11:12
1988111 5:9 21:8 22:15 23:10 approach III 7:23 19:23
19931'1 6:13 10:8 28:3 Afril fJI 9:11 20:24 brier (JI 12:12 16:2U
23:13 abnormalities III 11:22 1:2 briefly 1'1 4:4 5:21
1994111 8:15 12:4 15:17 16:11 area 1'1 18:23 18:24 bring III 23:9
1997141 1:12 3:3 16:12 20:1 bringlnglll 23:19
7:19 32:22 abnormality 1'1 11:16 arm 141 9:IB 22:7 bulge III 19:5
20:3 22:8 22:12
absolutely III 27:7 articles 1'129: 17 buslnesB III 4:2
-2- 30:3
Academy III 5:16 ascertain III 2B:3 -c-
2141 2:12 13:10 accidcnt I1I1 6:12
13:19 13:20 6:16 8:14 8:17 aside 1'1 11:11 20:21 CIII 1:3 3:7
20th III 32:22 10:17 10:18 11:21 21:19 13:16 16;5 24:11I
241'1 2:5 10:8 23:12 23:17 2l:18 aspect 1'1 26:25 27:11 C-Spine 1'1 2:14
24th 1'1 6:13 8:15 23:22 24:2 26:8 27:12 17:10
23:12 26:11 26:13 26:18 assess III 12:1 C4.C5 III 19:4
27:3 31:1 assessment III 9:3
29111 1:12 C5.C6(J1 19:4 IY:5
accidents 1'1 27:2U associated 1'1 W:3
29th III 3:3 27:20 26:18 29:14 candidate III 8:20
-3- according III 16:8 associations III 5:14 cannot III 28:6
accountlll IB:18 atrophy III 16:16 caption 1113:6 32:14
31'1 2:4 2:13 achieved I'I 26:23 attention III 10:16 earlll 27:20
15:4 15:7 15:8 27:9 attorney III 32:16 carelli 11:10
15:10 action 1'1 1:2 32:18 32:17 Care!J III 6:14 12:22
3004111 3:2 activities III 23:3 August(JI12:IB 26:19 12: 3 1l:3 13:5
actual 1'1 B:17 15:17 authorized III 32:4 carpal III 8:23 9:5
-4- 21:19 25:18 28:8 auto 1'1 8:14 23:12 case 141 3:6 9:7
41'1 2:14 17:12 30:25 available III 18:1l 25:2 2B:8
17:15 17:17 24:10 added III 5:12 15:22 2U:2U cases III 6:2
additional (II 5:11I aware 1'1 ealegorles III 1'11/0
29:9
-5- address 1114:2 axon III 14:9 causes I" 6:23 ""
5 1'1 2:16 18:5 addressed I" 15:13 eavitYll1 18:11
24:7 24:12 27:22 15:14 -B- Centerrll 1:13 3:5
27:25 administer III 32:5 4:' 4:13 27:14
5/30/95 1'1 2:13 admission III 11:2 BI'I 1:5 3:7 centrall'l 14:8 22:1
15:3 anerwards III 32:11 Bachelor II I 4:7 certain III 22:22
5001'1 1:13 3:5 again 1111 4:25 11:11 background III 4:5 Certainly III 7:25
4:3 12:2 12:23 15:16 Baker I"I 2:11 6:13 certainty 1'1 7:5
5th 1'1 7:19 8:3 15:19 16:9 17:21 13:8 13:15 13:16 8:10 2N
22:20 22:23 31:3 15:25 16:5 16:6 certirieatlonN III 5:11I
-7- agolll 5:18 Baric 1141 1:17 1:17 ccrtiried III 4:2U
ahead III 7:20 2:5 3:13 3:1l ~:II
7/9/96111 17:19 7:11 7:14 24 'I
Alexander 1'1 6:15 24:12 2414 24:17 certifr 1'1 32,/0 32M
12:8 24:18 31 :11 3114 32:1 32 IS 32:1'1
HUGHES, ALBRIGHT, FOLTZ & NATALE
717-540-0220\717-393-5101
Index I'lIgc I
')
(')
HUGHES, ALBRIGHT, FOLTZ & NATALE
717-540-0220\717-393-5101
Index Page 2
Multi-Page""
ccrvical - Duncan
PAUL II, McCABB, M.D.
cervical 1111 2:17 31:18 Dill 13:15 discuSSll123:2
10:21 10:25 14:25 concluding III 28:15 damage 14115:21 16:13 discussed 111 6:2
15:20 17:6 17:9 conclusions III 14:22 28:8 28:9 discussion III 30:8 r
17:18 18:4 18:16 condition 1111 Daniel III 15:14 disease 1101 7:2
24:14 6:23
chance (IJ 6:24 7:6 7:18 8:14 Darvocetlll 9:12 13:1 14:13 14:20
9:15 9:24 10:12 date 121 1:12 3:3 14:25 15:20 20:16
changcs ('1 16:15 1\:12 12:1 14:18 DAUPHIN III 32:1 21:5 21:23 22:1
16:22 18:1 18:25 14:23 17:24 19:9 dise88CSl21 4:22
31:6 23:13 28:18 28:20 Dave (IJ 24:18 22:19
Charlie 11122:8 28:21 David 1'1 1:17 3:13 disorder 1'1 14:9
chiefl'l 1\:1 22:3 conditions 141 8:25 13:15 13:16 16:5 20:15 20:15 23:17
22:5 9:2 9:22 10:9 deals III 4:15 29:8 29:22
chiropractic (IJ 16:20 conduction ('1 13:23 December (41 6:12 disorders 111 4:15
Christine 1241 1:3 14:3 14:15 15:2 8:15 10:8 23:12 4:24 5:1 6:1
3:7 3:14 6:8 30:24 dccrease III 12:17 12:25 30:5 30:5
7:18 9:3 10:16 Conductions 121 2:12 Defendant 1'1 1:6 disrufted 121 14:7
15:12 17:19 18:14 13:9 1:9 1:21 3:9 14:1
18:22 20:5 20:22 connected III 24:2 3:12 distress 121 21:4
21:2 22:17 23:2 consisted III 12:10 degree 1'1 4:7 4:9 21:7
24:19 24:20 25:1
25:22 26:7 30:14 consists III 14:2 7:5 8:9 9:5 division (II 10:1\
30:17 30:22 constitutes III 32:19 24:4 doctor 1221 3:22 4:4
Christine's 121 8:14 consult III 4:25 Department 141 2:14 4:14 7:3 8:12
19:21 contact 11124:25 2:16 17:10 18:3 8:12 9:1 9:8
chronic 1'1 16:15 deposition 1141 1:8 9:25 1\:9 13:12
21:4 continue III 8:4 2:10 3:4 3:8 15:6 17:14 18:7
23:17 continuing (21 1\:9 7:22 13:9 15:4 19:20 23:12 24:3
chronically III 9:22 28:25 17:1\ 18:5 31:16 25:4 25:24 27:13
CIVIL 121 1:2 1:4 coordination III 21:16 31:18 32:9 32:13 29:2 31:13
classification III 30:7 cord 111 4:16 18:2 32:19 doctors 1115:4
Clinic III 16:25 18:1\ 18:17 19:6 dennatomal III 19:1 done ('I 14:4 18:7
clinical 1'1 5:13 20:15 22:2 describe III 4:4 18:16
15:1\ 15:20 correct 111 24:10 24:10 5:21 1\:14 13:25 doubt (21 26:6 26:10
clinics III 4:23 24:13 26:8 26:9 21:2 21:10 23:4 Douglas (21 1:23
23:6
college 1'1 4:5 4:6 31:9 31:10 3:1
4:1\ counsel (2) 3:9 described III 22:9 down 111 9:18 14:4
collision III 10:7 32:16 32:17 dcscribing 121 19:17 22:6 23:1 24:1\
coming 1'15:2 COUNTY 121 1:1 22:8 31:5 32:10
28:1\ 32:1 dctail III 8:22 Dr 1211 3:25
29:4 2:1\
comment!'1 1\:21 course 141 1\:6 11:20 dctailedlll 6:24 4:18 6:13 6:13
12:3 12:16 12:5 12:13 diagnose 121 17:23 6:14 6:14 6:14
comments (II court 1'1 1:1 3:15 19:9 6:16 7:9 7:15
12:25 3:17 diagnosis 1101 8:1 8:6 10:16
COMMON 111 1:1 6:23 1\:9 1\:13 1\:17
commonly III covcred III 30:5 19:10 19:1\ 19:15 1\:25 12:5 12:17
30:3 covcring 121 6:1 20:1\ 28:22 29:5 13:3
Commonwealth ('1 5:5 29:6 30:3 30:4 12:22 12:23
14:6 13:5 13:6 13:8
32:3 32:5 crafts 141 23:5 23:7 diagnostic 141 1\:17 13:15 13:23 13:25
community (II 30:9 23:8 23:10 16:7 19:18 21:18 14:22 15:1\ 15:14
compensated ('1 25:4 Craig III 13:23 diffcrent (41 9:1\ 15:16 15:22 15:24
25:13 25:24 cramp III 22:24 10:12 12:25 14:11 16:1 16:5 16:6
complain III 23:9 diffcrential III 30:4 16:10 16:10 16:21
cramps 1'121:25 22:19 16:25 17:1 17:3
complained (II 23:13 22:22 difficult III 10:10 19:8 20:5 20:10
complaint (41 1\:3 cranial III 21:15 direct (61 3:20 24:25 20:18 21:21 24:7
22:5 22:7 28:4 cross-examination 121 26:5 26:25 27:12 24:18 26:19 26:21
complaints 111 10:1 24:8 24:16 28:15 27:4 27:7 28:16
10:11 11:1 13:1 CUMBERLAND III direction (II 32:12 30:12
22:3 23:25 28:13 1:1 directly 1'1 9:6 drafting III 25:16
completed (I] 4:12 current 1619:1 9:6 30:25 32:18 Drivc 141 1:13 3:2
component 1'1 8:2 13:2 21:25 23:25 disci') 14:25 15:20 3:6 4:3
9:2 19:25 25:8 19:4 drug (II 9:19
componcnts (II 7:11 cutlll 27:1 discomfort (21 1\:5 due 121 26:25 28:7
concerns (IJ 29:7 Cuthbertson 14) 2:15 1\:5 duly 121 3:19 32:9
conclude (21 26:16 2:17 17:11 18:4 discontinued III 20:9 Duncan (131 1:3
27:4 discontinuing III 27:2 ~
3:7 3:14 6:8
concluded 121 31:17 -0- diSCS('1 18:20 6:19 6:22 9:3
. ,
"
'_'J
--J
Multi-Page '"
Duncan', - Introduce
PAUl. II McCAUl! M I>
, ,
15:12 17:19 18:14 elthibilll7l 2:9 16:15 18:24 18:25 [hobblealll 23:2
24:19 25:1 28:16 2:10 13:9 1.1:13 Colksl21 28:1 29:10 honoslll 22:H
Duocan'S(11 7:18 13:14 13:17 13:19 Collowed III 21:12 lIosphallll 12:9
15:4 15:7 15:8
DURKIN (II 1:19 15:10 16:2 16:4 Collowing 121 4:9 hotlll 12:1lI
dystrophies III 30:6 17:11 17:15 17:17 23:6 hour 1'1 24:24 24:24
18:5 COIIOWSIII 3:19 25:9 2':1 I 2': II
-E- elthlbits(21 24:7 Coreano(11 22:10 25:19
educating (II 5:2 24:15 Coregoing (II 32:6 hourly III 262
education (II 5:2 eltistenccllI 19:19 Corward III 10:13 houR 121 22:24 25:20
educational (II 4:5 eltpect(11 16:12 Cound 111 B:l 17:21 hyper-CUBIleratlon III
either 121 12:24 16:24 eltperiencc III 4:19 20:3 21:3 21:22 19:21
E1avil (II 9:13 experienccd (41 26:7 22:21 27:24
26:1 I 26:17 27:19 Courlll 4:9 ...
electromyogram III eltperieneing III 29:1 Cull (41 7:1 21:5 IdentlCy 141 3:16
13:23
Electromyography (21 eltperl (21 6:4 7:9 21:B 21:14 13:14 15:10 17:17
2:12 13:8 eltplainll120:4 -0- Ima~lnSl21 IH:9
emergency ('I 6:15 explanation III 8:7 IB: 3
10: 19 10:20 11:3 eltpreSSIIJ7:14 gastrolntcstinallll 20:2 Immediately 121 10:17
11:24 19:23 eltpressed 121 7:17 gather II I 12:9 26:7
EMG(]I 14:10 14:15 7:18 general 141 5:25 11:9 Implnsed III 21:24
15:2 extensive (21 20:2 12:24 29:24 Im~lngementl21 IH:21
emfloyec 121 32:15 22:22 Gerald \21 1:5 3:7 I ,6
3 :17 eltlentlll 7:15 GlIII 13:1 Im~lnslns 121 IB:I
Epilepsy III 5:17 slven 141 B:22 11:11 I :IH
ESQUIRB(21 1:17 -F- 29:20 32:20 Improvement III 23:24
1:20 Fm 1:10 32:4 gradually III 23:23 Included 141 B:3
esscntially III 4:15 21:13 29:23 311:2
6:25 10:25 14:19 32:23 groups III 29:10 Includealll 4:16
18:12 19:3 19:15 Cact(11 29:3 guess ('1 5:IH 22:5 IncludlnSI1l 5:24
22:9 Cactor (21 9:2 23:19 2B:20 30: III 30:1 I 6:13 9:12 12:25
estimate (II 27:18 Cactors (II 10:6 17:4 21:15 27:22
evalusted (II 9:11 Cairl41 5:1 7:24 -11- IncreaNO III 12:16
evaluating 121 14:10 8:24 23:4 HI'I I:B 2:3 Inder;:ndenl (21 16:7
14:12 Call III 19:16 3:B 3:IH 32:7 22: 3 25:22
evaluation (III 10:20 Camiliar (31 2B:17 Hackman 141 1:10 INDBXI21 2:1
12:12 13:15 15:18 28:19 28:19 3:17 32:4 32:23 2:9
16:5 16:21 21:9 Camily (21 11:8 12:24 hatCI21 24:24 25:11 Indicate 121 27:7
21:10 21:14 25:9 Casciculations (II 16:17 hand (21 22:9 32:21 2H:25
25:22
evidence 1101 7:2 Ccelll 25:8 hcadlll 10:14 24:11 Indicated 1'1 IB:7
Ceeling1119:17 31:5 24:21 26:6 27:14
14:20 15:1 15:21 headache III 2H:16 311:15
19:5 21:22 22:1 CeW(41 5:18 19:22 5,25 Indicating III
22:21 23:16 24:7 23:23 26:5 Ilealthlll 6:15 21:23
euclly (2113:5 25:20 fibromyalgia 1121 19:12 Hcly IIlI 2:13 6:14 Indication 121 19:20
28:20 19:13 2B:17 29:3 11:9 11:13 11:17 31:H
eltam(21 11:15 11:22 29:5 29:11 29:14 12:5 12:17 15:3 indlrecllYlI1 J2:IB
examination 1161 2:2 29:15 29:18 29:21 15:14 15:14 16:1ll Individual III 6:2
3:20 6:22 6:25 29:25 30:B 26:21 26:22 27:4 Inhalers 121 9:23
7:1 7:4 16:8 field 141 5:19 5:22 27:7 11:11
16:11 16:14 20:14 6:5 7:9 lIely's 121 I 1:25 26:19 Inleetlonsl]1 17:4
21:15 21:19 23:15 fields III 5:4 hereby III 32:6 0:7 20:25
26:5 28:16 30:19 financially III 32:17 hereoCll1 32:14 Inlurlesl41 23:20
examinations (II 11:18 Cinding 1412H:3 2H:1ll hel1lunto III 32:21 7:15 27:20 2B:2
examine (II 6:IB 28: II 29:2 herselC\2I 3:16 16:24 Inlury 1]1 10:7 23:19
23:14 24:20 Cindlngsl'l 11:13 IlersheY"1 1:13 B:H
examined 121 22:3 11:25 20:11 21:21 1:14 3:5 3:6 Innervated III 14:11
24:21 2H:6 31:4 4:1 4:3 4:12 Inpatient III 4:24
example (21 10:11 fingers III 22:10 4:13 27:13 Input III 13:3 14:11
22:23 first (31 14:2 22,6 hlgllCrlll IH'I2 20:19
except 121 26:24 27:11 Cit 121 19:15 29:2' hlOllOIC II II 1:17 interested III 32:IB
exceptions III 2H:6 five (II 4:21 22:12 hlHtory I'I 625 H:19 Internist III 11:9
eltclusion III 30:16 27:14 H:22 11 :20 2U introduce 121 3: III
elterciscs III 12:11 Cocali'l 12:3 16:14 21:11 22:14 24:21 3:22
HUGHES, ALBRIGHT, FOLTZ & NATAI.I!
717-540-0220\717-393-5101
Index Page 3
Multi-pageT>l
involved - once
PAUL II McCABE M 0
, ,
IDvolvcd 121 21:11 ooklDglll 31:3 menllon III 8:24 21:14
22:7 28: I looks III 14:8 mild 1'1 19:3 19:4 neurologist 1.1 4:1
involves III 14:10 loosen III 23:1 21:4 4:13 13:7 IS:16 ,-
involving [II 22:9 loss III 16:IS minules III 22:12 neurologists 1'1 S:2
itself 1.1 18:2 18:17 lunglll 21:S mobility III 12:17 30:6
2S:18 27:S modes III 17:3 neurology 11.1 4:10
-M- moments III 26:S 4:14 4:20 S:II
-J- S:16 S:19 S:23
M.DI" 1:8 2:3 month(11 26:13 6:1 6:1 6:S
JII) 1:20 3:8 3:18 4:9 months ('I S:18 27:3 7:10 7:11 7:12
JAMES 1'1 1:19 32:7 mostlll 12:7 30:1
Jamie (.1 1:10 3:17 MacIntyre 1'1 1:23 motion III 12:11 Neurontin III 9:13
32:4 32:23 3:1 motorlll 21:16 neurophysiology III
Jefferson III 4:8 Magnetiell) 18:9 MRlII2I 2:16 17:6 S:13
John 121 1:20 3:11 main 1'1 8:18 9:4 18:3 18:7 18:8 newlll 5:2
Uoinls III 18:11 11:3 21:1 22:5 18:9 18:15 19:2 neWer(11 18:10
Uournahl) 30:2 30:23 24:12 28:)2 30:24 next (I' 27:10
~_udge (II 7:23 maintain (II 10:13 31:3 nine III 27:3
major(21 21:13 29:7 MSI'I 6:18 6:22 Nods 121
Jurgensen 1'1 2:13 majority II) 28:16 24:11 31:S
6:14 13:6 13:24 28:5 muscle 1'1 14:13 non-contrast 121 2:)6
14:22 15:3 IS:II marked 1112:10 13:9 14:20 18:3 24:12
15:16 16:10 15:4 15:7 16:2 16:13 16:16 16:17 nonnal121 10:25
UUIYI'I 17:11 17:15 18:4 16:18 20:14 21:25 14:16
3:23 8:7 30:5 19:11
match III 29:2 muscles I"I 10:IS Nos III 13:10
-K- matter 1.1 24:19 25:S 14:10 15:18 21:15 Notary 121 1:11 32:4
knCCll1 11:4 25:14 30:13 22:19 22:20 22:22 32:24
knowledge (I) 19:8 may (1.1 7:15 7:19 23:1 nole (.1 IS:II 16:9
8:3 9:5 9:10 muscular 121 19:18 26:22 27:4
Kosenske III 6:17 10:10 14:24 18:1 30:6 notes ISI 8:21 12:15
16:25 17:2 17:3 18:18 19:17 22:24
19:8 20:S 20:18 23:2S 29:23 30:25 must III 10:13 12:18 19:24 26:20
28:16 McCabe 1251 1:8 myclin(IJ 14:7 nothing 1'1 17:21
Kosenske's III 20:10 2:3 2:10 3:8 myofaseial121 19:12 21:23 21:24 21:25
3:18 3:24 3:25 19:13 23:15 31:11
-L- 4:18 7:9 7:15 now (121 3:10 3:IS
8:1 8:6 10:16 -N- 9:10 15:6 16:1
11IStl') 4:21 22:12 13:9 14:1 IS:4 20:8 21:13 23:25
26:5 15:22 16:1 17:11 name ISI 2:2 3:1 26:4 27:2S 28:15
LAWIII 1:2 18:4 21:21 24:7 3:7 9:14 24:18 31:17
learn 121 8:13 15:15 24:18 30:12 32:7 nature III 18:22 number 1'1 23:4 30:13
least III 7:18 McNally 1171 1:20 neaql) 18:24 numbers (II 24:9
lectured 121 S:19 2:4 3: II 3:11 necessary (II 7:22 numerous (II 4:22
3:21 7:8 7:12
5:22 7:25 8:5 13:11 neck 1111 9:18 10:1
lectures III 29:20 IS:5 17:13 18:6 10:3 10:14 10:IS -0-
lecturing II) S:25 24:6 24:13 26:5 11:5 11:23 13:2 O'BRIEN III
22:6 26:2S 27:11 1:17
left 1.1 31:12
9:18 11:4 negative 121 17:22 Oak(11 3:2
22:8 22:9 mean (II 28:21
letteq'l measured III 19:11 oaths (II 32:S
2:13 15:3 14:4 nerve 1"1 2:12 13:8 objection 1'1 7:14
level (II 21:24 medical (261 1:13 13:22 14:3 14:4 24:14
levels III 19:4 3:5 4:1 4:8 14:S 14:6 14:8 objective (71 22:16
IicenSe(11 S:8 4:11 4:13 S:3 14:15 14:20 15:2 28:3 28:6 28:11
S:17 6:3 6:8 15:21 16:13 18:1
licensed III 5:5 6:21 7:5 7:9 28:22 29:2 31:4
18:17 18:19 18:23
lifelll 21:13 8:9 8:13 8:14 19:6 20:15 21:23 oeeuq21 22:11 22:19
liked III 30:20 8:16 8:18 8:2S 28:8 30:24 22:22
likewise 121 25:13 9:1 10:16 16:19 nerves 1'1 4:16 4:17 Oetoberlll 32:22
19:20 24:4 27:13 offeq21
2S:24 26:10 30:9 14:11 15:18 21:15 7:9 24:6
limiting III 27:2S medication (21 22:20 24:7
9:8 offered 1'17:15 28:15
limits III 14:16 9:10 17:S nervous III 15:17
lines III 20:1 medications 1.1 9:12 neurologic 1111 4:22 offering III 7:20
Lionlll 3:2 9:16 20:7 20:8 4:24 S:I 6:25 office (IJ 11:20
7:2 9:4 11:22 often III
10ngcq'l 26:17 27:8 medicines III II : III 12:3 20:16 21:23 28:10
look 121 14:6 18:16 mcmbeql) 5:14 30:4 olderlll 10:2
members III 3:23 neurological 1'1 9:2 once(11 27:1
HUGHES, ALBRIGHT, FOLTZ & NATALE
717-540-0220\717-393-5101
Index Page 4
('-')
~ d._.~.
Multi-Page''''
one - residency
PAUL H. McCABE, M.D
~
,
onCll1 9:4 11:11 percent 12127:23 27:25 prevlouHIYlI1 30:13 receive 151 5:8 10:17
18:10 22:7 23:8 percentage III 27:18 primary III 14:13 12:13 16:19 16:22
25:19 27:11 29:7 perfonn (61 6:24 problem 121 8:18 received 121 4:6
ones III 22:6 11:17 16:8 17:7 21:8 4:9
ongoing ISI 14:20 21:8 21:18 problems 121 12:19 reconcile III 20:10
20:16 21:22 perfOrmc:dlUI 11:22 19:23 record III 25:19 25:21
operated III 8:23 11:24 13:23 15:2 proceeded III 4:8 32:20
opinion 161 7:17 16:6 17:8 17:18 produced 151 2:10 records 1111 6:8
13:7 15:23 15:24 22:16 23:3 30:14 13:9 15:3 17:11 6:10 6:12 6:13
25:1 30:22 30:17 30:18 30:21 18:4 6:21 7:4 8:13
opinions III 20:21 period J2I 16:20 24:20 profeHsion III 3:25 8:16 10:2 10:13
opportuni'lISI 6:7 peripheral III 4:17 profeHsionlll121 11:4 12:10 12:22
4:19 19:21 20:13 20:25
6:10 :18 12:21 pennanentlll 23:16 5:14 21:12 23:21
23:14 pertain III 10:10 provide III 6:23 Red III 3:2
opposed III 21:7 pertained III 28:8 8:9 14:17 reduced III
ordered 11118:15 pertinent 121 10:6 provided ISI 7:19 32:11
refeflsl 13:19 15:6
origin III 18:24 11:25 8:17 30:15 15:7 16:1 17:14
otherwiSC(11 9:2 Philadelphis III 4:11 providing 121 8:8 referenced III 30:13
outpatient III physical 1'1 12:7 25:25
4:23 referred III 16:24
outpatients (II 4:23 12:15 12:19 21:14 provinglll 19:19 16:24 29:14
overlap 11110:9 21:19 23:24 27:1 psychiatry III 5:11 reflexes (II
30:18 31:6 psychologieallsl 7:15 21:17
physician ISI regard 121 14:23 30:4
-P- 10:20 7:17 12:12
12:24 19:24 psychologies (II 7:16 regarding 141 6:12
Pili 15:14 physicians 121 20:11 psychology III 7:13 8:18 14:18 15:12
packs III 12:10 26:15 PTIII 26:23 regards (21 29:20 30:21
paid 121 25:5 25:7 piekcd III 16:14 Public 141 1:11 32:4 Rehab (II 6:15
pain 1101 9:17 10:1 pinched III 18:23 32:11 32:24 relate 121 28:12 31:8
10:3 11:14 12:17 place 141 1:13 25:21 pull III 11:4 related ISI 9:6 23:17
13:2 14:25 16:24 29:10 32:14 30:25
17:5 18:25 19:12 Plaintiff 141 1:3 pulmonary (41 8:19 relates (41 27:18 28:1
19:13 19:18 21:12 1:18 3:14 6:8 8:20 9:21 13:1 28:4 29:3
22:6 22:13 26:7 planned (II 27:2 purposes (II 7:21 relating III 29:17
26:11 26:18 26:23 put(21 22:25 29:10
26:24 27:5 27:8 played III 23:21 relation III 25:1
27:9 27:11 28:4 PLEASIIII:I -Q- relative (21 32:15
28:13 29:1 29:24 pleasant III 21:3 32:16
31:9 point (II 7:8 8:1 qualifications (II 5:12 relief ISI 16:22 26:23
part 141 12:7 14:8 8:20 15:22 16:23 questions III 8:7 27:9
14:9 21:13 22:20 26:16 26:17 31:12 32:9 relieslll 28:22 28:24
particularl21 21:24 points 121 14:5 20:1 quiveringlll 16:17 28:25
27:11 portion 11122: 10 rely (II 26:16
partieularlY(11 10:4 poscd III 6:4 -R- relying 11127:4
parties III 32:16 possibly III 18:1 radiatelll 22:6 remarks III 10:2
parts III 14:2 posterior (21 26:25 radiation (II 18:25 remember III 25:20
past III 8:21 27:12 Radiology 141 2:14 rendering (41 25:1
pathway III 14:5 posture III 10:13 2:16 17:10 18:3 25:14 30:12 30:21
patient(11 6:2 practice 141 27:13 raised II) 14:24 repeat III 17:9
patients ISI 4:25 27:18 28:1 29:3 raiscs III 15:19 report (141 2: II 7:19
12:16 19:15 practitioneflll 12:24 7:24 8:3 13:8
rangc 121 12:11 24:23 13:22 15:15 18:21
pattern (II 19:1 practitioners III 20:19 rate (II 26:2 25:14 25:17 25:18
Paul 161 1:8 2:3 Prednisone (21 9:20 rathcfl II 18:19 26:15 30:12 30:14
3:8 3:18 3:24 9:21
32:7 preparation (II reach III 14:22 reported III 17:21
25:18
pen (II 22:25 really IISI 5:24 7:16 reporter ISI 3:15
prescribe (I) 12:5 9:6 11:15 16:22 3:17 32:12
pencil III 22:25 prescribed 121 11:6 19:16 19:18 20:15 Reporter-Notary III
Pennsylvania 1101 1:1 12:7 21:22 22:5 22:18 32:11
1:14 3:3 3:6 present 121 I :22 13:12 23:15 28:21 28:22 reports II) 30: 19
4:3 4:11 5:6 29:25
5:17 32:3 32:6 presentation 121 8:2 represent (II 3:2
people (II 19:17 20:20 19:25 reason (21 26:6 26:10 representing (II 24:19
22:24 27:19 28:2 pretty (II 21:11 reasonable 1'1 7:5 resemble (II 23:25
28:7 28:25 29:7 previous 121 20:11 8:9 24:4 residency III
31:2 reaSOnS(117:16 4:10
pertll 25:9
,...)
