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3, Respondent. Antonio Dlaz resides at 55 Fox Hill Road. Shippensburg,
Pennsylvania 17257.
4 On or about March 19, 1995, Katelyn Misner was playing with other
children at the home of Antonio Diaz, when the Black Labrador type dog owned by
Respondent attacked and bit Katelyn Misner causing lacerations about her left cheek
bone and right eyebrow, as well as other superficial lacerations on her face.
5. As a result of the dog attack and bite wounds inflicted by the dog, Katelyn
Misner was taken to Chambersburg Hospital where she was treated for her lacerations.
6. Katelyn Misner underwent a course of medical treatment with Roy A.
Himelfarb, DDS and Dr. Ernest R Manders, a plastic surgeon. On June 12, 1995 Dr.
Manders examined Katelyn Misner and indicted she had obtained a good result from the
laceration repairs. Dr. Manders' report indicated that although Katelyn had a good
recovery from the lacerations, there is some residual visible scarring, specifically a 2.5
cm. long scar on Katelyn's cheek anterior to her right ear, but he was not recommending
that anything be done until Katelyn is at least age 10 or 11. He opined that there may
be a need for some scar revision at a future date. Medical Expenses totalling $895.00
have been incurred. Attached hereto, and incorporated herein as Exhibit "AU is a copy
of Dr. Manders' Report and the records from Chambersburg Hospital, including the office
notes of Roy A. Himelfarb, DDS.
7. Respondent has offered the Petitioners a structured settlement, with a
present value of $50,000.00, for settlement of the claim against the Respondent
asserting negligence on the part of the Respondent thereby causing the injuries suffered
by Katelyn Misner The structured settlement provides for an initial lump sum payment
.
PENNSTATE
.
DepInImat 01 SIIIi''Y
Division of Plastic and R=nmu=tive Surgery
Mrs. Lori Msner
57 Fox Hill Road
Shippensburg, PA m57
RE: rvnSNER, KateI)1l
Dear Mrs. Misner:
College of i'.ledicine
University Hospital' Childre:1's Hospital
The Milton S. Hershey Medical Center
P.o. Box 850
Hershey, Penmylvania 17033
Telephone (717) 531-8371
Telefax (717) 531-4339
June 12, 1995
tvlSHl\-IC #506178
,..
It \WS very nice to meet you and Katelyn. Katel)1l \WS bitten in March of 1995 on the side of
the face. She received a y,ound high on the right forehead near the hairline and this seems to be a VI'Ound
of lesser degree that has healed quite nicely. It is barely visible, partly do to the small hairs in the area
that cover it and disguise it. There is a 2.5 em long scar on Katel)1l's cheek anterior to her right ear and
this is more obvious. It has widened, as is typical for scars in this area at this age. It is red. As I palpate
the area, I can feel there is a resolving VI'Ound ridge. It is very lucky that no branches of the facial nerve
were injured, nor \WS the parotid duct.
My suggested course of treatment is that you use a sunscreen and protect this so it does not
become h}pel'pigmented this summer. As time passes, the area will become soft and the scar will become
\Vhite. It is likely that sometime she will WclIlt a revision, given the prominence of this scar on her cheek.
Katel)1l will be able to tell us \\hen If we revise this in the next year or two, we could ellpecl a widened,
red scar very IlUlCh like what she has now. I y,ould suggest that she be near 10 or 11. If she were quite
happy then and did not V\1IIlt this addressed until into her teenage years, that \\'Ould be perfectly all right.
If she were to elect to have this done today, I have indicated that it is not appropriate to do it now,
but for discussion's sake, how IlUlCh would it cost? The cost in our book for a scar revision of this size
is $580. You may use that as a benclunark in setting aside some money so that there is a sum available
to you someday to have this done, if you wish. It must be said that it could happen that a second revision
y,ould be n<<....""ry or a touch-up of some sort. It VI'Ould be wise to put again this sum away for the
possibility this small touch-up might be ",.......""ry.
I think this will get better. It will certainly become less obviOll'l with time than it is now. 1OOeed,.
it will not hold her back from having a full and wonderful life. In time, it may be her wish to have this
revised. If so, it y,ould be best to wait a few years in my estimation. Thank you again for letting us help.
