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HomeMy WebLinkAboutMINUTES - 12151992 - 1.3 (2) CLAIM 1.3© a BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15, 1992 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all "WarnE��® CLAIMANT: ALHADEFF, Sherise NOV 17 1992 ATTORNEY: Allan M. TAbor COUNTY COUNSEL Ryan & Tabor Date received MARTINQ. CAU& ADDRESS: 11 Embarcadero West, Ste. 130 BY DELIVERY TO CLERK ON November 12, 1992 Oakland, CA 94607 November 10, 1992 certified BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of.the above-noted claim. DATED: . November=16, 1992 IaIl DeputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors (✓) This claim complies substantially with Sections 910 and 910.2. r ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days. (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 1(1"V w( -,�, /f, BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (This Claim is rejected in full. { ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this-notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. . *For additional warnina See reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: - DEC 1 G IN? BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CONFIDENTIAL COUNTY COUNSEL'S OFFICE CONTRA COSTA COUNTY MARTINEZ, CALIFORNIA LNOV ENED MEMORANDUM Rvj ID OF SUPERVISORS 2 01992Date: November 20, 1992Lj To: Clerk of the Board of Supervisors cL� .�OSTAc�__ FROM: Greg Harvey, Deputy County Counsel RE: Claim of Sherise Alhadeff MR# 20-84-55-6 Attached is a claim which was received in the County Counsel ' s office on November 16, 1992 . P I errithew emorial N0V�' 799 AND CLINICS �� RECEAVEU November 12, 1992 NOV 2 01992 CLERK BOARD OF SUPERVI Office of County Counsel CONTRA COSTA CO," Contra Costa County CLAIM Sherise Alhadeff MR# 20-84-55-6 The attached claim for the above named patient was received by Certified Mail by Merrithew Memorial Hospital on November �12, 1992. Mark Finucane Health Services Director cla enc. xc: Ron Harvey Contra Costa County Srq c_Ux�`. A-301A (3/87) ` ,?0 y 5� MTC / • y 1 RYAN & TAB OR ALLAN M. TABOR 2 STATE BAR NO. 52846 11 Embarcadero West, Suite 130 RECEIVE® 3 Oakland, CA 94607 --� _ Telephone (510) 444-5350 4 �r�i� dDo I� Attorneys for Plaintiff. 5 CLERKBOARDOF SUOPERViSORS COWM221LA CO. 7 8 CLAIM 9 10 SHERISE ALHADEFF, 11 Claimant, 12 VS. 13 CONTRA COSTA COUNTY, 14 MARTINEZ COUNTY HOSPITAL - MERRITHEW MEMORIAL HOSPITAL , 15 DR. SAMUEL CHUA, DR. P. BARTSCHI , 16 Respondents 17 A. Sherise Alhadeff lives at 1522 St . Helena Drive , 18 Danville , CA 94526 . 19 B . Notices in this matter are to be sent to Ryan & Tabor , 20 11 Embarcadero West, Suite 130 , Oakland , CA 94607 . 21 D. On or about June 24 , 1991 , plaintiff was hospitalized at 22 the Martinez County Hospital , now known as Merrithew Hospital , 23 and was treated and cared for by Dr . Samuel Chua . On or about 24 'June 24 , 1991 , Dr . Chua performed some type of ankle 25 replacement/surgery on plaintiff' s ankle . 26 Thereafter she was referred to U.C.S.F. by said hospital and 27 doctors. On or about April 16 , 1992 , she was seen by the doctors 28 at U.C.S.F. , Dr. Phef£er , and learned that she may need a right RYAN&TABOR ATTORNEYS AT LAW 11 EMBARCADERO WESTASUITE 130 1 OAKLAND,CA 94507 (510)444-5350 1 ankle fusion . On or about June 25, 1992 , plaintiff did undergo a 2 right ankle fusion . 3 On May 12 , 1992 , Sherise Alhadeff called attorney Allan M. 4 Tabor regarding a legal matter unconnected to the treatment that 5 she received by the doctors and hospitals with respect to her 6 right ankle . Based on preliminary information that Allan M. 7 Tabor her attorney had reviewed , he advised her on or about 8 May 21 , 1992 that she may have a possible medical malpractice 9 case against Dr . P. Bartschi , Dr . Samuel Chua , Martinez County 10 Hospital , and Merrithew Hospital . 11 D. Inj uries: Plaintiff has suffered lasting and permanent 12 injuries to her right ankle as a result of the medical 13 malpractice of said Dr . Samuel Chua and Martinez County Hospital 14 - Merrithew Hospital . 15 E . Damages with respect to this claim are unknown , but the 16 Jurisdiction rests properly in the Superior Court and exceeds 17 $25 ,000 .00 . F. Names of public employees responsible, Dr . Samuel Chua . 18 DATED: November 9 , 1992 RYAN & TABOR 19 20 BY ALLAN M. TABOR 21 22 23 24 25 26 27 28 RYAN&TABOR ATTORNEYS AT LAW PORTOBELLO SQUARE 2 11 EMBARCADERO WEST,SUITE 130 OAKLAND,CA 94607 (510)444.5350 PROOF OF SERtVICE BY MAIL 1 (CCP SECTION 1013(A) , 2015 . 5) 2 I am a citizen of the United States and am employed in the 3 County of Alameda, California . I am over the age of eighteen 4 years and not a party to the within action; my business address 5 is 11 Embarcadero West, Suite 130, Oakland, California 94607. 6 On November 10, 1992 ,• I served within: 7 CLAIM 8 9 in said action by placing a true copy thereof enclosed in a sealed 10 certified mail , return receipt postage envelope with/postage thereon fully prepaid, in a United States 11 Postal service mail box at Oakland, California addressed as 12 follows : 13 Merrithew Hospital/Martinez County Hospital 2500 Alhambra Avenue 14 Martinez , CA 94553 15 Dr. Samuel Chua c/o Merrithew Hospital 16 Medical Staff Office 2500 Alhambra Avenue 17 Martinez, CA 94553 18 Contra Costa County Board of Supervisors - Clerk 19 651 Pine Street, Room 106 Martinez , CA 94553 20 Dr. P. Bartschi - mailed first class mail as they refuse certified 21 225 Spruce Street, Gridley, CA mail 22 I declare under penalty of perjury that the above is true 23 and correct. Executed on the above date at Oakland, California . 24 25 N TABOR 26 27 28 RYAN&TABOR ATTORNEYS AT LAW PORTOBELLO SQUARE 11 EMBARCADERO WEST,SUITE 130 OAKLAND,CA 94607 (510)444.5350 PA O a� u a� LO � �a < Q� .. cr w o wVa N f fl Q cs r a M w fL' 6N� t-7 0 �o2 ZOa 4 �4aa �„ w 1 RYAN & TABOR RECEIVED ALLAN M. TABOR 2 STATE BAR NO. 52846 11 Embarcadero West, Suite 130 NOV 1 2 1992 3 Oakland, CA 94607 Telephone (510) 444-5350 CLERK BOARD OF SUPERVISQSO 4 R L CO. Attorneys for Plaintiff 5 6 7 8 CLAIM 9 10 SHERISE ALHADEFF, 11 Claimant, 12 VS. 13 CONTRA COSTA COUNTY, 14 MARTINEZ COUNTY -HOSPITAL MERRITHEW�' MEMORIAL HOSPITAL , 15 DR. SAMUEL CHUA, DR. P. BARTSCHI , 16 Respondents 17 A. Sherise Alhadeff lives at 1522 St . Helena Drive , 18 Danville , CA 94526 . 19 B . Notices in this matter are to be sent to Ryan & Tabor , 20 11 Embarcadero West, Suite 130 , Oakland , CA 94607 . 21 D. on or about June 24 , 1991 , plaintiff was hospitalized at 22 the Martinez County Hospital , now known as Merrithew Hospital , 23 and was treated and cared for by Dr . Samuel Chua. On or about 24 June 24 , 1991 , Dr . Chua performed some type of ankle 25 replacement/surgery on, plaintiff' s ankle . 26 Thereafter she was referred to U.C.S.F. by said hospital and 27 doctors. On or about April 16 , 1992 , she was seen by the doctors 28 at U.C.S .F. , Dr. Pheffer , and learned that she may ' need a right RYAN&TABOR ATTORNEYS AT LAW PORTOBELLO SQUARE 11 EMBARCADERO WEST,SUITE 130 OAKLAND,CA 94607 Mftl AAA.R.1-5ft I ankle fusion . On or about June 25 , - 1992 , plaintiff did undergo a 2 right ankle fusion . 3 On May 12 , 1992 , Sherise Alhadeff called attorney Allan M. 4 Tabor regarding a legal matter unconnected to the treatment that 5 she received by the doctors and hospitals with respect to her 6 right ankle . Based on preliminary information that Allan M. 7 Tabor her attorney had reviewed , he advised her on or about 8 May 21 , 1992 that she may have a possible medical malpractice 9 case against Dr . P. Bartschi , Dr . Samuel Chua , Martinez County 10 Hospital , and Merrithew Hospital . 11 D. Injuries: Plaintiff, has suffered lasting and permanent 12 injuries to her right ankle as a result of the medical 13 malpractice of said Dr . Samuel Chua and Martinez. County Hospital 14 - Merrithew Hospital . 15 E . Damages with respect to this claim are unknown , but the 16 Jurisdiction rests properly in the Superior Court and exceeds 17 $25 ,000 .00 . 18 F. Names of public employees responsible , Dr . Samuel Chua . DATED: November 9 , 1992 RYA & TABOR 19 20 BY - -TAB OR YTABOR 21 22 23 24 25 26 27 28 RYAN&TABOR ATTORNEYS AT LAW PORTOBELLO SQUARE 2 11 EMBARCADERO WEST,SUITE 130 OAKLAND,CA 94607 PROOF OF SERVICE BY MAIL 1 (CCP SECTION 1013(A) , 2015. 5) 2 I am a citizen of the United States and am employed in the 3 County of Alameda, California . I am over the age of eighteen 4 years and not a party to the within action; my business address 5 is 11 Embarcadero West, Suite 130, Oakland, California 94607. 6 On November 10 , 1992 -,, 1 served within: 7 CLAIM 8 9 in said action by placing a true copy thereof enclosed in a sealed 10 certified mail , return receipt postage envelope with/postage thereon fully prepaid , in a United States 11 Postal service mail box at Oakland, California addressed as 12 follows : 13 Merrithew Hospital/Martinez County Hospital 2500 Alhambra Avenue 14 Martinez , CA 94553 15 Dr. Samuel Chua c/o Merrithew Hospital 16 Medical Staff Office 2500 Alhambra Avenue 17 Martinez , CA 94553 18 Contra Costa County Board of Supervisors - Clerk 19 651 Pine Street , Room 106 Martinez, CA 94553 20 Dr . P. Bartschi - mailed first class mail as they refuse maiiified 21 225 Spruce Street, Gridley, CA 22 I declare under penalty of perjury that the above is true 23 and correct. Executed on the above date at Oakland, California . 24 25 0//hD-- !L'Org-M. TABOR 26 27 28 RYAN&TABOR ATTORNEYS AT LAW PORTOBELLO SQUARE 11 EMBARCADERO WEST,SUITE 130 OAKLAND,CA 94607 MRM AAA-5350 c - errithevv c4j emorial OO �pO4aL� ion Na�e� o AND cLiNics November 12, 1992 "OFSUPER Office of County CounselContra Costa County CLE CLAIM Sherise Alhadeff MR# 20-84-55-6 The attached claim for the above named patient was received by Certified Mail by Merrithew Memorial Hospital on November 12, 1992. Mark Finucane Health Services Director cla enc. , /xc: Ron Harvey Contra Costa Count - n_aMn PA M71 )0 — y- MTc 1 RYAN & TAB OR ALLAN M. TABOR 2 STATE BAR NO. 52846 11 Embarcadero West, Suite 130 3 Oakland , CA 94607 �I(� Telephone ( 510) 444-5350 ECEN 4 Attorneys for Plaintiff. 5 NOV 17 1992 6 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. 7 8 CLAIM 9 10 SHERISE ALHADEFF, 11 Claimant, 12 VS. 13 CONTRA COSTA COUNTY, 14 MARTINEZ COUNTY HOSPITAL - MERRITHEW MEMORIAL HOSPITAL , 15 DR. SAMUEL CHUA, DR. P. BARTSCHI , 16 Respondents 17 A. Sherise Alhadeff lives at 1522 St . Helena Drive , 18 Danville , CA 94526 . 19 B . Notices in this matter are to be sent to Ryan & Tabor , 20 11 Embarcadero West, Suite 130 , Oakland , CA 94607 . 21 D. On or about June 24 , 1991 , plaintiff was hospitalized at 22 the Martinez County Hospital , now known as Merrithew Hospital , 23 and was treated and cared for by Dr . Samuel Chua. On or about 24 June 24 , 1991 , Dr . Chua performed some type of ankle 25 replacement/surgery on plaintiff' s ankle . 26 Thereafter she was referred to U.C.S.F. by said hospital and 27 doctors. On or about April 16 , 1992 , she was seen by the doctors 28 at U.C.S .F. , Dr . Pheffer , and learned that she may need a right RYAN&TABOR ATTORNEYS AT LAW PORTOBELLQSQUARE 1 11 EMBARCADERO WEST,SUITE 130 OAKLAND,CA 94607 15101see-sisn I ankle fusion . On or about June 25, 1992 , plaintiff did undergo a 2 right ankle fusion . 3 On May 12 , 1992 , Sherise Alhadeff called attorney Allan M. 4 Tabor regarding a legal matter unconnected to the treatment that 5 she received by the doctors and hospitals with respect to her 6 right ankle . Based on preliminary information that Allan M. 7 Tabor her attorney had reviewed , he advised her on or about 8 May 21 , 1992 that she may have a possible medical malpractice 9 case against Dr . P. Bartschi , Dr . Samuel Chua , Martinez County 10 Hospital , and Merrithew Hospital . 11 'D. Injuries: Plaintiff has suffered lasting and permanent 12 injuries to her right ankle as a result of the medical 13 malpractice of said Dr . Samuel Chua and Martinez County Hospital 14 - Merrithew Hospital . 15 E . Damages with respect to this claim are unknown , but the 16 Jurisdiction rests properly in the Superior Court and exceeds 17 $25 ,000 .00 . F. Names of public employees responsible , Dr . Samuel Chua . 18 DATED: November 9 , 1992 RYAN & TABOR 19 20 BY ALLAN M. TABOR 21 22 23 24 25 26 27 28 RYAN&TABOR ATTORNEYS AT LAW PORTOBELLO SQUARE 2 11 EMBARCADERO WEST,SUITE 130 OAKLAND,CA 94607 PROOF OF SERVICE BY MAIL 1 (CCP SECTION 1013(A) , 2015 .5) 2 1 am a citizen of the United States and am employed in the 3 County of Alameda, California . I am over the age of eighteen 4 years and not a party to the within action; my business address 5 is 11 Embarcadero West , Suite 130, Oakland, California 94607, 6 On November 10, 1992 served within: 7 CLAIM 8 9 in said action by placing a true copy thereof enclosed in a sealed 10 certified mail , return receipt postage envelope with/postage thereon fully prepaid, in a United States 11 Postal service mail box at Oakland, California addressed as 12 follows : 13 Merrithew Hospital/Martinez County Hospital 2500 Alhambra Avenue 14 Martinez, CA 94553 15 Dr. Samuel Chua c/o Merrithew Hospital 16 Medical Staff office 2500 Alhambra Avenue 17 Martinez, CA 94553 18 Contra Costa County Board of Supervisors Clerk 19 651 Pine Street, Room 106 Martinez, CA 94553 20 Dr . P. Bartschi - mailed first class mail as they refuse ceriified 21 225 Spruce Street, Gridley, CA mal 22 1 declare under penalty of perjury that the above is true 23 and correct. Executed on the above date at Oakland , California . 24 25 ABtMVM. TABOR 26 27 28 RYAN&TABOR ATTORNEYS AT LAW PORTOSELLO SQUARE +1 FMAAACADERG WEST,SUITE 130 1 Iv ti t t� h `\0 A v o W ' �u o wLO ` (31 Vucv , p, ° °� �c N U N VA u +?, L- O is U Wvo 2661 Z I AON C7 V) t'>��i cr O 4 Y ZOrUa a Q 0 4 O -- ' { CLAIM /- 30 ._ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15, 1992 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $20,000.00 Section 913 and 915.4. Please note all "Warnifts1r:71' CLAIMANT: BACON, Randall P. ATTORNEY• Charles Wildman, Esq. 2211 "A" Street Date received ADDRESS: Antioch, CA 94509 BY DELIVERY TO CLERK ON November 10, 1992 hand de 1 ivered BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. November-.16,-'. 1992 IVIL BATCHELOR, Clerk DATED: Bl: Deputy II. FROM: County Counsel TO: Clerk of the Board of Saper0sors ( This claim complies substantially with Sections 910 and 910.2. { ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 2- BY: Deputy County Counsel (f � III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: D E C 1 a� 19T PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Clara to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp RANDALL P. BACONRECEN Against the County of Contra Costa ) NOV 10 1992 or ) District) CLERK BOARD OF SUPER CONTRA COSTA C " Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 20,000.00 and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) May 11, 1992; at approximately 9:00 a.m. ------------------------------------------------------------------------------------ 2. Where did the damage or injury occur? (Include city and county) In the vicinity of McKewn Rd., approx. 