HomeMy WebLinkAboutMINUTES - 11051996 - C18 AM"�N
BOA; Or SUrER4:S"=.S Or COS-*-' :^STA COUNTY, CALIFORNIA November ._S, 1996
Claim Against the County, or District governed by) BOAKC ACTION
the Board cf Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Boa-., Action. All Section references are to } The Copy of this document mailed to you is your notice of
Califo•ria Government Codes. } the action taken on your claim by the Board of Supervisors
(Paragraph IV btlOw), given pursuant to &avtrnmtnt Code
13
Amount: $400,000.00 Section 913 And 915.4. Pleast note all Lt'C�,�'11
0D
CLAIMANT: Diane M. Fetherolf OCT Z 4 1996
ATTORNEY: OOUNTY COUNSEL
Date received MARTINEZ CALIF.
ADDRESS: Kelly A. McMeekin, Esq. 8Y DELIVERY TO CLERK ON October 24, 1996
Brayton Harley Curtis
P.O. Box 2109 IT MAIL POSTMARKED: Hand Delivered
Novato, CA 94948
I. FROM: Clerk of the $pard of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED October 24_ 1 q96 PIL LAT yLOR, tleri��
II. FROM: County Counsel TO: Clark of the $card 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 to 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 tate and send
warning Of Claimant's right to apply for leave t0 present a late claim (Section 911.3).
( ) other:
Dated: f J� 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 $a rd's Order entered in its minutes for
this date.
WttdiYt�vu 5, /994' PHIL BATCHELOR, Clerk,
Deputy Clerk
MARNING (Gov. code section 913)
Subject to Certain exceptions, you have only six (6) Wftths from the date this notice was personally served or
deposited in the mail to file a Court action on this claim. See Govermaent Cade Section 945.6.
You may seek the advice of an attorney Of your choice in Connection with this matter. If you want to Consult
An attorney, you should do so inadiately. • For Additional Nang See Reverse Side Of This,Notice.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I Am now, and At all times herein mentioned, love been a citizen of the
United States, over age 1$; and that today I deposited in the United States postal Service in Martinet.
California, postage fully prepaid a certified copy of this Bard Order and Notice to Claimant, addressed to
the claimant as shown above.
Dated:��` f�� BY: PHIL BATCHELOR b ,�$�-Q-�- - —�
Deputy Clerk
CC: CG+lnty Ccjr.se' County Administrator
1
C.aim ?,o: BUM OF VISORS OF C�ONnA COSTA
WDOnWrIONS To C1.Al2gm
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property .or growing crops and which accrue an or before December 31, 19671
must be presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
19669 must be presented not later than six moths after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Roca 1069 County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against mere than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the and of this
form.
• # i * • i f i f N f i f f f i ! i 6? # f i f i ! f
RE: Claim By Reserved for Clerk's filing stamp
Diane M. Fetherolf } RECEIVED
}
Against the County of Contra Costa ) OCT 2 4 1996
or
District) �R coy Ra COSTA ca soR$
in name
I I �
'The undersigned claimant hereby makes cla#m,against the County of Contra Costa or
the above-named District in the sum of $ 400,400 and in support of
this claim represents as follow3:
1. When did the damage or injury occur? (Give exact date and hour)
July 30, 1996
2, Wto-re did tlhw damp or inky occur? (Include city and county)
Merrithew Memorial Hospi'ta7 , Martinez, Contra Costa County
I
3. Bow did the damage or injury occur? (Give ;Lill details; use extra paper if
required) Plerrithew -Memorial Hospital failed to preserve the foreign body which it
removed from claimant. Said foreign body would have constituted evidence in claimant's
medical malpractice litigation.
4. What particular act or omission an the part of county or district officers,
servants or employees caused the injury or damage?
By failing to preserve said evidence, claimant has a spoilation of evidence claim
which has arisen by the fact that Plerrithew Memorial Hospital denies liability in
leaving the foreign body in claimant's abdominal cavity.
(over)
5. ' What are the names Of '0 or district officers, servanr employees causing
the damage or inJury?
Employees of Merrithew Memorial Hospital 's Pathology
Department whose identities are not yet known to claimant.
6. What damage or injuries do you claim resulted? (Give !till extent of injuries or
damages claimed. Attach two estimates for auto damage.
SEE ATTACHED
7. Hoa Was the amount claimed above occputed? (Include the estimated amount of any
prospective injury or damage.) Calculated by adding claimant's special and general
damages currently being claimed in her medical malpractice case, plus expenses.
S. Names and addresses of witnesses, doctors and hospitals. Edwin. 0. Carlson, M.D. ,
Robert Levin, M.D. , Neil Jayasekera, PI.D. , Stephen D Weiss, M.D. , Samuel Chua, M.D. ,
at Plerrithew Memorial Hospital , 2500 Alhambra Avenue, Martinez, CA 945531
9. List the expenditures you made on account of this accccijd nt. or injury:
D_ IZEM
$400, excluding attorney's fees
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES T0: (Attorney) or s son on his behalf."
Name and Address of Attorney
Kelly A. McMeekin, Esq. Cell/ A110%ekin, Attorney for Diane M. Fetherolf
BRAYTON HARLEY CURTIS Diane M. Fetherolf,°.I29 Bishop Road,
P.O. Box 2109 Crockett CA 94925
Novato, CA 94943 ss
Telephone No. X415) 398-1555 Telephone No. (510) 787-3249
eef • ee • • e � e • a • • ae ,�
NOTICE
Section 72 of the Penal Code provides:
*Every person moo, with intent to defraud, presents for allowanoe or for
papment to any state board or officer, or to any!eounty, city or district board or
allow or pay the same i! genuine, any telae or fraudulent
officer, authorized to
claim, bill, account, �oycher, oz ia'itings is punishable either by imprisonment in
the oovnty fail for a period of not more than one year', by a line of not exceeding
one thous wdi($1t 0)a '_ b of not such edings=mnt andten thousand dollarsfine, or b($10, 00,orby�
the Stateprison, by
both such imprisonment and tine.
ATTACHMENT TO CLAIM BY DIANE M. FETHEROLF
6. By said failure to preserve this evidence, claimant sustained damage, namely claimant's
opportunity to prove her claim against Merrithew Memorial Hospital was interfered with
substantially and it has prejudiced her opportunity to prove her claim for compensation
for her grievous physical and emotional injuries.