Sincerely yours,
Ernest K Man:Iers, MD.
Professor of Surgery and Pediatrics
Chief, Division of Plastic and
Reconstructive Surgery
H Wallace BruOOker, MD., 760 East Washington Street, Chambersburg, PA mal
Roy A Himelfard. MD.. 182 South Second Street, Chambersburg, PA 17201
EKMdek D: 06113/95 T: 06114/95 R; 06116'95 1em06135.a89
EXHIBIT
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I RECORD
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,ct1GENCY CARE UNIT RECORD
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CHEll a CHLAM'OIA HAN AAS IN ERP
CHEM' FACIAL BONES AfTN PORT PELVIS
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AMYLASE CT HE~ 'ORE m.. PORT C SPINE .. AyS
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MR 413 7/90
PROGRESS REPORT
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.,,\,1. I I. "I ,i. 11 I ,111\ !'111I1< I.dl',' H':il'l)t)',lldl' 1,11 ';(~rV'l,.':; PI:rlIJCOIl.:IJ. IIldl .111\ rlol
.",.
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I I, !i, Ii:' . 1,1111 I
. I "I'.
~_df Ii Irl!t III ~
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T:~!bl1(1 1 OJ; Il)/~'t.~~1:[~
it I :i 'I f II. ~ ^ r f I. Y:( ^ IlII f
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~IIIPPf"50UU~. PA 112.'
Obl2U''l.\ ........31 111 H3-b8b~_75 l'
Un, ...
<M
HIE.JAMUE'RSBUHl; fl(>SI'IT^L
II! Nutlh 'lro'lil'lllh "111'1'1 .tll.llIlI'4.'" 1'1II1;, 1'/\ 1.'.'111 . l~'L'l .'I>l 'i1;1
,\
EMERGENCY CARE UNIT
PATIENT INSTRUCTION SHEET
(717) 267-7146
~ .. ..._. l:...............~~J..6t..,.+MIfI'I.".-
"'!.-.': __'_\_"':~'~'.~"::'t,.___~:..~_.::.'~_._. ',:. . ....
The lIealHlell1 you hilv~ (f)I.e1wd hil, '''JI]I1 "",de,ed on an emergency basis only, It is irnpor1anllhal you follow discharge
1/lSllIrelioll' flll/llI""'lve lolluw.up call) Full"w Ihe 1/1511ucllons below Ihal are checked and any addillunal insl,uclluns given,
MEDlCAIION INSIRUCIIONS FOLLOW, UP CARE INSTRUCTIONS
I (i.'1 ptt~';(.lllllllllllllh~ll, lakt!," ,IIIIIIV IIU~IIIl;1l11J ,1'1 1 j HI~lllIlllllllltJ EtlltlllJHfI\:Y 1J1!~,lflnll!tlllll .___.
111l1'I.h'tlIJIIl;lhl!1 'JI',UlI1hlllJl! f1WlhCilIIOII II dilV{s) Daln. ____..._ rune _._._
dUt'li)IC III<lLlIlIl1 U1:CW'1 tr,I'~h.I/UlIllh! oWillllllUI I J Cilll Ur'd_._'_~___^_~_~_____
!II illllf~1 'auldl'lI, wW.pt~(lt'tl'iVJ/lvt{}ms) ,lIlll lehlphllllO I_~_ ~_ ___ ___._.._____-" ___
I !JlI1:u 1 frut~IlWIll.y OI'llallllll~lIll1l1l1lmhjjh!lv 101 follOW-lip illlPlllllllllf.IIII/l ._.____ dily(1).