HUGHES, ALBRIGHT, FOLTZ & NATALE
717-540-0220\717-393-5101
Index Page 5
n:sidcnta III 6:3 6:15 steroid 1'1 17:4 20:7 14:18 24:3 25:10
n:solution 121 18:12 sctlll 32:21 20:25 25:25 26:4 31:3
23:24 scvCrSIII"1 6:16 still 121 20:6 20:8 32:7 32:20
n:solvcd 1'1 12:19 9:11 9:23 10:12 strain III 10:14 testing III 30:21 ,-
27:5 27:8 11:19 12:15 17:3 strength III 21:16 tcsISI"1 11:17 13:23 I
Resonsncelll 18:9 22:24 23:5 29:7 studcnta 121 5:3 14:14 14:15 16:7
n:spectivcly III 13:10 sheath III 14:7 6:3 19:10 19:19 21:18
22:16 28:22 29:4
n:sp,intory 1'1 9:24 sheet III 32:14 studicSll1 22:20 30:13 30:16 30:19
2 :4 21:8 Shippensburg 121 6:14 study III 29:25 30:24
n:sponsc III 7:25 12:9 subjcctivc '21 28:4 textbooks III 30:2
n:sult 1'1 6:21 7:3 show 1'1 15:1 18:22 28:12 Thsnk 121 31:13 31:14
10:7 19:2 subjcctivcly III 29:1 themsclvcsl21 3:10
n:sulta 141 10:24 12:13 showcd 12119:3 23:16 substantial'21 11:15 19:7
14:14 17:20 showing III 21:25 23:19 therapy 16112:6 12:7
n:tumlll 11:8 shown (II 13:13 substantially III 27:5 12:15 12:20 23:24
revcalcd III 18:21 shrinking III 16:16 such 1'1 8:24 16:16 27:1
n:vicw I"I 6:7 6:11 sign III 20:16 18:19 22:1 22:21 therefore III 24:1
6:21 7:4 8:12 signal III 14:3 22:21 28:7 30:6 theY'VCII120:8
12:21 25:19 25:21 sip,nificant 161 8:2 32:17 Thomas III 4:8
rheumstology III 30:11 4:17 16:22 17:23 suffered III 10:7 thoncielll 18:11
right 161 5:21 10:18 17:25 19:25 suffering 121 28:17 three 121 25:20 26:24
21:13 28:14 30:12 similarl21 16:10 20:1 29:11 through 141
30:20 simply III 15:7 suggcsting III 20:14 5:3
22:16 24:7 28:11
role I" 23:21 simulating III 14:5 summarizclll 4:18 throughout III 11:20
room 161 6:15 10:19 situation III 18:14 support 1'1 15:21 tightncssIl1
10:20 11:4 11:24 22:1 29:9 21:25
19:23 slight III 11:5 suspicion III 14:24 times 1'1 10:10 11:19
root III 15:21 SMITH III 1:19 19:22 23:10 26:24
roots 1'1 18:2 18:17 societicsIl1 5:15 Swangcrl21 1:5 todsy 141 8:7 20:21
3:7
18:19 19:6 21:24 Socicty 1215:17 5:17 24:3 25:25
RPR/RMR121 1:10 sometimes III 22:21 swcarlll 3:16 Today'slll 3:3
sworn 121 3:19 32:9
32:23 somewhat III 10:13 took III 24:21
rulclll 29:4 somewhere III 24:23 symptoms 1'1 11:14 tOf: (1J 12:11 12:17
16:23 18:22 19:21
sorry (2J 13:16 13:17 20:4 22:16 23:6 2:10
-S- sought 121 15:23 20:18 23:11 23:22 topics III 5:22
sawIl1 24:21 specialists III 13:3 syndrome 1'1 9:5 training (1J 5:3
29:13 29:15 5:4 27:22
ssys 121 27:9 27:10 specialty III 30:7 transplant III 8:21
scanlll 17:6 specific 141 11:10 systemlll 15:18
SCHERER III 1:17 19:1 19:16 20:3 systems 121 18:10 travchll 14:4
school III 4:8 specifically III 29:22 20:2 treated III 20:23
treating 121 20:5
Scicnce III 4:7 specificd III 32:14 -T- 26:15
scope III 7:24 spcnd III 4:22 treatment 161 11:6
second 1'1 14:9 15:23 spent 141 22:24 25:5 takCSl21 14:3 18:18 12:5 12:10 12:14
15:24 25:10 25:16 taking 161 9:8 9:9 12:22 16:19 17:1
SCCf1l 4:21 4:25 spinal I"I 4:16 18:2 9:15 9:19 21:11 17:3
8:20 14:7 14:9 18:11 18:17 19:3 32:8 treatments III 11:10
14:11 20:13 19:6 20:15 22:2 talks III 29:23 trials III 17:5
sccing III 4:23 spinclIll 2:17 10:21 tcehniquc III 18:13 tricd 1'1 9:12 17:4
scek 121 13:3 17:1 10:25 17:6 17:9 techniqucs III 18:10 20:7
scekingll130:24 17:18 18:4 18:16 tells 121 14:19 17:25 truCI'1
18:17 24:10 24:14 29:2 29:8
scizures III 5:25 Spring 121 6:15 12:8 tends III 14:6 32:20
scnsation III 21:16 SSIII 32:2 TENSIII 17:4 trylll 29:4
sensory 121 16:15 slaffl21 4:13 4:20 tennl!1 1:4 28:18 tunneh21 8:23 9:5
18:25 stands III 28:19 two 141 7:21 14:2
sentence III 27:10 18:9 terms ISI 7:23 8:25 22:5 25:20
separatc III 22:13 stSrtcdll14:10 16:14 28:19 30:24 Tylcnollll 9:12
Scptcmbcr(21 1:12 stsrts III 24:10 tcstl'l 13:25 14:2 type 141 17:1 18:22
3:3 states 121 16:9 26:23 14:3 15:2 30:23 19:18 21:7 ,
serics ISI 2:14 8:6 stcnognphicslly III tcstificd III 3:19 types (21 9:23 22:21 ,
17:10 17:18 24:10 32:10 tcstify III 7:5 typewriting III 32:12
scrvices 121 4:25 slcnosis III 19:4 tcstimony 1'1 7:20 typically 141 14:4
Multi-Pagc1lol
residents - typically
PAUL H. McCABE, M.D,
HUGHES, ALBRIGHT, FOLTZ & NATALE
717-540-0220\717-393-5101
Index Pugc (,
" ,.'
.- ;'J:~
Multi-Pagcnl
ultrasound - yourself
PAUL H. McCABB, M D
- .
22:25 28:6 30:5 whlplub-rcllted (II
28:2
-u- whlplub-typc III 27:19
ultruound III 12:11 whole III 5:24
Um-bum(al 26:3 Wllkel(11 4:6
28:24 wlJbln I"I 7:5 7:23
unlblc(41 7:1 15:1 8:9 14:16 24:3
15:17 16:10 29:25 30:8 32:5
under ('I 19:16 26:19 wilDess 1101 2:1
3:8 3:16 3:18
32:12 6:4 24:11 31:15
undellO (2] 16:20 32:9 32:20 32:21
17:6 womln (1121:3
undergone III 12:12 worked (21 27:1' 27:17
understand (41 28:24 workup (II 20:2
29:13 30:15 31:2
unltlll 17:4 WOI'BC III 10:5
University 151 1:13 worsencd III 23:23
3:5 4:3 4:6 writer's III 22:24
4:8 writing (II 22:25
up I'] 5:18 7:1 written (1129:17
16:14 22:12 23:1 wrong III 13:17
24:11 28:11 30:3
31:5 -x-
used 121 19:17 29:6
using 121 9:23 22:11 X-rsY(41 10:21 10:25
usullly (1122:13 11:23 28:12
X-rslS('71 10:22 10:24
-V- 17: 17:7 17:9
17:20 31:3
VIII 1:4
VanBosklrk (a] 6:14 -y-
16:21 year (II 8:17
varicty II] 5:24 years 141 4:9 4:21
various 1'1 4:23 6:1 23:5 27:15
12:25 14:5 14:10 yctlll 29:1
18:10
vcrify (II 22:15 yourself (II 3:22
vcrsuslll 3:7
VCSSCIIII 28:9
vietilD8ll]27:15
VIDBOGRAPHBR(41
1:23 3:1 3:15
31:16
Videolmlgcslll 3:2
videotape (al 7:22
31:16
videotaped lal 3:'
3:9
vlcwlngll] 18:10
visitlal 6:16 21:2
-w-
wcakncSS(11 18:24
weakncsscsIl1 16:15
week lal 26:11 27:1
weekly (1126:24
weeks II] 23:23
wcleoDIC(11 31:15
whatnot(11 29:10
WHBREOF(II 32:21
whiplash III 27:15
~
o
u
Index Page 7
HUGHES, ALBRIGHT, FOLTZ & NATALB
71 7-54OHD220\7 I 7-393-5 101
.
~
,....,
D~,VID C 6.L.I~ER, I.'.,D.
t5:lW"'.LNUT 60TTOI.'. F:OJ.D
CARLISLE FA 17013
.l'
..
NAME
Christine Duncan
AGE
TODAY'S D,t.TE
DATE OF 61RTH 12/25/4
ADDRESS
REF,ERREO 6....
805 Baltimore Rd. Shippensbu~~.
pa t .,?c;:.,
...
532-3056
Dr. Hell/' / Carlisi.. Ifnoop PHONE (HOME)
FJ.MIL Y DR,
PHONE (V~ORlq
.
"\:''''
. '.
URAl.ICE Auto- Nationwide. PLACE OF EMPLOYMENT
Il-lS ... - Allergies: PCN,
Access '
PROBLEM lihiplash: car acciden~ 1 qq" PREVIOUS X-RAYS
Ibuprofen
2nd opinion
_ reaup~t.t:lti hy
a~~y Roh~~~ n'~~~9A
'. -,1
- Cd/.. (LCC.L,''''~
:flu. .:J.~/lf~ 3
a"j .;;~ 1'f?S" .
Christine is a 48-year-old female who is here ~or a second
op~nion at the request of her attorney. Christine states
\ her history goes back two years ago when she was involved in
a motor ~ehicle accident. She wa~ hit from behind while at
a stop light. She states the car was going approximately
twice the speed limit which was 25 m.p.h. She was hit
1irectly from behind. She had transient loss of
consciousness.' The car was not totaled. She has had
persistent pain in the neck since that time.
-
'.,
PAST MEDICAL HISTORY, Significant for C.O.P.D. for which
she takes Prednisone anG Theophylllne as well as an
inhalant. There is no other past medical history other than
~ecent b~east surgery for a cyst being removed. She is on
jisability because of her C.O.P.D.
3he has been under treatment by Dr. Helr who felt she nad
severe whiplash.
;XAMI~ATION: There are no visible abnormalities to the
:ervical spine. There is no muscle atrophy in either
;h9~lde~ gLrdle. The patient has globally decreased range
Jf motion of the cervical spine with appro~imately 30% loss
Jt motion in all planes. She has pain with both.
~ypere~tension, as well as forced forward fle~ion. She has
\,'0' e\l'id~nce of any ner'/e root ~rritation and no neuJ;ologic
. sLgns With no atrophy. r9fle~ asymmetr7, weakness or sensory
~~ss Ln the C4. C5, C5, C7. CS. or 7l 1LstribueLon.
. ,
, !
..~
iI~l'AIf-"".'.
1:.,",U~,~, ' "'''-. :,",,'J.', -',
'llLe.'O.Yl ~l .
~ZCf;"9 " .
-"l
~
CHRISTINE lXlNCAN
Compression did not produce any radiculopathy.
X-RAYS: There is some facette arthritis at C7-Tl.
IMPRESSION: Hyperextension injury, cervical spine.
DISCUSSION: We do know that hyperextension injuries cause
more prolonged discomfort than any other type of cervical
spine injury including motor vehicle accident. Also/ this
patient is on Prednisone and therefore has Prednisone
induced osteopenia and osteoporosis because of that
medication. I saw no objective findings, however, of any
nerve root impingement, fractnre, dislocatioh or '
subluxation. At a point two years post injury without
objective findings, it is difficult for me to comment
extensively about this case.
We do know that people who are rearended and sustain a
hypertextension type of injury as would occur with this type
of accident are prone to a more prolonged period of problems
than other types of cervical spine injuries. DCB
.
J
...,
elECTROMYOGRAPHY
} NERVE CONDUCTIONS,
~\",.- ( , III
. ~ 0...'_........,_
~ I,
""'1). Oc 26, 1994
,
MAE
,
~'\
Christine Duncan
'AOORESS
805 Baltimore Road
Shippensburg, PA 17257
D08. 12125/46
Outpatient. Dr, Carey
Ilethod. Excel 2-channel EIlG by Cad\/el,
IMPRESSION
NORMAL NERVE CONDUCTIONS m THE: LE:rr UPPER EXTnEHITY. NO FOCAL E:HG
ABNORMALITIES .
I The patient has continuing neck and upper arm pain. Hotor nerve
conductions were performed using ,2 ms. stimulation, Compound action
potentials for the median nerve are illustrated below after focal stimulation
at the wrist, mid arm, axilla, and Erb's point, Segmental nerve conductions
are well in the normal range, Distal sensory functions were easily obtained.
Ulnar nerve conductions are intact, Ulnar nerve F-response was easily
obtained at 26 ms. (normal less than 30).
COMMENT
Needle examination revealed no neurogenic abnormalities in the muscles
tabulated. No fascicu1ations or positive waves were seen in the deltoid or
biceps. Action potentials produced with voluntary contraction were normal.
A paracervica~ exam was not done.
JCJ/gmj
.
NERVE CONOUCTION STUOIES
nlN
5
WEEP
S
.... :
. ,
, ,
. , ' . . . . . .
.---- - -...............-...-..................................................................--..-........................
, ... ,;~=--,:"._.."...-L.,'_...,.,::."..,-,..,-;.,..,....,,_l_,..,....,.~,.._.,::L.,.",-'"
. : .', . .
...;:;.~........................................................:.............................................
_t. ..~
. . . . .
......................................-...........................-.........................
. , ,
. , ,
, , ,
a.lll.
, "
.. ........ ......................................._......._.__.........._.........M............
, , ,
c.,,"
. . .. ....
.........-..-...................................... ............ .........................................-....-...-.............................
. , "
. , "
, , ,
, ,
, . . , . . .
.-.---.-.........-............-..-.........................................,.............,.............-...........-..................,.,.".
" ,
p~ 8 uB TEnp OFF
8Tln L&u&~ 117 nA 18B U
HCV aNGRY
FOOTOMITCII
850 WA~NUT BOTTOM ROAD
CAR~ISLE, PA 17013
(717) 243'3944
:1.1 ~ll
.. ,".' - '''''', .-'.",~"':.' .".
iWi,':A:,. Mi~~i..
ftljH7' .."
LEFT MEDIAN MOTOR
ONDET
(no)
4.1
'1'.6
111.5
13.4
APB
URlaT
nNTE CUD
RMU",LoR
ERU
DaT SEo-D NCU
(en) (no) (n".)
I-R 8.11
2-1 19.0 3,S S4.3
3-2 IS.ll 2.951.'1'
4-3 211.~1. 2.9 69.8
Anp
(uU)
O-P
I 1081111
2 11121111
3 96811
4 111711B
RI:Vfl:W
r1CDlnu I1010R
J, CRAlk~.
U~~;;~OGY
.~ristina Duncan e.......\ e.,........
EMG Data
Date: october 26/ 1994 5:41 pm
patient:
Physician: t
Summary of EMG and NCV ftndinas.
site
NERVE CONDUCTION REPORT
Onset Delta Our Ampl
(ms) (ms) (ms) (uV)
I
!
I
Nerve
Dist
(cm)
NCV
(m/s)
-------------------------------------------------------------------------------
L Median Motor Wrist 4.10 10000.0
ante cub 7.60 3.50 10200.0 19.0 54.30
Axilla 10.50 2.90 9600.0 15.0 51.70
Erbs 13.40 2.90 10700.0 20.0 69.00
L Median F-Wave Wrist 27.30 27.30 8.0
L Median Sensor wrist 3.66 1.53 12.8 ---- ----
palm 6.34 2.68 1.96 7.6 19.0 70.90
L Ulnar Motor site 1 3.50 11100.0
site 2 7.40 3.90 11200.0 21.0 53.80
site 3 9.30 1.90 10400.0 16.0 84.20
L Ulnar F-Wave wrist 26.30 26.30 120.0
EMG NEEDLE STUD~
side Muscle Nerve Root Fib Psw Ply Fsc Rec Comment
-------------------------------------------------------------------------------
Lt 1stDorlnt Ulnar C8-T1 0 0 Nml 0 Nml Normal
Lt Deltoid Axilla C5-6 0 0 Nml 0 Nml Normal
Lt Triceps Radial CG-7-8 0 0 Nml 0 Nml Normal
Lt Biceps Musc C C5-6 0 0 Nml 0 Nml Normal
Lt pronat teres 0 0 Nml 0 Nml Normal
Lt BrachioRad Radial C5-6 0 0 Nml 0 Nml Normal
Lt BrachioRad Radial C5-6 0 0 Nml 0 Nml Normal
.."
"'
,-.
Ba:LVEDERE MEDICAL CORPORATION
850 WALNUT BOTTOM ROAD
CARLISLE, PA 17013
/"/..,.",IM,,lirilll'
JOSEPH E, GREEN. III. M,O,
J, CRAIG JURGENSEN. M,O,. NEUROLOGY
STEVEN L HATLEBERG. M,D,
DAVID p, ALBRIGHT, M,D,
Hay 30, 1995
='~i~,I,'r
I.l,.,".,..,'_.,.. '
,~ Ci "... "8'
.,"2.':,(/ , .
Daniel P. Hely, H.D.
816 Belvedere Street
Carlis1e, PA 17013
lIE. Christine C. Duncan
DOB. 12/25/46
Dear Dan.
I fv..tned Chrl8tine in re<J&l"d to her neck pain. She has had continual
pa.in at the bue of the neck s:Lnce Decellbar 24, 1993. She recalls be:Lng
struck frOIl the rear by another veh1cle, and thrown forward. She developed
1lIIIIIediate pain at the bue of the neck. An x-ray wu done and wu neqative
and she 1IU re1eued from the hospital. She cont:Lnues to have pain with
forwll1'd l:lex:l.on and rotation. SOlIetilllll later she developed pa.in and
"nlllDbnus" :Ln the left foreana and hand. A nerve conduction study in October
1994 1IU negative. Pulmonary disease lIllS the caWle of her to discontinue
working in June 1992. She developed shortness of breath at thet time, and
the diagnosis of pulmonary fibrosis 1Ia8 ..de. She now experiences shortness
of breath through the night and Wles inhalant treatllents every four hours
(Serevent, Atrovent, Proventil). She stopped smoking in 1992. She had
previously worked in a hOWlecleaning position for Sh1ppenebu!:q University. '
On lllC.aII\ she weighs 136 pounds. Mental status is noJ:llllll.. She makes
intermittent heaVing resplratione. Accessory lIW1cles in the neck are
increased. Ocular exaa ill negative. pueive lIovellents about the neck are
decreued for rotation and l:lex:l.on. There is no paracarvical IIUIIcle SPllllII or
defOrmity however. Muscles in the upper extrellities are of noJ:llllll. vo1ue.
Resilltive strength 18 excellent for prox1mal, III1d-arJI, and :Lntr1nsic IIWIcles
bilaterally. Tendon reactione are brisk and llYIIIIetric. There are no
cutaneoUII seneory abnoJ:llllll.ities. There are no long tract eigne :Ln the legs.
Her neck pain is suggestive of cervical disk diseue. There is no
clinical evidence, however, for cervical nerve root dallage. She is not
:Lnterested at this point in further diagnostic lIlIlasures, and certainly not in
a neurosurgical procedure. An HRI scan has not been scheduled. I aa
optilll1stic, however, that her pain will subside in the colling IIOnthll. In the
lIIeantille, she enjoys normal functional ability.
Thank you very IIUch.
Very truly yours,
,.~t1~
JCJ/9IIj
DEPARTMENT OF RADIOLOGY
,-
if/A. ,I .~~;WI ~.;"
~;~os'piJ--\
:-/ aIth Services
10" e
,.J arkei Street. P.O. Box 310' Ccirlille, Pennsylvania 17013.0310' (717)249-1212
,.""
_,.I': "
" .
-/<l' ,
'" CARLISLB IMAGING ASSOCIATBS, P.C.
DUNCAN, CHRISTINB C. 49Y
805 BALTIMORE ROAD
SHIPPENSBURG, PA 17257
07/09/1996
X-RAY #104440
MED. REC, .555410
DR. KOSENSKE TED
C-SPINE SERIES
Five views of the cervical spine were obtained prior to HRI
evaluation,' and demonstrate gross preservation of bony alignment, disc
spacing, and bony integrity in the cervical distribution, There is
subtle sclerosis extending from the C2 through the C5 level in the
posterior elements, suggesting a degree of facet degeneration, Facet
joints remain "open", however. Neural foramina appear grossly patent
bilaterally. There is no evidence of deep soft tissue swelling.
IMPRBSSION: "
Negative'study for plain film evidence of acute
cervical pathology,
~J' CUTHBERTSON,
H.D.
RJc/nb
T: 07/09/1996 02:04 pm
,,:;-', ".
.""
:' .
."
..' ,':'
. ~. . . . /. .
'. ,~.
" '
',J,:'. ;,.~ ~.-{~~~
...., , -','
':, ,:(:7:',<!;:'U>":: :~:::, '
. \ .' ~:.. ',' . ..... :" ';.
"
.,. '
"
.' . '.
',., '.. ';,.' ":"
, .
;.
.' ""- ,;
"'. <~:,,:'
......;".
"
'-......,
RADIOLOGY FILE
.-,..--;-'-- -
_;.:="l
--"
--
--
" .~-
! . 1~~ ~
0< _' u_.......... ~
"
'.
,
, CARLISLB IMAGING ASSOCIATBS,
~, . . .".
DUNCAN, CHRISTINB C.
80S BALTIMORB ROAD
SHIPPENSBURG, PA 17257
49Y
07/09/1996
X-RAY U04440
MBD. RBC. '555410
DR. KOSBNSKE, T.
NON-CONTRAST HRI OP THB CBRVlCAL SPINB
This study consists of sagittal sequences with T1, intermediate, T2*
weighted fast spin echo technique and relatively T2 weighted gradient
echo technique, followed by axial gradient echo, T2 weighted images
from the C2 through the T1 level.
Visualized portions of the posterior fossa appear grossly normal. ,The
cervical spinal cord is normal in signal characteristics and overall
size throughout. 'The central canal appears somewhat narrowed in
sagittal images at the C4 and CS levels, and very subtle dorsal disc
prominence centrally at those levels may actually abut the anterior
cord with neck flexion. The magnitude of findings does not suggest
focal, disc protrusion or extrusion, however, Very subtle dorsal disc
prominence , centrally and eccentric left at the CS-6 level may
represent 'a very small disc bulge. Axial images otherwise show no
localized pathology,
. . " .
'.
.
IMPRESSION:
There is central spinal stenosis, localized to the C4-S
and CS-6 levels, with a mild disc bulge contributing to
narrowing at the CS-6 level centrally and eccentric
left.. Disc disease only contributes slightly to this
,:', predominantly ,congenital, configuration,,'~':.There is no
"evidence of myelomalacia or other pathology at this.
"time:; , '
" . . :'~'. ;. \' :.~
.'
. ,"""
.. .'
. '
Cl'
, ,
'" " ",:: . J
. . "
.. .
'. RAND J; CUTHBBRTSON,
'"
H.D.
. '1f!'F;i/;iS~~dI':;.
,',. RJC/ je'.'.,:..;; 'f.:: '.,,<' ',..
, 'T:" 07/09/1996' 02:4S pm,
~ ",:<.; -. ~. ::' ':'J;::',i~.':': ~ '.
'. .:-.~.'~:':_.:;'~: '.;',.:.:~';.'\I~'.~;:o~.? c':'t/. 0': ....
~ H . 'or .
H 4.. ....