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO: Kelly A. McMeekin, Esq.
Brayton Harley Curtis
P.O. Box 2109
Novato, CA 94948
RE: CLAIM OF:Diane M. Fetherolf
Please Take Notice as Follows:
The claim you presented against the County of Contra Costa or District governed by the Board
of Supervisors fails to comply substantially with the requirements of California Government
Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below:
[XX] 1. The claim fails to state the name and post office address of the claimant.
[] 2. The claim fails to state the post office address to which the person presenting the
claim desires notices to be sent.
[] 3. The claim fails to state the date, place or other circumstances of the occurrence or
transaction which gave rise to the claim asserted.
[ ] 4. The claim fails to state the name(s) of the public employee(s) causing the injury,
damage, or loss, if known.
[] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars
($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim
fails to state the amount claimed as of the date of presentation, the estimated
amount of any prospective injury, damage or loss so far as known, or the basis of
computation of the amount claimed. If the amount claimed exceeds ten thousand
dollars ($10,000), the claim fails to state whether jurisdiction over the claim would
rest in municipal or superior court.
[] 6. The claim is not signed by the claimant or by some person on is behalf.
[] 7. Other:
VICTOR J. WESTMAN, County Counsel
By: Vy
Andrea W. Cassidy Deputy County Counsel
Page 1
CERTIFICATE OF SERVICE BY MAIL
(C.C.P. §§ 1012, 1013a, 2015.5; Evidence Code§§641, 664)
1 declare that my business address is the County Counsel's Office of Contra Costa County, 651 Pine Street, Martinez,
California 94553; 1 am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a
party to this action. I served a true copy of this Notice of Insufficiency and/or Non-acceptance of Claim by placing it in an
envelope addressed as shown above, sealed and postage fully prepaid thereon, and thereafter was, deposited this day in
the U.S. Mail at Martinez, California.
I certify under penalty of perjury that the foregoing is true and correct.
Dated: October .)��1996 at Martinez, California.
cc: Clerk of the Board of Supervisors (original)
Risk Management
(NOTICE OF INSUFFICIENCY OF CLAIM:GOVT.CODE§§910,910.2,920.4,910.8)
Page 2
ll
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
' November 5, 199h. _
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Boar 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: $400,000 Section 913 and 915.4. Please note all WT
CLAIMANT: Diane M. Fetherolf
OCT 1 Q 9996
ATTORNEY: Kelly A. McMeekin, Esq. COUNTY o0UNSEL
Brayton Harley Curtis Date received MARTINEZ CALIF.
ADDRESS: P.O. Box 2109 BY DELIVERY TO CLERK ON October 8, 1996
Novato, CA 94948
BY IFIL POSTMARKED: Hand Delivered
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
October 1q 1996 tdIl RATCVIELOR, Clem ad�—
DATED: : epu y �`- ,
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
( ) This claim complies substantially with Sections 910 and 910.2.
(�G) 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 - 16 'q L 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: PHIL BATCHELOR, Clerk, By , Deputy Clerk
YARNING (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 16; 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: BY: PHIL BATCHELOR by Deputy Clerk
CC: County Cc;�.se County Administrator
mm OF Z:u. ;. ' .uB, ftfi Wbllu, Ai?�
zxM�� To a
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 an 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. (.GoIrt. Code $911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 1060 County Administration Building, 651 Pine Street, Martinez, CA 9 +553.
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 and of this
form.
ase * e rt e e e * • +} eee • • e e e : : • +a e e 1>r • • f f e • e • +a • :r e e r i e
RE: Claim By Reserved for Clerk's filing Stamp
Diane M. Fetherolf } ......_,_..�
} RECEIVE®
Against the County of ntra Costa } ^ 8 W6
or }
District} CLERK BOARD OF SUPERVISOR
n nacre
CONTRA COSCO.
} TA
The undersigned claimant hereby makes claim against the County .of Contra Costa or
the above-named District in the sum of $ _ 400,460 „ and in support of
this claim represents as follows:
1. When did the damage or injury occur? (Give exact date and hour)
July 30, 1996
3. m--h did tom. bilge er inj_• . ooaur? (lnolude city wd camty)
Merrithew Memorial Hospital, Martinez; Contra Costa County
3. Now did the damage or injury ocour? (Give full details; use extra paper if
r*gUired) Merrithew Memorial Hospital failed to preserve the foreign body
which it removed from claimant. Said foreign body would have constituted
evidence in claimant's medical malpractice litigation.
4. khat particular act or omission on the part of oounty or district officers,
servants cr employees caused the injury or damage?
By failing to preserve said evidence, claimant has a spoilation of
evidence claim which has arisen by the fact that Merrithew Memorial
Hospital denies liability in leaving the foreign body in claimant's
abdominal cavity.
(Over)
5. What are the names ofV or district officers, serumt3 or employees causing
the damage Or injury? Wpcloyees of Merrithew Memo! Hospital 's Pathology
Dept. whose identities are not yet known to claimant.
S. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
SEE ATTACHED
How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damn e.) Calculated by adding claimant's special and
general damages currently being claimed in her medical malpractice case,_
plus expenses.
8. Names and addre33e3 Of Witnesses, doctors and hospitals. Edwin O. Carlson, MD,
Robert Levin, MD'I. Neil Jayasekera, MD, Stephen D. Weiss, MD, Samuel
Chua, MD at Merr' ithew Memorial Hospital, 2500 Alhambra Avenue, Martinez ,
CA 94553
9. List the expenditures you made on account of this accident or injury:
DATE rM AMOUNT
$400, excluding attorneys ' fees
Gov. Code See. 910.2 provides:
"The claim mat be signed by the claimant
SM NOTICES TO: (Attorney) or by somd person on his behalf."
Name and Address of Attorney
Kelly A. McMeekin, Esq'.