I I l'olllllUII! 1:IIIH!l1ll1ll!lllraluJIl5 ,IS llimdp.lf 1 WflIkll(S CUIJIIWIlSillillll_ Hehlllllo !tUt ErnelUBfll:Y
j 1 I.lkl! 1,',11 AllVll III r~Il!ln)II!'o'f'IY hUll hlJ'lJ~i ,IS fll~lli)rllm!l11 or t;IlIllilrl YIlIJII:llIIIIJ;lIIY'~ dl!~iiIJllilll!lJ
1ll'1'lh'tllw palll or "~VI:I !lwillm thiln 10 I ~ llllysil:lall if you develllJlIIl!W WllIptonrl, il YIIII'
~,I'II ,lfhlll!l}lIill rl!l!du:alllllllllfOllllilhon (OV!!I) SYIIlDlulllshilve 1101 illlpltJvmJ In _.. _:___
1 ! Al1hIIlOIII;~; 1 1 Mw;dll mlil~;lIIls lJaY(:i), or II illlY i1SIlHt.l or your comJlhlJ1I should
I ) Allll Iltll,III11II,IIIllrt!'l 1 I f),!r;()11l11~:;1,1ll1:;J 5lJtldl!nly WOJSllJl
I 1 Njlrl;Hfll:~Jsllllilllvf!S AllhlllSlilllUl1llS I I Rlllumln lhe ElIlefl)HI1I:Y f)op.ullllP.1I1 or l:illl your
falTlIly dodO( uIlmellialelV11 you IJeyolup new
5Yl1Iplormi, II yow symplllul!l havlllIlll mql1uv~1
ill __ _...___. daY3. Of II ,my J5Jmd 01 yuur
cllndllllJII shol/ld sudllUllly worsel/
WOUNO CARE
~I'l p ilit", ..lIilj - .iI' HI WI! ill i tll! Irr~l
!!IV!"j
, I Lttll.I,\illq 11'1', 1111:0'1"1",1/ 11'1111','" 1111", :11111
.\_1:11 \',1 !Ill Id ,',i111 ':",jl' !lId .'i.IIHl .'J,lh'l dlY
i1llt/I'II!llil, ,!H'!' """1,\,111 ,;PIIl,lpll.III'f'dll'!;lIl1'
Iff l)f~ II 'l,tll', 1I1"lllh' '.'.I'I!!ld h,t; 11I',lll'rI
IHIHIII)lwll'f ,""IIPd,II"IMlIl
lith'
H'IVI1 '1lIrJlI', 1")lIt)'.l'lI il!
11,111'
11.1',1\)
lld-,l"l
11I11P!'.I,Jdd,' ,^,I',1l hWI!';
UIUII:HIjIIlYN!tll ;1 t:lp ,11111 .'t,llr~r, IIlt'II/f.lpply
;;II\lrllll~llll t:1!~,HII ,llhll!'llll~'i'; Kl'qlllrl~';';111l1
111';IiI,Uilllh'l
Y'llll NlillIllllni 111'1'11 i'l11',!'!1 wlH, 'ih'JI...ltlp'i
Illl'V IIl1d Ill! kl'pl rll:.lIl ;Illd dlV II',IVI~ ';11:11
'illljJ'; IIi P I;Ir:I~ 1 Jl till II \I ~V [, III 01' :iIlUU[ ill u~olJ:;IV III
dhOtll flvl1lo ';I'VPli rl,IV'j
1 I IMulll il!lllll~dl,l!l'I'1 lllll;!! flllt'ltll'tllV 1l1~1I,1I11t11'll1
{)I YOllllilllllly diU III! II ',It III'; Ollllh~!t!1JI1 tll~vl'!nll
IIlJ:W;t!;I!l11 rHlll1:';; ';hl'lIl1UI, !JIb, loulwllil, rl'd
~tr 1', lk '; !I'il ~r
: W;IIIII \\0111'1 ';II;lk:; t'II:IiIfII,rWi';t!'j lor V11II1I11Ihl:,
hHH hl!lI:';il;lIly
ORTIIOPEOIC & BACK INJURIES
i i ^pplv IU'IJIIt'lHlI!!!'lJlly In l!ltl"lll!'r:l!~tl ,!It'iIIIllUIP
1H!)(I-1Il IU!IJl:i .uul ~1'Jp 111'II'v"tr:d In /!:dllW
'i'/tI'UUIII
i i Ht':;l dll!'dl'd ,lil',1 dd',f';) IllUllhl P,1I11 hj~l!
