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HomeMy WebLinkAboutMINUTES - 12011998 - C28 .. ... ..... CLAIM BOAM OF SUPEMS4R OF CONTRA COSTA COUNTY, CAI DIINIA BOARD AC-n December '1, 1398 Claim Against the County, or District Governed by 1 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to 1 The copy of this document marled to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given 27,CTIaW�0 pursuant to Government Code Section 913 and 915.4. Please note',all "Warnings„ OCT 2 7 199$ AMOUNT: In excess of $25,000.00 COUNTY COUNSEL CLAIMANT: Ronald Baker MARTINEZ CALIF. ATTORNEY: Martin T. Snyder DATE RECEIVED: October 26, 1998 Snyder, Cornelius & Hunter October 26, 1998 ADDRESS: 399 Taylor Blvd., Suite 106 BY DELIVERY TO CLERK ON: Pleasant Hill, CA 94523 BY MAIL POSTMARKED: Unreadable L FROM: Clerk of the Board of Supervisors TO. County Counsel Attached is a copy of the above-noted claim. October 27, 1998 PHIL BATCHELOR, Clerk Dated: By: Deputy � / IL FROM- County Counsel TO: Clerk of the Board of Superv° ors (v,/f This claire► 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: 1 0 ae' By: � �`� Deputy County Counsel U 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: DC&, PHIL BATCHELOR, Clerk, By �' , Deputy Clerk WARNING (Gov. code section 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 h3AII.JNG 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 wepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. t-ciiBy: PHIL BATCHELOR By ±�Deputy Clerk Asei County Administrator O.CT-22-1998 09.'53 CONTRA COSTA CTY RISK MGT P.02/03 ' Claim to: HOARD OF SUPERvWR'S OF CONTRA COSTA COUNTY I�IUtj'I'ICl1YS'!b CLAIMA�t'T A. Claims reladag to caases of action for death or for lajury to person or to personal property or growing crop and rrttich accrue ea or before December 51, 1987,mut be presented not later than the 10e day mer the accrual of cite cause of action. Claims relating to causes of action for death or for injury to person or to pd rm W property or growing dupes and which scow spa or after Jasuss7 1, 191111,must be presented not later than six months after the McCraw Q(the cause of acelon. Claims rViating to any other rause of Action mast be pros it ad later than one year after the McCraw of the dame erf action. (Govt Code x'111.1 ) a Claims must be tried with the Clerk of the Board of Supervisors at its drm is Room 106, County Administrati OCT-22-1959 09:53 CONTRA COSTA CTY RISK MGT P.03iO3 5. What are the amucs of county or district ofd ers,aen-ants,or emfiloy+tea causift the damage or injury? c. Who damages or injor€etr do yotr claim tvaulted° (Krm M#dew otimintits or amoven daimet A#wb two eadaysea for fit.. 'l� ,'�? r 3 -A,,y- ' . Dz Lc� 7. How was the above claimed amount computed* pmopm4fte t owy or dam.) r -----------------------A,P1��" Pit' � ', - � f el u , --------- ------------- -___-_ ........ ............ M. Naam and iuldresses of�s doctors,and hoq*nlx Dvwt' 1`7 H7 +*L. t t 9-: IZ Vii, f ' i k.. __ q:5 ,_. ..___-_ ...G _1 !. Lint tirtr expeaditt m you made on account of this accident or uyurr. Gov.Code Sec 9101 providm �. muNt be Signed,by the ct"AM SEND NOTICES To: (wtt MMM) or by mum perns on hid bd " Name and Address of Attorney ''u si�naftrrp) CIO .9 052- Telephone No, Tttepboae No. 5 0 J& NOTICE Section 72 of the Penal Code prpvidea: "Every person who.with intent to defraud,presents#or allowance or for paymaat to any state board or otli€er,or to any county,city or district board or officer,autherimil to allow or pay the same if g wine,any Uht or fraudtil+eat cWm,,,brill,acomirnt,voucher,dr writing,is punishable dtber by iatprisonmexit in the county jail for a period of not mom than am year,by a time of not enceding one thousand dollars($im),or by both such impriseament and fuw,or by imp r isvomat in the sstatx prism.by a foe of not exaaeding ten thousaa d dollars(Stil is). or by both such imprimmew and fine. TOTAL P.03 k� Customer Name ;-._}u' �5 'ct tom` HomeAddress {-x, ViS and Detail Center Phone gate ,-} . (A Time Appian 80 Center P.O.# 1261"Cara hills Dr. Job 8y Phone Pinole,CA 94564 Make of Car?. Condition , }>�'. Year >' } Mode#f' Calor , 510-724-5112 Salesperson ' 4724 MacDonald Ave. r Estimate$ Richmond,CA 94805 610.234.6112 SERVICE P#itG#r ExteriorServices Original Paint Repaint No Warranty Q Limited Warranty Mont ® Interior Services: DeaierComments 5 a f=abric Prctecticn ® Extra Serviceas: } Extended Service: t. Subtotal Tax CusLnmerSignature TOTAL s WHITE-8 PEA CAR WASH CANARY-REALE PINK-CUSTOMER. yf(ff-/' ii R to ; < �f o APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA rOSi`A CD CALIFORNIA BOARD ACTION Dec. >1,- 1998 Application to File Late Claim ) NOTICE TO APPLICANT Against the County, Routing ) The copy of this ocument mai ed tc you is your Endorsements, and Hoard Action.) notice of the action taken on your application by {All ,Section Referenoes areto } the 'Board of Supervisors (Paragraph III, below), California Government Cade.} ) given pursuant to Government Code Sections 911.8 and 915.4. 'Please note the AA`N'M" below. Ciaimantt Mandi Lea Beck. MIT- James Maria Cruz-Rincon M Attorneys F. Joseph Bechelli, Jr. OCT 1 8 1998 Boatwright, Adams & Bechelli Address: 1738 Grant. Street COUNTY COUNSEL Concord, CA 94520 MARTINEZ CAKtoher 2b 1998 ,Amounts $5,000,000,00 By delivery to Clerk on , Date Received: October 26, 1998 By 'mail, postmarked on Hand-delivered I. : erk cs tee Board cf Supervisors TO t County Counsel Attached is a dopy of the above noted Application to File Late Claim. DATEDs October 23 1998 PHIL BATaJE R, Clerk, By � '. Deputy II. M: County Counsel TOt Clerk o t d of Supervisors ( ? The Hoard should grant this Application to File Late Claim (Section 911.6). { 1 The Board should deny this Application to File Late Clam (Section 911.6). DATE3sf` V-~` -� '` 'V'ICTOR 'WES'1 M, County Counsel, � �y� ',� ��� Deputy III. MOM MEW By mous vo e of Supervisors present (Cheer one only) { ) This Application is granted (Section 911.6). This Application to File Late Claim is denied (Suction 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: ? „PHIL BATCRELOR, Clerk, By Deputy WANING (Gov. Code 5911.8) If you wish to file a court action an this matters you must first petition the appropriate courtfor an order relieving you from the provisions of Gove rreent. Code Section 945.4 (claims mentation 1WArement). SeeGoveerramt code Section 946.6. Such petition must be tiled with the court within six (6) months from the Bata your application for leave to present a late olaim uw denied. You may seek the advise of any attorney of your choice in on with this ratter. If M Leant to consult an at should do so imm�ediata ClerkIV. FROM: t County -e Y A s ra e Attached are copies of the above Application. We notifed the apioant of the Board's action on this Application by mailing a copy of this document, d a memo thereof has ben tiled and endorsed on the Hoard's oopy of this Claim in accordance with Section 29703• NATE: t Ct BATCHELOR, clerk, BY ' .. :F ? 