5/10 mile from Carquinez .SOEnic s Port Costa, ContrgCosta ------------------------------------------------------------ --------------------- ty 3. How did the damage or injury occur? (Give full details; use extra paper if required) At the insistence of Contra Costa County Sheriff'sDepartment and Crockett-Carquinez Fire District, claimant was coerced into removing all of his clothing and was subjected to a hosing down of his entire person while naked. ------------------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Contra Costa County Sheriff's Department personnel threatened claimant with arrest if he did not remove all of his clothing and submit to a "decontamination process" and thereafter instructed Crockett-Carquinez Fire Department personnel to hose down claimant who was naked. (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? Contra Costa County Deputy R. West, Sargeant F. Gray —------—----—------------------------------------------— 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Pain and suffering resulting from assault, battery and infliction of emotional distress. ----—--—---------—------------------------—-----—------------ --------- -- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) General damages ------- --- --------- -- ------- - ------- --- ---------- ------------------------- 8. Names-and-addresses-of-witness;s,-doctors-and-hospitals- Witness: William Davis Cpt. Burnett & Lt. Charles Daryl 213 Acme Street Crockett-Carquinez Fire Department Oakley, CA 94561 ------------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE -ITEM AMOUNT Gov. Code See. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES..T.O: * (Attorney) -or-Jiy som-e person on his behalf." Name and Address of Attorney I 'J CHARLES WILDMAN, ESQ. - _ C_2�r 2?,/ , A 2211 "A" Street Attorney fot'1-C1aii&fnt Antioch, CA 94509 2211 "A" Street (Address) Antioch, GA 94509 Telephone No. (510) 754-2622 Telephone No. {51Q 754-2622 NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board 'or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. CLAIM /• 30 iI BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15, 1992 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the .action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $20,000.00 Section 913 and 915.4. Please note all "Warninj�LIFIVSD CLAIMANT: BACON, Randall P. NOV 17 1992 COUNTY COUNSEL ATTORNEY: Charles Wildman, Esq. ��� �� 2211 "A" Street Date received ADDRESS: Antioch, CA 94509 BY DELIVERY TO CLERK ON November 10, 1992 hand delivered BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: November.l6, 1992 JYIL BepCHtyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Sdparvfsors ( ✓1 This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days. (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: i Dated: �� y , �y/�Z BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( VThis Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By AK�', , Deputy Clerk WARNING (Gov. code sect 13) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Nov l 01992 CLER p -SU IE - 'IM AGAINST CROCKETT-CARQUINEZ FIRE DISTRICT Cn- I RA STA co. (pursuant To Government Code Section 910 et seq. Name of Claimant: RANDALL P. BACON Address of Claimant: 119 West 19th Street Antioch, CA 94509 Notices are to be sent to: Charles Wildman, Esq. 2211 "A" Street Antioch, CA 94509 Date and time of injury: May 11, 1992, approximately 9:00 a.m. Location of accident : In the vicinity of McKewn Road approximately 5/10 mile from Carquinez Scenic, Port Costa, CA Facts of accident : At the insistence of Contra Costa County Sheriff's Departient and Crockett-Carquinez Fire District, claimant was coerced into rel.oving all of his clothing and was subjected to a hosing down of his entire person chile naked. Identification of Government Vehicles : Names of publice employees causing injury: Cpt.. Burnett and Lt. Charles Daryl of Crockett-Carquinez Fire District Nature of claimants injuries .: Pain, suffering and other personal injuries resulting from assault, battery and infliction of emotional distress. Amount of Claim: $20,000.00 Itemization Of Damages Medical Expenses To Date: Loss of Wages : Future Medical Expenses : General Damages : $20,000.00 November 9, 1992 Dated: CAREneyyIN ClaimantHLSALN CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15, 1992 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $1,000,000. Section 913 and 915.4. Please note all "WarningVELFIVEI CLAIMANT: EITTREIM, Chantelle for Justin David Eittreim, Minor NOV 17 1992 ATTORNEY: Bruce G. Fagel, Esq. COUNTY COUNSEL 445 So. Beverly Drive, Ste. 200 Date received MARTINEZ, CAUR ADDRESS: Beverly Hills, CA 90212 BY DELIVERY TO CLERK ON November 16, 1992 BY MAIL POSTMARKED: November 12, 1992 certified I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ��IL gATCHELOR, Clerk DATED: November 17, 1992 : Oeputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (I/ This claim complies substantially with Sections 910 and 910.2. ( . ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: A-t— e- ��, /9 9 Z BY: �. Deputy County Counsel v II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD�ORDER: By unanimous vote of the Supervisors present (k) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DEC 15 1907 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. codes t- 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING 1 declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today 1 deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1,992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 1 LAW OFFICES OF BRUCE G. FAGEL Bruce G. Fagel, Esquuire #103674 2 445 South Beverly Drive, Suite 200 Beverly Hills, California 90212 RECEIVE® 3 Telephone: (310) 277-1288 4 Attorney for Claimants NOV 1 6 5 CLERK BOARD O'SUPERVISORS CONTRA COSTA CO. 6 7 8 CLAIM FOR DAMAGES AND PERSONAL INJURIES 9 10 11 JUSTIN DAVID EITTREIM, a ) Claim for Damages For minor, by and through his ) Personal Injuries 12 Guardian ad Litem, CHANTELLE ) EITTREIM; CHANTELLE EITTREIM, ) Government Code §910 13 ) Claimants, ) 14 ) VS. ) 15 ) COUNTY OF CONTRA COSTA, a ) 16 Public Entity, dba MERRITHEW ) MEMORIAL HOSPITAL, DOES 1 ) 17 through 50, Inclusive, ) 18 Respondents. ) 19 ) 20 TO COUNTY OF CONTRA COSTA, a Public Entity dba MERRITHEW MEMORIAL 21 HOSPITAL, a facility owned and operated by the COUNTY OF CONTRA 22 COSTA and to the health care providers named above: 23 YOU ARE HEREBY NOTIFIED that JUSTIN DAVID EITTREIM, a minor, 24 by and through her Guardian ad Litem, CHANTELLE EITTREIM, 25 CHANTELLE EITTREIM, Individually, whose addresses are in care of 26 their attorney, Bruce G. Fagel , ; 445 South Beverly Drive, Beverly 27 Hills, California 90212 , claim damages from the above-mentioned 28 entities and individuals in the amount, computed as of the date 1 i 1 of the presentation of this claim, of $1, 000, 000. 2 This claim is based on the personal injuries sustained by JUSTIN 3 DAVID EITTREIN, born April 24 , 1992 at said hospital. The child's 4 injuries are a result of negligence on the part of physicians and 5 other employees whose names are unknown at present. The names of 6 the public employees causing the child's injuries are unknown to 7 claimants at this time, although according to present information 8 they are nurses and other medical personnel employed by said 9 hospital. 10 The claim is also based on personal injuries and damages 11 sustained by CHANTELLE EITTREIM during the negligent labor and 12 delivery of her child, and thereafter. She weas injured during 13 the process of her labor and delivery, and also suffered severe 14 emotional distress. Said mother also claims damages for negligent 15 infliction of emotional distress for the negligent acts, lack of 16 informed consent and failure to warn. She also claims damages for 17 her own medical expenses, past and future, and loss of earnings 18 and earning capacity. 19 The damages to claimants consist of personal injuries, past .20 and future medical expenses, and loss of wages. 21 General damages and pecuniary damages: $1, 000, 000. 22 Medical expenses: unknown. 23 All Notices or other communication with regard to this claim 24 should be sent to the claimants in care of their attorney. 25 DATED: November 12 , 1992 26 LAW OFFICES OF BRUCE G. FAGEL 27 By sic < < •----�r � �, BRUCE G. FAGEL �-- 28 Attorney for Claimants . 2 1 . PROOF OF SERVICE 2 STATE OF CALIFORNIA ) ) ss 3 COUNTY OF LOS ANGELES ) 4 I am employed in the County of Los Angeles. I am over the age . of eighteen years and not a party to the within action. My business 5 address is 445 South Beverly Drive, Suite 200, Beverly Hills, California 90212 . 6 On November 12 , 1992 , I served the foregoing documents described . 7 as copy of Claimants'Claim for Damages for Personal Injuries on the interested parties in this action by placing a true and 8 correct copy theeof enclosed in a sealed envelope addressed as follows: 9 SEE ATTACHED MAILING LIST 10 [x] (BY MAIL) 11 [x] I deposited such envelope in the mail at Beverly Hills, 12 California. The envelope was mailed with postage thereon fully prepaid. 13 [x] As follows: I am "readily familiar" with the firm's 14 practice of collection and processing correspondence for mailing. Under that practice it would be deposited with 15 the U.S. Postal Service on . that same day with postage thereon fully prepaid at Beverly Hills, California in the 16 ordinary course of business. I am aware that on motion of the party served, service is presumed invalid if postal 17 cancellation date or postage meter date is more than one day after date of deposlit for mailing in affidavit. 18 [ ] (By FAX) 19 [ ] I delivered such envelope by hand to the offices of the 20 addressee. 21 [x] (STATE) I declare under penalty of perjury under the laws of the State of California that the above is true and 22 correct. 23 [ ] (FEDERAL) I declare that I am employed in the office of a member of the bar of this court at whose direction the 24 service was made. 25 Executed on November 12 , 1992 , at Beverly Hills, California. 26 27 Phyllis Simon 28 I 3 1 M A I L I N G L I S T 2 3 Clerk of the Board of Supervisors County of Contra Costa 4 651 Pine Street, Suite 106 Martinez , California 94553 5 andRRegu?arPMaSI 515 957 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 5 N lypyyI ;'J i z Q M 04 o to j QH to ._ .> > 44 4-) 4-) C�' Z {D U) •r1 0 -:1 -ri ° �4 �4 _ O P -I-) 44 (zl -P N -r-! - g: N rl a) 0pm - 4 U 4J U 41 co 44 4-4 0 N O Z N sdo X + a � U U "D L9 �Q�d6o I.-* F a p Q tl� ON o � r O O O � O•� SA N A,3 V Oca W 5-2 N O y ffi U i w Q N J CONTRA COSTA COUNTY Clerk of the Board Date: -December 23, 1992 To: Greg Harvey County Counsel From: Jeanne Bosarg Subject: Letter from Law Offices of Bruce G. Fagel Our office received the attached letter on December 21, 1992. The claim of Justin David Eittreim by Chantelle Eittreim was on the December 15, 1992 Board agenda and denied. Please let me know- if a response to this Letter is necessary. I am filing the original. letter with the original. claim in our Board minutes. Thank you. cc: Risk Management A LAW CORPORATION RECEIVED DRC 2 11992 ARK BOARD OF SUPERVISORS CONTRA COSTA CO. BRUCE G.FAGEL,M.D.,J.D. ADMINISTRATOR TRUDY MILLER RICHARD AKEMON BRON DRAGANOV MICHAEL BONGIORNO December 17, 1992, Clerk of the Board of Supervisors County of Contra Costa 651 Plne Street, Suite 106 Martinez, CA, 94553 Re: Justin David Eittreim and Chantelle Eittreim Dear Clerk: This office forwarded a Government Claim dated November 12, 1992. However, at this time, we are withdrawing said claim and will not be pursuing this matter any further. Thank you for your cooperation in this matter. Very truly yours, LAW OFFICES OF BRUCE G. FAGEL BRUCE G. FAEL VV 1. a. ,�O ,0cdcd 'q bey�� o w4) 1 0 Q0 w Jl z a '♦ ' Y CLAIM 1. 30 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15, 1992 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all "Warnings". CLAIMANT: FITCH, Allen, Sr. NOV 17 1992 SWEET, Cynthia WUNTY COUNSEL, ATTORNEY: Daniel E. Wilcoxen MARTINEh e" Patrick L. Hinrichsen Date received ADDRESS: Wilcoxen, Callahan, Montgomery BY DELIVERY TO CLERK ON November 10, 1992 and Harbison BY MAIL POSTMARKED: hand delivered 2114 K Street Sacramento, CA 95816 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: November:'.16, 1992 JaIL DepputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( r/) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days. (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: / �� ��, "W2 BY; Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: D E C 1 5 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this°notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 1 WILCOXEN, CALLAHAN, MONTGOMERY & HARBISON Daniel E. Wilcoxen, State Bar No. 054805 9 13 2 Patrick L. Hinrichsen, State Bar No. 142223 2114 K Street RECEIVED Sacramento, California 95816 4 Telephone: (916) 442-2777 Nov 10 1992 Attorneys for Claimants 5 CLERK BOAR®OF SIiPERVI CONTRA COSTA CO. . 6 7 8 9 In the matter of the Claims of 10 CYNTHIA SWEET, Individually, and CLAIM AGAINST PUBLIC ENTITY 11 ALLEN FITCH, SR., Individually, PURSUANT TO GOVT. CODE §910 12 Claimants, 13 14 Claimants, CYNTHIA SWEET, individually, and ALLEN FITCH, Sr., individually, 15 through their attorneys, hereby present their claim to CONTRA COSTA COUNTY; 16 CONTRA COSTA COUNTY DEPARTMENT OF HEALTH SERVICES; CONTRA COSTA 17 COUNTY HEALTH SERVICES, MERITHEW MEMORIAL HOSPITAL; CONTRA 18 COSTA COUNTY HEALTH SERVICES, MERITHEW MEMORIAL HOSPITAL AND 19 CLINICS; CONTRA COSTA COUNTY HEALTH SERVICES, MERITHEW MEMORIAL 20 HOSPITAL AND HEALTH CENTER; CYNTHIA ASHBROOK, M.D.; NANCY OWENS, 21 M.D.; MICHAEL VAN DUREN, M.D.; ALVIN LIN, M.D.; SHARON AMON, M.D.; 22 D. KENT HOBERT, M.D.; and U. APSEN, R.N., pursuant to the California Government 23 Code §910 as follows: 24 a. Claimants herein are CYNTHIA SWEET ("CYNTHIA'), and ALLEN FITCH, 25 SR. ("ALLEN"), whose addresses are 53 Cleopatra Drive, Pleasant Hill, California 94523. 26 b. The post office address to which claimants desire notice of this claim to be 27 sent is as follows: Daniel E. Wilcoxen, Patrick L. Hinrichsen, Wilcoxen, Callahan, 28 UW OFFICES OF MLCOXEN,CALLAHAN MONTGOMERY A HARBISON 2116 K STFEET SACRM£FRO,CA B a 1 Montgomery & Harbison, 2114 K Street, Sacramento, California 95816. 2 C. Commencing in or about late October or early November, 1991, through and 3 including May 20, 1992, plaintiffs employed the above named public entity(ies) and 4 its/their agents and/or employees, including but not limited to Cynthia Ashbrook, M.D., 5 Nancy Owens, M.D., Michael Van Duren, M.D., Alvin Lin, M.D., Sharon Amon, M.D., D. 6 Kent Hobert, M.D., and U. Apsen, R.N., and each of them, for prenatal care and the 7 birthing of their son, Allen Fitch, Jr., who was born on May 20, 1992. 8 In or about April of 1991, CYNTHIA began working at Dun & Bradstreet as 9 a temporary employee. In or about August of 1991, CYNTHIA became a permanent 10 employee but was not eligible for private insurance benefits through Dun & Bradstreet 11 until October 1991. 