: II'~I! f.Ji!h Jll";. dft 111)11.'1'11 ',I,('jqhl 1111111 ;llilllllJ
',lilJlIJ\~Jlllliljt P,llll, Illf!ll ')1')'I\'ly IlllIJlI1 lil Will,ll
;l1,IIVllu";
i Yllll HI,I~ r1'l1l@~ t~lxJII 1',lndiltl'! ,1Iu1/0l ~;plllll
f!'M'j rldihl n .111,:( h'd illl',1 t~ ';1111
p,ll11hJJ, l<''l'Ply illll/ i:llIIIUlIW Il~"~ IJI!III p,II11Ir!~I'
i ! Hl'd It"illlll tllI!(tI'~! lI;IY";}
I ',jo hlhrHII!';f~1 10 lli~ !ill !Ill' l1('d llil,'(';)
i 1 i\llpIYWilltltrl'IJllll!"",t"i Iii '111,Jk'; III ,11I'!ch'tl,lfI!i1
Ilir 11}111t1III!J!'i ./11";1',1 1IIIIIIuIII"; illJ,IY
I I WI',III'I,i:illl:L'llllliltll'.uulllJl :;plllllll)r
d,IVl';1
III I II ~ !~_~ I 11 :11111, I!" I I ,,v. H I 'I Ili 11111, U If! I WI .111111";
IIlt:ll'il'illHlly palll11l1 IIwr:ll_ IJllu~, 1)1 'iwnllt'lI,
/J'H1ml!QI h'l)'-PH Ilfl1llll1!dl,llely,ullloHllildHm
fIlW!!JI~I'1 V LU'I'"lll"'!I!
I)'y iJII !.,I\I ,ll.l l<rJlli!j 111 IL!~ 1I1'II/lu.lltlll ',!>I'd
;'-(.
'f.
f j ,II
,
IJlliI!I
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GENERAL INS IRUCTlONS
I I IJILW.N~ lIullI J11lilklf
I I 1,I~f! (Jllly :llllilll illllUUlll~i olcle,u lIuitls
fI'.'PrlUmllll
J I~Jalll",lly 11!~illllH! iI IUlIlHal diel. CillbuhydtillllS
'ifll:h ,l5Iflil~il. IllillllllW. i11)111t!~;;IUm lnlV bu
ludJllul. UallY lllmhll;ls liMY Illtlkc yom sYlllpluI1l5
W()ISH
I I lJ~if! ValllJlilflf 01 mol /11151 hlllllitlHier.
I fIll IJ.llII rJIlf~lIlpf!la"ltn O'lf!I Illl" lj~n aspllifl-Iice
Ilu:llic:alillfJ (Ivlcnul, rell1pla, Al:elall1inoplltln.
l!11: )Ily IOllllwl"yst:lll","Il!
EYE INSTRUCTIONS
I I Weill eYIl patch until redlCckmJ III _____.~ hours,
I I Wedl ~Il! p,llch lor IIe,l_ hilI/IS, Ihen
11!Inove it
I I Ul!!IImIII Ihe F mel!l'ncy Ol!I",IIIIenl or "III YOII'
ey" tJoclor illlfllp.tJialflly il illl:masimJ pain,
n~llless, dlschafye, 01 bluHl'lI vlslulI dll'lelops.
ADDITIONAL INSTRUCTIONS
I I Your X-fays ha'lr. wct!IVetf a plelilllllla,y
Inlcrplelallllll by the Elllcryency physician and
Will be ll!vlCwed by Ihe ,adlulnYlS1 wilhln24
hOllls. PIl!ase call1he ElIlCrYl!lICY Oepalt,""nlln
24 hllllf51mlinal Iflll!lplClalion
J YOIl havp.lt'i:eivp.11 a boosli!r IlIjl!(;lioll of flllo
lIIallllainllluler.lion ayainslle~lnlls (Iocklaw) allll
lW)'I(!J I'", IIII
,ILl IM,InIlIHlltl I~I 1:11 WI 1111 1~11 .fl.' -11m (If) I 1!!liil
1"'<llll n~J If WI nlll mil rrllj !l1I1 fll!j JlI..I II WluleinlllllF.rnellWflcyOejlill'"mlll,Yllurblood
f'Il!!I"; plllS~llle was fuund lu be eh~'Iol"Jd. flus lIIav be
lHII '1"~ll'illljl I': IJI/l! 10 11m 5111!5S 01 illI EmellJfm:y Uf!pilllmenl
.t_ip'_I!lI~._ ~. vISII. WI! lef,lJIl1llltJlUl YOIlf Illuml prHS511111 be
Ilr.m
I HJ\H~I' 11.11 1 ~ 1 t~ J mdlP,Ckl.~J by your family phYSician wiltulI one
I'll rql! week
IliI'r'itI'I/ I A wilma SVel:illll!1I ha~l bt!en ublailH.'1llll lesllur
IMI! II', 1:( Ii batleflll Please call1ha Emeryelll:Y UCll,J11menl ill
IIIJ) 'I"~ ,,~lll J day~ IOf Ilia lesulls.