1 y V. OMs 1 Countyunsel 2 County Adminibt or TO: Clerk Of the Boar of` supervisors Received copies of this Application and Board Order. DATED: County Counsel, By County Administrator, BY APPLICATION M FILE LATE CLAIM 11 ....... ......__. ......... ......... ......... ......._. ... ...... ......... _....._.. _ ........ _........... ............ ......... .._..... ......... ......... ......... ......... ......... ......... ......... ......... } 4 9 OCT 2 6, Mandi Lea Beek 4$ f'� a c/o F. Joseph Bechelli, Jr. CLIERu K Boatwright, Adams&Bechelli 1738 Grant Street Concord, CA 94520 Telephone: (925)587-9121 NOTICE OF INTENTION TO COMMENCE ACTION AGAINST HEALTH CARE PROVIDER.(+C.C.P. §3641 TO: DONALD DENT HOBART, M.D. 1210 Alhambra Avenue Martinez, CA 94553 JONATHAN L. SCHEFFER, M.D. 1404 Castro Street Martinez, CA 94553 JUDITH C. BLISS, M.D. 2500 Alhambra Avenue Martinez, CA 94553 AMY BUONCRISTIANI, M.D. 2500 Alhambra Avenue Martinez, CA 94553 MERRITHEW MEMORIAL HOSPITAL 2500 Alhambra Avenue Martinez, CA 94553 CONTRA COSTA COUNTY Board of Supervisors 551 Pine Street Martinez, CA 94553 PITTSBURG HEALTH CENTER. c/o Contra Costa County Board of Supervisors 651 Pine Street Martinez, CA 94553 REGENTS OF THE UNIVERSITY OF CALIFORNIA 300 Lakeside Drive, 7th floor Oakland, CA 94612 YOU ARE HEREBY NOTIFIED that M:ANDI LEA BECK, individually and as Guardian ad Litem for the minor child JAMES MARIO CRUZ,-RINCON, intends to file an action against DONALD KENTHOBART, M.D., JONATHAN L. SCHEFFER,M.D.; JUDITH C. BLISS, M.D., AMY BUONCRISTIANI, M.D., MERRITHEW MEMORIAL HOSPITAL, CONTRA COSTA COUNTY;PITTSBURG HEALTH CENTER.and REGENTS OF THE UNIVERSITY OF CALIFORNIA for professional negligence. The legal basis of this action will be that on or about October 25, 1997 and October 26, 1997, said DONALD KENT HOBART, M.D., JONATHAN L. SCHEFFER, M.D., JUDITH C. BLISS, M.D., AMY BUONCRISTIANI, M.D., MERRITHEW MEMORIAL HOSPITAL, CONTRA COSTA COUNTY,PITTSBURG HEALTH CENTER and REGENTS OF THE UNIVERSITY OF CALIFORNIA, and unknown others working for and employed by said parties and entities, negligently and carelessly failed to properly diagnose, treat and care for the medical condition of Claimant M[ANDI LEA BECK.in the pre-natal care and in the delivery of JAMES MARIO CRUZ-RINCON. Plaintiffs will allege and prove that they sustained the following losses and injuries as a proximate result of the aforementioned professional negligence: extreme emotional injuries, various economic losses, brain injuries, loss of various bodily functions, cerebral palsy and related conditions, and pain and suffering. Dated: F. JOSEP ECHELLI, JR. Attorney for MAN€3I LEA BECK, Individually and as Guardian ad Litem for the Minter Child JAMES MARIO CRUZ-RINCON (Send to Health Care Provider by Certified Mail,Return Receipt Requested) c:bfce\wpwm\atb\beck 90-day letter.wpd ........................................................................................................................................................................... ..................................................... CLAIM OF MANDI LEA BECK, I APPLICATION FOR LEAVE individually and as Guardian ad litem / TO FILE LATE CLAIM, for JAMES MARIO CRUZ-RINCON / ON BEHALF OF CLAIMANT (GOV.CODE SEC. 911.4) RECEIVED TO: DONALD KENT HOBART,M.D. JONATHAN L.SCHEFFER, M.D. JUDITH C. BLISS,M.D. AMY BUONCRISTIANI, M.D. 8 0 OF SUPERW MERRITHEW MEMORIAL HOSPITAL Coi7A OStA CO. CONTRA COSTA COUNTY PITTSBURG HEALTH CENTER I. Application is hereby made, pursuant to Govt Code Section 911.4, for leave to present a late claim founded on a cause of action forpersonal injury/professional negligence which accrued on 10125/97 and 10/26/97, for which a claim was not presented within the six- month period provided by Section 911.2 of the Government Code. For additional circumstances relating to the cause of action, reference is made to the proposed claim attached to this application. 2. The reasons that no claim was presented during the period of time provided by Section 911.2 of the Government Code are that the claimant was a minor during.all of the six- month period specified by Section 911.2 for presentation of the claim; excusable neglect by claimant's attorney in being unable to obtain medical records within said six months period; and the mental incapacity of claimant. In addition, the governmental entities cited above were not prejudiced by this delay, 3. This application is being presented within a reasonable time after the accrual of the cause of action, as more particularly shown by the Declaration of F. Joseph Bechelli,Jr. attached hereto. WHEREFORE, it is respectfully requested that this application be granted and that the attached proposed claim be received and acted on in accordance with Sections 912.4 -913 of the Government Code. Dated: F. JOSEPH Ak ib, JR. Attorney for MANDI LEA BECK, Individually and as Guardian ad Litem for James Mario Cruz-Rincon ........................................................................................................................................... ..................................................... CLAIM AGAINST PUBLIC ENTITY To: DONALD KENT HOBART, M.D. JONATHAN L. SCIHEFFER, M.D. JUDITH C. BLISS, M.D. AMY BUONCRISTIANI, M.D. MERRITHEW MEMORIAL HOSPITAL CONTRA COSTA COUNTY PITTSBURG]HEALTH CENTER MANDI LEA BECK, individually and as Guardian ad Litem for the minor child JAMES MARIO CRUZ-RINCON, hereby makes claim against DONALD KENT HOBART,M.D.; JONATHAN L. SCHEFFER, M.D.; JUDITH C. BLISS, M.D.; AMY BUONCRISTIANI,M.D.; MERRITHEW MEMORIAL HOSPITAL; CONTRA COSTA COUNTY and PITTSBURG HEALTH CENTER for the sum of$5,000,000.00(five million dollars) and makes the following statements in support of the claim: I. Claimant's mailing address is c/o F. Joseph Bech4elli, Jr.;Boatwright, Adams& Bechelli; 1738 Grant Street, Concord, California 94520. 2. Notices concerning the claim should be sent to the address shown above. 3. The date and place of the incident giving rise to this claim are 10125/97 and 10/26/97 at the Merrithew Memorial Hospital; 2500 Alhambra Avenue;Martinez, California. 4, The circumstances giving rise to this claim are as follows: At said time and place, Defendants DONALD KENT HOBART, M.D.; JONATHAN L. SCHEFFER,M.D.;JUDITH C. BLISS, M.D.; AMY BUONCRISTIANI, M.D.; MERRITHEW MEMORIAL HOSPITAL; CONTRA COSTA COUNTY and PITTSBURG HEALTH CENTER negligently and carelessly failed to properly diagnose, treat and care for the medical condition of Claimant MANDI LEA BECK in the pre-natal care and in the delivery of JAMES MARIO CRUZ-RINCON. .............. ........................................................................................................ ...................................... 5. Claimants injuries include without limitation- extreme emotional injuries;various economic losses; brain injuries, loss of various bodily functions, cerebral palsy, and related conditions. 