BRAYTON HARLEY CURTIS (91almiant's Signiature)
PO Box 2109 tlev Cr)l h5
Novato, CA 94948
V
5P VX)
Telephone No. (415) 898-1555 Telephone No� Lf/L Ls
of it 0 0 fA * Va a a a V a 0 tv W a V V aae
V O'T I C Z
Section 72 of the Pe=Ll Code provides:
*Evw7 person who, with intent to defraud, presents for alloAknoe or for
paymt to any *tat* board or officer, or to any county,, city or district board or
officer, authorized to allow or pay the um If genuine, any false or fraudulent
claim, bill, account, voucher, or writing, 12 punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($ItODO)# or by both such imprisonment and fine, Or by imprisonment in
the state prison, by a fine of not exceeding ton thousand dollars 010,000, or by
both such' imprisonment and fine*
ATTACHMENT TO CLAIM BY DIANE M. FETHEROLF
6. By said failure to preserve this evidence, claimant sustained damage, namely claimant's
opportunity to prove her claim against Merrithew Memorial Hospital was interfered with
substantially and it has prejudiced her opportunity to prove her claim for compensation
for her grievous physical and emotional injuries.
.AMMED C L A 1 M
BCA;: Or SU*'ER4'.S::.S Or CONT;: ",STA COUNTY, CALIFORNIA- November 5, 1996
Claim Against the County, or District governed by) BOAR�_ACT1ON
the Boar: cf Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Boa-: Action. All Section references are to The copy of this document mailed to you is your notice of
Califo-ria Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IY below), given pursuant to Government Code
Amount: $10,000.00+ Section 913 and 913.4. Please note all 'warr`T311VIE3)
CLAIMANT:Beale Hughes OCT 2 4 1996
ATiORNEY:1135 Sir Francis Drake Blvd. 410 COUNTY COUNSEL
Kentfield, CA 94904 Date received MARTINEZ CALIF.
ADDRESS: BY DELIVERY TO CLERK ON October 24, 1996
BY MAIL POSTMARKED: October 23, 1996
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: October 24, 1996L pWyLOR, Clark
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
This claim compiies 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: BY: Deputy County Counsel
1II. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 921.3).
IV. BOAR: ORDER; By unanimous vote of the Supervisors present
( ✓) This Claim is rejected in full.
( ) Other:
I certify that this is 9 true and correct copy of the Board's Order entered in its minutes for
this date.
09te07$4'"?a"I � 19g ' PHIL BATCHELOR, Clerk, By� �,s e fig. ja � — . Deputy Clerk
YARNING (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 aril 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 went to consult
an attorney, you should do so immediately• %. For Addition]. Warning See Reverse Side Of This Notice.
AFFIDAVIT pF MAILING
I declare under penklty Of perjury that I as now, and at 911 times herein mentioned, have been a citizen of the
United Stites, over age 18; and that today I deposited in tine 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.
Datedt /2 i /9 9 to BY: PHIL BATCHELOR b _�
y '�'•'�'.t-C �/S- Deputy Clerk
CC: County Cc.;rse' County Administrator
Jeffrey R. Siegel
Attorney at Law Concord Office:
2817 Crow Canyon Road
Suite 203 1485 Enea Court
San Ramon, California 94583 Suite 1330
510-820-7655 Concord, CA 94520
Fax No: 510-820-7656 (Appointment only)
October 23, 1996
Board of Supervisors
County of Contra Costa
651 Pine Street, Room 106
Martinez, California 94553
Re: Claim of Beale Hughes for Wrongful Death of Alison Hughes
Against County of Contra Costa
TO WHOM IT MAY CONCERN:
Pursuant to my conversation with Julie Aumock, your adjuster,
of October 16, 1996, this will confirm that Beale Hughes'
daughter's name was Alison Hughes and she died on March 31, 1996.
Please let this letter serve as an amendment to the claim.
Please contact Ms. Hughes directly on all further matters.
Thank you very much.
Very tr yours
F S .SEL
JRS:dw
cc: Beale Hughes
RECEIVED
OCT 2 41996
CLERK BOARD OF SUPER,ISORS
t. CONTRA COST,.o.Co.
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CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA November 5, 1996
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Boar; 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: $10,000.00+ Section 913 and 915.4. Please note all R542111IIV11D
CLAIMANT: Beale Hughes OCT 15 1996
ATI ORNEY: COUNTY COUNSEL
Date received MARTINEZ CALIF.
ADDRESS: 1135 Sir Francis Drake Blvd. #10 BY DELIVERY TO CLERK ON September 30, 1996
Kentfield, CA 94904
BY MAIL POSTMARKED: No Postmark-Certified Mail
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
October 15 1996 QQ IL gBATCIELOR, Cly
DATED• Ba: Depu y� ate—
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
C,< 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 D BY: UU 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: 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: BY: PHIL BATCHELOR by Deputy Clerk
CC: County Ccj,.se,: County Administrator
Jeffrey R. Siegel
Attorney at Law Concord Office:
2817 Crow Canyon Road
Suite 203 1485 Enea Court
San Ramon, California 94583 Suite 1330
510-820-7655 Concord, CA 94520
Fax No: 510-820-7656 (Appointment only)
VIA CERTIFIED/RETURN RECEIPT REQUESTED
FIRST CLASS 'U.S. POST
September 27, 1996
Board of Supervisors
County of Contra Costa
651 Pine Street
Room 106
Martinez, CA 94553
Re: Beale Hughes
Dear Sir/Madame:
Enclosed herewith is a Governmental Claim and one copy.
Please process the original and return the copy stamped "recieved"
in the envelope provided.
Thank you very much.
Very truly yours,
LAW OFFICE OF JEFFREY R. SIEGEL
Patricia A. Wylie
Litigation Secretary o
\PW
JEFFREY R. SIEGEL
•
LAW OFFICE OF JEFFREY R. SIEGEL RECEIVED
JEFFREY R. SIEGEL, ESQ. S.B.#112061
2817 Crow Canyon Road, Suite 203
San Ramon, CA 94583 SEP 3 01996
Telephone: (510) 820-7655
Fax: (510) 820-7656 CLERK BOARD OF SUPERVISORS
CONTRA COSTA CO.
Attorneys for Claimant
CLAIM AGAINST GOVERNMENTAL ENTITY
PUBLIC ENTITY:
County of Contra Costa, Office of Conservatorship - Health Services
1. Name and Address of Claimant:
Beale Hughes
1135 Sir Francis Drake Blvd. #10
Kentfield, CA 94904
(415) 454-4473
2. All notices should be sent to:
Beale Hughes
1135 Sir Francis Drake Blvd. #10
Kentfield, CA 94904
(415) 454-4473
3 . The date, place and other circumstances of the occurrence
or transaction which gave rise to this Claim are as
follows:
Claimant's daughter was conservatee of Contra Costa County.