":~'-'ii"'~;"J:I'1 I I Slop smOMlI1ll.
IAllll, l:i !f
_~~'!'~':!.t.,_'~ See ;UltlllUJl1iJl UlslluthlJllS
Ill'pl':11 dO';I! I!VI!IY ~ Iimll!) a~i 1U~~dl'd ! 1 Hp'jJtJ illllJlY (o'lm) 1 I ^nimal bill! !...
IJllllfJIIHmdh! dllllllll lJl,lIlkel:i I I lelalllJs '"1111U1IUaliun ~;elie5 (ove,)
'-:''''-7t;'=~-LJ'-;-1/-~ fJ"iJ"" ,u. j~~~2)Y "//i.i'j
'1./:..../. .. "'lj3;/';"7'1;;::\._._./d_~-"':/-].>U'''Lt:< .
" I,. Jl", I '
_ _.... J..-. _-_.__,_..._.._._'^___..
1:11111'flI rj'j!ln rM,mjIJrlllfjlJll~:Mi' IUCOMMI NIJI\lI(lfl:;
,\1;1
fillOliP
111 I~';':! ] I l'j liI'l '. ro II
MII'i Mil'; ~II'; ~n:; )R'; )IlS yns
1;11-1
, I!~ t
W'Hjtl!
ji!i~ I
'.
I) 1/ '/lil ;l,1 ,1~Jlfi ~I '" ','I ftJ-II/1 'i'l ,nl
.:'tl1
./1,.
'-..,----
1 h,:ldlY ,II klllJ"ttlPll1JP /l'1,I'J'il,Jlld lH.llh~I'JlillldU1q 1)1 Ill!! allow 1It~;IIW:hIJIlS, lIIdudll1!J Ihe illhhlilllliJl illSliuchull sllcels
.-.+-----.---..-
~.
l" jt."ltli PI 1Il",jJHlIjltlll' 1';111)', ~;illtl.t!IJlI!
/'..~ ,/~~/; /
Ill~',IU.III-, ',ilf!l,J:IIII!
fr'B"',', PI,1i1l1 dlfi 11 '11,
Oolle
rlllle---"~._AM~~
\,~ ',' &, ! i-.J' j -7f
tlltl'1!l5;llllll,JIIJIQ
[ [ HEAD INJUn v -
AI th,., plf"~"llllillln IIlll ~L1lj"nr'; <.('1111111"11 I'; r,,111;;':11;11J1'! illHI h(j~;pllaljl.,IIHIIlIS lIot r.ollsiuereu nocesslIry.
EIIlf\ltJ'~rw'l f)ppilllllll'tll (1' Ir~"ltll Illr I' e.';.t1Il,l!hlflll ,lilY (ll IIUJ fl:IIt,WlIUJ sVITl~lums occur'
1 Ml'nlillcllfllu':If111,dlilllljPllIll':II'llf.'f!f'illf1illll'l
;J VHIPllillll, n';procially fI1prf~ 111;111 Ofl(f!
;t SfNti11l or wlw;murllJ IIBil(JadHI
.1 {;umHd!;.IOn~ (Sf1l/tlrt'~..).
~ hlUttll'1nd Slf!f'PlfH'SCi or ddllt'ull'f III <lwnkmllnq . ovur and ,lbovo nnrlllnl bedllmo lIredno$S.