6. The names of the public employees causing the claimant's injuries include without limitation Donald Kent Hobart, M.D.; Jonathan L. Scheffer, M.D.; Judith C.Bliss. M.D., and Amy Buoncristiani, M.D. 7. My claim as of the date of this claim is$5,000,000.00. 8. The basis of computation of the above amount is as follows: Medical Expenses Incurred to Date: unknown Estimated Future Medical Expenses: unknown Loss of Wages: Unknown General Damages: $5,000,000.00 TOTAL $5,000,000.00 Dated: F. JOSEPH IOCHtLLI, JR. Attorney for MANDI LEA BECK, Individually and as Guardian ad Litem for James Mario Cruz-Rincon cAoffico\wpwms1bV=m governmental clam formwN c } ^ DECLARATION OF F. JOSEPH BECHELLI, JR. IN SUPPORT OF APPLICATION FOR LEAVE TO FILE LATE CLAIM I, F. Joseph Bechelli, Jr., declare as follows: 1. I have been retained by Mandi Lea Beck to explore the possibility of filing a claim and lawsuit for professional negligence relative to the injuries suffered by herchild James Mario Cruz-Rincon, who suffered extreme injuries during his birth on October 25 and.26, 1997 at Merrithew Hospital. That negligence caused James to be born with severe brain injuries, cerebral palsy, and related brain and bodily deficiencies. Mandi suffered extreme emotional harm and serious economic losses due to this same negligence, 2. We attempted to obtain the medical records in this case commencing in approximately March 1998, but we were not able to obtain the final set of records untilOctober 13, 1998. Only after receiving the final set were we able to ascertain the cause of the injuries and the reasonableness of filing a claim and lawsuit for these injuries. I declare under penalty of perjury that the foregoing is true and correct and that this declaration was executed in Concord, California on October 26, 1998. F. JOSEPH btC LLI, JR. Attorney for MANDI LEA BECK and.James Marin Cruz-Rincon u r LA H C APPLICATION TO FILE LATE CLAIM DECMBER_1, 1993 BOARD OF SUPERVISORS OF 6MM 55NA tX)UW, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT Against the County* Routing } The copy of this documenE ma ed you is your Endorsments, and Board Action.) notice of the action taken on your application by (All Section References are to } the Hoard of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARN=" below. Claimants Mandi Lea Reck and James Mario Cruz-Rincon Attorneys R. Joseph Bechelli, Jr. 0 C T 3 0 Boatwright, Adams & Bechelli Address: 1738 Grant Street COUNTY,COUNg Concord, CA 94520 MARTINEZ , Amounts $5,000,000.00 By delivery to Clerk on October 29, 1998 Date Reoeived: October 29, 1998 By mail, postmarked on Via Transmittal I. FER Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: October 29, 1998PHIL BATCHELOR, Clerk, By 1 .- Deputy I. FROMs County Cts—UW el : Clerk of the Board-of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). The Board should deny this Application to File Late Claim (Section 911.6). DATED: IO 34--g�- VICTOR WESTMAN, County Counsel, By c '7 d615i' eputy B—DM RDER By unan mous vote o Supervisors present (Cheek one only) ( ) This Application is granted (Section 911.6). { This Application to File Late Claim is denied (Section 911.5). I certify that this is a true and correct copy of the Board+s Order entered in its minutes for this date. DATE:-/I PHIL BATCHELOR, Clerk, By ��- � Deputy WARN (Gov. Cotte 5911.$) If you Wish to file a court action on this matter,, you must first petition the appropriate court for an order relieving you from the provision of Covert Code Section 945.4 (claim presentation requirement). Sere QOvelrnm* Code Section 946.6. Such petition must be filed With the court Within six (6) months fr+cm the :later your application for leave to present a late claim Was denied. You ERY seek the advice of any attorneY of your choice in connection With this Matter. _ IfYou,Want to am ult an attcrne should do so inodiatel . : Clarko : 1 Court y y sra 'or Attached are copiers 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 Board's copy of this Clam in accordance with Section 297133. 1� DATED: Nom- r PHIL HATCtLOR, Clerk, By . Deputy V. FRt�+i: 1 W el 797 County AMIEE gator Mt Clerk o the Board of Supervisors Received copies of this Application and Beard Order. DATED: County Counsel, By County Administrator, $p APPLICATION TO FILE LATE CLAIM 2 MEMORANDUM CONTRA COSTA REGIONAL MEDICAL CENTER CONTRA COSTA CONTRA COSTA HEALTH SERVICES Son HarveY HEALTH CENTERS OCT 2 9 1998 2540 Alhambra Avenue Martinez, California 94553 925 370-5195 October 26, 1998 dam i •; CEI 6 To: Contra Costa County Counsel From: William Walker,MD,Health Services Director ARK BOARD OF SUPERat6o"S Re: Mandi Beck and James Mario Cruz-Rincon CONTRA,COSTA Co. Enclosed please find a§364 Notice of Intent to Commence Action and an Application. for Leave to File Late Claim and the Claim regarding the above-named patients served on Contra Costa Regional Medical Center,formerly Merrithew Memorial Hospital on 10--25-98.Also,accepted at that time were the above-mentioned documents addressed to Judith Bliss,MD, and Amy Buoncristiani,MD. The following physicians were residents at the time of the event: Jonathan Scheffer,MD; Amy Buoncristiani,MD. Kent Hobert,MD, and Judith Bliss,MD, are county employees and staff physicians in the OB1Gyn Medical Staff department. c: Ron Harvey enc. •Contra Costa Substance Abuse Contra Costa Emergency Medical Services•Contra Costa Environmentat>Health•Contra Costa Health Plan• *Contra Costa Hazardous Materials•Contra Costa Mental Health• Contra Costa Regional Medical Center'•Contra Costa Health Centers Mandi Lea Beck c/o F. Joseph Bechelli, Jr. Boatwright, Adams&Bechelli 1738 GrantStreet Concord, CA 94520 Telephone: (925)687-9121 NOTICE OF ENTENTION TO COMMENCE ACTION AGAINST HEALTH CARE PROVIDER(C C P §364) TO: DONALD KENT HOBART, M.D. 1214 Alhambra Avenue Martinez, CA 94553 JONATHAN L. SCHEFFER, M.D. 1404 Castro Street Martinez, CA 94553 JUDITH C. BLISS, M.D. 2540 Alhambra Avenue Martinez, CA 94553 AMY BUONCRISTIANI, M.D. 2500 Alhambra Avenue Martinez, CA 94553 MERRITHEW MEMORIAL HOSPITAL 2500 Alhambra Avenue Martinez, CA 94553 CONTRA COSTA COUNTY Board of Supervisors 651 Fine Street Martinez, CA 94553 PITTSBURG HEALTH CENTER c% Contra Costa,County Board of Supervisors 651 Pine Street Martinez, CA 94553 REGENTS OF THE UNIVERSITY OF CALIFORNIA 300 Lakeside Drive, 7th floor Oakland, CA 94612 YOU ARE HEREBY NOTIFIED that MANDI LEA BECK, individually and as Guardian ad Litem for the minor child JAMES MARIO CRUZ-RINCON, intends to file an action against DONALD KENT HOBART, M.D., JONATHAN L. SCHEFFER,M.D., JUDITH C. BLISS, M.D., AMY BUONCRISTIANI, M.D., MERRITHEW MEMORIAL HOSPITAL, CONTRA COSTA COUNTY;PITTSBURG HEALTH CENTER and REGENTS OF THE UNIVERSITY OF CALIFORNIA.for professional negligence. The legal basis of this action will be that on or about October 25, 1997 and October 26, 1997, said DONALD KENT HOBART, M.D., JONATHAN L. SCHEFFER, M.D., JUDITH C. BLISS, M.D., AMY BUONCRISTIANI, M.D., MERRITHEW MEMORIAL HOSPITAL, CONTRA COSTA