She died on March 31, 1996 while under the conservatorship, due to
negligent care and supervision of County.
GOVERNMENTAL ENTITY CLAIM
PAGE -2-
4. A general description of the indebtedness, obligation,
injury, damage or loss incurred so far as it may be known
at the time of presentation of the Claim it as follows:
Wrongful death.
5. The name and names of the public employee or employees
causing the injury, damage, or loss, if known are as
follows:
Unknown at this time.
6. The amount claimed as of the date of presentation of this
Claim, including the estimated amount of any prospective
injury, damage, or loss, insofar as it may be known at the
time of the presentation of this Claim, together with the
basis of computation of the amount claimed is as follows:
Superior Court.
DATED: �' �a LAW OFFICE OF JEFFREY R. SIEGEL
0 By:
JEF EY R. S GEL
At rney fo laimant
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CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA November 5, 1996
Claim Against the County. or District governed by) BOARD ACTION
the Board cf Supervisors. Routing Endorsements, ) NOTICE TO CLAIMANT
and Boar: 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: Unknown Section 913 and 915.4. Please note all •warnin
CLAIMANT: Lizette A. Trice STO
ATiORNEY: OCT 15 1996
Date received COUNTYCOUNSEL
ADDRESS: 41 Wharf Dr. BY DELIVERY TO CLERK ON October I�RTtj �
Bay Point, CA 94565
BY MAIL POSTMARKED: Hand Delivered
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
October 15, 1996 QpNNIL ggATC ELOR, Clerk� 4 0. _
DATED: B1'. DePUT.y -/iS'0'�`��
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: 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
(V) 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.
--5- 1796P 1 9yCO PHIL BATCHELOR, Clerk. BYLL� . 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:�su�-nom /-2) BY: PHIL BATCHELOR Clerk
CC: County Cc,:rSe, County Administrator
- .laim to: BOARD OF SCPEROISORS OF-aIMA COSTA COOM
A. Claims relating to causes of action for death or for injury to person or to per-
conal property or growing crops and which accrue on or before December 31, 19879
mist 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,
19889 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 ane 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
Tom—.
f ! f s • f • • • ! 0 s a 0 4 0 0 • i ! 4 0 • • f i ! i • 0 f ! • 6 4 f f 0 f # i 0 *
RE: Claim By Reserved for Clerk's filing stamp
RECEIVED
Against the county or Contra Costa )
or ) OCT 1 51996
District)
Fi in name CLERK BOARD OF SUP RVISORS
CONTRA COSTA CO.
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of $ and in support of
this claim represents as follows:
w1+"rh31'Ltihp �1.11d.'j'�1 al of tha mien i r-i na 1 COUrtS
1. When did the damage or injury occur? (Give exact date and hour)
4/18 L 6-a D p g i m i t e l.Y..sZ_4�.iii"-....
2. Where did the damage or injury occur? (Include city and county)
41
3. Row did the damage or injury occur? (Give f%LU detallsf use extra paper if
required)
See attached .
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury. or damage?
See attached
(over)
Pc,%e, I '�
5. What are the names of county or district officers, servants or employees causing
• the damage or .injury?
Deputy STEPHANIE BROWN and other Officers of the CONTRA COSTA COUNTY
Sheriff ',sdepartment .
6. What damage or injuries do you claim resulted? (Give !till extent of injuries or
damages claimed. Attach two estimates for auto damage.
� SPP attar-•hor�
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury cr damage.)
See attached.
S. Names and addresses of witnesses, doctors and hospitals.
DR. NICHOLAS, BRANCH Clinic Navy Weapon Station
Shannon Bruno 57 Wharf Dr. Bay Point Ca . 94565
Janice Porter 38 Lakeview Dr . Bay Point Ca. 94565
9. List the expenditures you made on account of this accident or injury:
DAM IM MOM
10/7/9= window $237.00
4/ 96 door $150.00
Future door&jam $200.00 ( est)
f � i f f f • f * # • � • i f • � f f � • i ; � f f ! f f g ! f � i • f f f f f f lF
Gov. Code Sec. 910.2 provides:
^The claim must be signed by the claimant
SEND NOTICES T0: (Attorney) or by some Person on h half."
We- and Address of Attorney
ignature
41 . Wharf Dr.
(Address)
Bay Pd,int"..CA. 94565
Telephone No. Telephone No. ( 510) 458-2948
; fea • • f eee • sesf • se
NOTICE
Section 72 of the Penal Code provides:
wEvery 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 baiting, 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 01090009 or by
both such imprisonment and fine.
Lizette Trice
41 Wharf Drive
Bay Point, CA 94565
On April)g 11996, my daughter and some friends were playing
music when I arrived home at 5:30 p.m. The music was playing at low
volume; I had left the house at about 5:45 p.m. As I was leaving I
saw my neighbor pull into his driveway. Here is a statement of
Shannon Bruno, one of my daughter' s friends who witnessed the
incident.
DECLARATION OF SHANNON BRUNO
I, SHANNON BRUNO, herewith declare as follows:
I currently reside with my mother at 57 Wharf Drive in Bay
Point, California, 94565 . I am currently 17 years of age, and
can be reached at 458-3817 .
I was present on April 18, 1996, in the home of Sharonda
Thornhill, when there was an altercation between Sharonda
Thornhill and a female Contra Costa Sheriff ' s deputy.
I had been present that afternoon in Sharonda' s home. We
had played some music, but 'it was not being played very loudly.
At the time that the deputy came to the door, Sharonda was '
playing with her younger brother, and I was having my hair done
by my friend, Janice Porter. The front door to the house was
open, but the screen door was closed. When the police officer
came to the door, the music had been off for some time. _ The
police officer immediately stated, "Your music is too -loud. I
heard the music when I pulled up. Can you open the door?"
Sharonda opened the screen door. The officer stated, "I am tired
of all the complaints . Next time I will take both of you to
jail, or maybe just you" . Sharonda replied, "Well, my mom is not
home and I 'm a minor. Can you wait till my mom gets back. Can
you please leave" . As Sharonda was saying this, the police
officer attempted to step through the door. As she was doing
this, Sharonda was attempting to close the door. The police
officer put her foot in the door jam, and began pushing the door
to get in stating, "You will listen to what I have to say" .