12 Therefore, when CYNTHIA became pregnant with Allen Fitch, Jr. in or 13 about August.of 1991, she was not covered by any private health insurance and was 14 required to seek.County assistance for her pregnancy with Allen Fitch, Jr. 15 At all times prior to and during May 20, 1992, the above said public 16 entity(ies) and its/their agents and/or employees knew that CYNTHIA and ALLEN did 17 not have private insurance to cover the prenatal care and birthing of their child, Allen 18 Fitch, Jr., who weighed over 8 pounds at birth. 19 At all times prior to and during May 20, 1992, claimants CYNTHIA and 20 ALLEN advised the above said public entity(ies) and its/their agents and/or employees 21 that CYNTHIA had two prior children, Sara Sweet, born on April 4, 1984, and Nicholas 22 Sweet, born on August 27, 1986, both by Cesarean section due to Cynthia's cephalo-pelvic 23 disproportion and a condition of Cynthia's cervix which caused her cervix to be unable to 24 open more than approximately 9 to 9-1/2 centimeters. 25 In fact, the above said public entity(ies) and its/their agents and/or 26 employees had actual knowledge at all times prior to and during May 20, 1992 that Sara 27 Sweet and Nicholas Sweet had to be born by Cesarean section from their mother, 28 CYNTHIA, due to, including but not limited to, CYNTHIA's above said cephalo-pelvic UW OFFICES OF WILCOXEN,CALLAHAN MONTGOMERY R HARBISON 2114 N SKEET SACMMEWO,CA 26818 2 1 disproportion and/or the above said condition of CYNTHIA's cervix which included, but 2 was not limited to, a condition did not allow CYNTHIA's cervix to open more than 3 approximately 9 to 9-1/2 centimeters and therefore, CYNTHIA was not able to give birth 4 to a child vaginally. 5 The obstetrical history and physical performed by the agents and/or 6 employees of the above said entity(ies) on May 19, 1992 stated in part as follows: 7 "Hx [history] of C-section [Cesarean section] X 2 [times 2] initially force CPD [cephalo-pelvic disproportion] (9-1/2 centimeter [cervical] dil) & 8 fetal distress . . . previous cervical history C-section X 2. . . . 9 "Est fetal weight: 8 lb. . . 10 "Attempt VBAC [vaginal delivery] if head descends." 11 Notwithstanding the actual knowledge of the above said public entity(ies) and 12 its/their agents and/or employees, that CYNTHIA could not give birth to a child vaginally, 13 the above said public entity(ies) and its/their agents and/or employees at all times prior to 14 and during May 20, 1992, required (due to claimants' lack of private insurance) that 15 CYNTHIA have the birth of her child, Allen Fitch, Jr., vaginally, notwithstanding the 16 continuous and strenuous objections of CYNTHIA and ALLEN that their son, Allen Fitch, 17 Jr., be born by Cesarean section. 18 On or about 9:00 a.m. on May 20, 1992, the agents and/or employees of the 19 above entity(ies) began to induce CYNTHIA's labor by injecting and/or intravenously 20 giving CYNTHIA pitocin and/or oxytocin -- a chemical agent known to the agents and/or 21 employees of the above said entity(ies) to cause uterine and cervical rupture. The agents 22 and/or employees of the above said entity(ies) continued giving CYNTHIA pitocin and/or 23 oxytocin through and including May 20, 1992, at approximately 8:00 p.m. on the above said 24 date. The above said pitocin and/or oxytocin was given to CYNTHIA, notwithstanding the 25 actual knowledge of the agents and/or employees of the above said entity(ies) that 26 CYNTHIA's uterus had previously been through a minimum or two pregnancies which had 27 resulted in two live births only after Cesarean section surgeries were performed on 28 CYNTHIA in 1984 and 1986 as above said. UW OFFICES OF WILCOXEN,CALLAHAN MONTGOMERY& HARBISON 2114 K STFFET SACRM.ENM G B 8 3 1 On or about May 20, 1992, during the vaginal delivery of Allen Fitch, Jr., 2 CYNTHIA's pelvis was too small and her cervix was unable to open large enough to allow 3 the vaginal birth of Allen Fitch, Jr. During the birthing of Allen Fitch, Jr., the above said 4 public entity(ies) and/or its/their agents and/or employees required CYNTHIA to be 5 placed on her hands and knees and offensively touched CYNTHIA and used fundal 6 pressure and/or otherwise forcibly attempted to pull the head of Allen Fitch, Jr. through 7 CYNTHIA's cervix in order to force the delivery of Allen Fitch, Jr. The above said fundal 8 pressure and/or forcible pulling and/or stretching upon CYNTHIA's cervix performed by 9 the agents and/or employees of the above said public entity(ies) on CYNTHIA and Allen 10 Fitch, Jr. (after CYNTHIA had been placed on a known uterine and cervical rupturing 11 agent, pitocin and/or oxytocin, over a period of eleven hours prior to the birth of Allen 12 Fitch, Jr.), proximately caused CYNTHIA to incur a rupture of her uterus and cervix from 13 the.left lower anterior segment of the uterus, extending through the cervix. The rupture 14 extended obliquely to within 2 centimeters of the take off of the.right round ligament. 15 Thereafter, due to the ominous.signs of fetal distress caused by the agents 16 and/or employees of the public entity(ies) to Allen Fitch, Jr., and the rupture caused by 17 the agents and/or employees of the public entity(ies) to CYNTHIA'S uterus and cervix, the 18 above said agents and/or employees for the first time agreed to perform a Cesarean 19 section on CYNTHIA as claimants had previously demanded. Thereafter, the agents 20 and/or employees of the above said public entity(ies) caused CYNTHIA to sign a consent 21 form, consenting to the Cesarean section while she was in labor before said agents and/or 22 employees would perform the Cesarean section. 23 As a result of the above said negligence and despicable conduct of the above 24 said public entity(ies) and its/their agents and/or employees, and each of them, in causing 25 the above said fetal distress and rupture of CYNTHIA's uterus and cervix, Allen Fitch, Jr. 26 was born with apgars of 0 at 1 minute and 0 at 5 minutes, had flat EEG readings showing 27 no brain activity, and thereafter Allen Fitch, Jr. died as a result of the above said 28 negligence on June 6, 1992. LAW OFFICES OF WII.COXEN,CALLAHAN MONTGOMERY& HARBISON 2114 K STREET SACFAAAENID,CA 9 8 4 1 In addition, as a direct and proximate result of the negligence and battery of 2 the above said public entity(ies) and its/their agents and/or employees, CYNTHIA 3 incurred the above said rupture to her uterus and cervix and both CYNTHIA and ALLEN 4 have incurred general and special damages for their severe pain and suffering due to the 5 above said birthing events and have both incurred general and special damages as a result 6 of the wrongful death of their minor child, Allen Fitch, Jr. on June 6, 1992. 7 d. As a direct and proximate result of the medical negligence of the above said 8 public entity(ies) and their agents and/or employees, claimant CYNTHIA has incurred 9 damages as follows: 10 1. Claimant CYNTHIA has and will incur special damages and general 11 damages for the wrongful death of her son due to the above said negligence of the 12 above said public entity(ies) and its/their agents and/or employees, and each of 13 them, in causing the death of Allen Fitch, Jr. on June 6, 1992; and 14 2. Claimant CYNTHIA has and will incur damages in the future as a 15 result of the direct negligence performed upon her and her son and her 16 contemporaneous sensory perception of the above said negligence of the above said 17 public entity(ies) and its/their agents and/or employees in the prenatal care and 18 birthing of her decedent son, Allen Fitch, Jr., including, but not limited to, past, 19 present and future medical and/or psychological expenses, past, present and future 20 wage loss and general damages for severe emotional distress and pain and suffering; 21 and 22 3. Claimant CYNTHIA has and will incur damages in the future as a 23 result of the medical negligence and/or assault and battery of the above said public 24 entity(ies) and its/their agents and/or employees, and each of them, upon her in 25 causing the rupture of her uterus from the left lower anterior segment of her uterus, 26 which extended through her cervix which include, but are not limited to, past, 27 present and future medical and/or psychological expenses, past, present and future 28 wage loss, and general damages for severe emotional distress and pain and suffering UW OFFICES OF WILCAXEN,CALLIHAN MONTGOMERY& HAREISON 2114 K S1iEEf SACRAWNM MM6 5 I due to the above said acts of the agents and/or employees of the public entity(ies) 2 and CYNTHIA's probable inability to be able to have any children in the future; 3 d. As a direct and proximate result of the medical negligence of the above said 4 public entity(ies) and its/their agents and/or employees, claimant ALLEN has incurred 5 damages as follows: 6 1. Claimant ALLEN has and will incur special damages and general 7 damages for the wrongful death of his son due to the above said negligence of the 8 above said public entity(ies) and its/their agents and/or employees, and each of 9 them, in causing the death of Allen Fitch, Jr. on June 6, 1992; and 10 2. Claimant ALLEN has and will incur damages in the future as a result 11 of the direct negligence performed upon his son and/or his contemporaneous 12 sensory perception of the above said negligence of above said public entity(ies) and 13 its/their agents and/or employees, and each of them, in the prenatal care and 14 birthing of his decedent son, Allen Fitch, Jr., including, but not limited to, past, 15 present and future medical and/or psychological expenses, past, present and future 16 wage loss, and general damages for severe emotional distress and pain and suffering. 17 e. The names of the public agents and/or public employees currently known to 18 claimants who proximately caused the injuries and damages to claimants, include but are 19 not limited to: 20 1. CONTRA COSTA COUNTY DEPARTMENT OF HEALTH 21 SERVICES; 22 2. CONTRA COSTA COUNTY HEALTH SERVICES, MERITHEW 23 MEMORIAL HOSPITAL; 24 3. CONTRA COSTA COUNTY HEALTH SERVICES, MERITHEW 25 MEMORIAL HOSPITAL AND CLINICS; 26 4. CONTRA COSTA COUNTY HEALTH SERVICES, MERITHEW 27 MEMORIAL HOSPITAL AND HEALTH CENTER; 28 5. CYNTHIA ASHBROOK, M.D.; UW OFFCES OF WILCOXEN,CAUAHAN MONTGOMERY R HARBISON 2114 K STFEET SACRAAENTO,CA V18 6 1 6. NANCY OWENS, M.D.; 2 7. MICHAEL VAN DUREN, M.D.; 3 8. ALVIN LIN, M.D.; 4 9. SHARON AMON, M.D.; 5 10. D. KENT HOBERT, M.D.; and 6 11. U. APSEN, R.N. 7 f. Claimants CYNTHIA and ALLEN have suffered separate and severe injuries 8 arising from the negligence of the above said public entity(ies) and its/their agents and/or 9 employees, in the birthing of their minor child, decedent Allen Fitch, Jr., which caused the 10 death of said minor child on June 6, 1992 and the above said separate and severe injuries 11 to the claimants. Therefore, the individual special and general damages claims of 12 CYNTHIA and ALLEN each are far in excess of $10,000 and are in excess of the 13 minimum jurisdiction of the Superior Court. 14 DATED: October/, 1992. WILCOXEN, CALLAHAN, MONTGOMERY & HARBISON 15 16 y Dani E. Wilcoxen 17 ck L. Hinrichsen 18 Attorneys for Claimants 19 swEL-r.DEw\GOVT.CLM 20 21 22 23 24 25 26 27 28 UW OFflOES OF w UMEN,CALLAHAN MONTGOMERY& HAMSON 7114 K STMET SKWMENM G 9` O 7 WILCOXEN , CALLAHAN , GARYON= A LAW CORPORATION MONTGOMERY & HARBISON J SH FOSEPPH F..HA RBISON,III PATRICK L.HINRICHSEN ATTORNEYS AT LAW JOANNE M.MERRY 2114 K STREET RICHARD F.MILLS LAW CORPORATION SACRAMENTO, CALIFORNIA 95816 JAMES R.MONTGOMERY (916) 442-2 777 SUSAN T.PATRONIK FAX (916) 442-4118p id1 DAVID E.SMITH ;Dj (,J�� DANIEL E.WILCOXEN* A LAW CORPORATION 'CERTIFIED SPECIALISTS IN CIVIL TRIAL ADVOCACY BY THE NATIONAL BOARD November 9, 1992 NOV 1 O low OF TRIAL ADVOCACY VIA CALIFORNIA OVERNIGHT CLERK BOARD OF SUPERVI CONTRA COSTA CO Clerk of the Board 651 Pine Street, Room 106 Martinez, California 94553 Re. Fitch/Sweet vs. Merrithew Memorial Hospita4 et al Greetings: Enclosed please find our CLAIM AGAINST PUBLIC ENTITY PURSUANT TO GOVT. CODE §910, (original and three copies) against the following defendants: CONTRA COSTA COUNTY; CONTRA COSTA COUNTY DEPARTMENT OF HEALTH SERVICES; CONTRA COSTA COUNTY HEALTH SERVICES, MERITHEW MEMORIAL HOSPITAL; CONTRA COSTA COUNTY HEALTH SERVICES, MERITHEW MEMORIAL HOSPITAL AND CLINICS; CONTRA COSTA COUNTY HEALTH SERVICES, MERITHEW MEMORIAL HOSPITAL AND HEALTH CENTER; CYNTHIA ASHBROOK, M.D.; NANCY OWENS, M.D.; MICHAEL VAN DUREN, M.D.; ALVIN LIN, M.D.; SHARON AMON, M.D.; D. KENT HOBERT, M.D.; and U. APSEN, R.N., Please lodge with your office and return a filed copy to our office in the enclosed envelope. If you should have any questions, please contact this office. Your cooperation in this matter is appreciated. Very truly yours, PATRICK L. HINRICHSEN PLH:aeb Enclosures g:\cases\s\sweet.dew\county.Itr 1 ..: CLAIM /.,30 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15, 1992 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $500,000.00 Section 913 and 915.4. Please note all "Warnin" CLAIMANT: HAIDICH, John NOV 17 1992 ATTORNEY: Gail A. Fritschle COUNTY COUNSEL Attorney at Law Date received MARTINEZ. CALIF, ADDRESS: 987 Moraga Road, Ste. A BY DELIVERY TO CLERK ON November 13, 1992 Lafayette, CA 94549 hand delivered BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. November-16, 1992 IL BATCHELOR, Clerk DATED: �: Deputy II. FROM: County Counsel TO: Clerk of the Board of Su ors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �I/. ,� U� /� /�/9 2 BY: /C- Deputy County Counsel I III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( �This-Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. r Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code se ' 913) Subject to certain exceptions, you have only six (6) months from the date this°notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 3 5 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator a 1 GAIL A. FRITSCHLE [RECEIVED Attorney at Law 2 987 Moraga Road, Suite A Lafayette, CA 94549 NOV 1 31992 3 (510) 283-3540 Io1vOa.M , Attorney for JOHN HAIDICH CLERK BOARD O SI;PERVISORS 4 Y CONTRA COSTA CO. 5 6 7 In the Matter of the Claim of CLAIM AGAINST A JOHN HAIDICH, PUBLIC ENTITY 8 (Gov. C. Sections Claimant, 905, 905,2, 910, 910.2, 9 911.2) VS. 10 COUNTY OF CONTRA COSTA 11 12 JOHN HAIDICH hereby presents this claim to the County of 13 Contra Costa pursuant to Section 910 of the California Government 14 Code. 15 1. The name and post office address of John Haidich is 2099 16 Geary Road, Walnut Creek, California 94596. 17 2. All notices regarding this claim are to be sent to: 18 Gail A. Fritschle 19 Attorney at Law 987 Moraga Road, Suite A 20 Lafayette, California 94549 21 3. This claim arises from the failure to provide adequate 22 medical treatment during Mr. HaidichIs incarceration at the Contra 23 Costa County Detention Facility in Martinez, California from March 24 24, 1992 through August 25, 1992. Such action resulted in Mr. 25 Haidich's being subjected to severe pain throughout his 26 incarceration as the Contra Costa County Health Services refused 27 to follow doctors' orders. 28 N 1 4. All such actions by the Contra Costa County Health 2 Services and defense detention facility were intentional for the 3 purpose of inflicting cruel and unusual punishment and resulted in 4 emotional distress. Such actions were in violation of the civil 5 rights of Mr. Haidich. 