COUNTY;PITTSBURG HEALTH CENTER and REGENTS OF THE UNIVERSITY OF CALIFORNIA, and unknown others working for and employed by said parties and entities, negligently and carelessly failed to properly diagnose, treat and care for the medical condition of Claimant NIANI3I LEA BECK in the pre-natal care and in the delivery of JAMES M ARIO CRUZ-RINCON. Plaintiffs will allege and prove that they sustained the following losses and injuries as a proximate result of the aforementioned professional negligence: extreme emotional injuries, various economic losses, brain injuries, loss of various bodily functions, cerebral palsy and related conditions, and pain and suffering. D � / aced: F. JOSEPH WkEtLl, JR. Attorney for MANDI LEA BECK, Individually and as Guardian ad Litern for the NFinur Child JAMES MAEtIO CRUZ-RINCON (Send to Health Care Provider by Certified Mail, Return Receipt Requested) c:Wfficelwpwinlstblbeck 90-day letter.wpd CLAIM OF MANDI LEA BEC& / APPLICATION FOR LEAVE individually and as Guardian ad fitern / TO FILE LATE CLAM for JAMES MARIO CRUZ-RINCON / ON BEHALF OF CLA:tM[46i11T 1 (GOV. CODE SEC. 911.4) RECEIVED mow.,.... TO: DONALD SENT HOBART,M.D. JONATHAN L. SCHEFFER,M.D. JUDITH C.BLISS,M.D. � AMY BUONCRISTIANI, M.D. MERRITHEW MEMORIAL HOSPITAL CLE BOARD OF SzUPEF1 ;--- CONTRA COS'"' CONTRA COSTA COUNTY PITTSBURG HEALTH CENTER 1. Application is hereby made, pursuant to Govt. Code Section 911.4, for leave to present a late claim founded on a cause of action for personal injury/professional negligence which accrued on 10/25/97 and 10/26/97, for which a claim was not presented within the six- month ixmonth period provided by Section 911.2 of the Government Code. For additional circumstances relating to the cause of action, reference is made to the proposed claim attached to this application. 2. The reasons that no claim was presented during,the period of time provided by Section 911.2 of the Government Cade are that the claimant was a miner during all of the six- month period specified by Section 911.2 for presentation of the claim;excusable neglect by claimant's attorney in being unable to obtain medical records within said six months period; and the mental incapacity of claimant. In addition,the governmental entities cited above were not prejudiced by this delay. 3. This application is being presented within a reasonable time after the accrual of the cause of action, as more particularly shown by the Declaration of F. Joseph Bechelli,Jr. attached hereto. WHEREFORE, it is respectfully requested that this application be granted and that the attached proposed claim be received and acted on in accordance with Sections 912.4-913 of the Government Code. Lav Dated:ed. F. JOSEPH BY-CHVJLLI, JR. Attorney for MANDI LEA BECK,Individually and as Guardian ad Litem for James Mario Cruz-Rincon CLAE%1 AGAINST PUBLIC ENTTTY To: DONALD KENT HOBART,M.D. JONATHAN L. SCHEFFER, M.D. JUDITH C. BLISS,M.D. AMY BUONCRISTIANI,M.D. MERRITHEW MEMORIAL HOSPITAL CONTRA COSTA COUNTY PITTSBURG HEALTH CENTER MANDI LEA BECK., individually and as Guardian ad Litem for the minor child JAMES MARIO CRUZ-RINCON, hereby makes claim against DONALD DENT HOBART,M.D.; JONATHAN L. SCHEFFER, M.D.;JUDITH C. BLISS, M.D.;AMY BUONCRISTIANI, M.D.; MERRITHEW MEMORIAL HOSPITAL; CONTRA COSTA COUNTY and.PITTSBURG HEALTH CENTER for the sum of$5,000,000.00 (five million dollars)and makes the following statements in support of the claim: 1. Claimant's mailing address is c/o F. Joseph Bechelli, Jr.;Boatwright, Adams& Bechelli; 1738 Grant Street; Concord, California 94520. 2. Notices concerning the claim should be sent to the address shown above. 3. The date and place of the incident giving rise to this claim are 10/25/97 and 10/26/97 at the Merrithew Memorial Hospital; 2500 Alhambra Avenue;Martinez, California. 4. The circumstances giving rise to this claim are as follows: At said time and place, Defendants DONALD RENT HOBART, M.D.; JONATHAN L. SCHEFFER,`M.D.; JUDITH C. BLISS, M.D.; AMY BUONCRISTIANI, M.D.; MERRITHEW MEMORIAL HOSPITAL; CONTRA COSTA COUNTY and PITTSBURG HEALTH CENTER negligently and carelessly failed to properly diagnose, treat and care for the medical condition of Claimant MANDI LEA BECK in the pre-natal care and in the delivery of JAMES M.ARIO CRUZ-RINCON. C 5. Claimant`s injuries include without limitation: extreme emotional injuries;various economic lasses; brain injuries, loss of various bodily functions, cerebral palsy, and related conditions. 6. The names of the public employees causing the claimant's injuries include without limitation Donald Kent Hobart, M.D.; Jonathan L. Scheller, M.D.; Judith C. Bliss,M.D.; and Amy Buoncristiani, M.D. 7. My claim as of the date of this claim is$5,000,000.00. 8. The basis of computation of the above amount is as follows: Medical Expenses incurred to Date: unknown Estimated Future Medical Expenses: unknown Loss of Wages: Unknown General Damages: $5,000,000.00 TOTAL $5,000,000,00 Dated. F. JOSEPH MCHt4,Ll, JR. Attorney for MANDI LEA BECK, individually and as Guardian ad Litem for James Mario Cruz-Rincon c:\office\wpwin\slb\rmwn governmental claim form.wpd DECLARATION OF F. JOSEPH BECHELLI, JR. IN SUPPC}RT OF APPLICATION FOR LEAVE TO FILE LATE CLAIM 1,F. Joseph Bechelli, Jr., declare as follows: 1. I have been retained by Mandi Lea Beck to explore the possibility of filing a claim and lawsuit for professional negligence relative to the injuries suffered by her child James Mario Cruz-Rincon, who suffered extreme injuries during his birth on October 25 and 26, 1997 at Merrithew Hospital. That negligence caused James to be born with severe brain injuries, cerebral palsy, and related brain and bodily deficiencies. Mandi suffered extreme emotional harm and serious economic losses due to this same negligence. 2. We attempted to obtain the medical records in this case commencing in approximately March 1998, but we were not able to obtain the final set of records until October 13, 1998. Only after receiving the final set were we able to ascertain the cruse of the injuries and the reasonableness of filing a claim and lawsuit for these injuries. I declare under penalty of perjury that the foregoing is true and correct and that this declaration was executed in Concord, California on October 26, 1998. /,�7 F. JOSEPH BECHELLI,JR.. Attorney for MANDI LEA BECK and James Mario Cruz-Rincon APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS CONTRA COSTA COZlNTY, CALIFORNIA BOARD ACTION ; Application to File Late Claim ) NOTICE TO APPLICANT Dec. l, 1998 Against the County, Routing ) The copy of this 3Fcument ma-IM to you is your Endorsements, and Board Action.) notice of the action taken on ;your application by (All Section References are to the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Cade Sections 911.