fi [lillir:tJlly III willkifl\1 ('I dilllm~s5
1 Ilh"l~d or tit 'I !Ilh~ 'J1,';i(lfI
n Uh'od fJll.h',H IiqlluJ d',III111lV 111)111 rlflSI! ur fJ,Ug
!_ OHhcully r:P,..;lMlIlIl
, .. EMEIlGEr. CAFlE UNIT PATIENT INSTRUCT..5HEH
However, you shauh.J l,;onldGI tho
--
"
Ffllhlw 1I1H!;O 11i'I;f:"f)II~;
I. "lIilll';flOl i!-. prf1'lf'fll ql'jf1 0111'( dl':lr Uqllld..; hy 11l0l11h 1m lirst 12 hOlJr~ lullowing injury,
;J Sh"'!, i'; f1l1111111"'II. 110\'/1",1'1, I'OIIf'tll', ~,Ill '1I1d bo dlCdod fJVory 2-:] huurslfuriny sltJep periuds for next 24 hours 10 seo Ihollhey can bo
;WIIII(l'IIf'lllltllllltlll'l
:1 (ilvn II"UllJ1~1 '1'"'llljpr !ltnn ^';piflli Ilf 1~lpl1!)1 for p,'lin reHel, unlc'3s prtl!icnlJet..l by phytiidlll1.
... ^f'lJly iOJ 10 5wolll!ll ,He:,;., irllerllllll"lltly lor I1nl1t 2,' hour!}.
_._--_._._~-- -_.--~----
IMMUNIZATION INSTRUCTIONS
[ [ TETAIIUS, lllrHI IIEI1IA - TlI
You Il:l'In ff't;fli....I'd ;ll''l{J~J()r IlljPI hUllnl r d hll 111(l pllfpnSI1 01 nliunlililltng your protoclion againsl Tetanus (lockjaw) and Diphtheria.
1111<> injH !lllfl \',,111"(1";+ I'HI!P,lI"f111'r III ,"',11'; II i~; IIlIpllll;1I11. Ihflrnfom, to note the dafo of Ihis injeclion nnd contnct your fAmily doclor at
III'"' I'mlol 10 '1'1011'. fill ',HI! 1\1'"11"" ;t,., 11'1" tH111 1111111~ 1!'JPIlI you "nJr yU1JI5Hlf. it will be necessary to have a bousler idler 5 years have
elilp~e".
IITETAfllJS TOXOIlJ -Isr [JOSE
'(nil Ill!,!fl If'o-'i'J~d rho Ii!';l 11',1',1) (II rd Ifill" r'I'(lltd fof Iho plll'JfI~;~ of IJtoviding long.lollll proleclion againsl Tetanus infection (lockjaw). To
C'lrrtl'!'~I'~ !lIP lfllllllltti-, ili.,!! I"'r't"-';. ':"IlI;1l1 ynlll hnllly dlldor in ,1.6 WQP-ks in order tu receive tho second Injection. The 3rd nnd final
i1ii"llillll 11111' t I... I'" "(,,,'d r,-I" pl',lI:II': :111"1 III" r:nq1l1l1 injpclinll. WIUlllllli!'i inilial ilf1l11llnllillion pmr.essls completed. booster illjectlon
'.' ,III". '1"I'otl';1 "'11/" 'tl III p-w, I" :11 IIII' 111l11"l III inilll'(, It i~ itnPOllillll, lluJfcforo, lhal an accurate record lJa kepi of tho uales 01 these
1111t:dlllll"l.
MEDIC^TION INFORMATION SHEET
[ i MITIl.1I01ICS
'1'''11 In',,'!) 11"1'11 fliP' wlJ," I ;!I\ 1l111iH'llil'. :1 rll"fllil'ill 'julJslam::u which kills o( prevenls the urowlh of bacteria. Antilllotics ore used 10 treat
JUt '''(1:1' illf, , lir:'!': (. It pll1l"III'.I!' ,,,f', 1:..11. '.iIlWiti.;, Ufll\;ny infflclioll';, fllc,) AnlJbiolic!> 11/0 not ellOl:liva against viral infectiolls (colds).
1:11.,. .,n Il," ,.t",I;, '! ' r'I":' JiL, d l.r;"" In 1111' ilrirnwli'JI\'; l'Vr'1! 1I1C,luqh Yl/lIl1lay be fr~ellllg beller. Somo cultuJlonly u5cd anlllliolics'
rl J;ltl'l J I H'''''; .' ii! . 11',1 I'll I;' lilll;. r r 'iii' d:l~ .;ill, ;',tll"..iLillin, [1i.ldllln. ~;I~plril, ^llljlllOlllin, l~el1u;(. Owicof. Caclor, PmJialole, Tohacycline.