6 5. As a result of the violation of civil rights and of the 7 emotional distress suffered as a result of extreme pain, Mr. 8 Haidich has suffered damages in the amount of $500,000. 00. 9 6. The names of the public employees causing said damage are 10 unknown to claimant at present. 11 7. $500, 000.00. 12 13 DATED: November 13, 1992. 14 GAIL F ITSC 15 Attorney for Claimant JOHN HAIDICH 16 17 CASES\HAIDICH.CAP 18 19 20 21 22 23 24 25 26 27 28 e 1 GAIL A. FRITSCHLE Attorney at Law 2 987 Moraga Road, Suite A Lafayette, CA 94549 3 (510) 283-3540 4 Attorney for JOHN HAIDICH 5 6 7 In the Matter of the Claim of CLAIM AGAINST JOHN HAIDICH PUBLIC ENTITY 8 [Gov. C. Sections Claimant, 905, 905,2, 910, 910.2, 9 911.2] VS. 10 PROOF OF SERVICE COUNTY OF CONTRA COSTA 11 � 12 I, Gail A. Fritschle, say that I am a citizen of the United 13 States over 18 years of age, employed in the City of Lafayette, 14 Count of Contra Costa and not a Y party to the within action. My 15 address is 987 Moraga Road, Suite A, Lafayette, California 94549. 16 On November 13 1992 Iy personall served a CLAIM AGAINST A PUBLIC 17 ENTITY in the Matter of the Claim of JOHN HAIDICH VS. COUNTY OF 18 CONTRA COSTA on the Clerk of the Board of Contra Costa 19 Supervisors, 651 Pine Street, Martinez, California. 20 I declare under penalty of perjury at the 5e;goin/itrue 21 and correct. 22 GAIL A. FRiTSC1(L19 23 Attorney for Claimant JOHN HAIDICH 24 25 26 27 28 U `r` o � o o c� v o� v o-V-A v ms's' N � W c oU �o r- .._ �. ,,..... CLAIM 1. 30 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15, 1992 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: . $81.00 Section 913 and 915.4. Please note all "Warni WgIVED CLAIMANT: HELM, Robert NOV 17 1992 4300 Bemis Street ATTORNEY: Oakland„CA 94605 STN COUNSEL Date received IZ CALIF. ADDRESS: BY DELIVERY TO CLERK ON November 13, 1992 via Risk Mgmt BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, ppHH BATCHELOR, DATED: November- 16, 1992 Bl'il Clerk II. FROM: County Counsel TO: Clerk of the Board of Sup visors ( This claim complies substantially with Sections 910 and 910.2. h,4<( This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �0�`e'� U '� i I SZ. BY: Fee, uty County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrate (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (J�r This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk ell WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator i`IC J�tJ'•'ipL�i ADV Jo 1992 CONTRA COSTA COUNTY 4 MUNICIPAL RISK MANAGEMENT INSURANCE AUTHORITY 1911 SAN MIGUEL DRIVE • SUITE 200 • WALNUT CREEK,CA 94596 (510)943-1100 FAX(510)946-4183 November 10, 1992 �ECE'VE® Mr. Ron Harvey County Administrator Risk Management NOV 3 1992 751 Pine Street, 6th floor Martinez, CA 94553 CLERK BOP•FID OF SUPERVISORS CONTRA COSTA Co. RE: CLEiV&8NT: Robert rielm OUR PRINCIPAL: City of San Ramon DATE OF LOSS: 09/30/1992 Dear Mr. Harvey: Enclosed please find a copy of our claim file including the original claim filed by Mr. Helm along with additional information he provided at the request of the City. It would appear that the entire matter here revolves around a dispute Mr. Helm has with the Police Department. As we do not handle the claims against the County Sheriff's Department, I am sending this matter to your attention in hopes that you will take over the handling of this claim. Should you have any questions or need any assistance in any way, please feel free to contact me. Sincerely yours, Will Venski Liability Claims Adjuster WV:abw cc: Sandy-McPherson, City of San Ramon Enclosures • CONTRA CuSTA MUNICIPAL RISK MAi,AGEMENT LIABILITY/LOSS NOTICE FORM Use this form to report any incident or verified claim in which the city may be liable PERSONAL AND CONFIDENTIAL IN ANTICIPATION OF LITIGATION FROM: 501W ILA/W�^^-�(city or town( To: CONTRA COSTA COUNTY CITY CLAIM # y3,q,/L _ � ,• MUNICIPAL RISK MANAGEMENT policy yr. log number Insurance Authority 1911 San Miguel Drive, Suite 200 DATE & TIME OF LOSS Q ISO IG Z 91 `- 0 G-m Walnut Creek, CA 94596 DEPARTMENT LOCATION CODE _P_DLL S__JL Attn: Claims Manager (up to S letters) 'If one incident has multiple claimants, use same claim #, but add letter suffix and enter each in log, i.e.AL001(A). COMMENTS TO ADJUSTER 0C T 2 72' CLAIMANTANJURED'S NAME ADDRESS PHONE 4ba.� Hel/yA X300 &U.4-f ba.k� (A i'S10) 5V) - 136 CLAIMANT'S ATTORNEY ADDRESS PHONE NIS WITNESS NAME ADDRESS PHONE N f Iq CITY EMPLOYEE INVOLVED/CONTACT DEPARTMENT PHONE 5 LOCATION OF OCCURRENCE 561/K ✓ ''Wc• t - P X00-0 ------ DESCRIPTION OF OCCURRENCE/DAMAGE- POLICE/CHP CCURRENCE/DAMAGE POLICE/CHP REPORT# CITY VEHICLE/DRIVER # (or enter -none--) ENCLOSURES: VERIFIED CLAIM El POLICE REPORT PHOTOS (Check if incluoed) OTHER DATE b 2 SUBMrr TED BY PHONE NO.ZK-224 6 DISTRIBUTION: Original to Risk Mgmt.Office Br -LLN-7/88 CITY OF SAN RRMON TEL : 415-866-1436 Nov 02 ,92 11 :38 No .007 P .02 VIECE.1vto San Ramon OCT (/ V JJ Q 1992 CA LI /ORh-4 LSO ads '"OR,� c� o sAr�w�l+�ou 11VTEROFFICE MEMO Date: OCTOBER 21, 1992 To: City Manager, City Attorney, Personnel , Police Services From: City Clerk, Judy Macfarlane Attached is the following: Claim No, 043.92 Claimant ROBERT S. HELM 4300 BEMIS STREET OAKLAND, CA 94605 Date Received: OCTOBER 21 , 1992 NOTE. Appropriate department (department which is named in claim) to conduct an initial investigation and report to the Personnel Analyst within 15 calendar days from the date of this notice. \f0rms\C1Mf0rm. CITY OF SRN RRMON TEL : 415-855-1436 Nov 02 92 11 :38 NO .007 P .03 NOTICE OF CI.A.,_.A AGAINST THE CITY OF SAN R,,_'�ON, CALIFORNIA I (Government Code ss 910, 910.2) RETURN TO: City Clerk's Office City of San Ramon 2222 Camino Ramon San Ramon, CA 94583 CLAIMANT'S NAME: Robert S. Helm CLAIMANT'S ADDRESS: 4300 Bemis Street Number Street Oakland CA 94605 City State Zip Code CLAIVI LANT'S PHONE: 510-569-4307 , NAME AND ADDRESS OF PERSON TO WHOM NOTICES REGARDING THIS CLAIM SHOULD BE SENT (if different than above): Same as above DATE OF THE ACCIDENT OR OCCURRENCE: September 30, 1992 TIME OF THE ACCIDENT OR OCCURRENCE: 9:50 AM PLACE OF THE ACCIDENT OR OCCURRENCE: San Ramon Valley Blvd & Purdue Road San Ramon, CX GENERAL DESCRIPTION OF THE ACCIDENT OR OCCURRENCE(attach additional pages if more space is needed): San Ramon Police Department issued Citation A 25-956771 for violation of CVC 25000 and Citation # 25-113978-1 for violation of CVC 51-A and caused the ve c e to be towed y San Ramon Tow. NAMES, IF KNOWN, OR ANY PUBLIC EMPLOYEES CAUSING THE INJURY OR LOSS: San Ramon Police Department-Officer Olivera and Office Riley NAMES AND ADDRESS OF WITNESSES: NAME ADDRESS TELEPHONE 1. 2. NAMES AND ADDRESS OF DOCTORS, HOSPITALS WHERE TREATED: NAME ADDRESS TELEPHONE 1. 2. CITY OF SAN RRMON TEL : 415-856-1436 Nov 02 , 92 11 :38 N0 .007 P . 04 GENERAL DESCRIPTION OF THE LOSS, INJURY OR DAMAGED SUFFERED: Towing S nr ga charggs_ TO'T'AL AMOUNT CLAIMED: 81.00 THE BASIS OF COMPUTING THE TOTAL AMOUNT CLAIMED IS AS FOLLOWS: Damages incurred to date: Expenses for medical hospital care: $ , Loss of earnings: $ Special dama es for: Towing and .9 0 age charges $ 91.00 Generai Damages Estimated prospective damages as far as known Future expenses for medical and hospital care: S Future loss of earnings: $ Other prospective special damages: S Prospective general damages: S I/We, the undersigned, declare under penalty of perjury that I/we have read the foregoing claim for damages and know the contents thereof,, that the same is true of my/our own knowledge and belief, save and expect as to those matters wherein stated on information and belief, and as to them, I/we believe it to be true. DATED: sem --21, 1952 '• SIGNATURE OF CLAIMANT(S) Received in the City Clerk's Office this c-*2� day of 1992. SIGNA RE FOR CLAIMS RELATING TO INJURY TO PERSON OR PERSONAL PROPERTY, THIS FORM MUST BE FILED WITH THE CITY OF SAN RAMON WITHIN SIX MONTHS FROM THE ACCRUAL OF THE CAUSE OF ACTION. A CLAIM RELATING TO ANY OTHER CAUSE OF ACTION SHALL BE PRESENTED NO LATER THAN ONE YEAR AFTER ACCRUAL OF THE CAUSE OF ACTION. C.rorms\claim. 2 s CITY OF SRN RRMON TEL : 415-866-1436 NOV 02 92 11 :38 NO .007 P .05 October 28, 1992 City Clerk's Office City of San Ramon 2222 Camino Ramon San Ramon, CA 94583 Additional information requested by the City Clerk's Office on Claim Against the City of San Ramon by Robert S. Helm; Citation # 25-956771 was issued for violation of CVC 25000 which concerns Prohibited Stopping, Standing or Parking. CVC 25000 has 12 subsections; there is no reference to any subsection as to the reason for the citation. Citation # 25-113978-1 was issued for violation CVC 10751-A for no visible Vehicle Identification Number. The facts are that no visible Vehicle Identification Number is required on vehicles manufactured prior to 1968. The vehicle that was cited was 1964 Cadillac. The sign prohibiting parking in the area from which the vehicle was towed was improperly placed by an employee of R. M. Harris Company, General Contractors. The sign was placed facing the roadway rather than facing traffic. I did not see the sign when I parked the vehicle. Less than 24 hours after the vehicle was towed the sign facing the roadway was replaced with a sign facing traffic. There was no notice on the sign warning that vehicles cited in that area would be subject to being towed. I am filing this claim because I believe the vehicle should not have been towed. Robert S. Helm CITY OF SRN RRMON TES. : 415-866-1436 Nov 02 ,92 11 :38 No .007 F .05 SAN RON TOW 32-A Court ' SAN RAM4N, LtfORN1a 94583 (415) 820-6304 ,-' (80Q) 747.8894 TIME {q l +.� A.M. AEOUESr PM O 0CATION OF 41,11c iRckE ADDAE55 bP MILEAGE IRERVICE TIME EXTRA PERSC ,M + FINISH ... j,ws* — •*' ' FINISH ._ START . • START START TOTAL _ TOTAL _ TOTAL, YEAR MAKE t yo M ' OPIVER 9TONO. U -t6 PECIAL EQUIPMENT ❑ SLINGIMOIST TOW Q FLAT ❑ SINGLE LINE WINCNI WHEEL LIFT Q OUT OF GAS © DUAL LINE WINCH FLAT BED/RAMP Cl WRECK Q SNATCH kQCKS START ❑ RECOVERY ❑ SCOTCH BLOCKS Cl DOLLY LOCK OUT I /❑ c tL3EDT I S.f� G C.ti ARKS M 11.9AI E CKAAGB PaJ 7o�lw0 CHARGE A 011 CHUCIS ��4 -4 °; E r � ' I OPERATDA'3316NATURE TOTAL L I Q TOTAL, � — tUTNONfYEp 310NATURE 20734 road service, �OGUGT ell2�A�j+ne,Waa.Ye 4af TeuaevwoR[t�tl R,EE biOF>gtC11 •-�+ t CLAIM 1. 3o BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY,' CALIFORNIA Y Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15, 1992 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $500,000.00 Section 913 and 915.4. Please note all "Warninget<fJVED CLAIMANT: KREPLIN, Robert Charles NOV 17 1992 ATTORNEY: Gail A. Fritschle COUNTY COUNSEL Attorney at Law Date received MARTINEZ, GAU& ADDRESS: 987 Moraga Road, Suite A BY DELIVERY TO CLERK ON November 13, 1992 Lafayette, CA 94549 hand delivered BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: November 16, .1992 �aIL DeputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Sup isors ( vJ This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days. (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: /(��- �.�i /� l S 9Z BY: _ �< Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code secion 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warnina See reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator fl REC 1 GAIL A. FRITSCHLE Attorney at Law NOV 1 ;j ;�y2 2 987 Moraga Road, Suite A Lafayette, CA 94549 idiSO u• �►" ' 3 (510) 2 8 3-3 54 0 CLERK BOA'rtC°C,r SUPERVISORS C!1fVTR,7 COSTA Co. 4 Attorney for ROBERT CHARLES KREPLIN 5 6 7 In the Matter of the Claim of CLAIM AGAINST A ROBERT CHARLES KREPLIN, PUBLIC ENTITY 8 (Gov. C. Sections Claimant, 905, 905,2, 910, 910.2, 9 911.2] VS. 10 COUNTY OF CONTRA COSTA 11 / 12 ROBERT CHARLES KREPLIN hereby presents this claim to the 13 County of Contra Costa pursuant to Section 910 of the California 14 Government Code. 15 1. The name and post office address of Robert Charles 16 Kreplin is 4120 Kuhnle Avenue, Oakland, California 94605. 17 2 . All notices regarding this claim are to be sent to: 18 Gail A. Fritschle 19 Attorney at Law 987 Moraga Road, Suite A 20 Lafayette, California 94549 21 3 . This claim arises from the failure to administer 22 methadone to Robert Charles Kreplin in the amount of 90 milligrams 23 per day as ordered by Judge Richard Arneson by Order dated March 24 31, 1992. Following receipt of that Order, the Contra Costa County 25 Detention Facility and Health Care Services refused to provide the 26 doses so ordered. 27 4 . All such actions by the Contra Costa County Health 28 i 1 Services and defense detention facility were intentional for the 2 purpose of inflicting cruel and unusual punishment and resulted in 3 emotional distress. Such actions were in violation of the civil 4 rights of Mr. Kreplin. 5 5. As a result of the violation of Mr. Kreplin's civil 6 rights and of the increased pain and emotional distress and as a 7 result of the physical damages incurred as a result of the 8 withdrawal of methadone, Mr. Kreplin has suffered damages in the 9 amount of $500,000.00. 10 6. The names of the public employees causing said damage are 11 unknown to claimant at present. 12 7• $500, 000.00. 13 14 DATED: November 13, 1992. 15 FRITSCAft 16 Attorney for Claimant ROBERT CHARLES KREPLIN 17 18 CASESWREPLIN.CAP 19 20 21 22 23 24 25 26 27 28 1 GAIL A. FRITSCHLE Attorney at Law 2 987 Moraga Road, Suite A Lafayette, CA 94549 3 (510) 283-3540 4 Attorney for ROBERT CHARLES KREPLIN 5 6 7 In the Matter of the Claim of CLAIM AGAINST ROBERT CHARLES KREPLIN, PUBLIC ENTITY 8 [Gov. C. Sections Claimant, 905, 905,2, 910, 910.2, 9 911.2] VS. 10 PROOF OF SERVICE COUNTY OF CONTRA COSTA 11 12 I, Gail A. Fritschle, say that I am a citizen of the United 13 States over 18 years of age, employed in the City of Lafayette, 14 County of Contra Costa, and not a party to the within action. My 15 address is 987 Moraga Road, Suite A, Lafayette, California 94549. 16 On November 13, 1992, I personally served a CLAIM AGAINST A PUBLIC 17 ENTITY in the Matter of the Claim of ROBERT CHARLES KREPLIN VS. 18 COUNTY OF CONTRA COSTA on the Clerk of the Board of Contra Costa 19 Supervisors, 651 Pine Street, Martinez, California. 20 I declare under penalty of perjury t the fo a ing is ue 21 and correct. 22 GAIL . FR TSCHLE 23 Attorney for Claimant ROBERT CHARLES KREPLIN 24 25 26 27 28 O ttz r-� �� w� ,�o N� d, o v, o o�' V o� �� �� ��� N N p � �,,.� � �A¢' � �d' � �td ti v��,q� � + W � � ,,,,), � a � rn N @ 3 G �'` r �0 0 � � � .� ,F\ w� �U � �p � d �' O N r� ,� N t'- ��6 /. 9 CLAIM DEC 011992 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD AM" 4" the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15 , 1992 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board,of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $260 . 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MARTIN, Jess #22442 S.D.C.C. P.O. Box 208 ATTORNEY: Indian Springs , NV 89070 Date received ADDRESS: BY DELIVERY TO CLERK ON November 30 , 1992 (Via Counsel ) BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ,,qDATED: December 1 , 1992 JyIL Bep�HtyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Su visors ( ✓) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �.�-e�..�. f , 1 %y Z BY; Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) _Claim was returned as-untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By . Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this-notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service i,n Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant. addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator ►I CONFIDENTIAL COUNTY COUNSEL'S OFFICE CONTRA COSTA COUNTY MARTINEZ, CALIFORNIA > ;`; RECEIVED i MEMORANDUM ' NOV3 0 IV -LERK BOARL'OF SUPERVISORS Date: November 30, 1992 CGNTRACOSTA_LO_ To: Clerk of the Board FROM: Greg Harvey, Deputy County Counsel R$: Claim of JESS MARTIN Attached is a claim for damages against the County of Contra Costa. Please treat as a claim. I I i Mi."A q 5 p r,.44 s /Yep ` CONTRA COSTA. CY'� DETENTION FACILITY ( ) INMATE REQUEST FOR INFORMATION --- 1— MEDICAL REQUEST ' j r To: i£i i f'1 4� A 1:A/to%! From: � `�< r3-', � 8 Bkg# G►1d (DOB) . j �`Date:• /s .%:� ../-R.�,-�Housing,.Assignment;. :_, eVoz P. Check One: ( ) Request S<Grievance ( ) Appeal ( ) Other Request: WAS. � �¢�'.� �l/� �c� ��� ,�3 5 t��`� ��•�� S!`ir� r,� �.,�t,/'� ��'Dov /2� �..°r�+.�'� Wo r- i�t�'�d ©/� C� :�.�'��_',. i;,�Cis'?,a �� /{� e�C°i•�� , s Date Rd-63 Routed-To. - - - ANSWER: ( ) APPROVED ( )DENIED-(state reason] .. �-1�V, A17A�" -t �f�� Ale el r 01%d ii h M. i rlAw By: Date: / j ........,. Pink:Kept by Inmate Yellow:Reply.to Inmate White:To Booking DET 024:FRM 1/2/91 - - ��,�sa`�t ��u�:�` .d a �..✓r�,.�o.., f�v 6.e��mY� -n �C.a / IV .t,-.9 & COSTA COUNTY TENTION FACILITY ( ) IEQUEST FOR INFORMATION ,,{ ) MEDICAL REQUEST To: �' From: =! rs' ,S, AIAki f J4f g # 9aZc 27/ 7. (DOB) Date: Housing Assignment- Check-One:~`*. ('-' ) Request �><<Grievance' ( ) Appeal. ( . ) Other z . Request: WA ¢'fiy/'AE:. 1,1, 174' ?5: /ltirf; S,-e, 1.,e2AJ _/ 3Ti _3,4 Jam!Avw 1-)i4 /w y� 4.0 ivy .r'f.w /:/v )K r cc,, e S It-& ` � f Date Rec'dl-�y— —7—We ds6 . Routed To:""Y°"""""",""___� __ ____ ANSWER: ( ) APPROVED, ( ) DENIED-(state reason) r xC4 A ,0 a 0 P_ ,y A44 t .•,Y eJ,14 J 3 ff A) C Com' , er x- --2,6 lPr By: A5 ".._. f,�664 I/ Date: Pink:Kept by Inmate Yelle'w:Reply fo Inmate White:To Booking DET 024:FRM 1/2/91 - - 7% ILt CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA N 0 V N4. 139 Claim Against the County, or District governed by) BOARD AC 'r ouN,� the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15, 11%,92 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $422.60 or $326.60 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PEERSON, Ray 225 - 4th Street ATTORNEY: Rodeo, CA 94572 Date received ADDRESS: BY DELIVERY TO CLERK ON November 18, 1992 BY MAIL POSTMARKED: November 17, 1992 I. FROM: Clerk of the Board of Supervisors TO: County'Counsel' Attached is a copy of the above-noted claim. j�.Z . DATED: November 24, 1992 IVIL BATTCHELOR, Cler;kty II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( �) This claim complies substantially with Sections 910 and 910.2. ( _ ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so 'notifying claimant.. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 11-7 BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (Y) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 1 5 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection. with this matter. If you want to consult an attorney, you should do so immediately. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: D E C 15 1992 BY: PHIL BATCHELOR by Deputy'Clerk CC: County Counsel County Administrator -Claim to: - -BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT f. A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 19879 x must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and Which accrue on ora ter January 1, 1988, mist be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 1069 County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this orm. ' aeeae � � ee * aaeeafeaaes � ,� eaa � a * eeaeeeeeaa � � ea RE: Claim By ) Reserved for Clerk's filing stamp ) DECEIVE® Against the County of Contra Costa ). NOV 1 81992 or ) CLERK BOARD OF SUPERVISORS District) CONTRA COSTA CO. Fill in name ) The undersigned claimant hereby makes claim against Ae County of Contra Costa or the above-named District in the sum of $ .22.60 a2 2L.G 0 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 922 .zd2 992- 2. . Where did the damage or injury occur? (Include city and county) � �� Ccu r� Cis�.� C'Q t �� 7 z 3. How did the damage or injury occur? (Give full details; use extra paper if required) w4.s �'� a v 2 4-7 7WZ ColN&2OF / r � 7� S��-�-1 Ail ------------------ -- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? APP6A29-.0 7'e .99 6-ae-i c 7th A;a,s �.2o��v D 710 ' eo/2ti,�5-12 WIdILF AIC- c)a-S o u&2 14F76;,z i✓S- CA,--C, (over) ti E 5. What are the names of county or district officers, servants or employees causing the damage or injury? BAD 6'& ' 3 9Z_-------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7W Ay 73 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors and hospitals. _ JX)4_Y v 6 WWZZ*C�5 AZ L19 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must bej,'ignedjby the claimant SEND NOTICES TO: (Attorney) or some person on his behalf." Name and Address of Attorneyce a ' Claimant's Signature .2 X1-71 , Address Telephone No. Telephone No. S70- r11'�Z7 S�1 NOTICE Y Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and' fine. :: • �V1a 0-Auto *.�d. . . DOMESTIC EXPERT BODY REPAIRS FOREIGN 686 PARKER AVENUE�e RODEO, CA 94572 RESTORATIONS (415) 7gg-0606 (a speciality) y C�j e Date Car Owner �' t° / J4/Ao1 Address .9--S q Home Phone MakeYear �License No. T, b Mileage Business Phone Sy FRONT Hours Labor Parts S LEFT labor Parts S RIGHT Hour Parts Hy Hours Y Bumper __ Fender-_ Fender Frame -- HeadUmp --.__------ --- Headlamp Fri System -- — —--------— ---- - .— 'Co„„I --------------- --- Cowl Door Fri Door Fri Glass — ------ _— . Fri Panel Door Rear ---- Door Rear •me .— _ P.drk..lamp:l,2`h.+9+`�+t ^tWea..4 r v,.,,:-•e'4ft ., .+_.., tI .5'1 ;}.. ,t., rx �.�;.� +. t. '.S . y. ouar Panel ---(: Ouar Panel Grill ri— ,f Hood Rear gentler Rear Fender misc. REAR Bumper To Rad Sur, I ,J''r Undercoat Rear Panel f Trunk Lid /Paint a/ d Tail lamp AUTHORIZATION FOR REPAIRS Moloy You are hereby authorized to make the above speci• tied repair Signed fl'(J� s Labor, 16 Hrs. Parts S Wrecker Service $ This estimate.based on our inspection.does not include any additional parts or labor,that may be required after the Tax $ work has been started.Occasionally,after work has been started,damaged or broken parts.are found which were not Sublet E a evident on the first inspection.Because of this,the prices quoted herewith are not guaranteed. PARTS PRICES $ Terms are C.O.D.Payment in full due on delivery.Storage charges will begin to accrue immediately after completion of work. auR�ECT To CHANGE TOTAL a telephone: r' 550 sen pablo avenue (510) 799-4135 puuiq rodeo, california 94572 OWNER f J�j/�) PHONE-7 r o/ /� ( DATE / ~h ACC. DATE ADDRESS AGENT INSURANCE CO. PHONE / MILEAGE I.D. NUMBER LICENSE NO. `/ / 9 f A I t YEAR MAKE • MODEL • BODY TYPE • --r-ESTIMATED BY FRONT LABOR HRS. PARTS LEFT LABOR HRS. PARTS RIGHT LABOR HRS. PARTS MISCELLANEOUS LABORS. PARTS Bumper Fender Frt. Fender Frt. Bumper Gd. Fender Shield Fender Shield Brkt. Fender Midg. Fender Midg. Frame Headlamp Headlamp Cross Member Headlamp Door Headlamp Door Frt.System Sealed Beam Sealed Beam Wheel Park.Light Park.Light Hub Cap Disc. Cowl-Dash Cowl-Dash Hub S Drum Windshield TINT Windshield Midg. Knuckle Door,Front Door,Front Knuckle Sup. Door Hinge Door Hinge Lr.Cont.ArmDoor Glass TINT R Door Glass CLEAR TINT Up.Cont.Arm Vent Glass TILNTR Vent Glass TINTR Gravel Shield Door Midg. Door Midg. Steering Gear Door Handle Door Handle Steering Wheel Center Post .Center Post Horn Ring Door Rear Door Rear Rad.Grille .Glass TINT Door Glass TINTR Door Midg. Door Midg. Rocker Panel Rocker Panel Rocker Midg. Rocker Mldg. FLOOR&W/HSG. FLOOR&W/HSG. Quar.Panel Quar.Panel Fender REPAIR Fender. REPAIR PANEL PANEL Quar.Ext. Quar.Ext. Quar.Midg. Quar.Midg. Tail Light Tail Light Hood Top Hood Hinge . Hood Midg. REAR MISCELLANEOUS Ornament-Emb. Bumper Front Seat.Ad(. Lock Plate,Up. Bumper Gd. Top Lock Plate,Lr. Bumper Brkt. Aerial Horn Gravel Shield Tire/32. TREAD WN LEFT / Rad.Sup. Frame Paint•% C 1 Rad.Core Gas Tank Undercoat �f r Anti-Freeze Tail Pipe t i�k Rad.Hoses Lower Panel s ! t) Labor Hours @Gr�©(o $ Fan Blade-Belt Floor Water Pump,Pulley Trunk Lid Parts Less Disc. $ Q Motor Mts. Trunk Midg. Sublet&Net Items $ Trans.Link Wheel Hub&Drum Axle Towing $ Sales Tax $ „ 6 0 Total $ A-Align N-New OH-Overhaul S-Straighten or Repair EX-Exchange RC-Rechrome U•For Used Parts Signed: ESTIMATE EXPIRES 30 DAYS FROM DATE � � 1 .l i M d 40 M w R � M `o N Yn � NO ' my c _ CLAIM 1.30 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER-1 ,_1992�---, and Board Action. All Section references are to The copy of this document mailed to you.-ts your notice of California Government Codes. ) the action taken on your claim by the/Board of Supervisors (Paragraph IV below), given pursuant to Governmerolke m Amount: $5,000,000.00 Section 913 and 915.4. Please note all "Warnings" CLAIMANT: ROEMER, Brandon NOV I? 1992 SKINNER, Stacy COUNTY COUNSEL ATTORNEY: MARTIN94�P" Kevin L. Domecus, Esq. , Law Offices of Walkup, Shelby, Date received ADDRESS: Bastian, Melodia, Kelly, BY DELIVERY TO CLERK!ON November 10, 1992 (certified) Escheverria & Link November 9, 1992 650 California St. , 30th Floor_ BY MAIL POSTMARKED: San Francisco, CA 94108 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pH Bg DATED: November--16, 1992 JVIL DeputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of SaRerov6rs (✓) This claim complies substantially with Sections 910 and 910.2. ( . ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days. (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �11 Cwc /� l�l Z- BY: / Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD 0 DER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:—[)EG 15 1992 PHIL BATCHELOR, Clerk, By. ,Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR by 2&Zma== Deputy Clerk 17 CC: County Counsel County Administrator CONFIDENTIAL COUNTY COUNSEL'S OFFICEr CONTRA COSTA COUNTYF ECEIVE® MARTINEZ, CALIFORNIA OV 1 81992 MEMORANDUM pARD OF SUPERVISORS CONTRA COSTA CO. Date: November 13, 1992 TO: Clerk of the Board, Jeanne Maglio FROM: Victor J. Westman, County Counsel By: Gregory C. Harvey, Deputy County Counsel RE: Claim of Stacy Skinner and Brandon Roemer Attached is a claim for damages sent to Merrithew Memorial Hospital on behalf of Stacy Skinner and Brandon Roemer. aSiT.+ NOV 13 1992 errithew4 �;,� emorial ©�P�4Lad AND CLINICS November 10, 1992 Office of County Counsel Contra Costa County CLAIM Stacy Skinner and Brandon Roemer MR# 28-66-14-3 &57-28-75-3 The attached claim for the above named patients was received by Certified Mail by Merrithew Memorial Hospial on 11/10/92. Mark Finucane Health Services Director cla enc. xc: Ron Harvey Contra Costa County ° ---------- A-301A c-SK�A-301A (3/87) i • � LAW OFFICES OF BRUCE WALKUP' WALKUP, SHELBY, BASTIAN, MELODIA, GEORGE J.SHELBY RALPH W. BASTIAN,JR. KELLY, ECHEVERRIA & LINK PAUL V. MELODIA A PROFESSIONAL CORPORATION TELEPHONE DANIEL J.KELLY JOHN ECHEVERRIA 650 CALIFORNIA STREET, 30TH FLOOR (415)981- 210 JOHN D.LINK SAN FRANCISCO,CALIFORNIA 94108 FACSIMILE RICHARD B.GOETHALS,JR. (415)391-6965 RONALD H.WEC HT MICHAEL A.KELLY ,KEVIN L.DOMECUS - JEFFREY P. HOLL DANIEL DELCOSSO MARY E.ELLIOT RICHARD H.SCHOENSERGER November 9, 1992 OF COUNSEL CYNTHIA F. NEWTON WESLEY SOKOLOSKY,M.D.,J.D. ANN M.RICHARDSON Merrithew Memorial Hospital ICERTIFIED MAIL 2500 Alhambra Avenue Martinez, CA 94553 Re: Claim of Brandon Roemer and Stacy Skinner Dear Sir or Madam: Enclosed please find an original and one copy of Claim for Damages against Contra Costa County and Merrithew Memorial Hospital. Please acknowledge receipt on the enclosed copy and return to us in the envelope provided. Thank you for your cooperation. Very truly yours, KEVIN L. DOMECUS KLD:jw Enclosure i J, RECEIVEDWALKUP, SHELBY, BASTIAN, MELODIA, KELLY, ECHEVERRIA & LINK NW i 8 ow 650 California St. , 30th Floor ���Y San Francisco, CA 94108 Telephone• 415-981-7210 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. .Attorneys for Claimants CLAIM FOR DAMAGES AGAINST CONTRA COSTA COUNTY AND MERRITHEW MEMORIAL HOSPITAL TO: Board of Supervisors Contra Costa County 651 Pine Street, Rm. 106 Martinez, CA 94553 Merrithew Memorial Hospital 2500 Alhambra Avenue Martinez, CA 94553 The following claim is hereby made by and on behalf of BRANDON ROEMER and STACY SKINNER against CONTRA COSTA COUNTY and MERRITHEW MEMORIAL HOSPITAL. A. NAME AND POST OFFICE ADDRESS OF CLAIMANTS Stacy Skinner Brandon Roemer 225 Green, Apt. #5 Martinez, CA 94553 B. ADDRESS TO WHICH NOTICES ARE TO BE SENT Kevin L. Domecus Walkup, Shelby, Bastian, Melodia, Kelly, Echeverria & Link 650 California Street, 30th Floor San Francisco, CA 94108 C. AMOUNT OF CLAIM $5, 000, 000.00 : D. DATES OF OCCURRENCE May 26-27, 1992 E. PLACE OF OCCURRENCE Merrithew Memorial Hospital Claim For Damages November 9, 1992 Page 2 F. OTHER CIRCUMSTANCES OF OCCURRENCE The claimant Stacy Skinner was admitted to Merrithew Memorial Hospital on or about May 26, 1992, for induction of labor and the birth of her child. The claimant Stacy Skinner had. also been followed for her prenatal care by physicians at the Merrithew Memorial Hospital. During the prenatal period, the claimant had seizures and other complications. During the delivery process, the claimant was Ipoorly monitored, inappropriately medicated, and the delivery was unnecessarily delayed. The improper care during both the prenatal and delivery process resulted in the claimant Brandon Roemer being born with severe neurological deficits on May 27, 1992 . His injuries were the direct result of the negligence . and unauthorized acts of medical personnel at Merrithew Memorial Hospital. G. ITEMIZATION OF INJURIES AND DAMAGES TO CLAIMANTS The claimant Stacy Skinner suffered severe emotional distress and other injuries as a result of the delay in delivery and her observations of the severe injuries to her son. The claimant Brandon Roemer has suffered severe neurologic deficits, possible intracranial bleeding, and other injuries presently undiagnosed. H. ECONOMIC LOSSES Medical bills and loss of earnings are unascertained at present. I. EMPLOYEES CAUSING INJURY AND DAMAGE The names of all of the employees of said public entity responsible for the occurrence herein described are unknown to claimants at this time. i DATED: ��-� ,Cj Z WALKUP, SHELBY, BASTIAN, MELODIA, KELLY, ECHEVERRIA & LINK KEVIN L. DOMECUS Attorneys for Claimants i wrarava�aa�va cv a n.l • —4 P4 W H pqa P4 EA 0 x a� Ln LO .jj •rq >LLO >4 KV C3 0 cc N rr' N co •-) a •� •A � 04-) s4 o P a) Ln as N " � a 0 w Y , 10, wK 8 � zZ : a cu Q. Z LLa < ow 0g � o uQ Wg a M > � F U o � Wo a 0 g w w o W > LL WtD a Y . N Q WALKUP, SHELBY, BASTIAN, MELODIA, RECEIVED KELLY, ECHEVERRIA & LINK ® 650 California St. , 30th Floor NOV 1 O 1992 San Francisco, CA 94108 Telephone: 415-981-7210 CLERK BOARD OF SUPERVISOR Attorneys for Claimants CONTRA COSTA CO. � CLAIM FOR DAMAGES AGAINST CONTRA COSTA COUNTY AND MERRITHEW MEMORIAL HOSPITAL TO: Board of Supervisors Contra Costa County 651 Pine Street, Rm. 106 Martinez, CA 94553 Merrithew Memorial Hospital 