$ and 915.4. Please note the OWARN:t W below. Claimant: _ Maedi Lea Beck and T 77 James Mario Cruz-Rincon Attorneys F. Joseph Bechelli, Jr. OCT 2 9- Boatwright, .Boatwright, Adams & Bechelli Address: 1738 Grant Street ` Concord, CA 94520 Amounts $5,000,000.00 By delivery to Clerk on October 26, 1998 Date Received: 10/26/98 By mail, postmarked on Hand--delivered I. : Mork of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. 1998 PHIL BATCHF AR Joan Staley, ,�" �� Al t DATED: _ Ortnhpr 2S, , Clerk, By � -- - �J��Deputy I. ffiMs County Ccuniel TOM Clark of the Board o Supervisors ( ),--The Board should grant this Application to File Late Claim (Section 911.6). (t,� Tne Board should deny this Application to File Late Claim (Secti 911.6). DATED: 110-3014?9" VICTOR WESTMAN, County Counsel, By � � � puty NOW WE Ny urian mous vote of Supervisors presen (Check one only) ( ) This Application is granted (Section 911.6). ( 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. DATEs� L.; � PHIL BATCHELOR, Clerk, By �- w ' Deputy WARNING Wov. Cale J911.8) If you wish to file a court action an this matter, you mint first petition the appropriate court for an order relieving you from the provisions of ftvor mant Code Section 945.4 (claims p,�esmtaticn 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 yow oholoo in ocanection with this matter. If you want to consult an MtOrneX, you stvAd do so Igmbdiltp1Z. V. : CIZZE o f s y y A s ratbr 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 Board's copy of this Claim in accordance with Section: 29703. DATED: tll PHIL BATCHQAR, Clark, 83r �- - ;C� Deputy V. FRW-. 1 unty Coueael. county Admini gator 15: Clete of the Board Received copies of this Application and Board Order. of Supervisors DATEDs County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLAIM < i Mandi Lea Beck C/o F. Joseph Bechelli Jr. Boatwright, Adams& Bechelli M 1738 Grant Street Concord, CA 94520 Telephone: (925) 687-9121 NOTICE OF INTENTION TO COMMENCE ACTION' AGAINST HEALTH CARE PROVIDER tC C P &3641 TO: DONALD KENT HOBART, M.D. 1210 Alhambra Avenue Martinez, CA 94553 JONATHAN L. SCHEFFER, M.D. 1404 Castro Street Martinez, CA 94553 JUDITH C. BLISS, M.D. 2500 Alhambra Avenue Martinez, CA 94553 AMY BUONCRISTIANI, M.D. 2500 Alhambra Avenue Martinez, CA 94553 MERRITHEW MEMORIAL HOSPITAL 2500 Alhambra Avenue Martinez, CA 94553 CONTRA COSTA COUNTY Board of Supervisors 651 Pine Street Martinez, CA 94553 PITTSBURG HEALTH CENTER c/o Contra Costa County Board of Supervisors 651 Pine Street Martinez, CA 94553 REGENTS OF THE UNIVERSITY OF CALIFORNIA 300 Lakeside Drive, 7th floor Oakland, CA 94612 YOU ARE HEREBY NOTIFIED that MANDI LEA BECK, individually and as Guardian adLitem for the minor child JAMES MARIO CRUZ-RINCON, intends to file an action against DONALD KENT HOBART, M.D., JONATHAN L. SCHEFFER, M.D., JUDITH C. BLISS, M.D., AMY BUQNCRISTIANI, M.D., M ERRITHEW MEMORIAL HOSPITAL, CONTRA COSTA COUNTY;PITTSBURG HEALTH CENTER and REGENTS OF THE UNIVERSITY OF CALIFORNIA for professional negligence. The legal basis of this action will be that on or about October 25, 1997 and October 26, 1997, said DONALD KENT HOBART, M.D., JONATHAN L. SCHEFFER, M.D., JUDITH C. BLISS,M.D., AMY BUONCRISTIANI, M.D., MERRI'T`HEW MEMORIAL HOSPITAL, CONTRA COSTA COUNTY,PITTSBURG HEALTH.CENTER and REGENTS OF THE UNIVERSITY OF CALIFORNIA, and unknown others working for and employed by said parties and entities, negligently and carelessly failed to properly diagnose, treat and care for the medical condition of Claimant MANDI LEA BECK in the pre-natal care and in the delivery of JAMES MARIO CRUZ-RINCON. Plaintiff's will allege and prove that they sustained the following losses and injuries as a proximate result of the aforementioned professional negligence: extreme emotional injuries, various economic losses, brain injuries, loss of various bodily functions, cerebral palsy and related conditions, and pain and suffering. Dated: � A � F. JOSEPH ECffELLI, JR. Attorney for MANDI LEA BECK,'>Individually and as Guardian.ad Litem for the Minor Child JAMES MARIO CRUZ-RINCON (Send to Health Care Provider by Certified Mail, Return Receipt Requested) cAol icekvgurinlstbtbeek 40-day letter.upd CLAIM OF M;ANDI LEA BECK., f APPLICATION FOR LEAVE individually and as Guardian ad litem / TO FILE LATE CLAIM for JAMES MAR.IO CRUZ-RINCON f ON BEHALF OF CLAIMANT f (GOV. CODE SEC. 911.4) TO: DONALD KENT HOBART,M.D. k RECEIVED JONATHAN L. SCREFFER,M.D. JUDITH C. BLISS, M.D. r AMY BUONCRISTIANI,M.D. MERRITHEW MEMORIAL HOSPITAL CLERK SOAR of st-PERvIsORS CONTRA COSTA COUNTY CONTRA COSTA CO. PITTSBURG HEALTH CENTER 1. Application is hereby made, pursuant to Govt. Code Section 911.4, for leave to present a late claim founded on a cause of action for personal injury/professional negligence which accrued on 10/25/97 and 10/26/97, for which a claim was not presented;within the six- month period provided by Section 911.2 of the Government Code. For additional circumstances relating to the cause of action, reference is made to the proposed claim attached to this application. 2. The reasons that no claim was presented during the period of time provided by Section 911.2 of the Government Code are that the claimant was a minor during all of the six- month period specified by Section 911.2 for presentation of the claim; excusable neglect by claimant's attorney in being unable to obtain medical records within said six months period; and the mental incapacity of claimant. In addition,the governmental entities cited above were not prejudiced by this delay. 3. This application is being presented within a reasonable time after the accrual of the cause of action, as more particularly shown by the Declaration of F. Joseph Bechelli, Jr. attached hereto. WHEREFORE, it is respectfully requested that this application be granted and that the attached proposed claim be received and acted on in accordance with Sections 912.4 -913 of the Government Code. F4� r' Dated: �= F. JOSEPWAECAtLb, JR. Attorney for MANDI LEA BECK., Individually and as Guardian ad Litem for James Maria Cn -Rincon CLAIM AGAINST PUBLIC ENTITY To: DONALD KENT HOBART,M.D. JONATHAN L. SCHEFFER, M.D. JUDITH C. BLISS, M.D. AMY BUONCRISTIANI, M.D. MERRITHEW MEMORIAL HOSPITAL CONTRA COSTA COUNTY" PITTSBURG HEALTH CENTER MANDI LEA BECK., individually and as Guardian ad Litem for the minor child JAMES MARIO CRUZ-RINCON, hereby makes claim against DONALD KENT HOBART, M.D.; JONATHAN L. SCHEFFER, M.D., JUDITH C. BLISS, M.D.; AMY BUONCRISTIANI, M.D.; MERRITHEW MEMORIAL HOSPITAL; CONTRA COSTA COUNTY and PITTSBURG HEALTH CENTER for the sum of$5,000,000.00 (five million dollars) and makes the following statements in support of the claim: I. Claimant's mailing address is c/o F. Joseph Bechelli, Jr.;Boatwright, Adams& Bechelli; 1738 Grant Street; Concord, California 94520. 2. Notices concerning the claim should be sent to the address shown above. 3. The date and place of the incident giving rise to this claim are 10/25/97 and 10/26/97 at the Merrithew Memorial Hospital;2500 Alhambra Avenue;Martinez, California. 