" .
". ... -\'1
.'
-."':
"
. .,
" . ..... .
.. .',,-,
'.. ...-....
... ..
. ",'
.:., .
'.
RADIOLOGY FILE
~-~ .-..---.....-~-
--
.-,--~.-...__.......
-._-~
"~.-q""",j...,..
.....
,
,.
,
,
CHRISTINE C. DUNCAN,
Plaintiff
IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: 95-6807 CIVIL TERM
: CIVIL ACTION - LAW
v.
GERALD B. SWANGER,
Defendant
DEFENDANT'S TRIAL BRIEF
I. STATEMENTOFFACI'S
A. As to Liablllty
On December24, 1993, the automobile driven by the Defendant, Gerald B. Swanger
(hereinsfter"Defendant"), struck the rear of the vehicle driven by the Plaintiff. Christine C. Duncan
(hereinafter"Plaintifl"),as the Plaintiffwas stopped at a traffic signal at the intersection of West
King Street and Earl Street in Shippensburg Borough, Pennsylvania. The Defendant admits
liability for the collision but disputes the causation of the injuries Plaintiff alleges to have suffered
as a result of the collision.
B. As to Damages
The Plaintiffhas a prior medical history of carpal tunnel syndrome for which she had
surgery in 1990. Prior to the collision she was diagnosed as suffering from cardiopulmonary
disease ("COPD") which caused her difficulty breathing resulting in neck pain. The Plaintiff
herself could not differentiate the neck pain she alleges to have experienced after the motor vehicle
accident from that she experienced before the accident as resulting in her breathing difficulties.
All diagnostic tests performed, including x-rays and EMG's, failed to provide objective
evidenceofinjury. On June 30, 1994. seven months after the accident, the Plaintiffbegan a course
of physical therapy which provided her with pain relief, full range of motion in her neck and no
.
...,c...:_~-_,<..O...t'0~'l<:+f,w~j;-i';~~,'.'~
\
r
..
~
,
.'.
lateralizingsigns in her upper extremities within two months, In May of 1995, Dr. Hely noted that
there were "no physical signs to support a diagnosis" for Plaintiffs complaint of neck pain and he
referred her for a neurologic consultation. The PlaintifTwas seen by a neurologist, Dr. J. Craig
Jurgensen. who opined that Plaintiffs complaints of neck pain were suggestive of cervical disc
:-r:-
.It".,
"t,
l:f
~
ur
Qi
gf
t;:
1,
~
(.
~-
~:
".
1
'.'!'
disease but could not find clinical evidence of cervical nerve root damage. He noted that she had
"nonnal functional ability" and was optimistic that her pain would subside in the coming months,
In August of 1995, Plaintiff's counsel sent the Plaintiff to Dr. David C. Baker for a second
opinion, Dr. Baker could find no objective findings to support the Plaintiffs subJective complaints
of neck pain. In January of 1996, Plaintiffbegan treating with Dr. Ted D, Kosenske at the Pain
Clinic of Carlisle Hospital, who diagnosed her as suffering from post-traumaticmyofascial pain
syndrome. Her treatment has been by TENS unit stimulation and cervical epidural steroid
injections. The Defendant believes that the Plaintiff's symptoms and their cause pre-existed the
accident in question. Any injury which Plaintiffmay have experienced resolved after a short course
of physical therapy in August of 1994.
II. ISSUES PRESENTED:
DOESTHEPL~FFHAVETHEBURDENOFPROvtNG
ALL OF HER ALLEGED DAMAGES WITH REASONABLE
CERTAINTY?
(Suggested answer in the affinnative).
. ,-'......~..'
.' -, ~',;
\
..
!'
III. ARGUMENT
IN PERSONAL INJURY CASES, A PLAINTIFF HAS THE
BURDEN OF PROVING ALL INJURIES WITH REASONABLE
CERTAINTY,
It is acknowledged that in a personal injury case, a plaintill's purpose in suing for
compensatory damages is to be placed in the same position he or she would have been in if the
injury would not have occurred. Yosuf v. U.S., 642 F.Supp. 432 (M.D. Pa, 1986). In
Pennsylvania, a plaintiff bears the burden of proving his claim by a preponderance of evidence.
ComDal!nies des Bauxites de Guinee v. Insurance ComDanv of North Ameri!;!!, 55 I F.Supp. 1239
(E.D. Pa, 1982).
Even assuming liability is admitted. a plaintiff still has the burden of proving that injuries
were sustained and those injuries complained of resulted from the accident. Reist v. Manwiller.
231 Pa. Super. 444, 332 A.2d 518, 521 (1974). If a plaintiff does not sufficiently prove such
allegations, the defendant is entitled to the verdict. Griffin v. Tedesco, 355 Pa, Super. 475, 513
A.2d 1020 (1986); Gordon v. Trovato. 234 Pa. Super. 279, 338 A.2d 653 (1975). Pennsylvania
case law on damages also provides that damages are never presumed, nor can they be speculative,
but damages must be proved by competent credible evidence. Maxwell v. Schaefer. 381 Pa. 13,
112 A.2d 69, 73 (1955); Standard Pioc Coatinl! Co.. Inc. v. Solomon & Teslovich. Inc.. 344 Pa.
Super. 367,496 A.2d 840, 846 (1985). Even though the law does not command mathematical
precision in the detennination of damages, sufficient facts must be introduced so that an intelligent
estimate of damages can be derived. Delahantv v. First PeMsvlvania Bank, 3 I 8 Pa. Super. 90. 464
A.2d 1243, 1257-1258 (1983); (citing Rochez Bros..lnc. v. Rhoades. 527 F.2d 891 (3rd Cir. 1975),
cert. den, 425 U.S. 993.)
Moreover. even if a plaintiff introduces evidence as to her alleged injuries, the jury has the
,
','
,
discretion to believe or disbelieve all or part of the testimony from any witness. Feld v. Merriam,
314 Pa, Super. 414, 461 A.2d 255, 234 (1983). The detenninationofdamages lies Initially within
the discretion of the jury and their decision will not be disturbed on appeal absent clear abuse of
discretion. Glomb bv Salooekv. Glomb, 366 Pa, Super. 206, 530A.2d 1362,1368 (1987).
IV. CONCLUSION
The Plaintiff must prove, by a preponderance of evidence, that she sustained the injuries
complained of and there is a reasonably close connection between those injuries and Defendant's
conduct, Moreover, the injuries complained of must be proven to such an extent that the jury need
not engage in speculation.
Dated: l~r18'
Respectfully submitted,
By:
ES, SMITH
I..,.....~-~
DU ,ESQ
Attorney 1.0. #29563
JOHN J, MCNALLY, III, ESQUIRE
Attorney 1.0. #52661
P,O. Box 650
Hershey,PA 17033-0650
(717) 533-3280
Attorneys for Defendant
,....
CHRISTINE C. DUNCAN.
Plaintiff
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY. PENNSYL VANIA
: 95-6807 CIVIL TERM
v.
GERALD B. SWANGER, : CIVIL ACTION - LAW
Dcfcndant tI~ ~
\:~~Y
----
t's ncgligencc a substantial factor in bringing about the Plaintiffs harm?
If you answer Question ..
the courtroom.
~ .f~l-"d by" P"'''ff~ . ","".,,,,, ;~'S ~.
s
,. .
~>._. .' ~,..."..~ ,. _,"', :"F'" ~\ ~
Dated: ~
,
.
Respectfully submitted,
JAMES, SMITH, DURKIN & CONNELLY, LLP
U ,
Arney I.D. #29563
JOHN 1. MCNALLY, III, ESQUIRE
Attorney I.D. #52661
P.O. Box 650
Hershey, PA 17033-0650
(717) 533-3280
Attorneys for Defendant
2.015
2.05 (Clv) DEPOSITION TESTIMONY
The Iworn telUmony of ( 1>\. iii (. ~taken by depollUon (videotape) prior to thll
trial, II about to be prelented to you. The telUmony of a wltnell (party) who for lome
proper realon cannot be prelent to teltlfy In perlon, may be prelented In thll form. Such
teltlmony II given under oath and In the prelence of attomeYI for the partlel. who
quelt\on the wltnell. A court reporter takel down everything that II said and then
transcrlbel the testimony. (The use of videotape permits you to see and hear the witness
as he appeared and testified under questioning by counsel.) This form of testimony Is
entitled to neither more nor leIs consideration by the Jury because ofthe manner of Its
submission.
SUBCOMMITTEE NOTE
This explanation should be given when circumstances warrant Immediately prior to the
Introduction Into evidence of a deposition. It should not thereafter be necessary to refer to this
procedure In the final charge to the jury. It is set forth separately since Its use where no deposition
testimony Is offered would probabty be confusing and of no aid in guiding the jury.
It Is desirable that the court make specific reference to this type of evidence since It is somewhat
different from the normat presentation of testimony and ajury might disregard It,slnce they were not
afforded the opportunity to see or hear the witness, or give it undue weight because It Is transcribed In
permanent form.
IC, as is frequently done, a person Is ptaced on the witness stand to read the answers, the trial
judge may consider requesting that the transcript be read without gestures or undue emphnsis to
selected portions.
Cupyria.:hL t. 19K1 'n.c ItennKylvnnln Uur Imltltulu
1 of 1
Dute of Lust Revision
March 1972
.
CHRISTINE C. DUNCAN.
Plaintiff
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY. PENNSYLVANIA
: 95.6807 CIVIL TERM
: CIVIL ACTION - LAW
v.
GERALD B. SWANGER,
Defendant
DEFENDANT'S PROPOSED POINTS FOR CHARGE
~
Good morning, Ladies and Gentlemen. We're about to start the trial of this case, for which
you have been good enough to agree to serve as judges of the facts.
There are three things I would like to tell you before we actually get started:
First, what's your job. whaes your role here? Your role is to be the judges of the facts. to be
those who wiU tell us for the first. last. and only time what is the true and just verdict, according to
the law and according to the evidence in this case.
I am only the judge of the law. I am like the umpire at the baseball game. I call the balls and
strikes. and I say what is safe and what's out, according to the law. And the lawyers and I wiU be
discussing those questions from time to time. usually out of your hearing. But that's all I do. I make
sure we have a level playing field. according to the law.
You, on the other hand. my friends, have the very important job of deciding what is the
truth, of rendering a just verdict in this case.
How do you go about doing that? Well, you do it by paying close and careful attention to
the evidence. What is the evidence? The evidence is what you will hear as answers from the witness
stand.
Now, notice. I have said it's the answers. The attomeys will be asking questions-perhaps I
.
will even ask a question from time to time..but it is not the question that constitutes the evidence. It
is the answer that the \\;tness gives you. or it is the piece of paper. the document, the exhibit I allow
to come into evidence, which I allow you to consider as part of the evidence.
So please understlllld, it is the answer from the witness stlllld, not the question. Only if the
witness adopts the question, agrees with the question, does the question then become ofimportance.
The answer is the evidence.
What is your job, then, as you determine what is the evidence? Well, the easiest way to do it
is to say that you are the judges of credibility. You are there to judge what you believe, what you
will accept as true for the purpose of making an important decision. Because, you see. the decision
you make as judges of the facts is important not only to these litigants who appear before you. but it
is important to you, individually and collectively. It is important that you get it right. And, of
course, it's very important to our system and to the way in which our system works in resolving
disputes, which is what we have before us to solve.
The admission of evidence in court is govemed by rules of law. During the trial. the
attorneys may deem it necessary to make objections and it then becomes my duty to rule on those
objections and to decide whether certain evidence can be admitted for your consideration. You
must not concern yourselfwith the objections or my reasons from my rulings. The attomeys have
the right and duty to make objections in order to make sure that only legally sufficient and relevant
evidence is considered by you. You should not penalize any of the litigating parties because his or
her attorney makes objections. You must not consider testimony or exhibits to which I have
sustained an objection, or which I have ordered stricken from the record. None of my rulings should
be regarded as an indication of my opinion as to what your findings should be. You should not take
any questions I may ask witnesses as any indication of my opinion as to how you should determine
2
"
the issues of fact. Any opinion you think I may have lIS to the facts would not be at all important-
-you. and you alone. are the sole finders of the facts.
You must consider and weigh the testimony of each witness and give it the weight that, in
your judgment. it is fairly entitled to receive. The matter of the credibility of a witness. that is.
whether the testimony is believable in whole or in part, is solely for your detennination. I will
mention some of the factors that might bear on such detennination: whether witnesses have any
interest in the outcome of the case or have friendship or animosity toward other persons concerned
in the case; the behavior of the witness on the witness stand and the witness' demeanor; the manner
of testifying and whether witnesses show any bias or prejudice that might color their testimony; the
accurllcy of witnesses' memory and recollection; witnesses' ability and opponunity to acquire
knowledge of or to observe the matters they are testifying about; the consistency or inconsistency
of their testimony as well as its rellSonableness or unreasonableness in the light of all the evidence
in the cllSe.
When you judge credibility, you are doing something you do every day of your life. You do
it with your family, you do it with your friends. you do it with your business associates, you do it
whenever you go shopping or when you are out. That is, you have to decide what is it that you see
and hear? What is it that you are being told that you will accept as being nue. that you will accept
as being something on which you will base a decision?
An example I often give is that you see in yesterday's newspaper an ad from K-Mnrt. which
says they have a special on sale; and you go to K.Mnrt today and you go to the shelf where the
special should be and the shelf is empty; and you tum to the clerk and say, "Ms. Clerk, I would like
to have one of those specials"; and the clerk says to you. "I'm sorry, they are all sold out. We don't
have any in the back room, we don't have any in the warehouse; lIS far lIS I can tell, there are none of
3
,
them in existence, anywhere."
And just by the way the clerk says that to you, just by the WIly she looks, by the WIly she
sounds. you know thIIt you won't accept that lIS being so; or by the WIly she looks and the WIly she
sounds, you say IlICcept that, that's true, they II/'e sold out.
Slime thing you do every day.
Another way of judging credibility, I suggest to you. is lIS follows: a moment ago when I
walked into this room everybody WIIS IISked to plellSe rise. Well. we do thIIt not because 111m
somebody specinl, becIIuse 111m not. We do that because by wearing this robe and occupying the
role that I do in this counroom,I represent the law, and it is a way of reminding us of the serious
pwpose we're about here, not because 111m special.
As a matteroffac!. if the law were put together correctly, in my opinion. we would rise
when you clime into the room, not I. But, in l1I1Y event. do not let the formnlities of the counroom-
l1I1d you will hear the lawyers,saying "Your Honor." and other kinds of things thatll/'e customary-
fllZe you. PlellSe don't consider the formality of this room lIS being something different from what
you do every day.
Let me make this suggestion: assume that you II/'e sitting at home in your favorite chair, or
on the sofa, l1I1d the same witnesses come before you l1I1d give the same IIIlSwers. the same evidence
at your home lIS they will be giving in this counroom.
And when it's nil over, you go into the kitchen with your husbl1l1d or your wife, and while
you II/'e there, that person says to you, what did you think of that? What did you believe? What had
the ring of truth about itllmongst all of the l1I1swers. all of the evidence that you heard?
That's the way you do your job. You do the job for which you have lived the years you have
lived in your various W11lks of life. That's why each of you separately l1I1d nil of you together II/'e the
4
judges of the facts in this case.
What do you believe? What are you y,illing to base an imponMt decision on?
[f you recall, at the beginning of my address today. [ mentioned that there are three things [
need to tell you. Number 2 is, how do we go about presenting a case to you?
Well, in a few minutes when [ am done speaking we \\ill have what are known as opening
statements. That is, Attorney Roben L. O'Brien will tell you on behalf of his clients what he
believes the evidence will be. He will predict for you what he understands the evidence will be that
you will be hearing and seeing, and he does this so that you have an understanding, an outline, if
you will, of what this case is going to be about.
And this is done so that as you hear the evidence over the next severnl days-you see, you
don't get all the evidence at one time-as you hear the evidence over the next severnl days. you will
be able to organize it and see where the pieces begin to fit one \vith the other.
[t is not a time for argument, and counsel will not argue during opening statements. It is
simply like the picture on the cover ofajigsnw puzzle box. It tells you what thejigsaw puzzle, the
evidence, should look like when you have it all.
When he is finished, Attorney John J. McNally, III has a right to make an opening
statement on behalf of his clients. He may choose to do so, or he may say. "I would rather wait until
it's my turn to present evidence," which he is allowed to do, and which many fine lawyers decide to
do. So we will wait to see if Attorney McNally wants to make an opening statement now or ifhe
wishes to reserve.
In any event. after opening statements are concluded. Attorney O'Brien will then
commence with a presentation of evidence. He will call witnesses on behalf of his clients to the
witness stand. He will examine them on what is known as direct examination. which means that he
5
will ask questions and the witnesses will give Q/lSwers. which constitute evidence.
When each of the witnesses is done on direct examination, the witness will be subject to
cross-examination by Attorney McNnlly. Cross-elCaminntion bas two roles: one, to bring out the
facts thnt have not been brought out in direct examination, to add to your fund of information.
The second purpose of cross-examination is to ask questions that will help you to judge the
credibility of the witness. It is doubtful thnt during the course of this trinl nnyone is going to do like
they do in Perry MIlSOn, No one is going to jump up and sny, OIl confess, I did it.OI or OIl confess, I
didn't do it.OI Rather, the roles of cross-examination are what I have just suggested to you: to add
information, nnd nlso to ask questions so thnt. via those answers, you will have a better opportUnity
to judge what you shall believe nnd what you shall not.
When Attomey O'Brien bas completed the presentation of his case by way of his wimesses.
Attomey McNally then bas the right to call wimesses, and he will cnll them in order to conduct
direct examination. Those wimesses will be subject to cross-examination by Attorney O'Brien, just
as Attomey McNally has cross-examined the plair.tift's wimesses.
Do not discuss this case, or anything connected with it. among yourselves, until nil the
evidence is in nnd you have received the fina1 instrUctions from me and have retired to the jury
room for deliberations to reach your verdict. Do not pernnt others to discuss this case with you. or
in your presence. If such a thing should occur, you should advise me promptly. In addition, do not
talk to counselor the parties or witnesses on any subject. If you were to do so, even though
innocently. it could be misinterpreted nnd could create serious problems.
When nil of those witnesses are finished, you will then receive from me the instrUctions on
the law, what is sometimes called the charge. I will tell you the principles oflaw thnt apply to this
case so that you will be able to put the facts into their proper sequence, Q/lSwer the proper questions.
6
and render that trUe and just verdict.
When I am finished, Attorneys McNally and O'Brien will make closing nrgwnents. Those
nrgwnents from the lawyers are intended to marshal the evidence that you have heard. to suggest to
you what you should find to be credible, and to suggest to you what your verdict should be in the
case. That is the time for nrgwnent.
When the nrgwnents are concluded, the case becomes yours. And you will then decide, you
will reason together. you will deliberate and you will then tell us what is this trUe and just verdict,
of which I have spoken.
The attorneys and I are required by law to take up certain matters out of your hearing since
it is very important that you hear only evidence that is legally sufficient and relevant. We may do
this at what is known as a side.bnr conference where the lawyers come up and speak with me out of
your hearing. Do not concern yourself with such a proceeding. While you may be interested in
knowing what is being said, much of the discussion will turn on legal nrgwnents and certain
testimony that mayor may not be relevant to the case. In any event, as I have told you, you are the
judges of the facts and the only facts you may judge are those that are presented by wimesses under
oath. Consequently, while you may be tempted to feel that you are being left out of what is going
on at a side-bnr conference, you must understand that these conferences are being held in order to
assure that you consider only legally sufficient and relevant evidence and to give the attorneys an
opportunity to state their positions on legal issues.
So that's the sequence we will follow, and in a moment we will begin with the opening
statements.
One final thing: my friends, you are. and please believe me that you are, my partners, which
means. among other things, if there is anything we can do to make your service more comfortable.
7
more menningful. to assist you in understanding the evidence, all you need to do is to let me know.
And the way in which you let me know--suppose you need to take II brellk. or suppose you cnn't see
nn exhibit, or suppose you cnn't hell/' II witness milking llnSwers-all you need to do is raise your
hnnd nnd one of the counroom officials will note it. or I will. We will then ask whllt it is we cnn do
to help you, nnd we will respond in every WilY we are II110wed to. nnd tha.t we CllIl. to mllke your
service more comfortllble nnd more mellllingful.
You are, my mends. my pllI'tners, nnd so when we start IIt_[time ofday]nnd we work
until_ [time of day], we're going to work on this together.
We need to work together in II true plll'tllership in this case, beclluse this is an important case
for everybody, including you nnd me.
Thank you for being here.
Pa. SSJI (Clv) 1.00 Preliminary Instructions - General Nature of Action-Procedure-
Cautions
,9
The insuuctions in this section are designed for use during the trial to cover special
situations deemed to warrant explanation or direction by the court lIS the>' occur. Such insUUctions
or admonitions should be provided in appropriate uniform manner so that an orderly trial may be
conducted with expedition. and to enable the jury to understand the panicular incident and give it
proper weight. It is desirable that the court give whatever explanatory definition may be necessary,
rather than relinquish this to counsel who may be tempted to employ the opportUnity for
argumentative explanation or inappropriate detail.
InsuuctiQns relating to specific situations occurring during the trial might well be preferable
at the time the incident occurs, where they would be relevant and understandable, rather than at the
end of the CllSe, when its significance might well be lost. and the jury might be confused or directed
from the major issues. The final insuuctions could then be limited to such issues and the applicable
law.
Pa. SSJI (Civ) 2.00 Instructions During Trial-Introduction
9
The sworn testimony of Paul H. McCabe. M.D.. taken by videotaped deposition prior to this
trill1. is about to be presented to you. The testimony of a witness who for some proper rellSOn
cannot be present to testify in person. may be presented in this fonn. Such testimony is given under
oath and in the presence of anorneys for the parties, who question the witness. A court reporter
takes down everything that is said and then transcribes the testimony. The use of videotape pennits
you to see and hear the witness lIS he appeared and testified under questioning by counsel. TI1is
fonn of testimony is entitled to neither more nor less consideration by the jury because of the
manner of its submission.
Pa. SSJI (Civ) 2.05 Deposition Testimony
10
11
The exhibits which have been identified Il/ld received in evidence are now being shown to
you for your careful examination. without discussion lit this time. to Ilid you in understllllding the
testimony.
Pa. SSJl (Clv) 1.19 Exhibits
12
Ordinary care is the care a reasonably careful person would use under the circumstances
presented in this case. It is the duty of every person to use ordinary care not only for his own safety
and the protection of his property, but also to avoid injury to others. What constitutes ordinary care
varies according to the particular circumstances and conditions existing then and there. The
nmount of care required by the law must be in keeping with the degree of danger involved.
Pa. SSJI (Clv) 3.01 OrdInary Care - DefinItion
In ordcr for thc PlnintilTto recovcr in this casc. thc Defcndant's ncgligcnt conduct must
havc becn a substantin! factor in bringing about thc accident. This is what thc law recognizcs as a
Icgal cause. A substantial factor is an actual. ren! factor. n!though thc result may be unusual or
unexpectcd. but it is not an imaginllty or fanciful factor or a factor having no conncction or only an
insignificant connection with thc accidcnt.
Pa. SSJI (Clv) 3.25 Legal Cause
13
The number of witnesses offered by one side or the other does not, in itself, detennine the
weight of the evidence. It is a factor, but only one of many factors which you should consider.
Whether the witnesses appear to be biased or unbiased; whether they are interested or disinterested
persons, are among the important factors which go to the reliability of their testimony. The
important thing is the quality of the testimony of each witness. In shon. the test is not which side
brings the greater number of witnesses or presents the greater quantity of evidence; but which
witness or witnesses, and which evidence, you consider most worthy of belief. Even the testimony
of one witness may out weigh that of many, if you have rellSOn to believe his testimony in
preference to theirs. Obviously, however, where the testimony of the witnesses appear to you to be
of the same quality, the weight of numbers assumes particular significance.
Pa. SSJI (CIv) 5.03 Number of Witnesses
14
You may find inconsistencies in the evidence. Even aclUlll contradictions in the testimony
of witnesses do not necessarily melln thatllnY witness has been wilfully false. Poor memory is not
uncommon. Sometimes a witness forgets; sometimes he remembers incorrectly. It is also lnie that
two persons witnessing IIn incident may see or hear it differently,
If different parts of the testimony of IInY witness or witnesses appear to be inconsistent. you
the jury should try to reconcile the conflicting statements, whether of the same or of different
witnesses, IInd you should do so ifit can be done fairly IInd satisfactorily.
If, however, you decide that there is a genuine IInd irreconcilable conflict of testimony, it is
your function IInd duly to detennine which, if IInY, of the contradictory statements you will believe.
Pa. 8SJ1 (Civ) 5.04 ConOlctlng Testimony
15
You will recall that Paul H. McCabe. M.D. gave testimony of his qllll1ifications as an expert
in the field of neurology. A witness who has special knowledge, skill, experience, training or
education in a particular science. profession or occupation may give his opinion as an expert as to
any matter in which he is skilled. In determining the weight to be given to his opinion, you should
consider the qllll1ifications and reliability of the expert and the reasons given for his opinion. You
are not bound by an expert's opinion merely because he is an expert; you may accept or reject it, as
in the case of other witnesses. Give the weight, if any, to which you deem it entitled,
Pa. SSJI (Clv) 5.30 Expert Testimony. CredlbUlty Generally
16
,.f.
"",-.....'
In civil Cl1SCS such l1S this one. the Plaintiffs have the burden of proving those contentions
which entitle them to relief.
When a partY has the burden of proof on a particular issue, his contention on that issue must
be established by a fair preponderance of the evidence. The evidence establishes a contention by a
fair preponderance of the evidence if you are persuaded that it is more probably accurate and trUe
than not.
To put it another way, think. if you will. of an ordinary balance scale. with a pan on each
side. Onto one side of the scale, place all of the evidence favorable to the Plaintiff; onto the other,
place all oCthe evidence favorable to the Defendant. If, after considering the comparable weight of
the evidence, you feel that the scales tip, ever so slightly or to the slightest degree, in favor of the
Plaintiff, your verdict must be for the Plaintiff. If the scales tip in favor of the Defendant, or are
equally balanced, your verdict must be for the Defendant.
In this case, the Plaintiff has the burden of proving the following propositions: that the
Defendant were negligent, and that that negligence Wl1S a substantial factor in bringing about the
accident. If, after considering all of the evidence, you feel persuaded that these propositions are
more probably true than not trUe, your verdict must be for the Plaintiff. Otherwise, your verdict
should be for the Defendant.