Sharonda replied, "Will you please leave. Get out of my house.
I 'm a minor. I don' t have to talk to you. Please come back when
my mom is home. " As Sharonda was saying this, the police officer
was pushing through the door and backing Sharonda up. The
officer stated again, "You will listen to what I have to say" .
Sharonda stated on several occasions, "Will you please leave. "
She stated this as she was backing up, putting her hand up in the
air trying to tell the officer to leave her hone. When Sharonda
was putting her hand up in the air in front of her, she at no
time placed her hand in close proximity to the- officer's face.
Finally, as the officer had pushed completely through the
door, Sharonda stated, "I don' t want to ask you again-get the
fuck out of my= house" . She stated this with her hand in the air,
and the police officer began slapping at her hand stating, "Get
your hand out of my face. " Sharonda replied, "My hand is not in
your face. " This occurred at least twice as the police officer
was pushing her way into the residence and backing Sharonda up.
Sharonda eventually stated to the cop, "Get out, get out" and the
cop immediately grabbed Sharonda by her hair. Sharonda had a
fake ponytail on, and the police officer eventually succeeded in
pulling the ponytail completely off Sharonda' s head. The police
officer then began to shove Sharonda around, and they began to
tussle. Eventually, they struggled through the open doorway, out
pQ 5e-4 off'-7
Gj iy
DECLARATION OF SHANNON BRUNO
Page Two
into the front yard. I saw the police officer strike Sharonda
twice with her billy club and Sharonda ran back inside of the
house.
Once Sharonda came into the house, she attempted to close
the front door, but I believe it was jammed with a piece of
carpet that had been pushed into the doorjam during the struggle.
I do not believe that the front door was actually closed when the
police officer came back up to the front door of the residence.
Next to the front door there is a sliding glass window. It was
completely open on one side. The police officer then proceeded
to break the glass-side of the window with her billy club and
yell into the home, "I 'm gonna get you, bitch" .
In the struggle with the female police officer, Sharonda' s
shirt had been completely torn off. _
Approximately five minutes later, a male police officer came
to the door, and yelled in rapid succession, "Open the door, open
the door" . Immediately after yelling this, the police officer
kicked in the front door and rushed inside. He then rustled
Sharonda to the ground, and put both of her arms in twisting arm
locks behind her back. I presume .he was attempting to handcuff
her. At this time Sharonda was screaming in pain and telling him
that he was going to break her arms. While Sharonda was on the
ground, not resisting, the female police officer came into
Sharonda' s residence and placed her knee on Sharonda's neck, and
dug her fingernails into Sharonda' s upper arm and stated to
Sharonda, "I ' m gonna get you back for what you did to me
outside" .
Sharonda was eventually taken out to a police vehicle in the
front yard without her shirt, wearing only a bra. She was kept
in the car for approximately 45 minutes without a shirt on. I
asked one of the police officers present if I could get her a
shirt, and they told me, "Pio" . I requested that-the female
deputy who first came to the house give Sharonda a shirt to wear,
and she stated, "HELL NO" .
I did not =see Sharonda resist any police officers in any
fashion other than telling the first female officer that they
could not come into her house and that she was a minor. I feel .
that the actions of this female officer, and the male officer
were very inappropriate.
{pale 6- o 7
DECLARATION OF SHANNON BRUNO
Page Three
Even though the sheriff' s officers present knew that I was
in the house and witnessed the entire incident between Sharonda
and the female sheriff' s deputy, I have never been asked about
this incident by the sheriff' s department or asked by anybody to
give a statement in this matter.
I declare the foregoing to be true and correct under penalty
of perjury, and pursuant to All the laws in the state of
s'
California. Executed thiday of May, 1396, in Bay Point,
California.
hannon Bruno
GENERAL DESCRIPTION OF INJURIES AND BASIS OF COMPUTATION OF
DAMAGES:
Compensatory damages are based upon the violation of
Claimant ' s civil and constitutional rights , including but not
limited to the right to privacy, the right to be free from
unreasonable search and seizure, the right to due process , and
the right to equal protection of the laws . Compensatory damages are
also based on the loss of freedom suffered when Claimants were'
arrested and incarcerated. Compensatory damages are also based on
monetary damages sustained by Claimants as a result of this
wrongful conduct and wrongful prosecution, including, but not
limited to attorneys fees , administrative costs and lost wages , , in
an amount presently undetermined.
Punitive damages are based upon the outrageous , malicious
nature of the officers ' acts. The above-described acts of these
officers were willful, wanton, malicious, oppressive and fraudulent
and done in conscious disregard of the peace of mind and civil
rights of Claimants .
e -7
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA November 5, 1996
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Boar; 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: Unknown Section 913 and 915.4. Please note 1tv"1711,3)
CLAIMANT: Kenneth K. Silva, Sandra L. Silva
0 C T 15 1996
ATTORNEY: Richard C. Bennett, Esq.
Bennett, Johnson &Galler Date received COUNTY COUNSEL
ADDRESS: 1901 Harrison St. , Ste. 1650 BY DELIVERY TO CLERK ON October1RTi1CALIF.
Oakland, CA 94612
BY WAIL POSTMARKED. Hand Delivered; via Risk Mgmt.
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: October 15, 1996 fail �puylOR. Cler:�� �� _
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: /(0 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:
r
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
Datede-uc�nP �,� �0 PHIL BATCHELOR, Clerk, Big- -�-J;' dJ— Deputy Clerk
61ARNING (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 nil 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 16; 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:�� X21 i99� BY: PHIL BATCHELOR Deputy_Deputy Clerk
—r
CC: County Cc,;rse,; County Administrator
errithew Ron Ha1D C �
emorial
C@0WOMIL OCT 141996
AND HEALTH CENTERS
October 8, 1996
To: Contra Costa County Counsel
From: William Walker,M.D.,Health Services Director
Re: Kenneth Silva
Enclosed please find a Claim regarding the above-named patient received by hospital administra-
tion on 10-7-96 by certified mail.
enc.
cc: Ron Harvey
CONTRA COSTA COUNTY ST
LAW OFFICES
BENNETT, JOHNSON & GALLER
A PROFESSIONAL CORPORATION
MAIN OFFICE
1901 Harrison Street
— - 16th Floor
Oakland,CA 94612
[R (510)444 5020
AX(510) 835-4260
October 4, 1996 OCT 1,96
HOSPITAL AWINISTI4AT�fl�I
telE RflTHE141 IMEM0RIAL H08PITA L
AND CLINICS
Merrithew Memorial Hospital
2500 Alhambra Avenue
Martinez, CA 94553
Re : Claim of Kenneth and Sandra Silva
Gentlemen:
Enclosed please find an original and copy of a Claim
presented on behalf of our above-captioned clients with regard to
the medical care received by Mr. Silva at your facility.