4. The circumstances giving rise to this claim are as follows: At said time and place, Defendants DONALD DENT HOBART, M.D.; JONATHAN L. SCHEFFER, M.D.; JUDITH C. BLISS, M.D.;AMY BUONCRISTIANI, M.D.; MERRITHEW MEMORIAL HOSPITAL; CONTRA COSTA COUNTY and PITTSBURG HEALTH CENTER negligently and carelessly failed to properly diagnose, treat and care for the medical condition of Claimant MANDI LEA BECK in the pre-natal care and in the delivery of JAMES MARIO CRUZ-RINC N. 5. Claimant's injuries include without limitation: extreme emotional injuries;various economic losses, bran injuries, loss of various bodily functions, cerebral palsy, and related conditions. 6. The names of the public employees causing the claimant's injuries include without limitation.Donald Kent Hobart, M.D.; Jonathan L. Scheller, M.D.; Judith C. Bliss,M.D., and Amy Buoncristiani, M.D. 7. My claim as of the date of this claim is $5,000,000.00. 8, The basis of computation of the above amount is as follows: Medical Expenses Incurred to Bate: unknown Estimated Future Medical Expenses: unknown Loss of Wages: Unknown General Damages: $5,000,000.00 TOTAL $5,000,000.00 Dated: F. JOSEPH kCHELLI, JR. Attorney for MANDI LEA BECK, Individually and as Guardian ad Litem for James MArio Cruz-Rincon cAofficelwpwin\sibViawn govameuW claim fb=.wpd h Cv DECLARATION OF F. JOSEPH BECHELLI, JR. IN SUPPORT OF APPLICATION FOR LEAVE TO FILE LATE CLAIM I, F. Joseph Bechelli, Jr., declare as follows: 1. I have been retained by Mandl Leif Beck to explore the passibility of filing a claim and lawsuit for professional negligence relative to the injuries suffered by her child Tames Mario Cruz-Rincon, who suffered extreme injuries during his birth on October 25 and 26, 1997 at Merrithew Hospital, That negligence caused James to be born'<with severe brain injuries, cerebral palsy, and related brain and bodily deficiencies. Mandl suffered extreme emotional harm and serious economic losses due to this same negligence. 2. We attempted to obtain the medical records in this case commencing in approximately March 1998, but we were not able to obtain the final set of records untilOctober 13, 1998. Only after receiving the final set were we able to ascertain the cause of.the injuries and the reasonableness of filing a claim and lawsuit for these injuries. I declare under penalty of perjury that the foregoing is true and correct and that this declaration was executed in Concord,'California on October 26, 1998. F. JOSEPH>3' CHELLI, T.R. Attorney for MANDI LEA BECK. and Tames Mario Cruz-Rincon r C7 �J a SNYDER , CORNELIUS & HUNTER A Professional Law Corporation Martin T. Snyder Mark Cornelius Robert B Hunter,IICT 2 6 19918 . } ;4 D OF SUPE, October 23, 1998 Ms. Ann Cervelli, Chief Clerk BOARD OF SUPERVISORS CONTRA COSTA COUNTY 651 Pine Street, Suite 106 Martinez, CA 94553 Reference: Ronald Baker v. Merrithew Memorial Hospital, et al. Dear Ms. Cervelli: Enclosed please find a notice of claim from my client, Mr. Ronald Baker, against the County Hospital and various of its employees. Would you kindly acknowledge receipt of same. Very truly yours, SNYDER, CORNELIUS &HUNTER MARTIN T. SNYDER MTS:vsv Enclosures 399 TAYLOR BOULEVARD, SUITE 106 • PLEASANT HILL, CALIFORNIA • 94523 PHONE: (925) 691-0400 6 FAX: (925) 691-9785 } MARTIN T. SNYDER(SBN#58343) SNYDER, CORNELIUS &HUNTER 399 Taylor Blvd., Smite 106RECEI , ED Pleasant Hill, CA 94523 Telephone: (925) 691-0400x Facsimile: (925) 691-9785 :T Attorneys for Claimant CLERK BOARD OF SUPERMORS RONALD BAKER CONTRA COSTA CO. Claim of CLAIM FOR PERSONAL INJURIES RONALD BAKER, (Government Code §910) VS. MERRITHEW MEMORIAL HOSPITAL; STEPHEN WEISS, M.D.; PENNY STRINGER, M.D.; DAVID RAFAEL, M.D.; and DOES 1 through 50, inclusive. TO MERRITHEW MEMORIAL HOSPITAL; STEPHEN WEISS, M.D.; PENNY STRINGER., M.D.; DAVID RAFAEL, M.D.; AND DOES 1 THROUGH 50, INCLUSIVE: YOU ARE HEREBY NOTIFIED that RONALD BAKER, whoseaddress is 1240 Walker Avenue, #101, Walnut Creek, California 94596, claims damages from MERRITHEW MEMORIAL HOSPITAL; STEPHEN WEISS, M.D.; PENNY STRINGER; M.D.; and DAVID RAFAEL, M.D., in an amount in excess of$25,000. This claim is based on injuries sustained by claimant RONALD BAKER on or about May 20, 1998, when during diagnosis, surgery and/or treatment, at MERRITHEW MEMORIAL HOSPITAL, performed by MERRITHEW MEMORIAL HOSPITAL employees, STEPHEN WEISS, M.D., PENNY STRINGER, M.D., DAVID RAFAEL, 1 ''I'll-,.......................................................................................................................................................................... ..................................................................... M.D., and DOES 1 through 50, RONALD BAKER'S femoral nerve was incorrectly clamped and/or otherwise damaged. This incorrect clamping caused RONAL BAKER to lose the use of his left leg which resulted in his inability to participate in many life activities which he previously enjoyed as well as lost wages due to his inability to work as desired. All references herein to MERRITHEW MEMORIAL HOSPITAL include references to its agents, servants and employees. The amount claimed by claimant RONALD BAKER is in excess of$25,000 and jurisdiction over this claim rests in the Superior Court. All notices and other communications with regard to this claim should be sent to claimant by sending them to Martin T. Snyder, Attorney at Law, Snyder, Cornelius & Hunter, 399 Taylor Blvd., Suite 106,Pleasant Hill, California 94523 DATE: October 23, 1998 SNYDER, CORNELIUS &HUNTER By: MARTIN T. SN-YDER/ PROOF OF SERVICE I, VICTORIA VONKRIEGENBERGH, declare: I am employed in the County of Contra Costa, California in the offices of a member of the Bar of this court, at whose direction this service was made. My business address is 399 Taylor Blvd., Suite 146, Pleasant Hill, CA 94523. I am over the age of eighteen years and not a party to this action. On the date given, I served the following document(s): CLAIM FOR PERSONAL INJURIES in the case entitled: Baker v. Merrithew Memorial Hospital, et al. on all interested parties through their attorneys of record by placing a true and correct copy thereof addressed as shown on the attached service list, as designated below: ✓ BY FIRST CLASS MAIL (C.C.P. §§1013A,et se I caused said document(s) to be deposited in the United States Mail in a sealed envelope with postage fully prepared at 399 Taylor Blvd., Suite 106, Pleasant Hill, California, following the ordinary practice at my place of business of collection and processing of mail on the same day as shown on this declaration. BY HAND DELIVERY/PERSONAL SERVICE (C.C.P. §§1011,et seq. : I caused said document(s) to be personally delivered by a courier to each addressee. BY TELECOPYIFACSIMILE (C.C.P. §§1012.5, et se .): I caused said document(s) to be telecopied to each addressee's telecopier(„Fax")number. BY EXPRESS MAIL (C.C.P. §§1013 ©(d),et seg.): I caused said document(s) to be deposed with an express service carrier in a sealed envelope designated by the carrier as an express mail envelope, with fees and postage prepaid. BY