Pa. SSJ1 (Clv) 5.50 Burden of Proof
17
In an action for damages. the Plaintiff has the burden of proving each and every element of
damage which he or she seeks. It is not up to the Defendant to disprove an element of damage.
Klmotek v. Anast, 350 Pa. 593,39 A.2d 932 (1944)
18
'-t~!~"'i.:
Damages IlI'C never presumed. nor can they be speculative. but damages must be proved by
competent credible evidence.
Maxwell v. Schaefer. 381 Pa. 13, 112 A.2d 69 (1955)
19
" -:~Y~~I~".~'.~~ffi~~~~Jlt!'r:t~-e Irrt~~fl'-!;'~-,;,~'
-;.,.::....',-!
I c.' '-'iI" .~-:'_'t.,'. ';?,.~'_:;(~iY,~~~t!;;-~!;t\~.'J);;,;:-;.-:~
Damages should not be awarded as a punishment, Damages should not be awarded on the
basis of sympathy, benevolence or sentimentality.
Herb v. Hallowell, 304 Pa. 128, 154 A. 582 (1931)
20
Dated: -5J. l0 ~qe By.
Respectfully submitted,
JAMES, SMITH, D
//
P.O, Box 650
Hershey, PA 17033-0650
(717) 533-3280
Attorneys for Defendant
21
& CONNELLY, LLP
IRE
CHRISTINE C. DUNCAN.
Plaintiff
V.
GERALD B, SWANGER.
Defendant
#27
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY. PENNSYLVANIA
CIVIL ACTION - LAW
NO. 95-6807 CIVIL TERM
PRETRIAl CONFERENCE
At a pretrial conference held April 29. 1998. before
Edgar B. Bayley, Judge. present for the plaintiff was Robert L.
O'Brien. Esquire. and for the defendant. John J. McNallY. III.
Esquire.
Plaintiff was injured when rear-ended by defendant who
was under the influence of alcohol. The parties agree that
evidence pertaining to defendant.s drinking will not be admitted
although plaintiff may introduce evidence of how the collision
occurred.
Plaintiff sustained soft tissue injury complicated by
preexisting cardiopulmonary disease. Plaintiff. who has full
tort coverage. seeks general damages.
The parties agree that the depositions of two
witnesses will be conducted prior to
trial. one and a half days.
Estimated time of
J .
Edgar
Robert L. O'Brien. Esquire
For Plaintiff
John J. McNally, III. Esquire
For Defendant
:prs
. . ,.
.--y--.'
,
I
"
Q,
APR 2 4 1998 tP
CHRISTINE C. DUNCAN
Plaintiffs
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY, PENNSYLVANIA
V.
GERALD B. SWANGER
Defendants
\?\~WflRETRIAL MEM.ORANDUM
1. Facts As To Liability - The Plaintiff was stopped at a Ughtln downtown
: NO. 95-6807 CIVIL TERM
Shlppensburg, Pennsylvania. The Defendant rear-ended the Plaintiff's motor vehicle.
At the time of the accident, the Defendant was intoxicated and charged with DUI.
2. Facts As To Damaaes - The force of the impact caused the driver's seat
to tear loose from its moorings. The Plaintiff was the sole occupant of the vehicle and
suffered whiplash injuries. Despite numerous types of treatment, including physical
therapy, chiropractic care, a TENS unit, injections and medications, she continues to
have pain due to the damage in the cervical area. The Plaintiff, prior to the accident,
had been determined to be disabled due to problems primarily associated with her
lungs.
3. Prine IDa I Issues - The Defense contends that the Plaintiff does not suffer
from any injury related to the accident. The Plaintiff contends that she was injured and
continues to have pain.
4. Leaallssues - The Plaintiff does not anticipate any legal issues In
reference to testimony, exhibits, etc.
5. Witnesses - The Plaintiff will testify, her live-in boyfriend, Robert
Bauserman: her daughter, Sherry Calamsn; her treating physician, Ted Kosenske,
M.D. Plaintiff will reference her treatment history with various medical personnel
through Exhibits relating to the dates, types, cost and treatment.
Respectfully Submitted,
O'BRIEN, BARIC & SCHERER
.' .
7. Settlement Neaotla!l.2Dl- The Defendant has not tendered any offer.
I
BY: ~ A)..J..A ,
Robert L. O'Brien, Esquire
1.0. #28351
17 West South Street
Carlisle, Pennsylvania 17013
717-249-6873
..' ~ .
.
,
CHRISTINE C. DUNCAN.
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY. PENNSYLVANIA
95-6807 CIVIL TERM
v.
GERALD B. SWANGER.
Defendant
: CIVIL ACTION - LAW
DEFENDANT'S PRETRIAL MEMORANDUM
Submitted by: .
John J. McNally, III, ~squlre
Counsel for Defendant:
Gern1d B. Swanger
I. STATEMENT OF FACTS
A. As to Liability
On December 24. 1993. the automobile driven by the Defendant. Gernld B. Swanger
(hereinafter "Defendant"). struck the rear of the vehicle driven by the Plaintiff. Christine C. Duncan
(hereinafter "PlaintiIrJ, lIS the Plaintiff was stopped at a traffic signal at the intersection of West
King Street and Earl Street in Shippensburg Borough, Pennsylvania. The Defendant admits
liability for the collision but disputes the causation of the injuries Plaintiff alleges to have suffered
lIS a result of the collision.
B, As to Damages
The PlaintiffhllS a prior medical history of carpal ronnel syndrome for which she had
surgery in 1990. Prior to the collision she was diagnosed lIS suffering from cardiopulmonary
disellSe ("COPD') which caused her difficulty breathing resulting in postural changes and neck
pain. The Plaintiff herself could not differentiale the neck pain she alleges to have experienced
alter the motor vehicle accident from that she experienced before the accident as resulting in her
breathing difficulties.
All diagnostic tests perfonned, including x-mys and EMO's, failed to provide objective
evidence of injury. On June 30, 1994, seven months after the accident, the PlaintilT began a course
ofphysicnl thempy which provided her with pain relief, full range of motion in her neck and no
latemlizing signs in her upper extremities within two months. In May of 1995, Dr. Hely noted that
there were "no physicnl signs to suppon a diagnosis" for Plaintiffs complaint of neck pain and he
referred her for a neurologic consultation. The PlaintilTwas seen by a neurologist. Dr. J. Cmig
Jurgensen, who opined that Plaintiff s complaints of neck pain were suggestive of cervical disc
disease but could not find clinical evidence of cervical nerve root damage. He noted that she had
"nonnal functional ability" and was optimistic that her pain would subside in the coming months.
In August of 1995, Plaintiffs counsel sent the Plaintiff to Dr. David C. Baker for a second
opinion. Dr. Baker could find no objective findings to suppon the Plaintiff's subjective complaints
of neck pain. In January of 1996, Plaintiff began treating Yoith Dr. Ted D. Kosenske at the Pain
Clinic of Carlisle Hospital, who diagnosed her as suffering from post-traumatic myofascinl pain
syndrome. Her treaunent has been by TENS unit stimulation and cervical epidural steroid
injections. The Defendant believes that the Plaintiffs symptoms and their cause pre-existed the
accident in question. Any injury which Plaintiff may have experienced resolved after a shon course
of physicnl therapy in August of 1994.
II, STATEMENT OF ISSUES:
Liability - Defendant admits liability
Damages - Defendant questions whether the injuries allegedly sustained by the
Plaintiff were the result of the motor vehicle collision of December
24, 1993.
AMENDMENTS TO PLEADINGS:
None at this time.
STIPULATIONS:
Defendant stipulates os to authenticity of medicnJ records.
DISCOVERY:
Discovery objec!ed to: None known
Discovery outstanding:
( I) Defendant reserves the right to depose any witnesses identified by Plaintiff
at the Pre- TrinJ Conference.
(2) Plaintiffhns not fully supplemcnted her response to Defendant's
Interrogatories regnrding expert witnesses.
WITNESSES:
Defendant may cnJI:
A. Defendant Gerald Swanger:
B. Investigating police officer;
C. PlnintiffChristine Duncan, os on cross-exnmination:
D. Paul H. McCabe, M.D., neurology expert (via videotape)
E. Any of Plnintiff" s treating or consulting physicians
F. Any witnesses identified by Plaintiff at the Pre-Trial Conferencc os on cross-
exnmination:
Dated: l-1\'22-119
~
VII. EXHIBITS:
Medical records of Plaintilrs treating physicians and physicians whose
opinions were sought by Plaintiff. Defendant reserves the right to supplement this
response.
XIII. SPECIAL REOUESTS:
None known at this time.
IX. ESTIMATED TIME :TO TRY CASE:
I - W. days
X. SCHEDULING CONFLICTS:
None known.
Respectfully submitted,
JAMES, SMITH, DURKIN & CONNELLY. LLP
By:
KA NO ,ES
Attorney 1.0. No. 29563
JOHN J. MCNALL Y. III. ESQUIRE
Attorney 1.0. No. 52661
P,O. Box 650
Hershey, PA 17033-0650
(717) 533.3280
Attorneys for Defendant.
Gerald B. Swanger
CERTIFICATE OF SERVICE
I, JOHN J, MCNALLY, III, ESQUIRE, do hereby certify that I served a true and correct
copy of the foregoing Pre-Trial Memorandum upon the following below-named individual by
depositing same in the U,S. Moil. postage pre-paid at Hershey, Dauphin County, Pennsylvania
this '2 '2 "'~ay of April, 1998.
SERVED UPON:
Robert L. O'Brien, Esquire
O'Brien, Badc & Scherer
17 West South Street
Carlisle, PA 17013
c\
'", t ,
John J ; . ,
JAM S, SMITH &
CHRISTINE DUNCAN,
ro,; fJ,.tti ,..O~C ~Plaintiff
5fo,'rp ~NS b,,"1' ta
v.
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION-LAW
NO. 95 - (, Y01 CIVIL TERM
GERALD B. SWANGER,
;I'i 1:', OI//lAJ1' ~t, Defendant
.5h ; f r"l!. &1<"1. Pct, 17.2:{1
PRAECIPE
TO THE PROTHONOTARY:
Dear Mr. Welker:
Please issue a writ of summons in the above captioned matter
against the Defendant, Gerald B. Swanger.
Date: _12} I J '\ -,
O'BRIEN/ BARIC & SCHERER
by:
-:j:2(~~
Robert L. O'Brien, Esquire
Attorney for Plaintiff
I.D. . 28351
17 West South Street
Carlisle, PA 17013
Q
;
~
~ '3 ~
:i '.Ii ...
:r :r
..
,
l.I'>
C"'J
=
""'"
""
Q
~~
.'.r.
lH~. .~;:!
0":1 C:'7.
.-;:~;U~
II.. ':t .~~
C~. .,._
~. ,- ~:;;
;.f... -'4:
::(1 ~~~..r..
- HI ")hJ
'oI.,,~in.
. =>
'''U
<>
-
-
Co>
....
=
\t-
O
...
""
~
...
.
. .
.
Commonwealth of Pennsylvania
County of Cumberland
Ou:istine nmcan
805 Balt:irnore Road
Shippensburg. Pa. 17257
Court or Conunon Pleas
111.
No, ___~~:~JLQ7_~YiJl_telUl___________ 19____
Gerald B. Swanger
24 E. Orange Street
Shippensburg, Pa. 17257
In ____f:A'!!.J._ Ag!:J._Q.IJ:~_____________________
1:0 ___~F~_~_~~__~~~~______________________
You are hereby notified that
C~~!JJl~_t!ulCarL_______________________________________________________________________________
the Plaintifr has commenced an action in ______~jY..U_!_.IDl!_______________________________..______
against you which you are required to derend or a default judgment may be entered against you,
(SEAL)
._~OCit_~._l{el~_________________________
Prothonotary
Ilate ~C~_Jw.________________ 19~5_
By __~/1~ffi :;~r:---------------------
J
.
ro- r0- t z~
II'l II'l
N ~~~ .S
ro- ~B~
...
JJ~ J !I
II UlO! 00 Ul'" M
j @/, . :dI aI -5' ro-
. ~~CD
~I O~p.II'l'"
~oij Jj M' ,
I
. ..co 0\ ,
:;:1, ~ Q.JN~ I
o~;:: 2! a1ij .....'-PIl:N
401~ ~ ~l i81~.~ I
3lilC!:; I
~:g:a ~~Ul ro- . r0- t
:i Q:;.....UH_ I
lXlUl ,
"
H. Thomas K11ne, ~her1tt
SHERIFF'S RETURN - REGULAR
CASE NOI 1995-06807 P
connON WEALTH OF PENNSYLVANIA I
COUNTY OF cunBERLAND
DUNCAN CHRISTINE
VS.
SWANGER GERALD B
nICHAEL BARRICK . Sheriff or Deputy Sheriff of
CUnBERLAND County, Pennsylvania, who being duly sworn according
to law, says, the within WRIT OF sunnONS was served
upon SWANGER GERALD B _ the
defendant, at 1057:00 HOURS, on the -Zih day of December
19~ at 24 EAST ORANGE STREET
SHIPPENSBURG. PA 17257 .CUnBERLAND
County, Pennsylvania, by handing to SEANA OBERHOLZER. ADULT GIRL-
FRIEND OF DEFENDANT
a true and attested copy of the WRIT OF sun nONS
and at the same time directing ~ attention to the contents thereof.
Sheriff's Costs I
Docketing
Service
Affidavit
Surcharge
18.00
11. 76
.00
2.00
So ~~~~
S31.7b o'BRIEN BARIC
12/13/1995
by _
Sworn and subscribed to before me
this .u'l!:: day of AOnu~
19 q,: A. D.
(1&ML- n. "hL.a..... .t>~.
I' Prot.h-onotar1'
,
.
Commonwealth of Pennsylvania
County of Cumberland
QIrlstine Duncan
BOS BaltJrnore Road
Shippensburg, Pa. 17257
COUrl of Conunol\ Pleu
YL
Gerald B. Swanger
24 E. Orange Street
Shippensburg, Pa. 17257
No, m9..~:ti.ll.Q'U:i'l!J.._'t:em___m.m_ 19m.
In _mf:J,,!g_}~c;UqlJ:~______________mm_
. .. '.~ ~~..,'"
:. ;':,.,'
',. .,';:':)
":!:';1 . ".
;. ,. .!',
1:0 __~~~).q_~~__~~lUJe.______________________
'r'::, , '/ : '. ',' .;' .', '/ n:" L'~-L
h"'_~C:;;"1 ".~~ .....--
,.... a. ~ .'~..:..._
Prolhono:ary
You are hereby nolified tha I
~tQ~e_~Ce[l__.__.______.___________________________________________________._______.______
the Plain rill has commenced an aclion in ___.__~jY..U_~______.________________________________
against you which you are required 10 defend or a defaull judgmenl may be entered againlt you.
(SEAL)
._~oc~_~..j{el~euc________._._____._.__._..
Prothonolary
Date ~~_L..._m.___m____ 19..95_
By --9UffN./J.~f.h r:;ir:---um---mm----
"i
'.
.
it
.
'l;
f
::
.,
i
,
Cf'F" '.
. .i'i':
UEe ~
f : 1 ' I . ~
.) .~....' ;,.1 ~j
[".
,.,1,
t, .~
J
.
'" '" E+-
In In
N BS .S J.
'" .~~
....
J~.i J r
- ~Ul ~ ~ !Ul~ M
~fj :Pi ti. '"
- ro...-too ,<
~ O~ll<In'"
I ~jj M' ,
,
I . -ClOcn ,
:;1, ~ QJN "1:1' ,
1Il+-2! .a.J...-t_N ,
I :j~1 .~I i81.~ .- ,
~!j ,
ul 3....0'" ,
,
I ~ .... ,
'" .", ,
~ I ~O I o:;~ t-t_ 0
, '" Ul NUl 0
, ,
,~
:@
=
l!:!!::J
. C:!!::J
c:=.J
.IIU.;1IT" I-.CT"!W
r.; t'! <)\ ,/\ f.:
rASE NO: 1995-06807 P
C'1)MMON'~EAI.'rH or PEIHl,,;YL V Ml!t,:
COUNTY or CUMBERLAND
[J U.t!r::A!L..!;JiE r SEt!f:__._______. ___. __
vs.
S.'!{AtLG.!,:R GJ;:F ^l.l;>-1l._..._.m...._ ______.. _'n
_B.QJlJ';BL.L~t!lli,-2.B-'--___.. ...._.___..____.__.. :',h.?n if "1 Dc-puti' SherIff of
CUMBERLAND I:ounty, P",nnGY L'Iani". "ho bpin<1 duly sworn according
to 1.:J''''. oays,
the> withln C:'O]1PJ..t.<.It-lL_MLLl_I{OI.1<::1';..
was
Ei(!rved
u p'o'n __~\I Ati!JJ;R..f3.gRA1J'_.JL___.___._.__ _ _".'__' __...
ti,E'
d'?fc.ndant., at _J._;:.::~.!Jlo.\?,. H(Jl.lH::-;, {IU t.tll~ __~_r.9_ day of It;,i}',,_______ _ .__._~._.______.J
1~195. "t
2 L!':AIi.LQ~ A f!1;LS3..J.R f: ET
~;!Ll!'.t\;Jj.:.i.mlR.G,.._F.'A._J -,:; :R.__....._ __ __. .__
. t:;,l,Il1!Jx'lU..AND
G.:I\ln(}', P"nnsylvanvl, by handUlC] t.,) ~!':.MIII....OB!:=.RJJ.Q1-';;;.P'J_M!.Il!..:Ll.11
nlR<B~f.._~~L.P-I;:f.S R E.2JJ!.EN!::.f,__._ .__.....
" true and attested copy of ttwCi)!1El,AItlJ Ioll['...JIOU_C;.E.....__.____.__.__-'
and at the samf"-, time d1.l'Pct.inq H..LL <Jtt~:'I\t.lufi to thL' contc"'nls ther..::,oi.
Sherlff's Cost;;;:
[lcwke..t lOq
SC1' v l_C~lo
A[fld"v~t
Surctlar{J(30
~~(1 -J. It::: \It '-i"' :
~i~:~>;~.~~rr
11.1. 0,)
1 J, 76
. O~)
l~. lllt,
$::n'~-7'; f)' Ph J FN h/d~ P' t, ~" HEFl':r.:
c~5 '\:Ib.' l (,lit:.
~a[~dL-
~ ,.} ;1\1 t, 1 ~., jl.' ,- 1 .1. ..
;,"IIUf'fl -:ind D1Jb::':r':I l.b"":.d ti) bef, r'~' .',.,
t ~ 1 1 ~
9.1i.:' d";1"l~.
, (l~,4, t,. [I.
y.,~~:,~~'\[I>~M
J':'
.~;~ ';"'e<:
.- ..
( ': .,
j'. , "
, . --" ;;:j
'-t.I:' >
(,.)- ~
,-_I ;:.,~
..1",_'
ll. j. 1..._ , ::j
l? , i.)
CO , ~-J
.' ,: (/: I~';
'1
fi: , "r'a
" .' --
. .'
I, . .", j
t...: , .' , 0
z ~
~
'"
::J ~
t:l :s
e 0<1 ~ z
~E >< 0(
i ~
~
OJ ::e 0 z
jrn .; z
~
fii ~
::e :z:
< ::!
"'
.... :c
-' ...
..
-.:..-'
, .
.
~
'..
Of'
,.
."
.
,.
CHRISTINE C. DUNCAN,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
95-6807 CIVIL TERM
v.
GERALD B. SWANGER,
Defendant
CIVIL ACTION - LAW
BNTRY OF APPBARANCB
TO THE PROTHONOTARY:
Kindly enter the appearance of the undersigned on behalf of
the Defendant, Gerald W. Swanger, with respect to the above-
captioned action.
Respectfully submitted,
Dated. 0/1; #/,11
BY:c...-4~~Of~
~
. Attorney I.D. No. 29563
JAMBS, SMITH , DURKIN
P.O. Box 650
Hershey, PA 17033-0650
(717) 533-3280
Attorney for Defendant,
Gerald B. Swanger
, ,'.I<,l:';"~~tJl.,~.~V'!~c;j~~f'>.r';""'""":':-"",,,Jl!II.,..,,~..',._
.. \' .
<(~ ---
CBRTIPICATB OP SBRVICB
1/ KAREN DURKIN, ESQUIRE, do hereby certify that I served a
true and correct copy of the foregoing Entry of Appearance upon
the fOllowing below-named individual by depositing same in the
U.S. Mail, postage pre-paid at Hershey, Dauphin County/
Pennsylvania this ~"7J4.- day of May / 1996.
I
SERVED UPON:
Robert L. O/Brien, Esquire
O'Brien, Baric & Scherer
17 West South Street
Carlisle, PA 17013
~.
'.UA.~ )
a n urk: n, Esquire
, JAMES, SMITH , DURKIN
....-:-..._..
.
~
~:
i'l:
L~
~?::.
rg~;
9[,:
fi:l.,.
n:1'1 _I
/:.: ~$
tJs");R
..".
u:
'-
;-.;
(~
,'~
'...,....l
._I~_i:
"1;:,:1
:';$
'J;'?,'
~-~
,irE
'",
,:'1.
(J,
:or.:
..:....
<\I
-
; I
~ ~ ~ ~
~ E ~ ~
iJ .... c z
00(... , Z
oJ en .. f
.
13
~
....
~
=
ill
:c
.'
.
.
CHRISTINE C. DUNCAN,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
95-6807 CIVIL TERM
v.
GERALD B. SWANGER,
Defendant
CIVIL ACTION - LAW
DB.BNDANT'S ANSWER WITH NBW HATTBR
AND NOW, comes the Defendant, Gerald B. Swanger, by and
through his attorneys, James, smith and Durkin, to answer
Plaintiff's Complaint and aver New Matter as follows:
1. Admitted.
2. Admitted.
3 . Admitted.
4 . Admitted.
5. Denied. After reasonable investigation, the Defendant can
neither confirm nor deny whether Plaintiff's vshicle and the
vehicle driven by Charles Colley were stopped at a red light at the
intersection indicated at the time of the collision, and strict
proof thsreof is demanded at trial.
6. Admitted in part. It is admitted that the Defendant's
vehicle collided with the rear of Plaintiff's vehicle, but after
reasonable, Defendant cannot verify whether such collision resulted
in the Plaintiff's vehicle colliding with Mr. Colley, causing such
to be moved ten feet, and strict proof thereof is demanded at
trial. It is specifically denied that the Defendant operated his
vehicle at an excessive rate of speed and that he engaged his
brakes ten feet to the rear of the Plaintiff's vehicle. The
Defendant operated his vehicle within the speed limit governing the
.
roadway and engaged his brakes more than ten feet beyond the rear
of the Plaintiff's vehicle.
7. Denied. After reasonable investigation, the Defendant is
without knowledge or information sufficient to form a belief as to
the truth of the averments of paragraph seven (7) and strict proof
of the same is demanded at trial.
8. Dsnied. The averments in paragraph eight (8) as to
liability, causation and damages are conclusions of law to which no
responsive pleading is required and strict proof thereof is
demanded at trial.
9. Denied. The averments in paragraph nine (9) as to
causation are conclusions of law to which no responsive pleading is
required and strict proof thereof is demanded at trial.
10. Denied as stated. It is specifically denied that the
treatment sought by the Plaintiff was the result of injuries
incurred by the collision in question, and strict proof of same is
demanded at trial.
11. Denied. The averments in paragraph eleven (11) as to
liability, causation and damages are conclusions of law to which no
responsive pleading is required and strict proof thereof is
demanded at trial.
12. Denied. After reasonable investigation, the Defendant is
without knowledge or information sufficient to form a belief as to
the truth of the averments of paragraph twelve (12) and strict
proof of the same is demanded at trial.
13. Denied. After reasonable investigation, the Defendant is
without knowledge or information sufficient to form a belief as to
the truth of ths averments of paragraph thirteen (13) and strict
proof of ths same is demanded at trial.
COUNT I
14. The answers in paragraphs one (1) through thirteen (13)
are incorporated herein by reference.
15. Denied. The averments in paragraph fifteen (15) are
conclusions of law to which no responsive pleading is required and
strict proof thereof is demanded at trial.
WHEREFORE, Defendant Gerald B. Swanger respectfully requests
judgmsnt in his favor and against the Plaintiff, together with
costs.
NEW MATTER
16. The answers in paragraphs one (1) through fifteen (15)
are incorporated herein by reference.
17. The Plaintiff's actions are barred or limited pursuant to
the terms of the Pennsylvania Motor Vehicle Responsibility Act, 75
Pa.C.S. S1701 ~ sea., the provisions of which are incorporated
herein by reference.
18. Plaintiff's Complaint fails to state a claim upon which
relief can be granted.
WHEREFORE, Defendant Gerald B. Swanger respectfully requests
judgment in his favor and against the Plaintiff, togethsr with
costs.
& \,e
Dated.
-1 ~q~
"',. 'c'",
QUIRE
ney . #29563
J. MCNALLY, III, ESQUIRE
rney I.D. #52661
P.O. Box 650
Hershey, PA 17033-0650
(717) 533-3280
Attorneys for Defendant
..,,-~.'.."
VBRII'ICATIOH
Ths undersigned, GERALD B. SWANGER, hereby verifies that the
facts sst forth in the Answer with Nsw Mattsr are true and correct
to the best of his knowledge, information and belief and further
states that false statements herein are made subject to the
penalties of 18 Pa. C.S. section 4904 relating to unsworn
falsification to authorities.
GEk/f&l~
':.1-;:~">",-, 'M~'l-:f:0i,'_::{"i..~~~~~t~f'~t_,.
.
CBRTI~ICATB O~ SBRVICB
I, JOHN J. McNALLY, III, ESQUIRE, do hereby csrtify that I
served a true and correct copy of the foregoing Answer with New
Matter upon the following bslow-named individual by depositing same
in the U. S. Mail, postage pre-paid at Hershey, Dauphin County,
Pennsylvania this \()~ day of July, 1996.
SERVED UPON:
Robert L. O'Brien, Esquirs
O'Brien, Baric & Scherer
17 West South Street
Carlisle, PA 17013
J. -ly, II
, SMITH , DUR
,f!-\'
;';{~;'(;
\, _, ",.Y-i~'--~~~r,
I ~ I
~ ~ ~ ~
~ ~ ~ ~
~ ~ ~
o ~
;:~'tJ-rI:.~~J..ti_
po 9
'.",
.~
.
~
". '.
GERALD B. SWANGER,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 95-6807 CIVIL TERM
CIVIL ACTION - LAW
CHRISTINE C. DUNCAN,
Plaintiff
V.