Please "receipt" stamp the copy of the Claim and return it
to this office in the envelope provided.
Your prompt response will be sincerely appreciated.
Very truly yours,
BENNETT, JOHNSON & GALLER
RICHARD C. .BENNETT
RCB:clh
Enclosures
NAPA COUNTY RIVERSIDE COUNTY SANTA RARRARA
1001 Second Street 82500 Hwy. 111 COUNTY
Suite 295 Suite 5 204 North Vine Street
Napa,CA 94559 Indio,CA 92202 Santa Maria,CA 93454
(707)257-2110 (619)342-6697 (805)922-6674
RECEIVED
OCT 1 419%
1 GOVERNMENT CLAIM FOR DAMAGES _
2 K 80ARD OF SUPE ISORS
— CONTRA COSTA CO.
3 TO CLAIMEE: Merrithew Memorial Hospital
and its agents, employees and
4 staff members who are
presently unknown
5 2500 Alhambra Ave.
Martinez, CA 94553
6
FROM CLAIMANTS: KENNETH K. SILVA, SANDRA L. SILVA
7 2030 Boynton Avenue
Martinez, CA 94553
8
ADDRESS TO WHICH
9 NOTICES TO BE SENT: Richard C. Bennett, Esq.
BENNETT, JOHNSON & GALLER
10 1901 Harrison St . , Suite 1650
Oakland, CA 94612
11
DATE ' CLAIM ACCRUED: On or about June 4, 1996
12
PLACE CLAIM ACCRUED: Merrithew Memorial Hospital
13 2500 Alhambra Ave .
Martinez, CA 94553
14
CIRCUMSTANCES OF CLAIM: On or about January 23 , 1996, Claimant
15 KENNETH K. SILVA was injured in an
industrial accident . As a result of
16 said accident Claimant underwent a
series of x-rays which revealed a
17 benign pituitary tumor diagnosed by Dr.
Ken Bowers at Claimee MERRITHEW
18 MEMORIAL HOSPITAL on or about February
8, 1996 . Subsequent to said diagnosis
19 Claimees failed to recommend, or
consider, a medication regiment of
20 tumor shrinking drugs such as
Bromocriptine. Claimees insisted upon
21 immediate surgery upon Claimant' s tumor
which was unsuccessfully carried out on
22 or about April 4, 1996 .
23 Claimants contend that the care and
treatment rendered to the patient was
24 inappropriate, unwarranted,
unnecessary, negligent and as a legal
25 result thereof Claimant patient was
rendered severely brain damaged.
26 Claimants also contend that the
Claimees' failed to adequately inform
27 the patient of the risks of said
surgery and appropriate alternatives
28 thereto. Moreover, Claimants have
1 suffered severe emotional distress,
depression and Claimant patient will be
2 and is permanently unable to work or
independently care for himself .
3
As a further result of Claimees'
4 negligence, Claimant patient has been
forced to undergo multiple additional
5 surgeries.
6 Claimants first became aware of the
Claimees' negligent care and treatment
7 on or about June 4, 1996 .
8 ITEMIZATION
OF DAMAGES : Claimant KENNETH K. SILVA: Past and
9 future medical expenses, past and
future loss of earnings, pain and
10 suffering; Claimant SANDRA L. SILVA:
emotional distress damages, loss of
11 consortium, future loss of earnings for
attendant care and medical expenses .
12 The amount claimed exceeds the
jurisdictional limits of the Municipal
13 Court for Contra Costa County. The
exact amount of said damages is
14 presently unknown and is continuing but
will be proven at the appropriate time .
15
DATED: October 4 , 1996 .
16
BENNETT, JOHNSON & GALLER
17
18
19 RICHARD C. BENNETT, ESQ.
20
21
22
23
24
25
26
27
28
1 PROOF OF SERVICE
2 I, Cindy Hermanson, am employed in the County of Alameda,
State of California.
3
I am over the age of eighteen (18) years and not a party to
4 the within action. My business address is
BENNETT, JOHNSON & GALLER, 1901 Harrison Street, Suite 1650,
5 Oakland, California 94612 .
6 On October 4 , 1996, I served the within:
7 GOVERNMENT CLAIM FOR DAMAGES
8 on the parties to this action by placing a true copy thereof in a
sealed envelope, addressed as follows :
9
Merrithew Memorial Hospital
10 2500 Alhambra Avenue
Martinez, CA 94553
11
(Sent certified mail - return receipt requested)
12
/xxx / (BY MAIL) I placed each such sealed envelope with
13 postage thereon fully prepared for first-class mail, for
collection and mailing at Oakland, California, following ordinary
14 business practices . I am readily familiar with the practice of
BENNETT, JOHNSON & GALLER for processing of correspondence, said
15 practice being that in the course of ordinary business,
correspondence is deposited in the United States Postal Service
16 the same day it is posted for processing.
17 / / (BY PERSONAL SERVICE) I caused each such envelope to
be delivered by hand to the addressee noted above.
18
(BY FACSIMILE) I caused said document to be
19 transmitted by Facsimile machine to the number indicated after
the address (es) noted above between the hours of 9 : 00 a.m. and
20 5 : 00 p.m.
21 I declare under penalty of perjury under the laws of the
State of California, that the foregoing is true and correct .
22 Executed at Oakland, California, on October 4, 1996 .
23
24 _
CINDY H ON
25
26
27
28
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CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA November 5, 1996
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Boar,, 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: Unknown Section 913 and 915.4. Please-nole
CLAIMANT: Carl L. Morrison
OCT
ATTORNEY:
NSSL
Date received COUNTY NNCJ�
ADDRESS: 700 Berkshire Ct. BY DELIVERY TO CLERK ON OctobE IF
Dixon, CA 95620
BY WAIL POSTMARKED: Hand Delivered; via Risk Mgmt.