REGISTERED MAIL (C.C.P. §§1020,et se ) I caused said document(s) to be deposed with the United States mail, postage prepaid, return receipt requested, signed by addressee that said documents were received. I declare under penalty of perjury under the laws of the State of California and of the United States that the foregoing is true and correct. DATED: October 23, 1998 'V VICTORIA VONKRIEGENBERGH t SERVICE LIST LBaker v Merrithew Memorial Hospital, et al.) Ms. Ann Cervelli, Chief Clerk BOARD OF SUPERVISORS CONTRA COSTA COUNTY 651 Pine Street, Suite 106 Martinez, CA 94553 2 VwC/) co v Q _ m < o Co z g p m ' c J C z 4 m a r N C ' CD Cl, t i $OCIAL� FMME CLAIM 0, 2,-� Board of Commissioner Of Housing Authority of Contra Costa County amp ACMgN Weir 1, 1998 Claim Against the Canty, or District Governed by 3 the Board of Supervisors, Routing Endorsements, } NOTICE TO CLAIMANT and BwJ Action. All Section references are to 3 The copy of this document mailed to you is your Califty ria Government Codes. l notice of the action taken on your claim by the Board of Supervisors. (paragraph IV below?, Oven pursuant to Govermant Code Section 913 and 915.4. Please nate all "Warnings". AMOUNT: $1.00 - CLAIMANT: Pose Cordova ATTORNEY: BATE RECEIVED: November 4, 1998 ADDRESS: 1111 Ferry St. , #947 BY DELIVERY TO CLERK ON: November 4, 1998 Martinez, CA 94553 October , an BY MAIL POSTMARKED: November` 3, 1998 L FR01% Clerk of the Board of Supervisors TOS County Counsel > Attached is a copy of the above-noted claim. PHIL BAT LOR, Clerk Dated: November , 199B By: Deputy 11. FROM Count, Counsel T4: Clerk of the Board of Supervis s (V, This clai*.i 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). ) tither: Dated: By: Deputy County Counsel HL TRO? 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 pa-nd correct copy of the Board's Order entered in its minutesfor r this date. Dated:- 1 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code sectio 113) 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. AFFIDAVff OF NIAI•MG I declare under penalty of perjury that I am novo, 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 Beard', Order and Notice to Claimant, addressed to the claimant as shown above. Dated: - 1q1 q By: PHIL BATCHELOR By a22-- Deputy Clerk CC: County Counsel County Administrator Claim 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 personal property or growing crops and which accrue on or before December 31 1987,must be presented not later than the l 00th 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 stem Rose Cordova ) Against the County of Contra Costa - �p OFSiJpEi31SI�a.re or The Housing Authorit of Contra Costa District (Fill in name) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of$ 6 °�' --' and in support of this claim represents as follows: g4b 91 - 1. When did the damage or injury occur? (Give exact date and hour) 2. ere did f he d age or injury occ ? (Include city a6U county) r 41 � � 3. How did the damage or injury,occur? (Give fu detail • use extra paper if require J 4. WY&t particular act or omission on the part of county `r distrieVofficers,;servants or employees caused the injury or damage? - _- -- JJ elmform V 5. What are the names of county or district officers, servants or employees causing the damage or injury? 6. t damage or injuries do you claim resulted? (Give full extent of injuries or ; < � HoW was the Dunt claimed aboW computed? (Include the estimated ambunt of any p g prospective or i damage �r�/��•'�-�—~_-c��� --P4 c �,c iJ.�•yic- �ezh..' a+cog c » "�y e X y�°S�J� err�'.- cx� t:ag $. Narbes and addressesofAitnesses 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 NOTICE TO:, (Attorney) or by some person on his behalf." Name and Address of Attorney (Claimant's Signature) ddress) Telephone No. Telephone No.('" 5") &7..2 7ff a? 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." cimform f Y f lJ�.^s•2 iSL �- -1 _� moi/ ��'• F i �. ..:� ...� `. � 3 • ? .y�r�Y�•+ � -� s �t ►t► + .¢ � 4 7k Ic 9US31�56 H��e.ur yam, amok, -,w4— Clerk of The Board 651 Fine Street Martinez, CA 94553 i '1�+'KMiXririilNU�1► ;�r #hh0,143e41x*AhAIl##lIae1141A0.1 i CI Anv r ' ,,,DAR ► OF SUPF,,MSORS OF CONTRA COSTA COUNTY, C;hTHORNIA 8= ACACTtt;i11 40*; k W Claim Against the County, or District Governed by } the Board of Supervisors, Routing Endorsernents, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document nailed to you is your California Govrnnent Codas. 1 notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given ,� su C �IIant to Government Cade Section 913 and 7015.4. Please note all "Warnings„ AMOUNT: In excess of $10,000.00 OCT 3 0 1998 COUNTY COUNSEL CLAIMAW: Carol Ann Daly and Sean Daly MART{NEZCALiF. ATTORNEY: Ronald H. Rouda, Esti. DATE RECEIVED: October 28, 1998 Rouda, Feder & TietjenOctober 2$ 1998 ADDRESS: 44 Montgonary St. , #4'X;0 BY DELIVERY TO CLERK ON: San Francisco, CA 94104 October 27, 1998 BY MAIL POSTMARKED: L FRONL Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BAT LC3R, Clerk Dated: October 29, 1998 By: Deputy fJ II. FROM: County Counsel TO: Clerk of the Board of Supervisors (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 Beard 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). { t/�Other: `rKt Dated:" By:. � Deputy County Counsel M1 FROft Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 311.3). 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: �,�7d PHIL BATCHELOR, Clerk, By 9 9V7/—-- ' 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 N 4U_JNG 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.f Dated:_ �"t � By: PHIL BATCHELOR By_*7—/t,' *Deputy Clerk CC: County Counsel County Administrator __... ......... ......... ......... _...__._. ._ . ...... ........... __....... .......... ......... ......... ......... ......... ......... .. . _. ... __....._ ......... ......... ......... ......... .................. ......_....__._........_....................... 