PLAINTIFF'S RESPONSE
TO NEW HATTER
AND NOW, comes Plaintiff, by and through her attorney,
Robert L. O'Brien, Esquire, and responds to Defendant's New
Hatter as follows:
17. The averments in Paragraph 17 are conclusions of law to
which no responsive pleading is required and strict proof thereof
is demanded.
18. The averments in Paragraph 18 are conclusions of law to
which no responsive pleading is required and strict proof thereof
is demanded.
WHEREFORE, Plaintiff respectfully requests judgment in her
favor and against Defendant.
Respectfully submitted,
O'BRIEN, BARIC & SCHERER
By
-~~
Robert L. O'Brien, Esquire
Attorney for Plaintiff
I.D. II 28351
17 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
i
.
~.
i
f
.,
,
,.
.lL'
'.
~
~'
\~
~-
..
-'~,",""'''''~~
~j_l.. ,iL"",,,~~~J.ll_"t!,,!:?~....v' .
- -' .. '-':-"_'V::""'Y".;k.":,,,:""~'S- ,.~",:,-'.. 'i~i,~';-~"-~' \,-?if"'o'
.-
'.'
.
.- ..
I verify that the statements made in the foregoing
Plaintiff's Response to New Hatter 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
authori ties.
-~AJ'_'
ROBERT L. O'BRIEN, ESQUIRE
ATTORNEY FOR PLAINTIFF
Dated:
?jZc:c{t:tfo
....c,' -.".
. '-'--'.-~-' '~".'
,_ C-~'('''''.''_'''''--<4~.,.......,..,Jr,-,-,..+".l' , ..,Ji-.c
.pJ..&-'~ ftk,....u.
.k. '1'/'17 ~ IN"l
fBAEctlPI; FOR LISTING CASE FOR TRIA
TO THE PROTHONOTARY OF CUMBERLAND COUNTY:
Please list the following case:
(X) for JURY trial at the next term of civil court.
( ) for trial without a Jury.
CHRISTINE C, DUNCAN,
Plaintiff
(X) Civil Action. Law
( ) Appeal From Arbitration
( )
V,
GERALD B, SWANGER,
Defendant
(other)
The trial list will be called on December. 30.
1997
Trials commence on Februarv 2, 1998
Pretrials will be held on ~.Januarv 1, 1998
(Briefs are due 5 days before pretrials)
(The party listing this case for trial shall
provide forthwith a copy of the praecipe to all
counsel, pursuant to local Rule 214.1.)
f'lo. 95-6807 Civil Term
Indicate the attorney who will try case for the party who filas this praecipe: Robert L.
Q'Brlen, Esauire .
Indicate trial counsel for other parties If known: John J, McNall v, Esauire .
This case is ready for trial.
Signed: ~~A IO-^-
. -
Print Name: Robert L. O'Brien. Esaulre
Date: November 18, 1997
Attorney For: Plaintiff
;;,_.,;':::,~.;.,';:;';..;;2;.r";--"-' -"G;;;?i~.:f;;'
,-
~ C") ~
..
~Q N 8--
s~ .- . :.:.)
-~ u~
Co. -'
~g Q;:i
Lt. eo ~jUi
~~ ;o7)~
[I;'L' ::w ,,""
-r 0 iii' Ll
r-= ~ ~cc
15 r- Cj
0'1
..............,"'-
fRAECIPE FOR LISTING CASE FOR TRIAL
TO THE PROTHONOTARY OF CUMBERLAND COUNTY:
,
Please list the following case:
(X) for JURY trlel at the next term of civil court.
( ) for trial without a jury.
CHRISTINE C. DUNCAN,
Plaintiff
: (X) Civil Action. Law
: ( ) Appeal From Arbitration
: ( )
V.
GERALD B. SWANGER,
Defendant
(other)
The trial list will be called on Februarv 17.
199B
Trials commenca on March 16,1998
Pretrials will be held on Februarv 25, 199B
(Briefs are due 5 days before pretrials)
(The party listing this case for trial shall
provide forthwith a copy of the praecipe to all
counsel, pursuant to local Rule 214.1.)
No, 95-6B07 Civil Term
Indicate the attorney who will try case for the party who files this praecipe: Robert L.
O'Brien. ESQuire.
Indicate trial counsel for other parties If known: John J, McNallv. ESQuire.
This case Is ready for trial.
Slgned:~~()~
Date: November 1 B, 1997
Print Name: Robert L. O'Brien, ESQuire
Attorney For: Plaintiff
^-<i i-', ,;;,~":~c"
';;'1:~",\tf~?':,;:"
,<.',.. _.\..
II 0 ~
M f3~
:z::
Q... P-~
C') ~~
frl
Q a
15 ~
.,
~-
,-A',
..
,,-,,'>'
':\i
. .it~,'-:'
~" ."'\i1'"i( ," ]:''}~r\j:!:r}''~'i~f~;:!,~(1'~\ ~~,_::,
29,
CHRISTINE C, DUNCAN
v
GERALD B, SWANGER
"
iF
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: NO, 95-6807 CIVIL TERM
ORDER OF COURT
AND NOW, January 7,1998, counsel having failed to call the above case
case for trial when ready.
Robert L. O'Brien, Esq.
For the Plaintiff
John J. McNally, Esq.
For the Defendant
Court Administrator
:br
for trial, the case Is stricken from the February 2, 1998 trial list. Counsel may rellst the
By the Court,
m C\ \ \.u:.\ cc ~ \ (.<~
I-I;).-q'il"
~ In ~
c:; ,..
.. '"::1:'1;
ILIO N ~"):.....
SJf~ - 04'
f:E~ 0: (;J~
9r> N '.i"~i)
0'":_". ~..) :..:::
wr..:. 0:-'
~LJI ;!: IJJQj
F "--c roLl.
-, :E
u. Q:) a
0 c.'
10,
CHRISTINE C, DUNCAN
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
V
GERALD B. SWANGER
,
,
: NO, 95-6807 CIVIL TERM
ORDER OF COURT
AND NOW, February 17, 1998, the court having been notlfied that the above-
captioned case Is currently not at issue, the case is hereby stricken from the March 16,
1998 trial list. Counsel may relist the case when it Is trial ready.
By the Court,
Robert L. O'Brien, Esq.
For the Plaintiff
Court Administrator
-
\"r\cx..J.t.cI. c,~ ~ e '3
.) -~If- ~
John J, McNally, Esq
For the Defendant
:bb
iE -- i;;
.. N
i':> N j_1..::
UJQ .,:1%
(.)*""-. :r.: 1.):..;(
If" Q... . .~ ..::,
~~ .'~
.... ~ .'0.
,- "I','"
,. oN il.:;-~
.~t. t:::, 1'.hU
U:'I' La..) F!u...
[-' u.. ,,:.:.
u. ,'" :::l
0 0' U
PRAECIPE FOR LISTING CASE FOR TRIAL
TO THE PROTHONOTARY OF CUMBERLAND COUNTY:
.
Please list the following case:
( x) for JURY trial at the next term of civil court.
( ) for trial without a jury.
---------------------------------------------------------------------
Christine C. Duncan
Plaintiff
( x)
( )
( )
Civil Action - Law
Appeal From Arbitration
(other)
V.
Gerald B. Swanger
Defendant
No. 95-6807 civil
The trial list will be called on
April 21. 1998
Trials commence on May 18.1998
Pretrials will be held on April
29.1998 (Briefs are due 5
days before pretrials)
(The party listing this case for
trial shall provide forthwith a copy
of the praecipe to all counsel,
pursuant to local RUle 214.1.)
No. 95-6807
civil
19_
Indicate the attorney who will try case for the party who files this
praecipe: Robert I.. O'Brien. Esquire
Indicate trial counsel for other parties if known: John J. McNally.
Esquire
This case is ready for trial.
Signed: ~t->>
Date:-3..) z.5'h r
Print Name: Robert L. O'Brien, ESQuire
Attorney For: Plaintiff
j'le
~ Q ~
C":
6 ~ :':)~
~;-:: 0...
~~ :c ;.)~
Q. ~)~
..,
Q. In :;'0
~ N ,.J;;;:
a::: f5,:O
/:':: .....; cue;:
:c ;;;;
f3 co a
en
~
;p.
~,
,{
'.L
y.
f'
,......:.-
CHRISTINE C. DUNCAN,
PLAlNTIFF
V,
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
GERALD B, SWANGER,
DEFENDANT
95-6807 CIVIL TERM
ORDER OF COURT
AND NOW, this 19th day of May, 1998. the above-captloned case Is continued
to the July Term, Counsel Is not required to attend the call of the civil trial list on
Tuesday, June 9, 1998. There will be no pretrial conference unless requested by any
party,
Robert L, O'Brien, Esquire
For Plaintiff
By the Cou~/ ./
~\ 1Iw;1
- .
Edgar B. Bayley, J,
I
John J, McNally, Esquire
For Defendant
C-.t..L.a.. t>>~t.<1.... sf;>..4 q ,.
,.H'.
Court Administrator
:saa
"
.
. .
.
v,
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY. PENNSYLVANIA
: 95.6807 CIVIL TERM
CHRISTINE C. DUNCAN.
PlainlilT
GERALD B. SWANGER,
Defendanl
: CIVIL ACTION - LAW
PRAECIEPE TO ENTER TRANSCRIPT
TO THE PROTHONOTARY:
Kindly file the attached deposition transcription of Dr. Paul H. McCabe. with respect to the
above-captioned action.
Respectfully submitted,
JAMES, SMITH, DURKIN & CONNELLY, LLP
Dated:
~\ \~\q ~
\
By:
P.O. Box 650
Hershey, PA 17033.0650
(717) 533-3280
Attorneys for Defendant
:O"';.........-.'.....,~"'.____..."......:....~.,~.;...."'...'._...""'"'"-...*.~.,"~,.i';:..."..,...,~........~.~.~.. '"-__
. ~
-.
~
.
CERTIFICATE 010' SERVICE
I, JOHN J. MCNALLY. III, ESQUIRE, do hereby certifY that I served a true and correct
copy of the foregoing Praecipe to Enter Transcript upon the following below-named individua1(s)
by depositing same in the U, S, Mail. postage pre-paid at Hershey, Dauphin County. Pennsylvania
thisLdaYOfMay, 1998.
SERVED UPON:
Robert L, O'Brien, Esquire
O'Brien, Baric & Scherer
17 West South Street
Carlisle, PA 17013
..
.
.
<
.
".
.
ORIGINAL
.
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
CHRISTINE C. !>UNCAN , .
.
PLAINTIFF .
.
.
.
V . NO. 95-6807 CIVIL TERM
.
.
.
GERALD B. SWANGER, .
.
DEFENDANT .
.
DEPOSITION OF: PAUL H. McCABE, M.D.
TAKEN BY: DEFENDANT
BEFORE: JAMIE F. HACI<MAN, RPR/RMR
NOTARY PUBLIC
DATE:
SEPTEMBER 29, 1997, 9:03 A.M.
PLACE:
HERSHEY MEDICAL CENTER
500 UNIVERSITY DRIVE
HERSHEY, PENNSYLVANIA
APPEARANCES:
O'BRIEN, BARIC & SCHERER
BY: DAVID A. BARIC, ESQUIRE
FOR - PLAIUTIFF
JAMES, SMITH & DURXIN
BY: JOHN J. McNALLY, ESQUIRE
FOR - DEFENDANT
ALSO PRESENT:
DOUGLAS MacINTYRE, VIDEOGRAPHER
Hughes, 7CI6risbt, 'FOltz ir J/af4le :Reporting &riia, 8nt;.
115 PINE STREET. HARRISBURG. PA 17101
Hamsburg 717,232.5844 Fax 717.232-9837 Lanc:utar 717-393-510t
. .
1
2
3
4
5
6
7
8
9
10
11
12
13 3.
14 4.
15
16 5.
17
18
19
20
21
22
23
24
25
. -." - -", ... ,,,.-.,,,,:C<:"~_ ;J';.'\".;~K ~'i1'"
.
-,
2
WITNESS INDEX
NAME
PAUL H. McCABE, M.D.
BY: MR. McNALLY
BY: MR. BARIC
EXAMINATION
3
24
EXHIBIT INDEX
McCABE DEPOSITION EXHIBIT NO.
1. REPORT OF DR. BARER
2. ELECTROMYOGRAPHY NERVE CONDUCTIONS
5/30/95 LETTER FROM JURGENSEN TO RELY
DEPARTMENT OF RADIOLOGY C-SPINE SERIES BY
CUTHBERTSON
DEPARTMENT OF RADIOLOGY NON-CONTRAST MRI OF
THE CERVICAL SPINE BY CUTHBERTSON
PRODUCED AND MARKED
13
13
15
17
18
.
.
3
1 THE VIDEOGRAPHERI My name i. Douglas MacIntyre,
2 and I repre.ent Videolmaqe., 3004 Black Oak Drive, Red Lion,
3 Pennsylvania. Today'. date i. September 29th, 1997. The
4 time or day i. 9103 a.m. Thi. deposition is being
5 videotaped at the Her.hey M~dical Center, 500 University
6 Drive, Hershey, penn.ylvania. The caption or this case is
7 Christine C. Duncan ver.u. Gerald B. Swanger. The name of
8 the witn.ss i. Paul H. McCabe, M.D. This deposition is
9 being videotaped on behalr or the Defendant. Counsel will
10 now please introduce themselves.
11 HR. McNALLY I John McNally, here on behalf of the
12 Derendant.
13 HR. BARIC I David Baric, here on behalf of
14 Plaintirf, Christine Duncan.
15 THE VIDEOGRAPHERI The court reporter will now
16 please identify herself and swear in the witness.
17 THE COURT REPORTER: Jamie Hackman.
18 PAUL H. MCCABE, M.D., called as a witness, being
19 duly sworn, testified as follows:
20 DIRECT EXAMINATION
21 BY HR. McNALLY:
22 Q Doctor, if you could please introduce yourself to
23 the members or our jury.
24 A I'm Paul McCabe.
25 Q Dr. McCabe, what is your profession?
.
-
<
.
4
1 A Neurologist here at the Hershey Medical Center.
2 Q And your business address here?
3 A 500 University Drive, Hershey, Pennsylvania.
4 Q Doctor, if you could briefly describe for us your
5 educational background, beginning with college.
6 A My college was Wilkes University that I received
7 my Bachelor of Science degree in biology. From there I
8 proceeded on to medical school, Thomas Jefferson University
9 for four years, received an M.D. degree, and then following
10 that was my residency in neurology, which I started at the
11 Medical College of Pennsylvania in Philadelphia and then
12 completed here in Hershey. Since that time I've been on the
13 staff as a neurologist at the Hershey Medical Center.
14 Q Doctor, what is neurology?
15 A Essentially, it deals with disorders of the brain
16 and nerves. So it includes the brain, the spinal cord, and
17 peripheral nerves.
18 Q Dr. McCabe, could you summarize for us your
19 professional experience.
20 A I've been certified or on staff here in neurology
21 for approximately the last five years, of which we see
22 numerous neurologic diseases. We spend time in the
23 outpatient clinics, seeing outpatients with various
24 neurologic disorders, as well as time on the inpatient and
25 consult services, where we see, again, patients with
.
.
5
1 neurologic dieordere. And also a fair amount is for
2 education, educating new neurologists as they're coming
3 through their training, as well as medical students and
4 other doctor. that ars training in other fields.
5 Q Are you licensed by the Commonwsalth of
6 Penneylvania?
7 AYe..
8 Q When did you receivs your license?
9 A I believe that was in 1988.
10 Q Do you have any additional board certifications?
11 A Ye., I'm certified in neurology and psychiatry
12 from the American board, as well as added qualifications in
13 clinical neurophysiology.
14 Q Are you a member of any professional associations
15 or locieties?
16 A Yes, the American Academy of Neurology, the
17 American Epilepsy Society, and pennsylvania Medical Society
18 up until, I guess, just a few months ago.
19 Q Have you ever lectured in the field of neurology?
20 A Yes.
21 Q All right. If you could briefly describe some of
22 the topics that you've lectured on in the field of
23 neurology?
24 A It's really a whole variety, including things
25 from headache to seizures to lecturing on general anatomy of
~ ,
.
,
6
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
neurology, covering various disorders in neurology, as well
as individual patient cases always being discussed with
residents or medical students.
Q Have you ever posed as an expert witness in the
field of neurology?
A Yes, I have.
Q Have you had the opportunity to review any
medical records of the plaintiff, Christine Duncan?
A Yes.
Q What records have you had the opportunity to
review?
A The records regarding her accident on December
24th of 1993, including the records from Dr. Baker, Dr.
carey, Dr. VanBoskirk, Dr. Jurgensen, Dr. Hely, Shippensburg
Health services, Alexander spring Rehab, emergency room
visit from the accident, and several others, and Dr.
Kosenske.
Q Have you also had the opportunity to examine Ms.
Duncan?
A Yes, I did.
Q As a result of your review of the medical records
and your examination of Ms. Duncan, have you been able to
provide a diagnosis of her condition and/or its causes?
A Yes, I did have the chance to perform a detailed
neurologic history and examination on her, and essentially,
. .
7
1 going over her full examination, was unable to como up with
2 any evidence of any neurologic disease at this time.
3 Q Doctor, do you believe that as a result of your
4 examination and review of the records that you'll be able to
5 testify within a reasonable degree of medical certainty as
6 to her condition and its causes?
7 A Yes.
8 MR. McNALLY: At this point in time, I'd like to
9 offer Dr. McCabe as a medical expert in the field of
10 neurology.
11 MR. BARIC: Neurology only?
12 MR. McNALLY: Actually, neurology and
13 psychology.
14 MR. BARIC: I'm going to express an objection, to
15 the extent that Dr. McCabe may be offered for psychological
16 reasons, to psychologies, since I don't believe he's really
17 expressed an opinion as to any psychological components of
18 Christine Duncan's condition he's expressed in at least the
19 May 5th, 1997, report that was provided to us. I think we
20 can go ahead with him offering his testimony, although I
21 would ask that you break the two, I think, for purposes of
22 this videotape deposition so that we could, if necessary,
23 approach the judge in terms of whether this is within the
24 fair scope of his report.
25 MR. McNALLY: Certainly. In response, I'd just
""j;', ",:I:""'<~;>:~'/,;;,";:."...:,,,M'i;l
'.
< '
8
1 like to point out that Dr. McCabe has found that there is a
2 significant anxiety component to her presentation, and that
3 is included in his May 5th report. with that, we will
4 continue.
5 BY MR. McNALLY:
6 Q Dr. MCCabe, I am going to ask you a series of
7 questions today for your explanation to the jury, and in
8 providing those answers, I ask that all answers that you
9 provide are within a reasonable degree of medical
10 certainty.
11 A Yes.
12 Q Is that okay, Doctor? Doctor, from your review
13 of the medical records, were you able to learn of
14 Christine's medical condition before the auto accident of
15 December 24th, 1994?
16 A Yes, I was. There were some medical records that
17 were provided a year or so before the actual accident, and
18 her main medical problem at the time seemed to be regarding
19 her pulmonary history in that she had even gotten to the
20 point of going to see if she was a candidate for a pulmonary
21 transplant. There is also some other notes from the past
22 that aren't given in detail, but she did have a history of
23 carpal tunnel that was operated on in 1980, and also there
24 had been mention of a fair amount of things such as anxiety
25 in terms of some of her other medical conditions.
9
~~
,
.
1 Q Doctor, do any of these current medical
2 conditions have a neurological component or otherwise factor
3 into your assessment of Christine Duncan?
4 A The main one that would be neurologic would be
5 carpal tunns1 syndrome. It may have some degree, but I
6 don't think it's really directlY related to this current
7 case.
8 Q Is she taking any medication, Doctor?
9 A At the time I had seen her, she was taking
10 medication. I'm not sure what she may be on now, but when I
11 evaluated her in April of '97, she was on several different
12 medications, including Tylenol, Darvocet, and had also tried
13 Neurontin and AmitriptYline, or E1avil, which is the other
14 name.
15 Q Do you know what condition she was taking these
16 medications for?
17 A Well, for the pain that she was feeling in the
18 back of her neck and going down her left arm.
19 Q Do you know whether she was taking a drug called
20 Prednisone?
21 A She was also on Prednisone for her pulmonary
22 conditions, yes, and she had been on that chronically. And
23 I believe she's also using several types of inhalers for her
24 respiratory condition.
25 Q Doctor, do you know whether she had any prior
. ,
.
10
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
complaints of neck pain?
A There had been some remarks in older records
about her having neck pain, mainly associated with her
breathing, particularly if her breathing would become
worse.
Q How are these factors pertinent to your analysis
of the injury that she suffered as a result of the collision
of December 24, 1993?
A Well, there is some overlap of the conditions,
and at some times it may be difficult to pertain the
division between some of her complaints. So, for sxample,
her breathing condition, it's stated on several different
records that she must maintain a somewhat forward posture of
the head and neck, which is going to cause some strain on
the muscles in the neck.
Q Dr. McCabe, what medical attention did Christine
receive immediately after the accident?
A I believe right after the accident she was seen
in the emergency room that same day for which she had an
evaluation by the physician in the emergency room as well as
a cervical spine x-ray.
Q x-rays were taken at that time?
A Yes.
Q What were the results of those X-rays?
A Essentially normal cervical spine X-ray.
.
11
1 Q What were her chief complaints at the time of her
2 admission?
3 A Her main complaint at the time in the emergency
4 room -- I'll just pull the records -- were some left knes
5 discomfort and slight neck discomfort.
6 Q Was she prescribed a course of treatment after
7 that?
8 A Well, she did return to her, I believe, family
9 doctor or general internist, Dr. Hely, for her continuing
10 care, but no -- no specific medicines or treatments were
11 given aside from, again, one of the inhalers for her
12 breathing condition.
13 Q Did Dr. Hely make any findings?
14 A He did describe her pain and her symptoms but on
15 exam was not really able to find a substantial amount of
16 abnormality.
17 Q Did Dr. Hely himself perform any diagnostic tests
18 or examinations?
19 A He had several times that he had seen her in ths
20 office throughout the course of her history after the
21 accident and had made comment of not being able to find any
22 abnormalities on her neurologic exam that he performed as
23 well as not having anything on the neck x-ray that was
24 performed in the emergency room that day.
25 Q Are Dr. Hely's findings pertinent to your ability
12
1 to assess her condition?
2
A
Yes, I believe they are. They do, aqain, make
3 comment of him not beinq able to find any focal neuroloqic
4 abnormalities back at that time.
5
Q
Did Dr. Hely prescribe any course of treatment or
6 therapy?
7
A
He prescribed physical therapy for the most part,
8 and that was at both Alexander sprinq and also at
9 Shippensburq Hospital, and from what I could qather from the
10 records, mainly consisted of treatment with hot packs,
11 ultrasound and ranqe of motion exercises. On top of that,
12 she had also underqone a brief psycholoqical evaluation.
13
Q
Did she receive any results from this course of
14 treatment?
15
A
Several of the notes from ths physical therapy
16 patients do comment about them beinq able to increass her
~
17 mobility and decrease the pain. On top of that, Dr. Hely
18 also has in his notes from August of '94 that he believed
19 that her problems had been resolved with the physical
20 therapy.
o
v
~
r
21
Q
Have you had the opportunity to review any
22 treatment records of Dr. Carey?
"I
23
A
Yes, I did, and Dr. carey, aqain, appears to be
t.
J
,
24 either a family physician, a qeneral practitioner, and had
25 made various comments about different disorders, includinq
.
,. .' 0' '~"""-;'<":""''-'.'.-Y''~'.l'''c .
13
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
her pulmonary disease, some GI complaints that she had tor a
while, as well as her current neck pain.
Q Did Dr. carey seek the input ot any specialists
that you know ot?
A I'm not exactly sure it it's Dr. carey who had
asked tor it, but Dr. Jurgensen had been asked to give his
opinion, and he is a neurologist.
(Report ot Dr. Baker and Electromyography Nerve
Conductions produced and marked McCabe Deposition Exhibit
Nos. 1 and 2, respectively.)
BY MR. McNALLY:
Q Doctor, I'm going to present to you -- before
you, you will find what is shown as Exhibit No.1. Can you
identify Exhibit No.1?
A It is an evaluation by Dr. David D. Baker --
David C. Baker, sorry.
Q I'm sorry, I have the wrong exhibit before you.
A Oh, okay.
Q If you can refer to Exhibit No. 2 there.
A 2?
Q Yes.
A Okay. Okay. That is a report on nerve
conduction tests and electromyogram performed by Dr. craig
Jurgensen.
Q Describe that test for us it you could, Dr.
14
1 McCabe.
2 A The test consists of two parts. The first is the
3 nerve conduction test where ths time it takes for a signal
4 to travel down the nerve is measured, typically done by
5 simulating the nerve at various points along its pathway.
6 That tends to look mainly at the covering around the nerve,
7 called the myelin sheath, to see if it's been disrupted. It
8 also looks at the central part of the nerve, what's called
9 the axon, to see if there's any disorder. The second part,
10 or the EMG, involves evaluating various muscles that are
11 innervated by different nerves to see if their input has
12 been disrupted in any way, as well as also evaluating if
13 there's any primary muscle disease.
14 Q What were the results of these tests?
15 A Both the EMG and nerve conduction tests were
16 within normal limits.
17 Q Is that significant to your ability to provide
18 testimony regarding her condition at that time?
19 A Yes, it is. Essentially what it tells ms is that
20 there's no evidence of any ongoing nerve or muscle disease
21 at this time.
22 Q Did Or. Jurgensen reach any conclusions with
23 regard to her condition?
24 A He had raised some suspicion that there may have
25 been some cervical disc disease as the cause of her pain,
15
1 but was unable to actually show any evidence ot that when he
2 performed the nerve conduction test and the EMG.
3 (5/30/95 letter trom Jurqensen to Hely produced
4 and marked McCabe Deposition Exhibit No.3.)
5 BY MR. McNALLY:
6 Q Okay, Doctor, now I'm qoinq to reter you to what
7 we have marked as Exhibit No.3. It you can simply reter to
8 Exhibit No.3.
9 A Okay.
10 Q Are you able to identify Exhibit No.3?
11 A Yes, that's a clinical note by Dr. Jurqensen
12 reqardinq Christine Duncan.
13 Q And to whom is it addressed?
14 A It's addressed to Dr. Hely, Daniel P. Hely.
15 Q What were you able to learn from this report?
16 A Aqain, Dr. Jurqensen, beinq a neuroloqist, is
17 unable to find any actual abnormalities of the nervous
18 system, based on her evaluation of her muscles and nerves,
19 and aqain hs raises the question at that time of some
20 cervical disc disease. However, there is no clinical
21 evidencs to support any nerve root damaqe.