AlIII.IlITL/lI.1~l/11 CJJ]'{
\,'.. 'n f' I'" ',llllii"ld, fill" 11'," !II ,III :11111 tilll:Hllllt:jllll" for 11m Iwahlu'lll of your pain. Theso medicalions reliove poln by docreo5lng IliA
infl:lllilll;I""lI ,.tI'., Iii Ihl'; ',t, I"..f Ilt"1I ,111"1 Illhll'; flf "'/tlh InOlI. II YIlIl CltjJllIicllCO 11<lIJ5P.i:I, vurnilillU. or abdominal pnifl. stop tho
tll"flll, IIi. 'tl :ltl' I I "11'1,11 ," ,III II, 'I i, 'I I'., I'! ,I L d" HII', '1I'~lli(-;,lillll if 'illll It<lv'! Ili.lIJ an uleor or tJlceuiny hum your slomadl or lHlwnls. Thifl
II-ndi' '[11"111111' d. I"; '111, ."'11111 -dil' 1111,,11, i'll"; f:I,w,nll '111111 dtJdnr I' YIJIJ illO Illklrl~J ;lIIY uf lho fulluwiflU: (I) 1110ud 1I111lllers llkn
, "III;,.,,!i'1 ,., ',~r'lf'''1I I'j ,jl.dl'li, I';; d!l':d"'tl<; Id',!' Cltill,ISP,Iollfl;l!jP. I)y,,"~lor and Uiillulloso Do nollakl1l11ore IImll 0110 ilnli~
it,n.m'''''l!'''! tP,'rl;, '11-. IJ ,II 'I"'" ""I'!'" 1,1 ',1l1l'1 ;tlllli"II:HIHlldlnl'l dIn: ^~~fJiril1, iiml.lIl'{ ulhm ovor-Iha-cul/nlflf flIotfidllOS cOlllaininH
l'!lll' !!II!",,,l'<d 11 111,1, ;1;, I, I.!, h' !-1I11'14'#. Clilllllll, rllJl.l/uliilin. Dolc.lJid, Mf~d(}lIlen, nle, You lIlilY use Tylunol nltmy wilh anti-
irlfl<llllrll,lh1rif";,
'"I~t.1 [11F! M./l11l 5
II,,, I'" "1'1'11' '0""1 I", ..111"'11 IH" '1.1" 1/111;1'1 ,"'t,'IP.I:;f' y(~llr rflll"ll~ Illllllhl1i1lion 1U1I1 u!lIul(p'!;_ Unlil you ha\lo bf!C1l ublo to c-cporiencn
1111 . 'II I. I'" . ill tl" I III rlr d rln";1 I ,q I" pi/'ll ;111 ~Hrcr.ill: IlU nor work alound diIl100ll)U5I1liu.:hinory; UO NOr climu ludders or
" Illr III IlIqh. Iii if -;, .It ',II Ii!''''''; i JI. 'II H r q 1II11'-. ill!:' Ihul wl!llo...! lakil1~J tillS llu~tflr.:alllJn_ f
.
(:If)^JI'/P~ rrlo pt\nt:UII!;S
I-',n I'l"'! t.., I'".I;L 'TLLlll" 1'; I' '11 1,1 tillf It'';tllll'1I1 111 \111~ LII1f'lql'llt:Y CillO Ullit. no nor: dllVC, ullnk nlcol1ohc Levmayer., 0( work fl,l;
, I" 1 'II - .. j' ,f,l: ,I !,. F''' II','.' 1"1;" k.,J 'I" I 1,1I11!1I'11' l'rll'd~.lll dlS,lppOill You fIli\Y lIemJ a:j'il"faIlCU willkiJllJ ,Iwl ~holll"
'" (.., I.. 1 "~I '11'1' II, I' '111 i'.'" .11'11'",rll'!~;lllltlr ,lllrliIIUllilllllt:'UlI:illlun. y<IU will 1\f!IJII tu lol1ow thu"l! 1I1Shlll;hol19 O.U.I,
l"Ii"',',1111 If; ;'1011:
IlFCl1flf'a" 'fI I'"', ;"-,flll MlfIlWiI'-,C-1ltIC,
:1",
,,,' ",' 11",1-'" II) rp!i"vf' nr f''''','f'lll lilt' ';'1lTlpl'lrll~ of your IIlplltcnl problem. Take lhmn on!y itS directod.