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
a
• October 15, 1996 Qg IL ggATC�ELOR, Cler
DATED.
O : Depu y
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: �� C /V 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
( his 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: -5-, /W4 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 16; 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. l
Dated: Wit-f��/:f-) g�—p BY: PHIL BATCHELOR Deputy Clerk
T �
CC: County County Administrator
: -,�- OF WEEN,Zd0115', 0£ CSA COCA.CQlW'Y
I1:SI'RUCTI0235 TO Ca..A�'ihtdT
A. Claims relating Lo causes of action for death or for injury to person, or Lo 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 accrualt of :the cause .
of action. Claims relating to any other cause of action-mist be presented not
later than one year after the accrual of the cause of action. (Govt. Code 5911.2.)
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
fog.
RE: Claim By ) Reserved for Clerk's filing stamp
CA rPoP)ZISo& RECEIVED
Against the County of Contra Costa ) OCT F
or
�tA y
District) CLERK BOARD OF SUPERVISORS
Fill in tame ) CONTRA COSTA CO.
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sur of and in support of
this claim represents as follows:
1. When did the damage or injury occur? (Give exact date and hour)
3v 9t, oo Pm
2. Where did the damage or injury occur? (Include city and county)
3. How did the damage or injury occur? (Give frill details; use extra paper if
required) vim'
4. What particular act or omission on the part of county or district officers,
se.^vants or employees caused the injury or damage? : I _ s OS i o� WS-9 X1 N
VEHICLE ACCIDENT REPORT
DATE -'l 1p TIME 2 � ACCIDENT LOCATION
Vehicle Equipment No.� Lic. Plate No. 'Year/Make/Type
County Driver: Other Driver:
Name Name C-)1jj- L- YZ�'✓✓�S w�
Department
Home Address Home Addressk'--s
Home
Home Phone # Home Phone
Work Phone # Work Phone 51 o - k-7 ,z I u C 7-1- 3
Driver's License # Driver's License #
Car: Year ��SAr Make Model
If Personal or Rental Vehi ,e Registered Owner r.lLL nAkvylsu
Name & Address of Agent Address .g-flv,-c
Phone # -2- ',�--�
Li cense Plate
Insurance Company
Police Report Taken: es No Address
Policy #
Police Dept. Agents Name
List Injured Parti s: List Witnesses:
1. Name 1. Name Cr I � l`1✓11 �
Phone # Phone #
Address Address
Street Street
y tate p Code City 5tate Zip Code
2. Name 2. Name W,((q-
Phone
l q- i f�
Phone # Phone #
Addre Address
Street Street
City State -Zip Code City State Zip ode
3 Name 3. Name �o Yh MLw
hone # Phone #
Address Address
Street Street
City State Zip ode City State Zip Code
Seat Belt Worn By County Driver: Yes o i \7-,h0fs
Damage to County Vehicle F,iAL"o Iz- -P °,�^ I(
Damage to Other Vehicle C 4 C/ /C
7-11
11-wnoc-lc- . .335— /Y`/z- - (A y
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7/•29/96 HONDA OF VACAVILLE Page: 1
Phone (707) 449.5940 Fax (707)451-2213 dp i
ACCORD 1992 4DR LX Section: BODY Page: WINDSHIELD; (G 12 ) G�
5
17
7 17
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12 13 196
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BLOCK ID: G 12 ILLUSTRATION: SM4385200B
PARTS PICK LIST
Item Ref Description Part QTY Unit Price EXT PRICE
1 1.3 GLASS, FR. 3246790 1 466.31 466.31
2 1.4 GLASS, FR. 3287489 1 466.31 466.31
3 2 RUBBER, FR. 3287497 1 29.68 29.68
4 3 SPACER, FR. 3863024 2 3 .20 6.40
5 4 MOULDING, FR. 3536406 1 33 .38 33.38
6 6 MOULDING, R. FR. 3863040 1 67.14 67,14
7 7 E-CLIP, FR. 3287554 2 1.56 3.12
8 10 MOULDING, L. FR. 3863073 1 67.14 67.14
9 11 SEAL, FR. INSTRUMENT 3289980 1 16.64 16.64
10 13 CLIP A, FR. 3396686 8 1.72 13.76
11 14 CLIP B, FR. 3302098 8 1 .72 13.76
12 15 CLIP, FR. WINDSHIELD 3302155 4 1.36 5.44
13 16 CLIP C, FR. 3302163 2 1.72 3.44
14 17 CLIP, FR. (UPPER) 3302189 5 1.56 7.80
W,Q �k-j_ 140'�Oj . Total: $1,200.32
1 11
Copyright 0 1996 American Honda Motor Co. Inc. All Rights Reserved 3
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Bob Stambaugh
Owner
(707) 447-4112 907 Merchant Street
FAX: (707)447-4161 Vacaville,CA 95688 ; '^'
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CLAIM
BOARD OF SUPERy150RS OF CONTRA COSTA COUNTY, CALIFORNIA November 5, 1996
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: Unknown Section 913 and 915.4. Please note af89a„r=.i_ng$�,M
CLAIMANT: Sarah McDaniels and Devon Tolbert1996
ATiORNEY: Robert B. Galler, Esq. �CT 1 5
Bennett, Johnson & Galler Date received COUNTYCOUNSEL
ADDRESS: 1901 Harrison St. , Ste. 1650 BY DELIVERY TO CLERK ON October 11+ARTlyf6CALIF.
Oakland, CA 94612
BY MAIL POSTMARKED: Hand Delivered; via Risk MQmt.