2500 Alhambra Avenue Martinez, CA 94553 The following claim is hereby made by and on behalf of BRANDON ROEMER and STACY SKINNER against CONTRA COSTA COUNTY and MERRITHEW MEMORIAL HOSPITAL. A. NAME AND POST OFFICE ADDRESS OF CLAIMANTS Stacy Skinner Brandon Roemer 225 Green, Apt. #5 Martinez, CA 94553 B. ADDRESS TO WHICH NOTICES ARE TO BE SENT Kevin L. Domecus Walkup, Shelby, Bastian, Melodia, Kelly, Echeverria & Link 650 California Street, 30th Floor San Francisco, CA 94108 C. AMOUNT OF CLAIM $5, 000, 000.00 : D. DATES OF OCCURRENCE May 26-27, 1992 E. PLACE OF OCCURRENCE Merrithew Memorial Hospital Claim For Damages November 9, 1992 Page 2 F. OTHER CIRCUMSTANCES OF OCCURRENCE The claimant Stacy Skinner was admitted to Merrithew Memorial Hospital on or about May 26, 1992 , for induction of labor and the birth of her child. The claimant Stacy Skinner had, also been followed for her prenatal care by physicians' at the Merrithew Memorial Hospital. During the prenatal period, the claimant had seizures and other complications. During the delivery process, the claimant was poorly monitored, inappropriately medicated, and the delivery was unnecessarily delayed. The improper care during both.. the prenatal and delivery process resulted in the claimant Brandon Roemer being born with severe neurological deficits on May 27, 1992 . His injuries were the direct result of the negligence and unauthorized acts of medical personnel at Merrithew Memorial Hospital. G. ITEMIZATION OF INJURIES AND DAMAGES TO CLAIMANTS The claimant Stacy Skinner suffered severe emotional distress and other injuries as a result of the delay in delivery and her observations of the severe injuries to her son. ' The claimant Brandon Roemer has suffered severe neurologic deficits, possible intracranial bleeding, and other injuries presently undiagnosed. H. ECONOMIC LOSSES Medical bills and loss of earnings are unascertained at present. I. EMPLOYEES CAUSING INJURY AND DAMAGE The names of all of the employees of said public entity responsible for the occurrence herein described are unknown to claimants at this time. DATED: WALKUP, SHELBY, BASTIAN, MELODIA, KELLY, ECHEVERRIA & LINK KEVIN L. DOMECUS Attorneys for Claimants LAW OFFICES OF BRUCE WALKUP WALKUP, SHELBY, BASTIAN, MELODIA, GEORGE J.SHELBY RALPH W. BASTIAN,JR. KELLY, ECHEVERRIA & LINK PAUL V. MELODIA A PROFESSIONAL CORPORATI rELEPHONE DANIEL J.KELLY psp p JOHN ECHEVERRIA 650 CALIFORNIA STREET, 301F:L'00 ®3�mg7 IgJVED ( 15)981-7210 JOHN D.LINK SAN FRANCISCO,CALIFORNIA941c 19 FACSIMILE RICHARD B.GOETHALS,JR, RONALD H.WECHT - (45)391-6965 MICHAEL A.KELLY NOV 10 1992 KEVIN L.DOMECUS JEFFREY P. HOLL DANIEL DELL'OSSO MARY E.ELLIOT CLERK BOARD OF SUPERVISORS RICHARD H.SCHOENBERGER _ CONTRA COSTA CO. __..JOFCOUNSEL CYNTHIA F. NEWTON November 9, 1 WESLEY SOKOLOSKY,M.D.,J.D. ANN M.RICHARDSON i Board of Supervisors CERTIFIED MAIL Contra Costa County 651 Pine Street, Rm. 106 j Martinez, CA 94553 Re: Claim of Brandon Roemer and Stacy Skinner Dear Sir or Madam: Enclosed please find an original and one copy of Claim for Damages against Contra Costa County and Merrithew Memorial Hospital. Please acknowledge receipt on the enclosed copy and return to us in the envelope provided. Thank you for your cooperation. Very truly yours, KEVIN L. DOMECUS KLD:jw Enclosure I r j I sroa��v.m�a,�a� }4S ' N q ;o E-4 `t a M ni N r. Lf) 'J 0 41 ON Er rte• N t�J� U En O ca O V N e� cd •� b4 p 4j a � 0r-4 ).4 0 0 to D � o W Z 10, C\l et O Lu U _( Z ti Z.� 9 P Z Q CO� Q Q M 0 '` 0U F. O 3 > = s ¢ O mCr f� u Z g = W o Z U? LL J ` � = w to a Y N 4 } y errithew Iemorial C,).pY p�4CQL AND CLINICS R CEI E Nov I 0 1992 November 10, 1992 BOARD OF SUPERVISORS CONTRA COSTA CO. Office of County Counsel Contra Costa County CLAIM Stacy Skinner and Brandon Roemer MR# 28-66-14-3 &57-28-75-3 The attached claim for the above named patients was received by Certified Mail by Merrithew Memorial Hospital on 11/10/92. Mark Finucane Health Services Director cla enc. xc: Ron Harvey ' °/ Contra Costa CoG LAW OFFICES OF BRUCE WALKUP WALKUP, SHELBY, BASTIAN, MELODIA, GEORGE J.SHELBY RALPH W. BASTIAN,JR. KELLY. ECHEVERRIA & LINK PAUL V. MELODIA DANIEL J.KELLY A PROFESSIONAL CORPORATION TELEPHONE JOHN ECHEVERRIA 650 CALIFORNIA STREET, 30TH FLOOR (415)981-7210 JOHN D.LINK RICHARD B.GOETHALS,JR. SAN FRANCISCO,CALIFORNIA 94108 FACSIMILE RONALD H.WECHT (415)391=6965 MICHAEL A.KELLY KEVIN L,DOM ECUS JEFFREY P. HOLL DANIEL DELL'OSSO MARY E.ELLIOT RICHARD H.SCHOENBERGER OF COUNSEL CYNTHIA P. NEWTON November 9, 1992 WESLEY SOKOLOSKY,M.D.,J,D, ANN M.RICHARDSON Merrithew Memorial Hospital CERTIFIED MAIL 2500 Alhambra Avenue Martinez, CA 94553 Re: Claim of Brandon Roemer and Stacy Skinner Dear Sir or Madam: Enclosed please find an original and one copy of Claim for Damages against Contra Costa County and Merrithew Memorial Hospital. Please acknowledge receipt on the enclosed copy and return to us in the envelope provided. Thank you for your cooperation. Very truly yours, KEVIN L. DOMECUS KLD: jw Enclosure l , WALKUP, SHELBY, BASTIAN, MELODIA, KELLY, ECHEVERRIA & LINK 650 California St. , 30th Floor San Francisco, CA 94108 Telephone: 415-981-7210 Attorneys for Claimants CLAIM FOR DAMAGES AGAINST CONTRA COSTA COUNTY AND MERRITHEN MEMORIAL HOSPITAL TO: Board of Supervisors Contra Costa County 651 Pine Street, Rm. 106 Martinez, CA 94553 Merrithew Memorial Hospital 2500 Alhambra Avenue Martinez, CA 94553 The following claim is hereby made by and on behalf of BRANDON ROEMER and STACY SKINNER against CONTRA COSTA COUNTY and MERRITHEW MEMORIAL HOSPITAL. A. NAME AND POST OFFICE ADDRESS OF CLAIMANTS Stacy Skinner Brandon Roemer 225 Green, Apt. #5 Martinez, CA 94553 B. ADDRESS TO WHICH NOTICES ARE TO BE SENT Kevin L. Domecus Walkup, Shelby, Bastian, Melodia, Kelly, Echeverria & Link 650 California Street, 30th Floor San Francisco, CA 94108 C. AMOUNT OF CLAIM $5, 000, 000.00 D. DATES OF OCCURRENCE May 26-27, 1992 E. PLACE OF OCCURRENCE Merrithew Memorial Hospital i Claim For Damages November 9, 1992 Page 2 F. OTHER CIRCUMSTANCES OF OCCURRENCE The claimant Stacy Skinner was admitted to Merrithew Memorial Hospital on or about May 26, 1992, for induction of labor and the birth of her child. The claimant Stacy Skinner had also been followed for her prenatal care by physicians at the Merrithew Memorial Hospital. During the prenatal period, the claimant had seizures and other complications. During the delivery process, the claimant was poorly monitored, inappropriately medicated, and the delivery was unnecessarily delayed. The improper care during both the prenatal and delivery process resulted in the claimant Brandon Roemer being born with severe neurological deficits on May 27, 1992 . His injuries were the direct result of the negligence and unauthorized acts of medical personnel at Merrithew Memorial Hospital. G. ITEMIZATION OF INJURIES AND DAMAGES TO CLAIMANTS The claimant Stacy Skinner suffered severe emotional distress and other injuries as a result of the delay in delivery and her observations of the severe injuries to her son. The claimant Brandon Roemer has suffered severe neurologic deficits, possible intracranial bleeding, and other injuries presently undiagnosed. H. ECONOMIC LOSSES Medical bills and loss of earnings are unascertained at present. I. EMPLOYEES CAUSING INJURY AND DAMAGE The names of all of the employees of said public entity responsible for the occurrence herein described are unknown to claimants at this time. DATED: WALKUP, SHELBY, BASTIAN, MELODIA, KELLY, ECHEVERRIA & LINK" By: KEVIN L. DOMECUS Attorneys for Claimants 1.30 CLAIM NOV 3 01992 " BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA (AUNTY COUNSEL Claim Against the County, or District governed by) BOARD AC INQ° "UP` the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 15 , '1992 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $300 . 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ROWELL, Walter and Christina 229 Raye Avenue ATTORNEY: Oakley, CA 94561 Date received ADDRESS: BY DELIVERY TO CLERK ON November 25 , 1992 BY MAIL POSTMARKED: November 24 , 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: November 30 , -.1992 IVIL BATCHELOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors (� This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late"and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: qpL BY: �� Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). -IV. BOARD ORDER: By unanimous vote of the Supervisors present )/This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. t You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately, *For additional warning see reverse side of this notice. i AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 1 5 199Z BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Cla ir. to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLADAMT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later ,than the 100th day after the accrual of the cause of action. Claims relating to causes of.,action for.death or for injury to person or, to personal property or growing crops and which accrue on or after January 1 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later,.than .one. year. after .the accrual of the cause of acti on. . (Govt. Code §911.2. B'. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in: D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp 00 �nwolj RECEIVED Against the County of ContraCosta NOV 2 51992 or CLE BOARD OF SUPERVISORS District) CONTRA COSTA CO. (Fill-in name The undersigned claimanthereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 6 9-tit) and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) L 2. Where-did-the damage or injury occur? (Include city and county) S 3. How did damage-=Winjury occ (Give full details; use extra paper required) 0.11 I l' r 5 k L_101 4. Whal0particular act or omission on thA part of county or district officers, servants or employees caused the injury or damage? , 76 -41 w La- W t,4� 0J Lo pN, (over) �. wnat are the names of county or district officers, servants or employees causing the damage or injury? »____r»__»_____»_»_Mq_.IR______»__»_M__»»_____-------------- What __»__»______»What damage or- injuries do you claim resulted? (Give full' extent'of injuries or damages claimed. Attach two estimates for auto 'damage. )17A-V- 7. 1 _7. How was the amount clai4d ab ve computed? (Include the estimated amount of any prospective injury or damage.) $. Names and addresses of witnesses, doctors and hospitals. ----------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT ' Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO:' (Attorney) or by someperson-on his.behalf.". Name and Address of Attorney 6 ot� K�U JAI, (Claimantfs Signature ddr s Telephone No. TelephoneO, '�F' * M NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. � 1 3-®"CUO"OIVI AUTO DETAILING 2665'ANTIOCH/PITT HWY. 754-3829 NO. 92 Date ` 19—'P— Name LZ Address SOLD BY CASH C.O.D.CHARGE ON ACCT. MDSE. PAIDOUT H �} RETD. DESCRIPTION ' 9 1!71� 2 4 5 4 6 7Z 8 9 s !4 0 £lt 12 Customer's Rec' Order NO. By KEEP THIS SLIP FOR REF RENCE 51-240/01242 REdFORM, me 7 c�a•o{ E ani' L O G' 50 ..ps o 0 Q a mda�� i G da ca U In 070 UO d O` POO ©J t U 0-101- 0 G G y vf�ce) oiT Co.) Q d3 N 'd dU- O 5 d1 .n IS' dU N V c L3 O pG +- E � -Oo t� 3a°-v cam .• � iRooan dS°tS c p. a cock V)405. CD ci- ZVc�cVV� � o°� ^tel o o .Q, -d o °' -•°a 2 ,7id' S 0- c: o ;°a odoa- o 3O �o, Ooo4 3a o,d dOL 'o 0' c -das ° v 15 Oa O 06 C 4)U 3. Vo Z O O O � d d � c y dt� O O � ��c ._- s 3 y„ 0 4- 9q6 1 O N I uj Q c•.t ` QG Z _!u cc taa u 1. 3o CLAIM RECE11rZD BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA NQ V �) N n 199? Claim Against the County, or District governed by) BOARD A N the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DEC ElECyl!�92 and Board Action. All Section references are to The copy of this document mailed to you is your notice A California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SAMAAN, Mary SAMAAN, Makaram ATTORNEY: James E. McGlamery Date received ADDRESS: Thompson & Heller 3600 American River Dr. , Ste. 150 BY DELIVERY TO CLERK ON November 24. 1992 Sacramento, CA 95864 BY MAIL POSTMARKED: November 23. 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel' Attached is a copy of the above-noted claim. ppHH g DATED: November 24, 1992 IV Deputy OR, Clerk n II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: #011 t,�•cc Z 5 M2 BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORR: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sectio 13) Subject to certain exceptions, you have only six (6) months from the date this-notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LAW OFFICES OF THOMPSON & HELLER ROBERT M.THOMPSON TELEPHONE STEVEN M.HELLER A PROFESSIONAL CORPORATION (916)978-7300 THOMAS D. NIELSEN BLANE A.SMITH 3600 AMERICAN RIVER DRIVE JAMES E. MCGLAMERY PHILLIP R. BONOTTO SUITE 150 FAX MICHAEL M. MEADE (916)488-9185 R. LAWRENCE BRAGG SACRAMENTO, CALIFORNIA 95864 KAREN LEE JACOBSEN PENNEE K. PARKER CHANCE L.TRIMM �p ggI��� ®Y8 BRIAN S.JACOBSEN e•y+,ECEI-8VED KAREN A.ASPLUND C 96e 1144++ THOMAS W. BARTH JOHN V IROLA BRETT EAROS NTHAL November 23 , 1992 NOV 2 4 9992 Ct ERt(CC-ARD Or`0: J.—VISORS Board of Supervisors Ca) r= fl• County of Contra Costa 651 Pine Street, lst Floor Martinez, CA 94553 Re: Claim of Mary Samaan and Makaram Samaan Date of Loss : 9/4/92 Dear Sirs or Madams : Please be advised that this firm has been retained by Mary Samaan and Makaram Samaan to protect their interests for personal injuries sustained on September 4, 1992 at the Richmond Marina . I enclose for filing and processing, a Notice of Claim on behalf of Mr. and Mrs . Samaan. Please forward an endorsed copy of the Notice of Claim in the self addressed stamped envelope provided. Thank you for your attention and courtesy in this matter. Very truly yours, THOMPSON & HELLER A' Professional Corporation By: Brett E. Rosenthal BER: llb Enclosure 09011 1 JAMES E. McGLAMERY, State Bar #099433 THOMPSON & HELLER 2 A Professional Corporation RECEN ® 3600 American River Dr. , Suite 150 3 Sacramento, California 95864 Telephone: (916) 978-7300 NOV 2 41992 4 Attorneys for Claimants MARY SAMAAN and MAKARAM SAMAAN CLERK BOARD GF SUPERVIS S 5 CONTRA COSTA CO. 6 7 8 9 IN RE: 10 CLAIM OF MARY SAMAAN and, CASE NO. MAKARAM SAMAAN, 11 NOTICE OF CLAIM Claimants . AGAINST COUNTY OF 12 CONTRA COSTA 13 I, James E. McGlamery, attorney at law, on behalf of 14 MARY SAMAAN and MAKARAM SAMAAN, hereby present this claim to 15 the City of Richmond, County of Contra Costa, pursuant to 16 Section 910 of the California Government Code. 17 1. The names and post office address of claimants 18 is : MARY SAMAAN and MAKARAM SAMAAN, 869 Bluff Lane, Fair 19 Oaks , CA 95628 . 20 2 . The post office address to which claimants desire 21 notice of their claim to be sent is as follows : MARY SAMAAN 22 and MAKARAM SAMAAN, c/o Thompson & Heller, 3600 American 23 River Drive, Suite 150, Sacramento, CA 95864 . 