22 Q Dr. McCabe, at any point in time are you aware of
23 whether a second opinion was souqht?
24 A I believe she did have a second opinion by Dr.
25 Baker.
16
1 Q Now, Dr. McCabe, I'd like you to refer to what
2 we've marked as Exhibit No.1, if you could.
3 A Okay.
4 Q What is Exhibit No.1?
5 A That is the evaluation by Dr. David C. Baker.
6 Q Do you know whether Dr. Baker performed any
7 independent diagnostic tests?
8 A He did perform an examination of her, according
9 to the note I have here, and on that he states, again, that,
10 similar to Dr. Jurgensen or Dr. Hely, he's unable to find
11 any abnormalities on her examination.
12 Q Would you expect to find any abnormalities?
13 A If there were muscle or nerve damage, yes, that
14 can be picked up on an examination in terms of focal
15 weaknesses, focal sensory loss or chronic changes in the
16 muscle, such as atrophy, which is just shrinking of the
17 muscle, or fasciculations, which is a quivering of the
18 muscle.
19 Q Did she receive any further medical treatment?
20 A For a brief period she did undergo a chiropractic
21 evaluation by a Dr. VanBoskirk and, from what I could tell,
22 did not really receive any significant relief or changes in
23 her symptoms. And I believe it was at that point that she
24 then was either referred or referred herself to The Pain
25 Clinic and Dr. Kosenske.
17
1
2
3
4
5
6
Q What type of treatment did she seek from Dr.
Kosenske?
A Dr. Kosenske had sevsral modes of treatment he
had tried, including a TENS unit, steroid injections, and
also some trials of medication for her pain. He also had
her undergo an MRI scan of the cervical spine.
7 Q Did he also perform X-rays or have X-rays
8 perfot1Ded?
9 A He did repeat cervical spine X-rays.
10 (Department of Radiology C-Spine Series by
11 cuthbertson produced and marked McCabe Deposition Exhibit
12
13
14
15
16
17
18
19
20
21
22
23
24
25
No.4.)
BY MR. McNALLY:
Q Doctor, I'd like you to refer to what we've
marked as Exhibit No.4.
A okay.
Q Can you idsntify Exhibit No.4?
A Yes, it is a cervical spine series performed on
7/9/96 on Christine Duncan.
Q Okay. What were the results of those X-rays?
A Again, nothing was found, and they reported as
being negative.
Q Is that significant to your ability to diagnose
her condition?
A Yes. It tells me that there are no significant
18
1 changes in the bone that may be possibly impinging on nerve
2 roots or the spinal cord itself.
3 (Department of Radioloqy Non-Contrast HRI ot the
4 Cervical spine by Cuthbertson produced and marked McCabe
5 Deposition Exhibit No.5.)
6 BY HR. McNALLY:
7 Q Doctor, you also indicated that an HRI was done.
B What is an HRI?
9 A HRI stands tor Magnetic Resonance Imaging. It's
10 one ot the newer techniques tor viewing various systems in
11 the body, brain, spinal cord, joints, thoracic cavity, and
12 essentially has a much higher resolution than any othsr
13 currently available imaging technique.
14 Q In the situation with Christine Duncan, why was
15 an HRI ordered?
16 A It was done to look at her cervical spine, the
17 spinal cord itself, and also the nerve roots on the spine,
18 and that takes into account anything that may be impinging
19 on those, such as the bones or nerve roots or, rather,
20 discs.
21 Q If the report revealed impingement of that
22 nature, what type of symptoms would Christine show?
23 A Well, if a nerve was being pinched at its area of
24 origin or near that area, she could have focal weakness,
25 focal sensory changes or radiation of pain. It would be in
19
1 a speciric what we call dermatomal pattern, however.
2 Q What did her MRI show?
3 A Essentially, it just showed some mild spinal
4 stenosis at the levels or C4-C5 and C5-C6 and a mild disc
5 bulge at C5-C6. There was no evidence, however, or any
6 impingement on the spinal cord or on the nerve roots
7 themselves.
8 Q To your knowledge, has Dr. Kosenske been able to
9 diagnose her condition?
10 A He did give her a diagnosis, after these tests
11 came back as being normal or negative, and his diagnosis, I
12 believe, was myofascial pain as well as fibromyalgia.
13 Q What is myofascial pain and fibromyalgia?
14 A currently, at this time, they appear to be a
15 diagnosis essentially to fit in patients that have not
16 really been able to fall under other specific categories,
17 and they're mainly used for people that may be describing a
18 type of muscular pain, but there's really no diagnostic
19 tests for proving their existence.
20 Q Doctor, is there any indication in the medical
21 records of Christine's hyper-exaggeration of her symptoms?
22 A There are some. There are a few times that she
23 was seen in the emergency room with her breathing problems,
24 and notes are made by the physician that there were a
25 significant anxiety component to her presentation. The
20
1 othsr area that points along the similar lines was an
2 extensive workup she had tor some gastrointestinal systems,
3 and no specitic abnormality was ever able to be tound to
4 explain those symptoms.
5 Q How was Dr. Kosenske treating Christine?
6 A currently, at this time, I believe still with
7 some steroid injections and had tried medications. I'm not
8 sure it she's now still on those medications or it they've
9 bsen discontinued.
10 Q Are you able to reconcile Dr. Kosenske's
11 diagnosis with the findings of all the previous physicians
12 that she had seen?
13 A Well, from what I could see by the records and my
14 examination, I could not find anything suggesting muscle or
15 nerve disorder or spinal cord disorder. So I really could
16 not find any sign of any ongoing neurologic disease at the
17 time.
18 Q Do you know whether Dr. Kosenske has sought the
19 input of any other practitioners?
20 A I'm not aware of any other people being asked for
21 opinions aside from those we've talked about today.
22 Q Do you know how Christine is currently being
23 treated?
24 A Only from when I had seen her in April. I know I
25 had records of further steroid injections, but they were the
,
21
1 main thing I had seen.
2 Q Describe your visit with christins in April.
3 A I found her to be a very pleasant woman. She was
4 in some mild rospiratory distress because of her chronic
5 lung diseass. She was able to give me a full history of
6 everything that had happened. She did not appear to be in
7 any other type of distress, appear, as opposed to her
8 respiratory problem, and I was able to perform a full
9 evaluation on her.
10 Q Describe your evaluation of her.
11 A Well, it involved taking a history, which pretty
12 much had followed all the records of the pain and how it has
13 become a major part of her life right now, and also included
14 a full physical, or I should say neurological evaluation,
15 including examination of her cranial nerves, her muscles,
strength, her sensation, her coordination, and her
16 her motor
17 reflexes.
18 Q
19 A
20 did not.
21 Q
22 A
Did you perform any diagnostic tests?
Not aside from the actual physical examination, I
What were your findings, Dr. McCabe?
I had really found no evidence of any ongoing
23 neurologic disease. There was nothing indicating nerve
24 roots at any particular level being impinged, nothing
25 showing any current muscle cramps or tightness, and nothing
22
1 to support any evidence of central disease, such as the
2 spinal cord or the brain.
3 Q What were her chief complaints when you examined
4 her?
5 A Her chief complaint was really, I guess, two main
6 ones. The first was the neck pain that would radiate down
7 her arm. The other one, complaint she had, involved what
8 she was describinq as Charlie horses in her left arm and her
9 left hand, and essentially she described these as involvinq
10 all of the fingers and the top portion of her forsarm, that
11 they could occur at any time, but mainly while she was usinq
12 her arm, and would last up to about five minutes. They were
13 usually separate or independent from the pain by her
14 history.
15 Q Are you able to verify the cause of these
16 symptoms throuqh any objective tests that had been performed
17 on Christine?
18 A There really could -- I could not find any
19 cause. Some cramps of the muscles can occur in diseases of
20 nerves or muscles, but aqain, no studies to this point have
21 found any evidence of such. And sometimes such types of
22 cramps can just occur from extensive use of certain muscles
23 over and over aqain, the best example I can qive beinq
24 writer's cramp for people who may spent several hours at a
25 time writinq and typically have to put their pencil or pen
23
,
1 down to loosen up their musclss.
2 Q Did Christine discuss with you any hobbies that
3 she had or any activities that she performed?
4 A Yes, she does describe doinq a fair number of
5 crafts and that she has been doinq those for several years.
6 Q Did she describe her symptoms fOllowinq doinq
7 those crafts?
8 A Well, the crafts were one of the thinqs that
9 could brinq them on because she did complain about, at
10 times, not beinq able to do as many or as much of the crafts
11 as she would like because of havinq these symptoms.
12 Q Doctor, did the auto accident of December' 24th,
13 1993, cause the condition which she complained of at the
14 time you had the opportunity to examine her?
15 A There was really nothinq on her examination that
16 I could find that showed any evidence of any permansnt or
17 chronic disorder related to that accident.
18 Q Do you believe that the accident was a
19 substantial factor in brinqinq about that injury, her
20 injuries?
21 A It played some role. She did, by records, appear
22 to have some symptoms at the time of the accident that
23 qradually worsened over a few weeks, but they did appear to
24 have resolution or improvement with her physical therapy,
25 and it may just be that her current complaints now resemble
24
1 what those were like, and thersfore it has just been
2 connected to the accident.
3 Q Doctor, has all your testimony been today within
4 a reasonable degree ot medical certainty?
5 A Yes, it has.
6 MR. McNALLY: At this time I'd like to offer the
7 Exhibits 1 through 5 into evidence and offer Dr. McCabe for
8 cross-examination.
9 MR. BARIC: Let me make sure I have ths numbers
10 correct. No. 4 starts out as C spine series, correct?
11 THE WITNESS: (Nods head up and down.)
12 MR. BARIC: And 5 then is the non-contrast MRI?
13 MR. McNALLY: That's correct.
14 MR. BARIC: cervical spine. I have no objection
15 to the exhibits.
16 CROSS-EXAMINATION
17 BY MR. BARIC:
18 Q Dr. McCabe, my name is Dave Baric, and I'm hsre
19 representing Christine Duncan in this matter. For what
20 period of time did you examine Christine the day you
21 indicated that you saw her, took her history and examined
22 her?
23 A I believe it was somewhere in the range of an
24 hour to an hour and a half.
25 Q Was that the only direct contact you have had
25
1 with Christine Duncan in relation to renderinq an opinion in
2 this case?
3 A Yes, it is.
4 Q Doctor, are you beinq compensated for your time
5 that you spent on this matter? Are you beinq paid?
6 A Yes.
7 Q And how much are you paid?
8 A Well, my current fee, at the time of her
9 evaluation, was $300 per hour.
10 Q Your testimony was that you spent, you believe,
11 an hour to an hour and a half, was it --
12 A Yes.
13 Q on that day? Likewise, were you compensated
14 for renderinq a report in this matter?
15 A Yes, I was.
16 Q Do you recall how much time you spent draftinq
17 that report?
18 A The actual preparation of the report itself was
19 probably about one hour or so. The record review, I don't
20 remember exactly, but that was two or three hours.
21 Q Would that record review have taken place before
22 or after your independent evaluation of Christine?
23 A I believe it was before.
24 Q And, likewise, Doctor, are you beinq compensated
25 for appearinq here today, providinq your testimony?
26
1 A Yes.
2 Q The same hourly rate?
3 A Um-hum.
4 Q Now, I believe your testimony, based upon the
5 last few moments of your direct examination of Mr. McNally,
6 you indicated that you have no reason to doubt that
7 Christine experienced some pain immediately after the
8 accident, is that correct?
9 A That's correct.
10 Q Likewise, do you have any reason to doubt that
11 she experienced pain a week after the accident?
12 A No, I don't.
13 Q A month after the accident? Same question.
14 A No.
15 Q What report of any of the treatinq physicians did
16 you rely upon then to conclude at the point in time -- or
17 what point in time she actually no lonqer experienced any
18 pain associated with the accident?
19 A I believe it was in August under Dr. Rely's
20 notes.
21 Q It's Dr. Rely.
22 A Rely. There is the note, I think it is 8/24/94,
23 that states pain relief has been achieved with PT. She had
24 been qoinq three times weekly, has very little pain except
25 at direct posterior aspect of the neck, and due to that had
27
1 cut back her physical therapy to just once a week and had
2 planned on discontinuing it.
3 Q So, approximately nine months after the accident,
4 you're relying upon the note of Dr. Hely then to conclude
5 that her pain had sUbstantially resolved itself?
6 A Yes.
7 Q Does Dr. Hely indicate that it had absolutely
8 resolved and there was no longer any pain?
9 A Well, he says pain relief has been achieved, but
10 then also in the next sentence says that there is very
11 little pain except at one particular aspect of the neck,
12 direct posterior aspect.
13 Q Doctor, in your practice here at Hershey Medical
14 Center -- I believe you indicated you've been here for five
15 years have you worked with victims of whiplash injuries?
16 A Yes, I have.
17 Q Have you worked with -- well, tell me, what
18 percentage of your practice would you estimate relates to
19 working with people who have experienced whiplash-type
20 accidents or injuries in car accidents?
21 A I'd say, since the time I have been here,
22 including some of my training, probably about 5 to 10
23 percent.
24 Q Have you always found that in working with -- and
25 now I'm limiting my question to the 5 to 10 percent of your
28
1 practice that relates to tolks who have been involved in
2 whiplash-related injuries. For those people, have you
3 always been able to ascertain an objective tinding that
4 relates to their subjective complaint ot pain?
5 A Well, I'd say tor the majority ot them we
6 typically cannot tind objective tindings. The exceptions
7 would come along when we have people that, due to such an
8 injury, have pertained actual nerve damage or, in some case,
9 blood vessel damage.
10 Q So, more often than not, you're not finding
11 you're not coming up with an objective finding through an
12 X-ray or an MRI that would relate to the subjective
13 complaints of pain?
14 A Right.
15 Q Now, you offered, in concluding your direct
16 examination, that Or. Kosenske has indicated that Ms. Duncan
17 is suffering from fibromyalgia. Are you familiar with that
18 term and that condition?
19 A I'm familiar with the term. In terms of familiar
20 with the condition, I guess it depends on exactly what do
21 you mean by the condition. Since there really are no
22 objective tests for making the diagnosis, it really relies
23 on somebody saying they have it or don't have it.
24 Q Um-hum. Well, it relies upon -- as I understand
25 it, it relies upon people continuing to indicate
29
1 subjectively that they're experiencing pain, and yet there
2 is no objective finding to match it. Isn't it true, Doctor,
3 that as it relates to fibromyalgia, in fact, your practice
4 is to try to rule out other things with tests before coming
5 to a diagnosis of fibromyalgia?
6 A Well, that is how the diagnosis is used by
7 several people. I think one of the major concerns is, is it
8 a true disorder or not.
9 Q And you're aware, are you not, that support
10 groups have been put in place and whatnot for folks who are
11 sUffering from fibromyalgia?
12 A Yes.
13 Q And there's a syndrome, as I undsrstand it,
14 that's been associated with fibromyalgia and referred to as
15 fibromyalgia syndrome?
16 A Yes, there has been.
17 Q Have you written any articles relating to
18 fibromyalgia?
19 A No.
20 Q Have you given any lectures in regards to
21 fibromyalgia?
22 A Not specifically about that disorder. It's been
23 included, though, in some of the talks that may be about
24 pain in general.
25 Q Does fibromyalgia really fit within the study of
30
1 neurology?
2 A It will be included in textbooks and the journal
3 articles because it is commonly a diaqnosis that comes up in
4 reqard to differential diaqnosis from other neuroloqic
S disorders, and also muscle disorders are typically covered
6 by neuroloqists as well, such as muscular dystrophies.
7 Q Is there another classification or specialty
8 within there has been more of a discussion of fibromyalqia
9 in the medical community?
10 A There probably have been. My guess, and it's
11 mainly a guess, would be rheumatology.
12 Q All riqht. Dr. Mccabe, in renderinq your report
13 previously in this matter, you referenced a number of tssts
14 that you performed on Christine. The report that you had
lS provided, that, as I understand it, indicated to the
16 exclusion of anythinq elss all of the tests that you
17 performed on Christine.
18 A Well, I had performed just a physical
19 examination. I was qoinq by the reports of other tests.
20 Q All riqht. Would you have liked to have
21 performed any further testinq in reqards to renderinq an
22 opinion of Christine?
23 A No. Actually, the main test would have been the
24 MRI and the nerve conduction tests in terms of ssekinq out
2S an actual cause that may have been directly related to the
31
1 accident.
2 Q And, as I understand it from the previous
3 testimony, the MRI and the X-rays, aqain, you're lookinq for
4 objective findinqs?
5 A (Nods head up and down.)
6 Q Physical changes to the body
7 A Yes.
8 Q -- that would relate then to an indication of
9 pain, correct?
10 A Correct.
11 MR. BARIC: I have nothinq further at this time.
12 MR. McNALLY: I have no further questions 'at this
13 time. Thank.you, Doctor.
14 MR. BARIC: Thank you.
15 THE WITNESS: You're welcome.
16 THE VIDEOGRAPHER: This videotape deposition is
17 now concluded. The time of day is 9:48 a.m.
(Whereupon, the deposition was concluded at 9:48
18
19 a.m.)
20
21
22
23
24
25
32
1 COUNTY OF DAUPHIN
.
.
2
: SS
3
COMMONWEALTH OF PENNSYLVANIA :
4
I, Jamie F. Hackman, a Notary Public, authorized to
administer oaths within and for the Commonwealth of
5
6
Pennsylvania, do hereby certify that the foregoing is the
testimony of PAUL H. McCABE, M.D.
I further certify that before the taking of said
7
8
9
deposition, the witness was duly sworn; that the questions
and answers were taken down stenographically by the said
Reporter-Notary Public, and afterwards reduced to
typewriting under the direction of the said Reporter;
10
11
12
13
I further certify that the said deposition was taken
at the time and place specified in the caption sheet hereof.
14
15
I further certify that I am not a relative or employee
or attorney or counsel to any of the parties, or a relative
16
17
or employee of such attorney or counsel, or financially
18
interested directly or indirectly in this action.
I further certify that the said deposition constitutes
19
20
a true record of the testimony given by the said witness.
IN WITNESS WHEREOF, I have hereunto set my hand this
21
22
20th day of Octcber, 1997.
23
N
F. Hackman, RPR/RMR
//' Jam e
Not
i.. I
24
25
NOTAAIAI. SEAL
JAMIE F, HIoCI<MAN. HctIIy PlIbIIc:
t-!"omurv. 00upNn C<<wy
~ ,... .., )........ r:x"'- .
1._~'V ..... __, - ...........~ '5. 1998
Multi-Pagcl><
$300 - ccrtif
PAUL H. McCABE. M.D
alonS[]1 14:5 20:1 blSCd(21 15:18 26:4
-$- -8- 28.7 become 12110:4 21:13
$300(11 25.9 8n4/94 (II 26:22 always [21 6:2 27:24 beginning(11 4:5
28:3 behalf [21 3:9 3:11
-'- -9- American (]I 5:12 3:13
5:16 5:17 best (II 22:%3
'94(11 12:18 95-6807 (II 1:4 Amitriptyline (II 9:13 betwcen III 10:11
'97[11 9:11 9:03121 1:12 3:4 amount12l5:1 8:24 biology [II 4:7
9:48121 31:17 31:18 11:15
-I- analysis [II 10:6 Black[11 3:2
-A- anatomy [II 5:25 blood III 28:9
1m 2:11 13:10 board [21 5:10 5:12
13:13 13:14 16:2 a.m(41 1:12 3:4 answers PI 8:8 body 121
8:8 32:10 18:11 31:6
16:4 24:7 31:17 31:19 anxiety 1]18:2 bOnC(11 18:1
10(21 27:22 27:25 ability PI 11:25 14:17 8:24
19:25 bODCSIl1 18:19
13 (21 2:11 2:12 17:23 appearlSJ 19:14 21:6 brain (41 4:15 4:16
15(11 2:13 able [III 6:22 7:4 21:7 23:21 23:23 18:11 22:2
17[11 2:15 8:13 11:15 11:21 APPEARANCES [II bn:ak (I I 7:21
12:3 12:16 15:10
18[11 2:17 15:15 19:8 19:16 1:16 bn:athing 1'1 10:4
1980[11 8:23 20:3 20:10 21.5 appearing [II 25:25 10:4 10:12 11:12
1988[11 5:9 21:8 22:15 23:10 approach [II 7:23 19:23
1993 [31 6:13 10:8 28:3 April 1]1 9:11 20:24 brief [21 12:12 16:20
23:13 abnormalities ['I 11:22 21:2 briefly [21 4:4 5:21
1994[11 8:U 12:4 15:17 16:11 area(]1 18:23 18:24 bring [II 23:9
1997 [41 1:12 3:3 16:12 20:1 bringing (II 23:19
7:19 32:22 abnormality 121 11:16 anD [41 9:18 22:7 bulge [II 19:5
20:3 22:8 22:12
-2- absolutely (II 27:7 articles [2129: 17 business [II 4:2
30:3
2(4) Academy (II 5:)6 ascertain [II 28:3 -C-
2:12 13:10 accident (II) 6:12 aside (31
13:19 13:20 11:11 20:21
20th [I) 6:16 8:14 8:17 21:19 C[SJ 1:3 3:7
32:22 10:17 10:18 11:21 13:16 16:5 24:10
24(21 2:5 10:8 23:12 23:17 23:18 aspect PI 26:25 27:11 C-Spine[21
23:22 24:2 26:8 27:12 2:14
24th (3) 6:13 8:15 17:10
23:12 26:11 26:13 26:18 assess [II 12:1 C4-C5 (II 19:4
29[11 27:3 31:1 asscssmcot (II 9:3
1:12 accidents [21 27:20 associated PI C5-C6121 19:4 19:5
29th (II 3:3 10:3
27:20 26:)8 29:14 candidate (II 8:20
-3- according (II 16:8 associations (I) 5:14 cannot (II 28:6
account (II 18:18 atrophy [I) 16:16 caption [213:6 32:14
3 (6) 2:4 2:13 achieved 121 26:23 attc1ltion (II 10:16 car (II 27:20
15:4 15:7 15:8 27:9 attorney (21 32:16 Cl\Rl (II 11:10
15:10 action 121 1:2 32:18 32:17 Carey ('I 6:14 12:22
3004fll 3:2 activities (II 23:3 August 121 12:18 26:19 12:23 13:3 13:5
actual (61 8:17 15:17 authorized (I) 32:4 carpal (21 8:23 9:5
-4- 21:19 25:18 28:8 auto 121 8:14 23:12 case (41 3:6 9:7
4('1 2:14 17:12 30:25 available [II 18:13 25:2 28:8
17:1S 17:17 24:10 added (I) 5:12 15:22 20:20 cases [II 6:2
additional (11 5:10 aware PI categories [II 19:16
29:9
-5- address (114:2 axon (II 14:9 causes [21 6:23 7:6
5(6) 2:16 18:5 addressed 121 15.13 cavity (II 18:)1
24:7 24:12 27:22 15:14 -B- Center(SJ 1:13 3:5
27:25 administer [II 32:5 4:1 4:13 27:14
5/30/95 (21 2:13 admission (II 11:2 B(21 1:5 3:7 central [21 14:8 22:1
15:3 afterwards (II 32:11 Bacbelor(l) 4:7 certain (II 22:22
500(31 1:13 3:5 again (II) 4:25 11:11 background (II 4:5 Certainly (I) 7:25
4:3 12:2 12:23 15:16 Baker (I) 2:11 6:13 certainty PI 7:5
5th (21 7:19 8:3 15:19 16:9 17:21 13:8 13:15 13:16 8:10 24:4
22:20 22:23 . 31:3 15:25 16:5 16:6 certifications [I) 5:10
-7- ago (II 5:18 Baric (141 1:17 1:17 certified 121 4:20
abcadlll 7:20 2:5 3:13 3:13
7/9/96[11 17:19 7:11 7:14 24:9 5:11
AleXlnderr21 6:15 24:12 24:14 24:17 certify []I 32:6 32:8
12:8 24:18 31:11 31:14 32:13 32:15 32:19
HUGHES, ALBRIGHT, FOLTZ & NATALE
717-540-0220\717-393-5101
Index Page
Multi-Page'"
, cervical - Duncan
PAUL H. McCABB. M.D.