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
October 15 16 IL BATCHELOR, Cler
DATED: 99ae B�: Deputy
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: D A6 8Y:dWZQAvU 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
( V/ 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:W04-embtA ���99ly PHIL BATCHELOR. Clerk, By, v�t�n2w / � 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 nail to file a court action on this claim. See Goverment 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:_)_)&tA--� 12) 99�p BY: PHIL BATCHELOR biLe�nR- v�a��' Deputy Clerk
CC: County County Administrator
errithew Harvey
Z�emorial Ron
C@0MIL
AND HEALTH CENTERS OCT 141996
October 8, 1996
To: Contra Costa County Counsel
From: William Walker,M.D.,Health Services Director Vc
Re: Sarah McDaniels and Devon Tolbert
Enclosed please find a Claim regarding the above-named patients received by hospital administra-
tion on 10-7-96 by certified mail.
enc.
cc: Ron Harvey
jot _
a
CONTRA COSTA COUNTY ST "-
LAW OFFICES
BENNETT, JOHNSON GALLER
A PROFESSIONAL CORPORATION
MAIN OFFICE
1901 Harrison Street
16th Floor
Oakland,CA 94612
(510)444-5020
FAX(510) 835-4260
October 7, 1996
Merrithew Memorial Hospital
2500 Alhambra Avenue
Martinez, CA 94553
Re : Claim of Sarah McDaniels and Devon Tolbert
Gentlemen:
Enclosed please find an original and copy of a Claim
presented on behalf of our above-captioned clients with regard to
the medical care received by them at your facility.
Please "receipt" stamp the copy of the Claim and return it
to this office in the envelope provided.
Your prompt response will be sincerely appreciated.
Very truly yours,
BENNETT, JOHNSON & GALLER
ROBERT B. GALLER
RBG:clh
Enclosures
NAPA COUNTY RIVERSIDE COUNTY SANTA BARBARA
1001 Second Street 82500 Hwy. 111 COUNTY
Suite 295 Suite 5 204 North Vine Street
Napa,CA 94559 Indio,CA 92202 Santa Maria,CA 93454
(707)257-2110 (619)342-6697 (805)922-6674
RECEIVED
1 GOVERNMENT CLAIM FOR DAMAGES ACTe 14 X96
.� .. -k
2 CLERK BOA D OF SUPERVISORS
CONTRA COSTA CO.
3 TO CLAIMEE: Merrithew Memorial Hospital
and its agents, employees and
4 staff members who are
presently unknown
5 2500 Alhambra Ave .
Martinez, CA 94553
6
FROM CLAIMANTS : SARAH McDANIELS and
7 DEVON TOLBERT, a minor
295 Amante Drive
8 Pacheco, CA 94553
9 ADDRESS TO WHICH
NOTICES TO BE SENT: Robert B. Galler, Esq.
10 BENNETT, JOHNSON & GALLER
1901 Harrison St . , Suite 1650
11 Oakland, CA 94612
12 DATE CLAIM ACCRUED: Date of Discovery of Malpractice
May 3 , 1996
13
PLACE CLAIM ACCRUED: Merrithew Memorial Hospital
14 2500 Alhambra Ave.
Martinez, CA 94553
15
CIRCUMSTANCES OF CLAIM: Claimants SARAH McDANIELS and DEVON
16 TOLBERT, a minor, patients of Claimee
MERRITHEW MEMORIAL HOSPITAL, and under
17 the direct care and supervision of said
Claimee and its agents and employees,
18 were treated negligently during the pre-
natal period and labor of Claimant SARAH
19 McDANIELS and subsequent delivery and
birth of Claimant DEVON TOLBERT on or
20 about October 8, 1995 . Said negligence
resulted in severe personal and
21 emotional injuries to Claimants SARAH
McDANIELS and DEVON TOLBERT.
22
Claimee and its staff failed to properly
23 evaluate, care for and super-vise the
pre-natal period as well as the
24 progression of the labor of Claimant
SARAH McDANIELS and the subsequent
25 delivery and birth of Claimant
DEVON TOLBERT. Claimee knew and
26 was aware, or should have known and
been aware, that prior to labor and
27 delivery that Claimant DEVON TOLBERT
was a very large fetus and was
28 therefore subject to birth complications
1 along with Claimant SARAH McDANIELS .
On or about October 8, 1995, during
2 delivery, Claimant DEVON TOLBERT became
stuck and lodged in the birth canal
3 and thereafter was forcibly yanked and
pulled from the birth canal, causing
4 severe injuries to Claimants .
As a direct and legal
5 result of the negligence of Claimee and
its staff as alleged herein, Claimants
6 suffered severe personal and emotional
injuries . Claimants became aware of the
7 negligent care provided by Claimee on
or about May 3 , 1996 .
8
9 ITEMIZATION
OF DAMAGES : The medical bills incurred as a result
10 of the personal injury to Claimant
DEVON TOLBERT as well as future medical
11 costs and pain and suffering and
emotional distress incurred by Claimants
12 as a result of the negligent care and
treatment rendered by Claimee. The
13 exact amount of the damages are unknown
at this time and will be proven at the
14 appropriate time . The damages will
exceed the jurisdictional limits of the
15 Municipal Court for Contra Costa County.
16
DATED: October 7, 1996 .
17
BEN JOHNSON & GA LER
18
19
20 OBER B. GALLER, ESQ.
21
22
23
24
25
26
27
28
1 PROOF OF SERVICE
2 I, Cindy Hermanson, am employed in the County of Alameda,
State of California.
3
I am over the age of eighteen (18) years and not a party to
4 the within action. My business address is
BENNETT, JOHNSON & GALLER, 1901 Harrison Street, Suite 1650,
5 Oakland, California 94612 .
6 On October 7, 1996, I served the within:
7 GOVERNMENT CLAIM FOR DAMAGES
8 on the parties to this action by placing a true copy thereof in a
sealed envelope, addressed as follows :
9
Merrithew Memorial Hospital
10 2500 Alhambra Avenue
Martinez, CA 94553
11
(Sent certified mail - return receipt requested)
12
/xxx / (BY MAIL) I placed each such sealed envelope with
13 postage thereon fully prepared for first-class mail, for
collection and mailing at Oakland, California, following ordinary
14 business practices . I am readily familiar with the practice of
BENNETT, JOHNSON & GALLER for processing of correspondence, said
15 practice being that in the course of ordinary business,
correspondence is deposited in the United States Postal Service
16 the same day it is posted for processing.
17 / / (BY PERSONAL SERVICE) I caused each such envelope to
be delivered by hand to the addressee noted above .
18
(BY FACSIMILE) I caused said document to be
19 transmitted by Facsimile machine to the number indicated after
the address (es) noted above between the hours of 9 : 00 a.m. and
20 5 : 00 p.m.
21 I declare under penalty of perjury under the laws of the
State of California, that the foregoing is true and correct .
22 Executed at Oakland, California, on October 7, 1996 .
23
24 U41A
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25
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