24 3 . On September 4, 1992, while viewing a boat for 25 prospective purchase at the Richmond Marina, Richmond, 26 California, claimant, MARY SAMAAN, suffered personal injuries 27 under the following circumstances : Claimant was stepping off 28 1 a boat owned by John McCloud, docked in the Richmond Marina, 2 onto a plastic crate placed next to the boat. As a result of 3 the plastic crate being too short for the boat, being 4 unattached to the concrete dock and lacking a hand rail, as 5 claimant stepped onto the crate, it slipped out from under 6 her causing her to fall and hit her head on the concrete 7 dock. 8 4 . Claimant was taken to the emergency room at 9 Kaiser/Richmond, where she was x-rayed and treated for a 10 severe concussion. Claimant also suffered injuries to her 11 left thigh and back and is currently experiencing significant 12 headaches, tingling on the left side of her face, extreme 13 fatigue, memory loss and ear related problems affecting her 14 balance. Dr. Stoode, a neurologist, has diagnosed claimant 15 as having a severe concussion. 16 5 . As a result of personal injuries sustained by 17 claimant, MARY SAMAAN, claimant, MAKARAM SAMAAN has suffered 18 a loss of love, companionship, affection, society, comfort and sexual relations . 19 20 6 . So far as it is known to :James E. McGlamery at the date of filing this claim, MARY SAMAAN has incurred 21 damages in an amount in excess of $5, 000, for the Kaiser/ 22 23 Richmond Emergency Room visit, Kaiser/Sacramento North, 24 visits with Doctors Harr, Matthew and Dennerich, visits with Dr . Stoode, Dr. Kelada and the performance of a CT scan at 25 Kaiser/Sacramento North. 26 27 28 -2- 1 7. At this time, the names of the employees and/or 2 agents of the City of Richmond, County of Contra Costa 3 responsible for the Richmond Marina are unknown. 4 8 . At the time of the presentation of this claim, 5 MARY SAMAAN and MAKARAM SAMAAN claim damages in excess of 6 $10, 0000 . 00 and jurisdiction is appropriate in the Superior 7 Court, County of Contra Costa . 8 DATED: November 17, 1992 THOMPSON & HELLER A Professional Corporation 9 10 By: 11 JAMES EP4 . MCGLAMERY Attorneys for Claimants 12 13 1543D 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -3- i- �� flflfl ??11 N (? A�3 ..^ cf) N N cn $.AO U Lo i:p y� N � u � N W O N O C4 *.A cis o 0 O N �d W to cdCwt V Ca CC o 00 Z CO oc � W � y > ltl a o = a ? 0 O w d5 o z w V' U ;d � y U � O 3 O m w ul a g U Z i C r 1. 30 CLAIM RECEIVJ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Nov =' Claim Against the County, or District governed by) BOARD ACM the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMNAtS"V�1!�92:' and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all "Warnings". CLAIMANT• SLUSHER, Randall C. ATTORNEY: Geoffrey M. ..Faust, Esq. Law Offices Date received ADDRESS: One Maritime Plaza, Suite 1300 BY DELIVERY TO CLERK ON November 20, 1992 (via Counsel.; San Francisco, CA 94111 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County,-Counsel' Attached is a copy .of__the__above-noted claim. DATED: November 24, 1992 JyIL BATCHELOR, Clerk5�" P y II. FROM: County Counsel TO: Clerk of the Board of 5 visors (V) This claim complies substantially with Sections 910 and 910.2. ( . ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days-(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( h Other: 1 Ayus NOTE E O e= LopkeM106 00 50E OF -rkits 00-rice RE C►VIt. R%GttTS. CLA tMS Dated: AJPQUm.64.,_ 2-1. / f Z BY: 4e• Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sec 13) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an ,attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LAw OFFICES OF GEOFFREY M. FAUST Contra Costa Cou_ ONE MARITIME PLAZA, SUITE 1300 RECEIVED SAN FRANCISCO, CALIFORNIA 94111 TELEPHONE (415) 397-8433 N 0 V 16 1992 FACSIMILE (415) 397-4016 Office of November 13, 1992 County Administrator RECEIVE® County Administration Office 2 01992 651 Pine Street Martinez, CA 94553 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. Dear County Administrator: Enclosed please find the original and one copy of the Claim by Randall C. Slusher [California Government Code Section 910 ] . Please file the original and return the copy, file endorsed, in the enclosed self-addressed stamped envelope. Thank you 'for your attention towards this matter. Very truly yours, Gle4 ' � Geoffrey M. Faust Enclosure: as stated GMF:mg RECEIVE® WV 2 01992 CLAIM BY RANDALL C. SLUSHER [California Government Code Section 910] CLERK BOARD OFSUPERVIS CONTRA COSTA CO. This claim is brought against Contra Costa County, the Contra Costa County Board of Supervisors (hereinafter referred to as "the Board") , ex-officio governing body of the Probation Department, and against Gerald S. Buck as County Probation Officer. In accordance with Government Code § 910, the following information is provided: (a) The name and post office address of Claimant: Randall C. Slusher 251 Augustine Drive Martinez , CA 94553 (b) The post office address to which the Claimant desires Notice is to be Sent: Geoffrey M. Faust, Esq. One Maritime Plaza, Suite 1300 San Francisco, CA 94111 (c) Date, Place and Other Circumstances of the Occurrent or Transaction that Gave Rise to the Claims Asserted: This claim is for wrongful termination and violation of Claimant's Fourteenth Amendment right pursuant to 42 U. S.C. § 1983 . The County Probation Officer's 1992-93 budget reduction recommendation, adopted by the Board of Supervisors, eliminated the only Administrative Services Assistant III (ASA III) position in the Probation Department, which was held by Claimant. Elimination of the position, and the recommendation underlying it, were not based on the objective operational needs of the Probation Department, but instead were based on arbitrarily -1- protecting career probation. professional staff over business administration professionals such as Claimant. Initially, the Probation Department's reduction plan established that claimant was not included as a part of a 30% reduction. However, as a result of special pleading, based on personal needs unconnected to the operations of the Probation Department, on June 22 , 1992 , Probation Officer Buck altered the proposed budget reduction recommendation to protect the jobs of Probation Supervisors II, by instead recommending the elimination of Claimant's position. The above-described favoritism is part of a pattern of arbitrary personnel decisions by the Probation Department under the direction of Mr. Buck. The common thread is a bias in the form of cronyism towards career probation personnel, in violation of Claimant's rights of property, equal protection, and due process of law as established by the County Merit System, Contra Costa County Code, Article 33-3 . 503 , et sea. Thus, Mr. Buck staffed the newly created "personnel manager" assignment in January 1992 by placing a Probation Supervisor II to perform departmental personnel activities. As evidenced by the classification for Probation Supervisor II, expertise or experience in personnel functions is not a qualification for a PSII position. The Claimant requested consideration for the position when it was created, but was rejected. (d) General Description of the Indebtedness, Obligation, Injury, Damage or Loss Incurred so far as may be Known at the Time of the Presentation of the Claim: -2- (i) Loss of. economic benefit to Claimant as a result of the wrongful termination in violation of his general rights; (ii) Emotional distress and non-economic losses from violation of Claimant's rights as a result of the actions described above; (iii) Attorney's fees as provided by law including, without limitation, 42 U. S.C. § 1988; (e) The Name(s) of the Public Employer Causing the Injury, Damage or Loss, if Known: Probation Officer Gerald Buck, as well as members of the Board of Supervisors of Contra Costa County. (f) Amount Claimed as of the Date of Presentation of the Claim, Including the Estimated Amount of Any Prospective Injury, Damage or Loss in as far as it may be Known at the Time of the Presentation of the Claim, Together with the Basis of the Computation of the Amount Claimed: (i) Wages and employment-related benefits as a result of the termination; (ii) The exact amount of these benefits is within the knowledge of the County Personnel Department and changes on a daily basis; (iii) Damages for emotional distress and suffering attributable to the conduct of Mr. Buck and the County; (iv) Attorney's fees incurred in connection with the presentation of this claim and any litigation arising from the claim; -3- (v) Violation of Claimant's civil and constitutional rights; (vi) Damages for violation of Claimant's civil rights, property interest in employment, due process rights, and rights to equal protection under the laws. (g) Jurisdiction for Legal Resolution of this Claim is Provided in the Superior Court or the United States District Court for the Northern District of California. GEOFFREY M. FAUST Dated: November l , 1992 GZIrqjII LM�k Attorn or Plaintiff Randall C. Slusher slus11. 92 -4- CONFIDENTIAL COUNTY COUNSEL'S OFFICE - CONTRA COSTA COUNTY MARTINEZ, CALIFORNIA .'r�_r� MEMORANDUM LNOVCLE U ERViSORS Date: November 20, 1992 s rA CO. TO: Clerk of the Board of Supervisors FROM: Greg Harvey, Deputy County Counsel RE: Claim of Randall C. Slusher Attached please find a claim and letter from the claimants attorney received by the County Administrator on November 16, 1992 . w a c„ N � �d0 woo w� � U wr4' o ti CONFIDENTIAL COUNTY COUNSEL'S OFFICE CONTRA COSTA COUNTY MARTINEZ, CALIFORNIA RECEIVE MEMORANDUM NOV 2 51992 Date: November 25, 1992 CLEM BOARD OF SUPERVISE TO: Clerk of the Board CONTRA COSTA C FROM: Greg Harvey, Deputy County Counsel RE: Claim of Randall Slusher The attached claim was frowarded to us from Judge Patsey. ORCO INS SUPERIOR COURT v , 1gg STATE OF CALIFORNIA NO�N,Y��Of � COUNTY OF CONTRA COSTA COURTHOUSE MARTINEZ, CALIFORNIA 94553 RICHARD L. PATSEY TELEPHONE JUDGE November 18 14151 6 -4013 DEPARTMENT 13 / 1992 FAX: 1415151 646-146-1 312 RECEIVED- Arthur ECEIVE® Arthur Walenta Count- Counsel � 2 5 651 Pine St. Martinez, CA 94553 CLER CONTRA COSTA CO D OF SUPERVISORS Re: Slusher Claim Dear Arthur: Enclosed please find a copy of the claim and covering letter from Mr. Faust concerning the above. Sincerel-- , RICHARD ATSEY Judge of the Superior Court RLP:tb enc. / LAw OFFICFS OF GEOFFREY M. FAUST , ONE MARITIME PLAZA, SUITE 1300 SAN FRANCISCO, CALIFORNIA 94111 TELEPHONE(415) 397-8433 FACSIMILE(415) 397-4016 November 13, 1992 RECEIVE® NOV 2 51992 Honorable Richard L. Patsey Contra Costa Superior Court CLERK BOARD OF SUPERVISOR„ P CONTRA COSTA CJ 725 Court Street Martinez, CA 94553 Dear Judge Patsey: This government claim is being provided to you as supervisor of the probation dept of Contra Costa County. The claim has also been submitted to the County Administrators office. Thank you for your attention towards this matter. Very truly yours, G�� Va't'��- Geoffrey . Faust Enclosure: as stated GMF:mg RECEIVED NOV 2 5 1992 CLAIM BY RANDALL C. SLUSHER [California Government Code Section 9101 LERK BOARD OF SUPERVISORS CONTRA COSTA CO. This claim is brought against Contra Costa County, the Contra Costa County Board of Supervisors (hereinafter referred to as "the Board") , ex-officio governing body of the Probation Department, and against Gerald S. Buck as County Probation Officer. In accordance with Government Code § 910, the following information is provided: (a) The name and post office address of Claimant: Randall C. Slusher 251 Augustine Drive Martinez , CA 94553 (b) The post office address to which the Claimant desires Notice is to be Sent: Geoffrey M. Faust, Esq. One Maritime Plaza, Suite 1300 San Francisco, CA 94111 (c) Date Place and Other Circumstances of the Occurrent or Transaction that Gave Rise to the Claims Asserted: This claim is for wrongful termination and violation of Claimant's Fourteenth Amendment right pursuant to 42 U.S.C. § 1983 . The County Probation Officer's 1992-93 budget reduction recommendation, adopted by the Board of Supervisors, eliminated the only Administrative Services Assistant III (ASA III) position in the Probation Department, which was held by Claimant. Elimination of the position, and the recommendation underlying it, were not based on the objective operational needs of the Probation Department, but instead were based on arbitrarily -1- I protecting career probation professional staff over business administration professionals such as Claimant. Initially, the Probation Department's reduction plan established that claimant was not included as a part of a 30% reduction. However, as a result of special , pleading, based on personal needs unconnected to the operations of the Probation Department, on June 22, 1992, Probation Officer Buck altered the proposed budget reduction recommendation to ' protect the jobs of Probation Supervisors II, by instead recommending the elimination of Claimant's position. The above-described favoritism is part of a pattern of arbitrary personnel decisions by the Probation Department under the direction of Mr. Buck. The common thread is a bias in the form of cronyism towards career probation personnel, in violation of Claimant's rights of property, equal protection, and due process of law as established by the County Merit System, Contra Costa County Code, Article 33-3.503, At sea. Thus, Mr. Buck staffed the newly created "personnel manager" assignment in January 1992 by placing a Probation Supervisor II to perform departmental personnel activities. As evidenced by the classification for Probation Supervisor II, expertise or experience in personnel functions is not a qualification for a PSII position. The Claimant requested consideration for the . position when it was created, but was rejected. (d) General Description of the Indebtedness, Obligation, Injury, Damage or Loss Incurred so far as may be Known at the Time of the Presentation of the Claim: -2- (i) Loss of economic benefit to Claimant as a result of the wrongful termination in violation of his general rights; (ii) Emotional distress and non-economic losses from violation of Claimant's rights as !a result of the actions described above; (iii) Attorney's fees as provided by law including, without limitation, 42 U. S.C. S 1988; (e) The Name(s) of the Public Employer Causing the Injury, Damage or Loss, if Known: Probation Officer Gerald Buck, as well as members of the Board of Supervisors of Contra Costa County. (f) Amount Claimed as of the Date of Presentation of the Claim, Including the Estimated Amount of Any Prospective Injury, Damage or Loss in as far as it may be Known at the Time of the Presentation of the Claim, Together with the Basis of the Computation of the Amount Claimed: (i) . Wages and employment-related benefits as a result of the termination; (ii) The exact amount of these benefits' is within the knowledge of the County Personnel Department and changes on a daily basis; (iii) Damages for emotional distress and suffering attributable to the conduct of Mr. Buck and the County; (iv) Attorney's fees incurred in connection with the presentation of this claim and any litigation arising from the claim; -3- (v) Violation of Claimant's civil and constitutional rights; (vi) Damages for violation of Claimant's civil rights, property interest in employment, due process rights, and rights to equal protection under the laws. (g) Jurisdiction for Legal Resolution of this Claim is Provided in the Superior Court or the United State's District Court for the Northern District of California. GEOFFREY M. FAUST Dated: # November l 1992 v �� AttornW bor Plaintiff Randall C. Slusher slus11. 