cervical [III %:17 31:18 D[II 13:15 discll8s[IJ %3:%
10:%1 10:%' 14:%' concluding [II 28:15 damage (4115:%1 16:13 discll8sed (II 6:%
15:20 17:6 17:9 conclll8ions[11 14:%% 28:8 %8<9 discussion (II 30:8
17:18 18:4 18:16 condition [17J 6:%3 Daniel[IJ 15:14 discuc [101 7:%
%4:14 I
chance [II 6:%4 7:6 7:18 8:14 Dsrvocct(IJ 9:1% 13:1 14:13 14:%0
9:15 9:%4 10:1% date (21 1:1% 3:3 14:%$ 15:%0 %0:16
changes(ll 16:15 11:1% 1%:1 14:18 DAUPHIN [II 3%:1 %1:' %1:%3 %%:1
16:%% 18:1 18:%' 14:%3 17:%4 19:9 discucs[21 4:2%
31:6 %3:13 %8:18 %8:%0 Davo[ll %4:18 %%:19
Charlie (II %%:8 %8:%1 David ['1 1.17 3:13 disorder ['I 14:9
chief[]1 11:1 %2:3 conditions [41 8:%' 13:1' 13:16 16:' %0:15 20:15 %3:17
%%:, 9:% 9:%% 10:9 deals [II 4:1' %9:8 %9:%%
chiropractic [II 16:%0 conduction (II 13:%3 Dcccmbcr[41 6:1% disorders ('II 4:1'
Christine [241 1:3 14:3 14:15 15:% 8:15 10:8 %3:1% 4:%4 ':1 6:1
3:7 3:14 6:8 30.%4 deCreUC(11 1%:17 1%.%' 30:5 30:'
7:18 9:3 10:16 Conductions 121 %:1% Defendant [1I 1:6 disrufted (21 14:7
15:1% 17:19 18:14 13:9 1:9 1:%1 3:9 14:1
18:%% 20:' %0:%% connected [II %4:% 3:1% distress 121 %1:4
%1:% %%:17 %3:% consisted (II 1%:10 degree ('I 4:7 4:9 %1:7
%4:19 %4:20 %':1
%,:%% %6:7 30:14 consists [I) 14:% 7:' 8<9 9:' division fll 10:11
30:17 30:%% constitutes (II 3%:19 %4:4 doctor(221 3:%% 4:4
Christine's [21 8:14 consult [I) 4:%$ Department (4' %:14 4:14 7:3 8:1%
19:%1 %:16 17:10 18:3 8:1% 9:1 9:8
chronic 13116:15 contact [1124:%$ deposition [141 1:8 9:%$ 11:9 13:1%
21:4 continue [II 8:4 %:10 3:4 3:8 15:6 17:14 18:7
%3:17 continuing 121 11:9 7:%2 13<9 15:4 19:%0 %3:12 %4:3
chronically [II 9:%2 %8:%$ 17:11 18:' 31:16 %$:4 %$:%4 %7:13
CML12J 1:% 1:4 coordination (I) %1:16 31:18 3%<9 3%:13 %9:2 31:13
classification [II 30.7 cordl7J 4:16 18:% 3%:19 doctors (I) ':4
Clinic (I) 16:%' 18:11 18:17 19:6 dcrmatomal(11 19:1 done 131 14:4 18:7
clinical 131 ':13 20:1' %%:% describe (II 4:4 18:16
15:11 15:%0 corrcct(7J %4:10 %4:10 ':%1 11:14 13:%' doubt 121 %6:6 %6:10
clinics [II 4:%3 %4:13 %6:8 %6:9 %1:% %1:10 %3:4 Douglas 121 1:%3
%3:6 ,
collegc (]I 4:' 4:6 31:9 31:10 3:1
4:11 counsel 131 3:9 described [I' %%:9 down (7J 9:18 14:4
collision (I) 10:7 3:1:16 3%:17 describing 121 19:17 %%:6 %3:1 %4:11
COUNTY 121 %%:8 31:' 3%:10
coming 131 ,:% %8:11 1:1
%9:4 3%:1 detail [I J 8:%% Dr[S7J %:11 3:%$
comment (]) 11:%1 course (4) 11:6 11:%0 detailed [II 6:%4 4:18 6:13 6:13
1%:' 1%:13 diagnose 121 17:%3 6:14 6:14 6:14
1%:3 1%:16 6:16 7:9 7:1'
comments [II 1%:%$ COurt(]1 1:1 3:1$ 19:9 8:1 8:6 10:16
3:17 diagnosis [101 6:23
COMMON (I) 1:1 11<9 11:13 11:17
commonly [II covered [II 30:' 19:10 19:11 19:1$ 11:%$ 1%:5 1%:17
30:3 covcring 121 6:1 20:11 %8:%% %9:' 1%:%2 12:23 13:3
Commonwealth PI ,:, 14:6 %9:6 30:3 30:4 13:5 13:6 13:8
3%:3 3%:' crafts (4) %3:' %3:7 diagnostic (4) 11:17 13:1$ 13:23 13:%'
community [II 30:9 %3:8 %3:10 16:7 19:18 %1:18 14:2% 1':11 1$:14
compensated (3) %$:4 Craig [I) 13:%3 different (41 9:11 15:16 1$:2% 1$:%4
%,: 13 %':%4 10:12 1%:%$ 14:11 16:1 16:' 16:6
complain [II cramp [I) %%:%4 differential [I) 30:4 16:10 16:10 16:21
%3:9 cramps 131 %1:%' %%:19 16:%$ 17:1 17:3
complained (II %3:13 %%:2% difficult [II 10:10 19:8 %0:' %0:10
comflaint (4) 11:3 cranial (I) %1:1$ direct [') 3:%0 %4:%' %0:18 %1:%1 %4:7
%%: %%:7 %8:4 cross-examination 121 %6:' %6:%$ %7:1% %4:18 %6:19 %6:%1
complaints 171 10:1 %4:8 %4:16 28:" %7.4 %7:7 %8:16
10:11 11:1 13:1 CUMBERLAND (II direction [I) 3%:1% 30:1%
%%:3 %3:%' %8:13 1:1 directly 131 9:6 drafting [II %$:16
completed[IJ 4:1% current ['I 9:1 9:6 30:%$ 3%:18 Drive [41 1:13 3:%
component (3) 8:% 13:2 %1:%$ %3:%' disc PI 14:%$ ":%0 3:6 4:3
9:% 19:%' 2':8 19:4 drug (11 9:19
components [II 7.17 cut (II %7.1 discomfort [21 11:' duc (2) 26:%$ %8:7
conccmS(11 %9:7 Cuthbertson [41 %:1$ 11:5 duly 121 3:19 3%:9
conclude 121 %6:16 %:17 17:11 18:4 discontinued [I) %0:9 Duncan [U) 1:3
%7:4 discontinuing (II %7:2 3:7 3:14 6:8
concluded 121 31:17 -I>- discs [I) 18:%0 6:19 6:%% 9:3
HUGHES. ALBRIGHT, FOLTZ & NATALE
717-540-0220\717-393-5101
Index Page
Multi-Page'"
Index Page
Duncan's - introduc
PAUL H. McCABE. M D
":12 17:19 18:14 exhibitll1l 2:9 16:1' 18:24 18:2' I bobbles (II 23:2
24:19 2':1 28:16 2:10 13:9 13:13 folklll21 28:1 29:10 horses (II 22:8
DUnCID'S(11 7:18 13:14 13:17 13:19 followed III 21:12 Hospital (II 12:9
DURKIN (II 1:19 IN ":7 1$:8
":10 16:2 16:4 following (21 4:9 hotlll 12:10
dystrophies (II 30:6 17:11 17:" 17:17 23:6 hourI"~ 24:24 24:24
18:' f(\lIoWS(11 l:19 2':9 2':11 25:11
-E- exhibits 121 24:7 f011llll1DI11 22:10 2':19
educating (II ':2 24:" forcgoinglll 32:6 hourly III 26:2
education (II ':2 existence (II 19:19 forward (II 10:13 holUll 121 22:24 25:20
educational (II 4:' expect III 16:12 found PI 8:1 17:21 h~xaggeration (II
eithcfl21 12:24 16:24 experience (II 4:19 20:3 21:3 21:22 I :21
Blavil(11 9:13 experienced 141 26:7 22:21 27:24
26:11 26:17 27:19 four (II 4:9 +
electromyogram (II experiencing (II 29:1 fulh4' 7:1 21:' identify (41 3:16
13:23
Blcctromyography (21 expcrt(21 6:4 7:9 21:8 21:14 13:14 1':10 17:17
2:12 13:8 explain (1120:4 .0- imaging 121 18:9
emergency ('I 6:15 explanation (II 8:7 18:13
10:19 10:20 11:3 express (117:14 gastroinlcStinal(ll 20:2 immediately (21 10:17
11:24 19:23 expressed [21 7:17 gather (II 12:9 26:7
BMG('I 14:10 14:15 7:18 gcncra1 [41 ':2' 11:9 impinged (II 21:24
15:2 exlcDsive [21 20:2 12:24 29:24 im~ingcmcnt (21 18:21
employee (21 32:15 22:22 GeraId(21 I:' l:7 I :6
32:17 exlcDt(11 7:" GI(II 13:1 impinging (21 18:1
BpilcpsY(l1 ':17 given [41 8:22 11:11 IB.IB
BSQUIRE 121 1:17 -F- 29:20 32:20 improVClDCllt (II 23:24
1:20 F(ll gradually (II 2l:2l included (41 B:3
essentially (II 4:15 1:10 32:4 21:13 29:23 30:2
6:2' 10:2' 14:19 32:23 groups III 29:10 includes (II 4:16
18:12 19:3 19:15 fact [II 29:3 guess 1'1 ':IB 22:' including PI ':24
22:9 factor12J 9:2 23:19 2B:20 30:10 lO:1I 6:13 9:12 12:2'
estimate [II 27:1B factors (II 10:6 17:4 21:15 27:22
evaluated (II 9:11 fair (41 $:I 7:24 -H- incI'Case (II 12:16
evaluating (21 14:10 B:24 23:4 H[SJ 1:8 2:3 independent (21 16:7
14:12 fall(ll 19:16 3:8 3:IB 32:7 22:13 2':22
evaluation (III 10:20 familiar [II 2B:17 Hllr.lnnnn (4) 1:10 INDEX (21 2:1
12:12 13:15 ":IB 2B:19 2B:19 3:17 l2:4 l2:23 2:9
16:' 16:21 21:9 family 121 11:8 12:24 half 121 24:24 2':11 indicate (21 27:7
21:10 21:14 25:9 fasciculations [II 16:17 hand 121 22:9 32:21 2B:1$
2':22
evidence [101 7:2 fee [II 1$:8 head 121 10:14 24:11 indicated ['I 18:7
feeling (II 9:17 31:' 24:21 26:6 27:14
14:20 15:1 15:21 headache (II 2B:16 30:15
19:5 21:22 22:1 few [41 ':IB 19:22 ':25 indicating (11
22:21 23:16 24:7 23:23 26:' Health [II 6:15 21:23
exactly (II 13:5 25:20 fibromyalgia(121 19:12 Hely (1'1 2:13 6:14 indication (21 19:20
2B:20 19:13 2B:17 29:3 11:9 11:13 11:17 31:B
exam (21 11:15 11:22 29:5 29:11 29:14 12:5 12:17 1$:3 indirectly (II 32:IB
examination ("I 2:2 29:15 29:18 29:21 15:14 15:14 16:10 individual (II 6:2
3:20 6:22 6:25 29:25 lO:8 26:21 26:22 27:4 inhalers 121 9:23
7:1 7:4 16:8 field (41 5:19 5:22 27:7 11:11
16:11 16:14 20:14 6:5 7:9 Hely's (21 11:1$ 26:19 injections [II 17:4
21:15 21:19 23:15 fields (II ':4 hcn:bY(11 32:6 20:7 20:25
26:5 28:16 30:19 finaociallY(l1 32:17 hereof (II 32:14 injuries (41 23:20
examinations (II 1I:IB finding (4J 2B:3 2B:10 hereunto (II 32:21 27:15 27:20 28:2
examine (II 6:18 28: 11 29:2 herself(21 3:16 16:24 injury (II 10:7 23:19
23:14 24:20 findings ('I 11:13 Hershey ('I 1:13 28:8
cxamined 121 22:3 11:2' 20:11 21:21 1:14 3:' l:6 innervated III 14:11
24:21 28:6 31:4 4:1 4:3 4:12 inpatient (II 4:24
example 121 10:11 fingers [II 22:10 4:13 27:13 iOputlll 13:3 14:11
22:23 first [21 14:2 22:6 highcflll IB:12 20:19
except [21 26:24 27:11 fit 121 19:15 29:25 himsclf(llll:17 inlCrcsted (II 32:18
exceptions (II 2B:6 five (l( 4:21 22:12 history III 6:25 8:19 internist (II 11:9
exclusion III lO:16 27:14 8:22 11:20 21:' introduce [21 l:1O
exercises (II 12:11 focal[SI 12:3 16:14 21:11 22:14 24:21 3:22
HUGHES. ALBRIGIIT, FOLTZ & NATALE
717-540-0220\717-393-5101
Multi-Page""
involved - once
PAUL H. McCABE. M.D
.
Involved [II 21:11 looking [II 31:3 menlloo[11 8:24 21:14
22:7 28:1 looks [II 14:8 mild (II 19:3 19:4 neurologist 141 4:1
iovolves[11 14:10 loosen III 23:1 21:4 4:1l 1l:7 15:16
iovolving[11 22:9 loss [II 16:15 minutes [II 22:12 neurologists 121 $:2
itself [41 18:2 18:17 lung III 21:$ mobility [II 12:17 30:6
2$:18 27:$ modes [II 17:3 oeurology [lA' 4:10
-M- moments [II 26:$ 4:14 4:20 $:11
-J- $:16 $:19 $:23
M.D['I 1:8 2:3 month [II 26:1l 6:1 6:1 6:$
JllI 1:20 3:8 3:18 4:9 months [21 $:18 27:3 7:10 7:11 7:12
JAMES [II 1:19 32:7 most[11 12.7 30:1
Jamie (4' 1:10 3:17 Macintyre (21 1:23 motion 1lI 12: 11 Neurontin [II 9:13
32:4 32:23 3:1 motol[11 21:16 neurophysiology [II
Jefferson [II 4:8 Msgnetielll 18:9 MRl[121 2:16 17:6 $:Il
John (21 1:20 3:11 main ['1 8:18 9:4 18:3 18:7 18:8 new [II $:2
~oints [II 18:11 11:3 21:1 22:$ 18:9 18:1$ 19:2 newer[11 18:10
oureal [II 30:2 30:23 24:12 28:12 30:24 next [II 27:10
'udge[ll 7:23 maintain [II 10:13 31:3 niCC[11 27:3
Jurgensen 1'1 2:1l majol[11 21:1l 29:7 MS[II 6:18 6:22 Nods [11 24:11 31:$
28:16
6:14 1l:6 1l:24 majority [II 28:$ mUSele['1 14:13 non-contrast [II 2:16
14:22 1$:3 1$:11 marked 1112: I 0 13:9 14:20 18:3 24:12
15:16 16:10 1$:4 1$:7 16:2 16:1l 16:16 16:17 normal PI 10:2$
16:18 20:14 21:2$ 14:16
UIYI21 3:23 8:7 17:11 17:15 18:4 30:$ 19:11
mateh[11 29:2 muscles [II 10:15 Nos [II 13:10
-K- mal1cl(41 24:19 2$:$ 14:10 1$:18 21:15 NOlarypl 1:11 32:4
knCC[11 11:4 2$:14 30:13 22:19 22:20 22:22 32:24
knnwledge[ll 19:8 may [141 7:15 7:19 23:1 note [41 1$:11 16:9
8:3 9:$ 9:10 muscular [21 19:18 26:22 27:4
Kosenske [II 6:17 10:10 14:24 18:1 30:6 notes [S) 8:21 12:1$
16:2$ 17:2 17:3 18:18 19:17 22:24
19:8 20:$ 20:18 23:2$ 29:23 30:2$ must [II 10:1l 12:18 19:24 26:20
28:16 McCabe [2S) 1:8 myelin [II 14:7 nothing ['1 17:21
KosCDske'S[l1 20:10 2:3 2:10 3:8 myofascial[21 19:12 21:23 2t:24 21:2$
;
3:1.8 3:24 3:2$ 19:13 23:1$ 31:11
-L- 4:18 7:9 7:15 now [121 3:10 3:1$
8:1 8:6 10:16 -N- 9:10 15:6 16:1
last [II 4:21 22:12 13:9 14:1 15:4 20:8 21:13 23:2$
26:$ 15:22 16:1 17:11 name [51 2:2 3:1 26:4 27:2$ 28:15
LAW[II 1:2 18:4 21:21 24:7 3:7 9:14 24:18 31:17
learn [21 8:13 1$:15 24:18 30:12 32:7 nature [II 18:22 number[2123:4 30:1l
least[11 7:18 McNally [171 1:20 near [II 18:24 numbers [II 24:9
lectured [21 $:19 2:4 3:11 3:11 necessary [II 7:22 nlllDCrous [II 4:22
3:21 7:8 7:12
$:22 7:2$ 8:$ 13:11 neck [III 9:18 10:1
lectures [II 29:20 1$:$ 17:13 18:6 10:3 10:14 10:1$ -0-
lecturing [II $:2$ 24:6 24:13 26:$ 11:$ 11:23 13:2 O'BRIEN [II
31:12 22:6 26:2$ 27:11 1:17
left [41 9:18 11:4 negative [11 17:22 oat [I) 3:2
22:8 22:9 mean [II 28:21
lettel (21 mcasurcd[ll 19:11 oaths [II 32:$
2:13 15:3 14:4 nerve IUI 2:12 13:8 objection [11 7:14
level III 21:24 medical [261 1:1l 1l:22 14:3 14:4 24:14
levels [I) 19:4 3:$ 4:1 4:8 14:$ 14:6 14:8 objective (1J 22:16
IicenSe[l1 $:8 4:11 4:13 $:3 14:15 14:20 1$:2 28:3 28:6 28:11
licensed [II $:17 6:3 6:8 1$:21 16:1l 18:1 28:22 29:2 31.4
$:$ 6:21 7:$ 7:9 18:17 18:19 18:23
life [II 21:1l 8:9 8:1l 8:14 19:6 20:15 21:23 occur PI 22:11 22:19
liked [II 30:20 8:16 8:18 8:2$ 28:8 30:24 22:22
likewise [II 2$:13 9:1 10:16 16:19 nerves ['1 4:16 4:17 October[11 32:22
19:20 24:4 27:1l offel[11
2$:24 26:10 30:9 14:11 15:18 21:1$ 7:9 24:6
limiting [I) 22:20 24:7
27:2$ medication [II 9:8 offercd12l7:U 28:1$
limits [II 14:16 9:10 17:$ nervous [II 1$:17
lines [II 20:1 medications [41 neurologic [III 4'"'' offering [II 7:20
9:12 ,--
Lion[l) 3:2 9:16 20:7 20:8 4:24 $:1 6:2$ officc [II 11:20
7" 9:4 11:22 often 1lI
longell" 26:17 27:8 medicines [II 11:10 12:3 20:16 21:23 28:10
look [21 14:6 18:16 membel[11 $:14 30:4 oldef[11 10:2
members [II 3:23 neurological ('I 9:2 OnCC(11 27:1
HUGHES. ALBRlGIIT. FOLl'Z & NA1:ALE
717-540-0220\717-393-5101
Index Page,
Multi-Pagcnl
, one - residcncy
PAUL H. McCABE M D
. ,
OnC(11 9:4 11:11 percent (2J 27:13 27:25 preVIously (II 30:13 recelvc ('I 5:8 10:17
18:10 22:7 23:8 percentagc (II 27:18 primary!11 14:13 12:13 16:19 16:22
25:19 27:11 29:7 perform 1'1 6:24 probleml21 8:18 received 121 4:6
OnCS(11 22:6 11:17 16:8 17:7 21:8 4:9
onftoing(21 14:20 21:8 21:18 problems (21 12:19 reconCilC(11 20:10
2 :16 21:22 performed (121 11:22 19:23 record (11 25:19 25:2\
opcrated (II 8:23 11:24 13:23 15:2 proceeded (IJ 4:8 32:20
opinion ('J 7:17 16:6 17:8 17:18 produced ('J 2:10 records (III 6:8
13:7 15:23 15:24 22:16 23:3 30:J4 13:9 15:3 17:11 6:10 6:12 6:13
25:J 30:22 30:17 30:18 30:21 18:4 6:21 7:4 8:13
opinions (IJ 20:21 period (11 16:20 24:20 profcssion (IJ 3:25 8:16 10:2 10:13
peripheral(IJ 4:17 11:4 12:10 12:22
opportuni1, ('J 6:7 profcssional (21 4:19 19:21 20:13 20:25
6:10 :18 12:21 permanent(IJ 23:16 5:14 21:12 23:21
23:14 pertain (II 10:10 providc PI 6:23 Red (II 3:2
opposcd(IJ 21:7 pertaincd (II 28:8 8:9 14:1'1 reduced (II 32:11
ordcred (1118: 15 pertinent (1J 10:6 providcd (11 7:19 refer ('I 13:J9 15:6
origin (IJ 18:24 11:25 8:17 30:15 15:7 16:1 17:14
OtherwiSC(IJ 9:2 Philadelphia (II 4:11 providing (11 8:8 referenccd (IJ 30:13
outpatient (II 4:23 physical 1'1 12:7 25:25 refcm:d (lJ 16:24
outpatients (IJ 4:23 12:15 12:19 21:14 proving (II 19:19 16:24 29:14
ovcrlap (IJ 10:9 21:19 23:24 27:1 psychiatry (IJ 5:11 reflcxes (lJ 21:17
30:18 31.6 psychological PI 7:15
physician (11 10:20 7:17 12:12 regard (11 14:23 30:4
-P- 12:24 19:24 psychologies (IJ 7:16 regarding (4J 6:12
P(IJ 15:14 physicians (1J 20:11 8:18 (4:18 15:12
psychology (IJ 7:(3 regards (11 29:20
packs (IJ 12:10 26:15 30:21
P1r(IJ 26:23
paid (1J 25:5 25:7 picked (I' 16:14 Public (41 Rehab (II 6:15
1:11 32.4 relate (1J
pain pOJ 9:17 10:( pinched (II 18:23 32:11 32:24 28:12 31:8
10:3 11:14 12:17 place [41 1:13 25:21 pulhlJ 11:4 related (lJ 9:6 23:17
13:2 14:25 16:24 29:10 32:14 30:25
17:5 18:25 19:12 Plaintiff (4' 1:3 pulmonary (4' 8:19 relates f4J 27:18 28:1
19:13 19:18 21:12 1:18 3:14 6:8 8:20 9:21 13:1 28:4 29:3
22:6 22:13 26:7 planncd(11 27:2 purposes (II 7:21 relating (IJ 29:17
26:11 26:18 26:23 put (21 22:25 29:10
26:24 27:5 27:8 played(11 23:21 relation (II 25:1
27:9 27:11 28:4 PLEAS (II 1:1 .0- relative (11 32:15
28:13 29:1 29:24 plcasant(IJ 21:3 32:16
31:9 point (IJ 7:8 8:1 qualifications (I J 5:12 relicfPJ 16:22 26:23
part(AJ 12:7 14:8 8:20 15:22 16:23 questions PI 8:7 27:9
14:9 21:13 22:20 26:16 26:17 31:12 32:9 relies PI 28:22 28:24
particular (21 21:24 points (21 14:5 20:1 quivering [II 16:17 28:25
27:11 portion [IJ 22:10 reIY[IJ 26:16
particularly [I J 10:4 poscd (II 6:4 -R- rclying [II 27:4
parties [II 32:16 possibly (II 18:1 radiate (I J 22:6 remarks [II 10:2
parts (IJ 14:2 posterior (11 26:25 radiation [II 18:25 remember [I] 25:20
past(IJ 8:21 27:12 Radiology (41 2:14 rendering [41 25:1
pathway (II 14:5 POSture[IJ 10:13 2:16 17:10 18:3 25:14 30:12 30:21
patient [II 6:2 practice [41 27:13 raiscd [II 14:24 repeat [II 17:9
patients PI 4:25 27:18 28:1 29:3 raises (lJ 15:19 report (14J 2: 11 7:19
12:16 19:15 practitionCr[11 12:24 7:24 8:3 13:8
rangc (21 12:11 24:23 13:22 15:15 18:21
pattcm(IJ 19:1 practitionCIS [II 20:19 rate[IJ 26:2 25:14 25:17 25:18
Pau!['J 1:8 2:3 Prednisonc (2J 9:20 rather (II 18:19 26:15 30:12 30:14
3:8 3:18 3:24 9:21 reach [II reported (I I 17:21
32:7 preparation (II 25:18 14:22
really (IS] 5:24 7:16 reporter PJ 3:15
pen[IJ 22:25 prescribe [II 12:5 3:17 32:12
pencil(IJ 22:25 9:6 11:15 16:22
prescribed [2J 11:6 19:16 19:18 20:15 Reporter-Notary (II
Pennsylvania (101 1:1 12:7 21:22 22:5 22:18 32:11
1:14 3:3 3:6 present (211 :22 13.12 23:15 28:21 28:22 reports (lJ 30:19
4:3 4:11 5:6 presentation (21 8:2 29:25 represent [I I 3:2
5:17 32:3 32:6
pcoplc[l] 19:17 19:25 reason (11 26:6 26:10 representing III 24:19
20:20
22:24 27:19 28:2 pretty!11 21:11 reasonablc PI 7:5 resemblC[11 23:25
28:7 28:25 29:7 previous (21 20:11 8:9 24:4 residency (II 4:10
per(l] 25:9 31:2 reasons [II 7:16
HUGHES, ALBRIGHT, FOLTZ & NATALE
717-540-0220\717-393-5101
Index Page
Multi-Page'"
residents - typically
PAUL H. McCABE. M.D.
n:sidcnts (II 6:3 6:15 stero~d('1 17:4 20:7 14:18 24:3 25:10
n:solution ('I 18:12 set (II 32:21 20:25 25:25 26:4 31:3
23:24 sevcralllol 6:16 still (JI 20:6 20:8 32:7 32:20
n:solvcd ('I 12:19 9:11 9:23 10:12 strain (II 10:14 testing (II 30:21
27:5 27:8 11:19 12:15 17:3 stn:ng1h(11 21:16 tests (Ill 11:17 13:23
Resonance (II 18:9 22:24 23:5 29:7 studcnts (11 5:3 14:14 14:15 16:7
n:spectivcly (II 13:10 sbcath(11 14:7 6:3 19:10 19:19 21:18
22:16 28:22 29:4 ,
n:sr,iratory (11 9:24 sheet (II 32:14 studics (II 22:20 30:13 30:16 30:19 I
2 :4 21:8 Shippcnsburg ('I 6:14 study (II 29:25 30:24 I
responsc (II 7:25 12:9 subjcctive ('I 28:4 textbooks (II 30:2 I
result ('I 6:21 7:3 sbow ('I 15:1 18:22 28:12 Thank ('I 31:13 31:14
10:7 19:2 subjcctively (II 29:1 tbcmsclves (11 3.10
results (41 10:24 12:13 sbowed (1)19:3 23:16 substantial ('I 11:15 19:7
14:14 17:20 sbowing(ll 21:25 23:19 therapy ('112:6 12:7
return [IJ 11:8 SbOWD (II 13:13 substantially (II 27:5 12:15 12:20 23:24
n:vcalcd (II 18:21 shrinking (II 16:16 sucb (') 8:24 16:16 27:1
review (II 6:7 6:11 sign (II 20:16 18:19 22:1 22:21 thcmlforc (II 24:1
6:21 7:4 8:12 signal (II 14:3 22:21 28:7 30:6 they'vc (1120:8
12:21 25:19 25:21 significant ['I 8:2 32:17 Thomas (II 4:8
rheumatology (II 30:11 14:17 16:22 17:23 suffcred (II 10:7 thoracic (II 18:11
right 1'1 5:21 10:18 17:25 19:2.5 suffcring (11 28:17 tbrcc (11 25:20 26:24
21:13 28:14 30:12 similar(11 16:10 20:1 29:11 throup (41 5:3
30:20 simply (II 15:7 suggcsting (II 20:14 22:1 24:7 28:11
rolc[11 23:21 simulating (II 14:5 SummariZC(11 4:18 throughout (II 11:20
room ('I 6:15 10:19 situation (II 18:14 support (JJ 15:21 tightness (II 21:25
10:20 11:4 11:24 22: I 29:9
19:23 slight (II 11:5 suspicion (II 14:24 times (S] 10:10 11:19
root (I) 15:21 SMITH (II 1:19 19:22 23:10 26:24
roots (51 socicties(11 5:15 Swanger ('I 1:5 today (41 8:7 20:21
18:2 18:17 3:7
18:19 19:6 21:24 SOCiCty('15:17 5:17 24:3 25.25
RPR/RMR(11 sometimes (II swear (II 3:16 1roday's.(l1 3:3
1:10 22:21 sworn (11 3:19 32:9
32:23 somewbat(11 10:13 took (II 24:21 i
rulC(l1 29:4 somcwbcn:(11 symptoms ('I 11:14 tog(1l 12:11 12:17
24:23 16:23 18:22 19:21 :10
sorry (11 13:16 13:17 20:4 22:16 23:6
-S- sought (2) 15:23 20:18 23:11 23:22 topies(11 5:22
SaW(11 24:21 specialists (II 13:3 syndrome [JJ 9:5 training (1) 5:3
29:13 29:15 5:4 27:22
says ('I 27:9 27:10 specialty (II 30:7 transplant (II 8:21
scan (II 17:6 specific (41 11:10 system (II 15:18
SCHERER(II 1:17 19:1 19:16 20:3 systems (11 18:10 travel (II 14:4
scbool(ll 4:8 specifically (II 29:22 20:2 treated (II 20:23
treating (11 20:5
Science (II 4:7 specificd III 32:14 -T- 26:15
scope [II 7:24 spend (II 4:22 tn:atment (II 11:6
second (11 14:9 15:23 spent (41 22:24 25:5 takes ('I 14:3 18:18 12:5 12:10 12:14
15:24 25:10 25:16 taking (') 9:8 9:9 12:22 16:19 17:1
see (11 4:21 4:25 spinal(ll 4:16 18:2 9:15 9:19 21:11 17:3
8:20 14:7 14:9 18:11 18:17 19:3 32:8 treatments (I) 11:10
14:11 20:13 19:6 20:15 22:2 talks III 29:23 trials (II 17:5
seeing (II 4:23 spinc (III 2.17 10:21 technique (II 18:13 tricd ('I 9:12 17:4
seek ('I 13:3 17:1 10:25 17:6 17:9 tccbniqUCS(l1 18:10 20:7
seeking (I )30:24 17:18 18:4 18:16 tells (11 14:19 17:25 true ('I 29:2 29:8
18:17 24:10 24:14
seizures III 5:25 Spring('1 6:15 12:8 tends (II 14:6 32:20
sensation (II 21:16 SS(II 32:2 'fENS (II 17:4 try III 29:4
seosory (31 16:15 staff ('I .:13 4:20 term ('I 1:4 28:18 tunncl(,) 8:23 9:5
18:25 28:19 WO(AI 7:21 14:2
sentence (II 27:10 stands (II 18:9 terms IS) 7:23 8:25 22:5 25:20
scparate (II 22:13 started III 4:10 16:14 28:19 30:24 1rylenol(11 9:12
Scptembcr(3l 1:12 starts (II 24:10 test (51 13:25 14:2 type (41 17:1 18:22
3:3 states (1) 16:9 26:23 14:3 15:2 30:23 19:18 21:7
serics (51 2:14 8:6 stenograpbically III testificd III 3:19 types ('I 9:23 22:21
17:10 17:18 24:10 32:10 testify (II 7:5 typewriting (II 32:12
services ('I 4:25 stenosis (II 19:. testimony ('/ 7:20 typically [4' 1.:4
Index Page (,
HUGHES. ALBRIGHT. FOLTZ & NATALE
717-540-0220\717-393-5101
,
D~,VID C 6,"I~ER, I.'hD.
t5')WJ..LNU160TTOI.', ROI.D
C.'-RLISLE PA 1701 ~
.'-GE.