,II . t. . I _,' ,1,,1, .It',!:irl:ll,,il'; III II;UIIllllti,'t'J:, CIU'I;k WIlli your IlrJctur b(lfom takulU ilIIY illhlilinll.ll
I I 11,,,' III ': 11...111<11' dll'.'i',ltl":-,'~. P'".llf'~j~;"I!"~;, e"jjll!niilly In duldff'll. 11Il11'.u,1I htl'lIne!,';.
,I ((, t /1'," I,t,. ,,!f"!.l .,J;I'IIIlI1," Il'lltJfll!d lu 'JIIIU plly~il;1,1I1 irnnltJul.lh+,.. 01) 111,11 t1,IVfJ U,
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POWER Of ATTORNEY
AND
CONTINGENT fEE AGRElMENT
· KNOW ALL MEN BY THESE PRESENTS. thtll I, RANDY MISNER, parent and
legal guardian of KATELYN MISNER. do hereby rei "in HANDLER AND WIENER. of
Harrisburg, Pennsylvania, as my attorneys to ne\jotiate for an adjustment or to
Institute for me In my name, any legal proceedings or actions that in their judgement
are necessary, In connection with my claim for d...mages against ANTONIO DIAZ
and/or HIS WifE for Injuries or damages sustained by KATEL YN MISNER, as a result
of an accident that occurred on or about March 19. 1995.
I agree not to settle or adjust the above claim IIr any proceedings based thereon
without the written consent of my said attorneys.
NOW, THEREFORE, in consideration of the stJrvices so to be rendered by my
said attorneys, I hereby covenant. promise and agrt:LJ to pay to my said attorneys for
their professional services rendered, THIRTY - THtiEE AND ONE-THIRD (33 1/3)
PERCENT of whatever sum is recovered as a resull of settlement without suit; or
fORTY (40%1 PERCENT in the event suit Is Iilud; IIr TWENTY PERCENT (20%1 of
settlement or verdict if, for any reason, I negotiate directly or engage other counsel
to represent me. Any necessary expenses and costs advanced or incurred by Handler
and Wiener will be reimbursed regardless of whethtH or not there is any recovery.
Counsel reserves the right to withdraw if, after complete investigation, they
determine that there is no merit to the claim.
I hereby authorize the said attorneys to pay bills for medical and hospital
treatment by payment directly to physicians or hosllitals concerned.
I ACKNOWLEDGE that I have read. approved and understood the above
Contingent Fee Agreement and Power 01 Allorney and I acknowledge having received
a copy of the same. The terms set forth are agreeable. yj
IN ~~ESS W}l}REOF. I have hereunto Silt IllY hand and sealthisj ',) _.?day
of ~~~ .1995.
,
'. ",,', ':. " .(SEAL)
RANDY MISNER, parent and
l!loal guardian of KATEL YN
MISNER
/
/
/
(SEAL)
EXHIBIT
-1L
...........LaAl........,.
. .. ..
Handler and Wiener
l"ebruary 1, 1996
BLlled through 02/01/96
Bill numbe!"
201275-00000-001 WSH
KATELYN MISNER
57 FOX HILL RD
SHIPPENSBURG PA 17257
DISBURSEMENTS
04/10/95
04/27/95
06/30/95
07/28/95
10/17/95
11/03/95
02/01/96
02/01/96
02/01/96
02/01/96
02/01/96
02/01/96
02/01/96
02/01/96
Smart Corp
Roy A Himelfarb DDS
Health Information Management Services
University Physicians
Book Binding Costs
Photography Costs
proth of Cumberland County
Proth of Cumberland County
Document Reproduction
Fax Charges
Document Reproduction
Postage Costs
Postage Costs
Long Distance Telephone Charges
Total disbursements for this matter
BILLING SUMMARY
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16_52 .
5.00 .
8.75 .
7.50 .
2.00 .
36.00 .
45.50 .
5.00 .
20.60 .
5.00 .
21.80 .
7.36 .
2.25 .
2.43 .
.
- - - - - - - - - - .
$ 185.71 .
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