92 -4- i � seri �p fir,14 r to rn �a � Ul V Q N Uj Z O m a o 'o, O � r¢ u O U Z [( O r Q U °• 'o � U q. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA NO(/ql) Claim Against the County, or District governed by) BOARDA �� j�9a the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DECEMBER 1 , 92 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice o ` California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $250.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: VAUGHN, Regina 127 Alder Court ATTORNEY: Hercules, CA 94547 Date received ADDRESS: BY DELIVERY TO CLERK ON November 18, 1992 hand delivered BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel.; Attached is a copy of the above-noted claim, pp��{{ gg DATED: November-24, 1992 61�IL DeputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors (VI This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �6r�a,.,c .ZS 1 IF 17Z BY: d Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BO7) This R:. By unanimous vote of the Supervisors present ( Claim is rejected .in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: DEC 15 1992 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code sectio 13) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice df an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warnin0 See reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DEC 15 1992 BY: PHIL BATCHELOR by ► Deputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLADVUNT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops,and which accrue on or before December 31, 1987Y ,must be presented not later than the 100th day after the accrual of, the cause of, action. Claims-relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later thari six months after the accrual of the cause of action. ' Claims relating to any other cause of action must be presented not later,.than.one-year-after the accrual of the cause of action. (Govt. -Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Rom 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the Count-Y, the, name of the District should be filled in. D. If the claim i's against more than one public entity, separate claims must be filed against each public entity. E. Fraud. 'See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. It III, C* RE: Claim By Reserved for Clerk's filing stamp j. RECEIVED 6. ost Against the-Count eontra--C or District) CLLMEE RD OF SUPERVISORS (Fill-in name) CQNTRXCOSTA�cb- The undersigned-claimant,- hereby makes claim against thAFounty of Contra Costa or the above-named Districtin the sum of and in support of this claim represents as follows: 1. When did the damage orinjury occur? (Give exact date and hour.) U 2. Where did-the damage or injury occur? (Include county) COL- 3. How did the damage or injury occur? (Give full details; use extra paper if required) 4. at par .4. r act or omission on the part of county or district',�ffl6ers, servants loyees caused the injury or damage? (over) f 4 � D. wnat are the nates of county or district officers, servants or employees causing the damage or injury? ---1hL___L 5. What damage or injuries do you claim resulted? Give full extent-*of injuries y ( � damages claimed. Attach two estimates for auto damage.* - e- 7.7 How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.). j - _�.. ,___ 's 3. Names and addresses of witnesses, dog ors and hospitals. 9. List t e expendit s you ma a on account of this accident or injury: DATE I AMOUNT Gov: Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney or by_wme person on his.. lf." Name and Address of Attorney (glaimant's Signature C. Address Telephone No. Telephone No. e `j��� � qd`G�' �� NOTICE Section 72 of the Penal Code provides: - . . _ . . _ _. "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing; is punishable either by imprisonmentin the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. MI :43u C E a � m o > 30 so 0E.o$ c ° o � > co $ o�� oo ° _ M –6012 ">-. W z EE � o> C 7 2 O VO'O V W W M E N Zc c 1 ` ooui >0 �f $Es S Q oo Eook Q W 5 _ LLJ �I Oaz) Z—Z 0 a �< "QQ �o � � Qd J toc °O> 8ps Im 40 I S O _ o z G W < < $ l� z J � � W J CIM IL t IL WA IL v 1 O t so, N W oCl O .s \'o E J AIMP amu- �¢m zt Ck" �t wo-tK. Qeth ncar� � Y� el a,hjmr 4' eu�� rte, C� fuzz /�'�• — -- ��46hv - `�fwn� t 15 a�G�—�o�rmubQe — y RECEIVING RECORD -�T;, t Y�Oi^ oz`s I-O�CS � RECEIVED FROM ADDR •. -� in a., PURCHASE DER NO.OR RETURNED FREIGHT &i 11 LL NO. DATE GOODS m VIA REPAID COLLECT i 3WA ev 4oo REk C3 rA� 9 10 11 r: REMARKS:CONDITIONS, ETC. NO.PACKAGES WEIGHT RECEIVED BY CHECKED BY I DELIVERED TO ' °'F°R'" BE SURE:TO MAKE THIS '2L259/ 01259 RECORD ACCURATE AND COMPLETE r FPPP cl Cliff Jenkins 231-0109 Q9 • • • JENKINS DETAIL "Your Car Specialist In Clear%ling" ` 12494 San Pablo Avenue • Richmond,CA z x - 1 RECEN o DEC 041992.%� APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA CX)UNW CWNM Hob TION DECEMBER 15, 1992 Application to File Late Claim ) NOTICE TO APPLICANT Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to ) the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNING" below. Claimant: VOYLES, Mildred Attorney: Address: 6976 Wisteria Street San Ramon, CA 94583 Amount; By delivery to Clerk on November 30, 1992 (via Risk Mgm1 Date Received: 11/30/92 By mail, postmarked on I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application File Late Claim. DATED:. December 4, 1992 PHIL BATCHELOR, Clerk, By Deputy II. FROM: County Counsel Clerk of the Board of Supervisors ( ") The Board should grant this Application to File Late Claim (Section 911.6). ( �1 The Board should deny this Application to File LateClai (Section 911.6). DATED: ��� �,/lid,VICTOR WESTMAN, County Counsel, By Deputy - e- III. BOARD ORDER By unanimous vote of Supervisors pr gen (Check one only) ( ) This Application is granted (Section 911.6). V) This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DATE: DEC 15 1992 PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code §911.8) If you wish to filea court action on this matter, you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed with the court Within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advise of any attorney of your choice in connection with this matter. IP you want to consult an .attorneyj you should do so immediately. IV. FROM: Clerk of the Board T0: 1 County Counsel 2 County Administrator Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has ben filed and endorsed on the Boards copy of this Claim in accordance with Section 29703. DATED: /5-- 9�- PHIL BATCHELOR, Clerk, By Deputy V. FROM: 1 County Counsel 2 County A rator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By -- - County Administrator., By APPLICATION TO FILE LATE CLAIM ' x.11725""92_ 0 i:20 '$2563308 - ;AW OFF-JW,FF,PL z OQ1 JOHN E.WALTZ N Dp AtTomey at Law �RECEIVE� NOV 01992 PAX TRANSMI � � TIAL LETTER CLERK B� OARD OF SUPERVISORS XNTRA COSTA CO. DATE: a S ��'' TIME TO: Name /fid AJ JqA� company .C. e . ,lei S/�' /�1' iso city Telephone. Number FAX Number 644 —Z04 FROM: Name Telephone Number (510) ZSG-3300 PAX Number (S10) 256-3308 (Canon FAX-270) Number of pages including this cover letter If you experience any problems with this facsimile transmission, please call our office number and ask for MESSAGE: J' L,� ,� • � t The Peri Executive Centre 2033 N.Main Street,Suite 430,Walnut Creek, California 94596 (415) 256-3300 l=%X(415)255-3308 lii:2 '92 ' 07.22 `�}`25t333tt$ Q004 • �1;i� MILDRM VOYUSRECEIVEW�_ - P 6976 Wisteria Steet y NOV 3 01992 San Ramon, CA 9r45S3 CLEL—B0 ARCi QF St1PERViSORS C N RA COSTA CO. November 13., 19'92 San-namon Fire Protecta.on District Atten: paramedics 1500 Bolinger Canyon Road San Ramon, CA 94583 Gentlemen This letter shall serve as notice, in accordance with Section 364 of the Code of Civil Procedure, that Mildred M. Voyles and Peggy ,S. Vaughn will file suit against you for damages resulting from the wrongful death of James Voyles. The legal basis for . this action will he the negligent failure to ,properly diagnose and transport Fames Voylesf to the nearest medical facility. Mildred M. Voyles and Peggy J. Vaughn will allege as a proxizate result of the aforementioned professional negligence that they have lost the care, comfort and society of decedent ,Tames Voyles and have been damaged in the maximum amount allowed by California law. Sincerely', Mildred X. Voyles 7 M14V:eas • R 117,'.5 2 0 i:23 $2563308 4AW OFF-JW,FF,PL X1005 '': !NOV 24 '92 1242 SAN RAMON VALLEY FIRE AIIMIN. ,2/10- 7- 962 Pee fou 22 X 92 0,3 t i STRICT CTION . I - A VALLEY. FIRE pROTE -S N' RAMON t �•, r MF YON ROAD (CMN. WON 9 3 mpg papmoN =1�dtt�ttSTAATiON - s3E-6680 ' ALARM INCIDENT REPORT is3. 475-The Arcd � ace ES?� t� �)� • ` R�pot�ed io_c�tton:�,���o��S �a_ _ _ (t.C.) Shit ftoong Pte: Resp Zone: Thomas Bros Aepoag Pity Addtess : —- -- RP Phan !. Method Recd 911: 4211: 1313:_—Radia,�,Sti11:�_X24 Bus Pty NATURE 4P DISPATCH ttructure SfE $make Investigation Medical Emergency I _ ehicie Fire ��, Alarm Company (Nature) ' Vildland Fire � Wiwi Aid Request Vehicle ,4cadent _ rli nc6 I�i>~e�. HaWdous Condition Hydrant Problem--­-. �—�- rah Flee Medan or Bark Fire Public Servlce T TIME RECORD r I"•R coda a — _o.s,-&_t26 ACA—asTa - -- ! Code Z AOR Ata SJR Ccde 2. O.S. A4t2 .A10 To: Jin Cade 2 O.S. AOR A1Q To:• �,,,,� S1R Cada 2 o.S.�AGR AIQ _To;� Codo 2 O.S AOR AIQ To: t� lJi7it /R _CW4 2_ :O.S. —_AUR AJQ Tcr •_•' €' 7rarispnr�frtg Anr+b �tRTo�Cade„ O.S. Ava3labie Tftr*:;drft Arm+ Code O.S. AYBiW ` AIR AMS;. . !►me Time UiXvated O.S. :}R Fbsp At Faap_ r . ' r } B•G. EJA C S. AOR AW Wef A4RT,,,,�;, On Sce AOR COVER IN Unit #: Enf&te: Toi, On Sme: A0A AIQ Unit#: Studute:, To:®. ._ On Scene:—AOR AIQ J Un#t q: Baratta: 7o:r on scam! i �,�.• Under Control. 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Dino Z��gae I - i . . �11-`25,'fl2 07:24 $256 308 4AW OFF'-jw,FF,PL .; (,{►:NOV 24 '92 12•'43 SAN RAMON VALLEY FIRE ADMIN!. la007 962 P03NOU p `� 83:i9~ ,,�.��::�I'. r+�y� ! "'. uteri �4'L1i°itrr' l i ml h it cr Incident Na �1p Ivuyf ureV .�1.1 Ho d .. i''7 ��;r13a�: WIS+rEc IA, 5; 3F' A0'kfet�tr;; ya w:• IRSREST SDs 4-0)24 Mac: 33E� c i7F_CrC�ral Information R w"A1'f :�iif..f'1Tt.:!'^IrJ• III . '"1'.1 G�• �.t ' �X1+1 IRyt��Z� _ M '\• ' y� f y� I .11.2 T:.'.616r+ Tbc..r;ei I is l':v Incident Data .r 'jr,3 w n. i i�"I •:'MFM:i jylC��' ,S+, �: r 711+.\ 1q�W: 1� �.� :ARE-AS' A*,A,r :: I tic«E 2art 71 i Alarm Ccmloln-! »t'� 1 %S* �Y'?' EJ ':`�C TC A4. `. r n ee Incident tkepoMtinc `C fi r � P R7_Z* :y `0GCAS DINC C Patient No 001 vF J'�~ +Vnirt.5 t•a Z:�Y .t T"1 SMiddle! 4'� \• �.Jf1.': i �.:';�• wr!ip� ��J 1�.:r.i� Amt'.i V�+R G^ r ? P`! y't"l.'? sL`_'�i: M �R*cL3s: +IY Phone: tet.? i 833 1C1n0 JAS r ♦� `�'�i Mitl.l C r'�,NiiY�R"'t,�i': i ~f•r+s./i ,R. TiM- ';, TID Locil Data Fialds A. - npF4=. Amtij.t,:'�c& ,,UTHCFZ I ZAT:CN NUMSER: ??c '.%A6LY RESPONSE NUMSER. _ ,��(,CF;.,i. +C�tSJitT�irC\ 1 RCI £*nh�p�tY*; i M�Ei��tyCS ASSUMEr. PATrtEMT, CARE ! TPS. tl. TF AIIISP 7.R 1 t I ADVANCED, LIFE S�ttI-'�t_R'Y 066 t>t ' DRFA RSSPC) SE .CCTjE TO :GENE : 3 LOGE THREE C=i FRGS. SCENE: 0 NO CGDE PRIMAS-^v. SURVEY: ��'► it?: PRIKARY COMPLAINT- u°' DIFFICULTY BREATHING ALS'�S WAY: C NOISY AND PARTIALLY C,997RU;'1" LABORED iR��R�y'� 1�c RSGULAR •1 't•� SLt,�s.n LOSS;, t SONE SKIN TEMGS'RATURS: 1 WARM t:I19;:` _ IN Md1stuRE: 2 MOIST SKIN ''M't7 t dL OR Ri PALE ' � VyyR+\EtryryA'L: iSeERO? SEa s� ORICNTJ=-:1 MND l'.'00NJ5nSES h .... t'i�Y.i RSr9 CNSS±: i OSE`s` 4'SRSAL CCMMANn EYE d-F r•r+.�j+.. i.7N�1V.'���.:: 4 rC'+M yw J y L o.r.•� 1• PLL SC- t , • 11/25/92 07:25 $2563308 -'�A49 OFF-JW,FF,PL Q1008 i.NOV 24 '92 .12:44 SRN RAMON VALLEY FIRE ADMIN. 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"�.+'+�w .T.r.. -._�_�. :sem. ^ry;•......�.• �=�_ �� —^""'�' ��'"*�" 11�iS!92. 07:21 U2563308 +AW OFF-JW,FF,FL 2002 PETITION TO ALLOW LATE FILING OF CLAIM 1, MIMRM VoYLRS, hereby Petition the City of San Ramon and San Ramon Valley Fire Protection District to allow me to file the attached claim against the City of San Ramon and San Ramon Valley Fite protection District for damages arising out of the wrongful. death of my husband, JAMES VOYLES, as more particularly described in trio attached claim and notice -pursuant to Code Of Civil Procedure Section 364. I did not file the initial claim within six months of my husbandfs death because I was unaware of the legal requirement to fire a notice of claim within that period. One year has not passed since the wrongful act has occurred, the city of San Ramon and Fire Protection District has not been prejudiced by this delay,. I was ignorant of the law and had not contacted any attorney until the f first time I contacted on attorney was on November 11, 1992. 1 declare under penalty of perjury that the above is true and correct. Dated at Pleasanton, California November 13, 1992. Mildred M. Voyles 11 25-/92 07,22 $256334$ 4AW OFF-JW,FF,PL Q003 N. -.w MILDRLD M. VOYLrs 6976- Wisteria Street San Ramon, CA 94583 i CLAIM AGAINST PUBLIC MENTI= i, miLDRED- m. VOYLES, who reside at 6976 Wisteria Street, San Ramon, CA 94553, hereby assert the Claim against San Ramon Valley Fire P-ctaCtian D:st�—iwt arising out Of hCgligant ,:?nft0t: of persons -whose identity- I do not presently have, . The wrongful. conduct occurred on November 19, 1992 at approximately 7:08 p.m. at ray residence, 6976 Wisteria Street, San Ramon, CA 94583 when the ambulance crew made a decision to take my husband Names Voyles to Kaiser, Walnut creek, CA, rather than to the nearest emergency facility. While on route. approximately give minutes .before arriving at the Kaiser Hospital, my husband's condition substantially worsened and only then did the ambulance personnel activate the emergency. signals and realize the seriousnoss of my husband's condition. As a proximate result of the aforementioned negligence of members of the San Ramon Valley Fire Protection District, names Voyles died can November 19, 1991, at 5: 17 p.m. The statutory notice in accordance with Section 364 of the Code of Civil Procedure is attached to this claim. DATED: November 13, 1992 ..�j Mil red M. Voyles MMV:eas 11-25,,92 97:27 '$2563308 4AW OFF-JfM1,FF,PL LJ019 ,.1-;,.NOV 24 192 12=47 SAN RAMON VALLEY FIRE ADMIN. �a2 Rta"1 f ttau P.7t10 e3-2; lgdo •, j� _ tom..,, 1[ 'KV r TRIP TICAM PTIME !OP RYiC� RtLx1E5T OI�TE }fvXc Up Tt4+ fig RE013 gr1f>YGSTAFF PZ LSM +� •• •---�axf{�"ot i : ( extension f CdVf1� Gfis EXCFP'iidN g ' tt i ❑ Reuiar D P1 Pausnt Claims Membership 1 ALS 4 ❑,Air l'-',.� Other(Spe0ify) 2 a �r9.rt tf•Oate A Q industrial ❑ °,� 3 3 afma�Egte �-� E Non-Member ' a�Aso+a roa T 15twr+ A !a� T t Passible YPL r rtcNO Staff-Otfiar Q'r-1oueatlenable Membership ''K f� Fiegu}ar 01 ernetQev � _ --otner Kuser Redo; (o Referral 11 ❑ Service not 15 ❑ Na Egvipr;yent R region - -• �• � Yes 12 ❑ SetivGe fi0t 17 ❑ AccessbiLliy C� pro-41ded at (T�r+inQ) Q No this fac.tity 5i ❑ Return Trip Tars l -- 14 C3 NO Nt�r3u>$ 52 Q Intm Facility r C] Yes . Transf*f Staff o 2i d NdPhysioian 5o C1 other.r.�=_.— `�•Ff4 ' tOLOCAZbt1 `rppi►TtaM tA�)C... 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