100.'-'I"SD,L,TE
CATE. OF 61RTH 12/25/4
NI-.ME
Christine Duncan
ADDRESS
REFE.RR.EO 6'1'
80S Baltimore Rd. Shiooensbu~~,
pI 1 "7?ct-r
'"
532-3056
F.e.MILY OR..
U,., ""ICE. Auto- Nationwide. PLACE OF EMPLOYMENT
INS fV"\J" . Al.lergies: PCN,
<\ccess
PROBLEM :o/hiplash: car acciden ~ 100' PREVIOUS X-RAYS
Ibuprofen
""
~.".
....... .
2nd opinion
_ rec:1'up-~t.:G1ti "'Y
~~" Rnh~~~ n'~-~jR
1 .----
" J!.
. Cd/.. ~ CeL,' '-' .:r
:ftu.,;l~/'f~ 3
a'1 d~ 1'19:)" ,
h~istine is a 48-year-old female who is here ,for a second
9~nion at the request of her attorney. Christine states
~er history goes back tWO years ago when she was involved in
motor ~ehicle accident. She wa~ hit from behind while at
stop light. She states the car was going approximately
twice the speed limit which was 25 m.p.h. She was hit
1irectly from behind. She had transient loSS of
consc iousness.' The car was not totaled. She has had
?ersistent pain in the neck since that time.
-
?AST MEDICAL HISTORYI Significant for C.O.P.D. for which
3he takes Prednisone anG Theophylline as well as an
lnhalant. There is no other past medical history other than
~ecent breast surgery ~or a cyst being removed. She is on
iisability because of her C.O.P.D.
3he has been under treatment by Dr. Hely who fel~ she nad
3evere whi~lash.
!X'\MI~'\TION: Thers are no visible abnor~alities to the
:ervical spine. There is no muscle ~trophy in either
;h9~lder girdle. The ?atient has globally decreased range
Jf motion of the cervical spine with approximately JO~ lOSS
JE motion in all planes. She has ~ain 'oIith both.
~y?erextension, as well as forced !orward flexion. She has
~~ evid~nce of iny nerv~ root ~rritation and no neu~ologid
3Lg~S wLth no a~rbphy, reflex asymmetry, weakness or sensory
~~ss In the C4, CS, C5. C7, C9. or 7l distribu~ion.
, ,
. !
AI~E
ADDRESS
IMPRESSION
COMMENT
I
Christine Duncan
,
elECTROMYOGRAPHY
NERVE CONDUCTIONS
805 Baltimore Road
Shippensburg, PA 17257
DOB. 12/25/46
t
t~
0ir1U.-.. C*WMt....
Outpatient I Dr. Carey
er 26, 1994
flethod I Excel 2-chaMel E:MG by Cadwel.
NORHllL NERVE CONDUCTIONS Dr THE LEFT UPPER Elt'1'REHITY. NO E'OClIL DIG
ABNommr.rrn:s .
· The patient has continuing neck and upper arm pain. Motor nerve
conductions were performed using .2 IRS. stimulation. Compound action
potentials for the median nerve are illustrated below after focal stimulation
at the wrist, mid arm, axilla, and Erb's point.. Segmental nerve conductions
are well in the normal range. Distal sensory functions were easily obtained.
Ulnar nerve conductions are intact. Ulnar nerve F-response was easily
obtained at 26 IDS. (normal less than 30).
Needle examination revealed no neurogenic abnormalities in the muscles
tabulated. No fasciculations or positive waves were seen in the deltoid or
biceps. Action potentials produced with voluntary contraction were normal.
A paracervi~ exam was not done.
JCJ/gmj
....,
":'EXH'B'f.
M1c~~~'
rq~9~>
,
NERVE CONDUCTION STUDIES
nlN
WEEP LEFT nCDIAH nOTOR
S ONOCT
APS (no'
IIRuT 4.1
ANTE cu. 7.6
AlCl....R 18.5
Euo 13.4
..... :
DUT
(cn'
l-R 8.8
2-1 19.8
3-2 15,8
4-3 28.1101,
_..
SEC-O NCU
(no' (nolo'
3.5 S4.3
2.9 Sl.?
2.9 69.11
.... ....................
: ..... :
-.. ...
..111.
An~
(uUI
0-'
1 18888
2 18288
3 961111
4 18?1I1I
......
ilr.v 11:"
MC:>I"N M010R
p~ uS TE~P OYF
STln ~EUE" II? nR 198 U
He,", IH_RY
FaOTIIUTe..
-
eso WALNUT BOTTOM ROAD
CAR..ISLE, PA 17013
(7171 243'3944
J.CRAI~~.
1}~;;~OGY
:tJ.11
. ";-:"~-:"'-:-'!t'~L;~,:~.j-i,~Cij'''"l'''''-''''.''-:PC'<<:
.
,
.l1ristine cUncan
e
!KG Data
t.,
Date: october 26, 1994
Patient:
Physician:
5:41 pm
c
SummarY of ~MG and MeV findinas.
NERVE CONDUCTION REPORT
Nerve site Onset Delta Dur Ampl Dist NCV
(ms) (ms) (ms) (uV) (cm) (m/s)
-------------------------------------------------------------------------------
L Median Motor wrist 4.10 ---- 10000.0
ante cub 7.60 3.50 ---- 10200.0 19.0 54.30
Axilla 10.50 2.90 9600.0 15.0 51.70
Erbs 13.40 2.90 10700.0 20.0 69.00
L Median F-Wave wrist 27.30 27.30 8.0
L Median Sensor wrist 3.66 1.53 12.8
palm 6.34 2.68 1.96 7.6 19.0 70.90
L Ulnar Motor site 1 3.50 ---- 11100.0
site 2 7.40 3.90 ---- 11200.0 21.0 53.80
site 3 9.30 1.90 ---- 10400.0 16.0 84.20
L Ulnar F-Wave Wrist 26.30 26.30 ---- 120.0
EMG NEEDLE STUDY
side Muscle Nerve Root Fib psw Ply Fsc Rec COlll1llent
-------------------------------------------------------------------------------
Lt lstDorlnt Ulnar C8-Tl 0 0 Nml 0 Nml Normal
Lt Del-coid Axilla C5-6 0 0 Nml 0 Nml Normal
Lt Triceps Radial C6-7-8 0 0 Nml 0 Nml Normal
Lt Biceps Musc C C5-6 0 0 Nml 0 Nml Normal
Lt pronat teres 0 0 NmlO Nml Normal
Lt BrachioRad Radial C5-6 0 0 Nml 0 Nml Normal
Lt BrachioRad Radial C5-6 0 0 Nml 0 Nml Normal
.."
Ba:LVEDERE MEDICAL CORPORATION
850 WALNUT BOTTOM ROAD
CARUSLE, PA 17013
lilt"""" ""'IIi<'iIl~
JOSEPH E. GREEN. III, M,O,
J, CRAIG JURGENSEN, M,O. ,NEUROLOGY
STEVEN L HA TLEBERG, M,O,
OAVII) p, ALBRIGHT, M,O,
Hay 30, 1995
..
~.. EX"I,BIT
c...~3
-2.1-1/
Daniel P. RelY, H.D.
816 Belvedere Street
Carlisle, PA 17013
IlEII Chr1atine C. Duncan
DOBI 12/25/46
Deer Dan.
:t ......1 n~ Chr1atine in reqard to her nedt pain. She has bad continual
pain at the bue of the neclc since Decl!llber 24, 1993. She recalls being
strUcIc troa the rear by another vehicle, and thrown forward. She developed
immediate pain at the bue of the neclc. An x-ray was done and VBII neqative
and she VBII released trOIll the hOllpital. She continUell to have pain with
forward flexion and rotation. SOMtiIIIe later she develOped pain and
"numbnells" in the left forearm and hanel. A nerve coDduct1on lItudy in October
1994 VBII negative. PulIIIonary d.1Ilease VBII the caWle of her to d.1Ilcontinue
working in June 1992. She developed shortness of breath at that tillie, and
the dialJIlOsill of pulmonary fibrosis Wall we. She now experiences Ilhortness
of breath through the night and Wles 1nh,,"'nt treatllllllts every four hours
(Serevent, Atrovent, Proventil). She stopped BIIIOking in 1992. She had
previoUIIly worked in a howseoleaning position for Shippensbw:9 University. '
On exaIII she weighs 136 pounds. Hental IltatWl is noJ:1ll8l. She makes
interm1ttent heaving respirations. l\ccessory lIUIloles in the Declc are
increased. OCUlar _ is negative. passive lIIOVellel1ts about the neclt are
decreased for rotation and flexion. There 15 no peracervicalllUllole Spalllll or
deformity however. Kwloles in the upper extrllll1ties are of noJ:1ll8l volUlle.
Resistive lItrenqth is excellent for proxilllal, IIid-aJ:lI, and intrinllic lIWloles
bilaterally. Tendon reactions are brisk and sygetric. There are no
cutaneOWl Senllory abnormalities. There are no long tract siqns in the legs.
Her neck pain is suqqelltive of cervical disk disease. There is no
clinical evidence, however, for cervical nerve root dallage. She is not
interellted at this point in further diagnostic lIIllasures, and certainly not in
a neurosurqical procedure. An Il1lI scan has not been scheduled. I am
optillliat1c, however, that her pain will subside in the colll1ng 1IIOI1the. In the
lIIeantillle, she enjOVll noJ:1ll8l functional ability.
Thank you very wch.
very truly yours,
J'~~
Jc:1/9IIIj
,~"".",l:,
"0
DEPARTMENT OF RADIOLOGY
....."1.
IMAGING ASSOCIATES, P.C.
DUNCAN, CHRISTINE C.
805 BALTIMORE ROAD
SHIPPENSBURG, PA 17257
49Y
07/09/1996
X-RAY 11104440
MED. REC. .555410
DR. KOSENSKE TED
C-SPINE SERIES
Fivs views 'Of the csrvical sp'ine' were. obtained prior- to MRI., .
evaluation,' and demonstrate gross preservation of bony alignment, disc
spacing i . 'and bony intsgrity in the cervical distribution. There is
subtle sclerosis extending from the C2 through the C5 level in the
posterior' elements, suggesting a dsgree of facst degeneration. Facet
joints remain "open", however. Neural foramina appear. grossly patent
bilatsrally. There is no evidence of d~ep soft tissue swelling. .'
IMPRESSION:"
'Negative'study for plain film svidence of acute
csrvical pathology.
.
'.
~. '.
&J.
CUTHBERTSON, M.D.
"
.'~ .
RJC/nb
T: 07/09/1996 ,02:04-:' pm
, ~ ., . ..:-
..... .;'; :.... :.";":',' " .
".'. .. --" , , -. >>0' ." . . . " . ...,... '~.".:",
. . . . '" .. ..".' ,~.... . ~'r.':: t..~." I..:J; ... .-
<::,.:::~::",::,::,~.\~,'t\~;:.;~:,~;.;:'::'" , - .':,': :',:-' ' "::
,';: .,': .._~, :.' .:-. . '-.:. ,t..' :, .~' .'
, ,~...'
.. " 'i~ ,- _. '. ..... ': "
-"J:'"
" ',', .'.
,., ',. '..; .
~~ ';.' ';.::. ~. .~ ..
-r:.',' ?" :. ~ . ',~<' .
'. ..;......
'._0-
.. ..
"
,
..-....
"
..
"..
-' ",
", .'
'.. _' .,:'. '., ,":~.-.: '~:".:_~~:.:f "'..
. .~..,: i' :",,"~~::~}i!;..I.Y;{:~~:~1t
';;~r',/>~(>',tri3? .,
.'
t." .!,..-
... ..
.'.~,{}~~:.:.,,:,.::.,):: '. ::.
'.. '~, ,.'
" .
,..'ti;..-.-t;-.','.'...........'.H....:.
.~~~EXHlal't'f.) ;;'-'.
..' Jf/J.~'} ;1~
~ \!j~:r:...
....;:.zf. ".,"" ' ~'i
. ;.~. - -~
.... ,'.' .
'.
". ..
: ' ':".:.:::':;' ;:~." 't '.
J", '.
..
. .:.-'
'.' '. h
." '.'
. ......
.:.....
,'.
'., -... .
",'.
'..........
,~
RADIOlOGY FIlE
".'..q ,-"'-!41,". ...~,.. ~',' '.JI~ "'l"'!.ll2r.'
...,~ n~ '"''1:''':1..:::.':/.''' f!.,."..,....~. ,.""." ..'. ""'....~#..,,'... - \......-.\:
" /"., .is r.~':;i7-\'" .,., ': 'I.t~:;;'. DEftARTII '-IT OF RADIOLOGY <.,'.
.' ......... . 1'... 1'" Tf.'.r.-rl1r.;ft' ~., .', rM 'U 'I
".." Osplta, .'. ....... \. " ..'....
........ . ...- . - ,',
~. 1-."... .....~-:..... ..... -'~ ,,-: '. t' '.... i~f""''''tl
,<j' ealth Sel'Vlces ". ~ .'. . " ,:.
. ~ 6 P~rk.~ s~';'i. P,O. Box 310 ~ Carlisle, Pennsylvania 17013-0310 . (7171 249-1212
,;, _...r'"': "i
....-, -
,_.~01'"
'CARLISLB IMAGING ASSOCIATBS, P.C.
r
DUNCAN, CHRISTINB C. 49Y
80S BALTIMORB ROAD
SHIPPENSBURG, PA 17257
07/09/1996
X-RAY 1104440
MBD. RBC. .555410
DR. KOSENSKE, T.
. .-..... .,'
""
NON-CONTRAST HaX OF. THE CERVICAL SPIIfB "
This study consists of sagittal ssquences with T1, intermediate, T2*
weighted fast spin echo technique and relatively T2 weightsd gradient
echo tschnique, followed by axial gradient echo, T2 weighted images
from the C2 through the T1 level.
. po,,, ," .
Visualizsd portions 'of the postsrior fossa appear grossly normal.:The
cervical' spinaL. cord' is normaLin'siqnal'characteristics and overall
size throughout;~.:':.The: central canal appears somewhat narrowed in
saqittal images'at the'C4 and CS lsvels, and' very subtls dorsal disc
prominencecsntrally at those levels. may actually abut the antsrior
cord with neck,flexion. The magnitude of findings does not suggest.
focal. disc protrusio~ or extrusion, however. . Very. subtle dorsal disc
prominenc'e. centrally and eccentric left at the CS-6 level may '.
represent'''a vsry smalL disc bulge. Axial images otherwise show no
localized pathology.., . . ,
.".~. :,: ..... . '.. i~:: .:... .. ." .
IMPRESSION: ".There is central spinal stenosis, localized to tlie C4-5
. and CS-6 levels, with a mild disc bulge contributing to
. :.narrowing at the CS-6 level centrally and eccsntric
. ::;: .. left.... Disc disease only contributes slightly to this'
.:' "" !'~",.; ;~':;':\;;::.~1 predominantly ,congenital, .configuration;'~~.'.There is. no.
"':-":; - .::.,:.':...'l<";::~: evidence of myelomalacia' or,. other patho'1ogy ,at this,.
,;%~;~,~~:~~~i~.~k .:;<'.~?~x,~i;~, (i:d~.~;~;;;/ ...~j, ,i,. ·
'_ -,~;.t~_.^"!.~~..._.l''''''''''-''''''''''''''''-'-'''' I,' ,-,-" .V.~" ..,. '..-". .",....
__ .-.~..,:..,;...r..'....... {._....'\.;"... ,,;.,.':; ,..... ...... -"''''';,. " .".........."CU.......ERTSOIf. K D'
~.' -'o..:1":"'-{t'.r~;'7:I~,.~..?{,;",::....J.~':' t../v~ ", -~. .:':...: .....". "j..J'" ..~.l\IUU'" "".: .LUg ,. .
': . '.; . ',;;. ,.:~ ~;~,~i" ~,~~.~.' />.> ::~: ;."~..." ",:. :,.....,::~.' . ,.,. ,:'. :.,:.~' ~~~,,;; ;,:....: '~""
..;RJC/je'I~.~:,'...~~~...c.;;..~':',~. :...... ~....:.,:.._';~..:. ,'j::'"' ". ..-:....:::...;..:.::..:,;;.;;:.;.. .~:, .....':...
. .. ." ..,,.. . ..' ..'
T' ':'07/09/1996:'02'48' '..:c'" .;, , ..... ..:'.': "'.
.. '. . .of" pm -. .. .. . .' .. ... -'.' . '. . .':' ...;-, .
. 'I ,....._.. - "*'Jt".-";>t'~'.l'" ,,' ',.. . -. . '0',": "', ". ~.~. t......~.. l . ". J'n . .. ,.... t"'!.'
<}:q~t~~~;~~~~;.~;.l~~.::tt,;,'~;'\Sr~,:<. ' ,]~.:}~~:~/ .,,' :L'i; , " '
..... .
""':',
~
r
',.
~ ....
..
.'
~. :-
RADlOlOGYFlLE
'.
"-- ..
.. 0,0
CHRISTINE C. DUNCAN,
P181nutt
: It TIE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
.
.
.
.
V.
.
.
.
.
GERALD B. SWANGER,
DefendMt
.
.
: NO. 85.aeo7 CIVI. TERM
.
.
.
.
: JURY TRIAL
VERDICT SLIP
srATE THE AMOUNT OF MONEY DAMAGES SUSTAINED BY TIE PLAlNTFF AS
A RESULT OF THE DEFENDANT'S NEGLIGENCE.
TOTAL
$
/V, '000 ,00
I
re.~~
EMANJFORE
JlL Y 7, 1998
.. '.
Dl\m: .,~~ CASE m. 5
.raJknul'f .~
~5-(P~()7 CIVIL TJ:R.n
6.' ..:u
7.' Jl:I
8.' IJr'"J
9.'~
10.' ill-I
22.'
-
2:1.'
24.' ~ "p~&.
25.. l\\acL:~ (~)
26.'
27.'
-
Idd~
"'\_nL .1.. :tI1I~"'d
Cl ~'\I\cu..u .. <;
~
,
.
CHRISTINE C, DUNCAN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO, 95-6807 CIVIL TERM
v.
GERALD B, SWANGER,
Defendant
POST-TRIAL MOTIONS
1) The Plaintiff, Christine Duncan, believes Ihatthe damages awarded by
the jury are inadequate in light of the testimony and the Defendant's admission of
liability, Accordingly, Plaintiff requests that the Court consider the additur.
2) The Plaintiff believes that the jury verdict is inadequate and requests a
new trial,
Respectfully submilled,
O'BRIEN, BARIC & SCHERER
BY:~~
Robert L. O'Brien, Esquire
Allorney for Plaintiff
17 West South Street
Carlisle, PA 17013
(717) 249-6873
Date: ~t..:LLll.-
,
.
..
.
CHRISTINE C, DUNCAN,
Plaintiff
v,
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 95-6607 CIVIL TERM
GERALD B, SWANGER,
Defendant
CERTIFICATE OF SERVICE
I hereby certify that on July~, 1996, I, Robert L, O'Brien, Esquire, of
O'Brien, Baric & Scherer, did serve a copy of the Post-Trial Motions, by first class U.S.
mall, postage prepaid, to the parties listed below, as follows:
Karen Durkin, Esquire and John J. McNally, III, Esquire
James, Smith & Durkin
P.O, Box 650
Hershey, Pennsylvania 17033-0650
~i)B,.,.. _
Robert L. O'Brien
.. r-. [:
i~ .;j ..:.~:
I.~: /.:, ") "I"
, ; .-
lJl
-:., ~ " . . : ~':.
I"c, f__ ! ~~~
..
('f) ~- .(l ,.,,)
f-"" ] t."
;.~. l . "7-
i:-\'~ _I . till
.. , .... , HJ..
: "'-.l
IJ. CO ':.:j
u 0' (,)
,
.
i ~
8 ~
old
~ ~ ! ~
Oo5lg
~ ~ ~ z
~ ~
en "'
! ~
'.
Dated:
'\ \\~\ ,\0
, \
By:/_
'--KA:R
Attorney I
JOHN J.
Attorney I.
CHRISTINE C, DUNCAN,
Plaintiff
v.
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY. PENNSYLVANIA
: 95-6807 CIVIL TERM
: CIVIL ACTION - LAW
GERALD B. SWANGER.
Defendant
DEFENDANT'S REPLY TO PLAINTIFF'S POST-TRIAL MOTIONS
AND NOW. comes the Defendant. Gerald B. Swanger. by and through his attorneys, James,
Smith, Durkin and Connelly, LLP to reply Plaintill's Post. Trial Motions lIS follows:
1. The Defendant. Gerald B. Swanger believes that the damages awarded by the jury are
adequate in light of the evidence and testimony produced at time of lrial and no additur is
warranted.
2. The Defendant, Gerald B, Swanger believes lhat the jury's verdict is properly founded on
the testimony and evidence produced at lime of tria!.
Respectfully submitted,
JAMES, SMITH, DURKIN & CONNELLY, I.LP
P.O. Box 650
Hershey, PA 17033-0650
(717) 533-3280
Attorneys for Defendant,
Gerald B. Swanger
. ""-:<"
_.~-..
~
.
CERTIFICATE OF SERVICE
I, JOHN J, MCNALL Y.IlI. ESQUIRE, do hereby certify lhat I served a true and eorrect
copy of the foregoing document upon lhe following below-named individual by depositing same
in the U,S, Mail, poslage pre-paid at Hershey, Dauphin County. Pennsylvania this ~day
of July _, 1998.
SERVED UPON:
Robert L. O'Brien. Esquire
O'Brien, Baric & Scherer
17 West South Street
Carlisle. PA 17013
;-':.':--",. >>
'.
.
. 'I.,. ~ ';'; ;. ':. '..
:~."
",-.
.1_:':;:
.'.',.,.
~';
.....
'i'
,
"
CHRISTINE C, DUNCAN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO, 95-6B07 CIVIL TERM
\
\
v.
GERALD B, SWANGER,
Defendant
PRAECIPE T.Q
WITHDRAW
TO THE PROTHONOTARY:
Dear Prothonotary:
Please mark on the docket, that the Plaintiffs post-Trial Motions are
withdrawn,
O'BRIEN, BARIC & SCHERER
BY: -- ~D((-.,~
Robert L. O'Bri'en, Esquire
17 West South Street
Carlisle, PA 17013
(717) 249-6B73
Date: July 23, 199B
~
CHRISTINE C. DUNCAN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO, 95-6807 CIVIL TERM
v,
GERALD B, SWANGER,
Defendant
CERTIFICATE OF SERVICE
I hereby certify that on July 23, 1998, I, Robert L. O'Brien, Esquire, of O'Brien,
Baric & Scherer, did serve a copy of the Praecipe to Withdraw, by first class U.S. mail,
postege prepaid, to the parties listed below, as follows:
John J, McNally, III, Esquire
James, Smith & Durkin
P.O. Box 650
Hershey, Pennsylvania 17033-0650
The Honorable Edward E. Guido
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
'-~66~
Robert L. O'Brien
~