14ECEIVEI CLAIM AGAINST COUNTY OF CONTRA COSTXr 2 8 '9 CLERK OF THE BOARD RQ OF S co ?w ER VWORS TO: COUNTY OF CONTRA COSTA, CLERK OF THE BOARD, 651 Pine Street, 1st Floor, Martinez, CA, 94553. CLAIMANTS: Carol Ann Daly and Sean Daly CLAIMANTS' ADDRESS AND TELEPHONE: 5659 Schooner Loop Discovery Bay Byron, CA 94514 (925) 516-3921 SEND NOTICES AND CORRESPONDENCE TO: Ronald H. Rouda, Esq. Rouda, Feder & Tietjen 44 Montgomery St. , #4000 San Francisco, CA, 94104 Telephone: (415) 398-5398 Fax: (415) 398-8169 DATE AND TIME OF OCCURRENCE: May 12, 1998 Approximately 9: 30 p.m. EXACT PLACE OF OCCURRENCE: State Route Highway 4, 547 feet west of Sellers Avenue, Contra Costa County, California. DESCRIPTION OF OCCURRENCE: On the above date and time, claimant Carol Ann Daly was proceeding eastbound on State Route 4 driving home at approximately 45 mph when another vehicle heading westbound in the opposing lane of traffic crossed the median centerline and struck her vehicle head-on causing her severe injuries. ACT OR OMISSION BY EMPLOYEE, OFFICER OR AGENT CAUSING INJURY THE OR DAMAGE: claimant is informed and ;relieves, and thereupon alleges, that the County of Centra Costa owned, maintained, operated, and controlled State Route Highway 4 in the area of claimant's accident. This public roadway was owned, maintained, operated and controlled by the County of Contra Costa in a careless and negligent manner. A dangerous condition existed at said location and was created and/or allowed to be created by said public entity. Said public entity had knowledge, actual and/or constructive, of a dangerous condition of the roadway before and at the time of claimant's accident. As a result of said dangerous condition of a public roadway, and the negligence of said public entity, a substantial risk of injury was created for drivers using due care on said public roadway. The failure of the County of Contra Costa to properly maintain said roadway and said dangerous condition caused claimant to be seriously injured in a head-on collision thereby causing her to suffer and sustain injuries and damages including, but not limited to, extensive facial and head trauma, fractures of the left radius, fractures of the third metacarpal, fractures of the right patella, fractures of the right foot, and fractures of the left clavicle. EXTENT OF INJURIES AND DAMAGES CLAIMED. Carol Ann Daly suffered the injuries as described above requiring a chest tube inserted for pneumothorax, computerized tomography scan of the head and facial bones, a right patellectomy, repair of the quadriceps, closed reduction and percutaneous pinning of the richt foot metatarsal fracture, bilateral short-leg splints, aright knee immobilizer placement, as well as suture and irrigation of multiple traumatic lacerations including, but not limited to, full thickness lacerations of the nose, nasal cartilage, the septal laceration, and the lips. Medical expenses to date are unknown. To date, claimant has been completely disabled from her employment. Wage loss is unknown. AMOUNT OF CLAIM: Claimant's claim is in an amount that far exceeds $10, 000. 00 and exceeds the jurisdiction of the Superior Court. The exact amount is unknown at this time. DATED: ROUDA, F & ETJEN By 7R LD ROUDA�� orny for Claimant CLAIM AGAINST COUNTY OF CONTRA COSTA CLERK OF THE BOARD TO: COUNTY OF CONTRA COSTA, CLERK OF THE BOARD, 651 Pine Street, 15t Floor, Martinez, CA, 94553 . CLAIMANTS: Carol Ann Daly and Sean Daly CLAIMANTS' ADDRESS AND TELEPHONE: 5659 Schooner Loop Discovery Bay Byron, CA 94514 (925) 516-3921 SEND NOTICES AND CORRESPONDENCE TO: Ronald H. Rouda, Esq. Rouda, Feder & Tietjen 44 Montgomery St. , ,x`4000 San Francisco, CA, 94104 Telephone: (415) 398-5398 Fax: (415) 398-8169 DATE AND TIME OF OCCURRENCE: May 12, 1998 Approximately 9:30 p.m. EXACT PLACE OF OCCURRENCE: State Route Highway 4, 547 feet west of Sellers Avenue, Contra Costa County, California. DESCRIPTION OF OCCURRENCE: On the above date and time, claimant Carol Ann Daly was proceeding eastbound on State Route. 4 driving home at approximately 45 mph when another vehicle heading westbound in the apposing lane of traffic crossed the median centerline and struck her vehicle head-on causing her severe injuries. ACT OR OMISSION BY EMPLOYEE, OFFICER OR AGENT CAUSING INJURY THE OR DAMAGE: Claimant is informed and believes, and thereupon alleges, that the County of Contra Costa owned, maintained, operated, and controlled State Route Highway 4 in the area of claimant's accident. This public roadway was owned, maintained, operated and controlled by the County of Contra Costa in a careless and negligent manner. A dangerous condition existed at said location and was created and/or allowed to be created by said public entity. Said public entity had knowledge, actual and/or constructive, of a dangerous condition of the roadway before and at the time of claimant's accident. As a 'result of said dangerous condition of a public roadway, and the negligence of said public entity, a substantial risk of injury was created for drivers using due care on said public roadway. The failure of the County of Contra Costa to properly maintain said roadway and said dangerous condition caused claimant to be seriously injured in a head-on collision thereby causing her to suffer and sustain injuries and damages including, but not limited to, extensive facial and head trauma, fractures of the left radius, fractures of the third metacarpal, fractures of the right patella, fractures of the right foot, and Fractures of the left clavicle. EXTENT OF INJURIES AND DAMAGES CLAIMED: Carol Ann Daly suffered the injuries as described above requiring a chest tube inserted for pneumothorax, computerized tomography scan of the head and facial bones, a right patellectomy, repair of the quadriceps, closed reduction and percutaneous pinning of the right foot metatarsal fracture, bilateral short- leg splints, a right knee immobilizer placement, as well as suture and irrigation of multiple traumatic lacerations including, but not limited to, full thickness lacerations of the nose, nasal cartilage, the septal laceration, and the lips. Medical expenses to date are unknown. To date, claimant has been completely disabled from her employment. Wage loss is unknown. AMOUNT OF CLAIM: Claimant's claim is in an amount that far exceeds $10, 000.00 and exceeds the jurisdiction of the Superior Court. The exact amount is unknown at this time. DATED: RUUDA, F & ET i' By R LD ROOD o rn7 for Claimant LAW OFFICES ROUDA, F +DER & TIETJF+ N .44 MONTGOMERY STREET 40TH FLOOR, SUITE 4000 SAN FRANCISCO,CALIFORNIA 94104 (415) 398-5398 RONALD H. ROUDA +PROFESSIONAL CORPORATION JOHN M. FEDER FAX(415) 398-8183 TIMOTHY G. TIETJEN MARK J. ZANOISINI October 26, 1998 RECEIVED OCT 2 8, 1998 CLERK 13 R ()F SUPERvt oqs Clerk of the Board GQNR 0.gTA On County of contra Costa 651 Pine Street, 1st Floor Martinez, CA 94553 Re: Daly v. County of Contra Costa, et al. Dear Sir: Enclosed please find the original and one copy of the Claim Against County of Contra Costa, Clerk of the Board, in the above-referenced matter. Also enclosed is an additional copy of this letter which we request you date and sign, returning it to us in the enclosed envelope, acknowledging your receipt, of the referenced claim. Thank you for your consideratio a d cooperation. Very yours, R ALL; H. ROUDA RHR:tjs enc. LAW OFFICES ROUDA, F+'EDER & TIE'T'JEN 44 MONTGOMERY STREET 40TH FLOOR, SUITE 4000 SAN FRANCISCO,CALIFORNIA 94104 (415) 598-5398 •RONALD H. ROUDA -PROFESSIONAL CORPORATION JOHN M. FEDER FAX(415)398-8189 TIMOTHY G.TIETJEN MARK J. ZANOSINI October 26, 1998 Clerk of the Board County of Contra Costa 651 pine Street, 13t Floor Martinez, CA 94553 Re: Daly v. County of Contra Costa, et al. Dear Sir: Enclosed please find the original and one copy of the Claim Against County of Contra Costa, Clerk of the Board, in the above-referenced matter. Also enclosed is an additional copy of this letter which we request you date and sign, returning it to us in the enclosed' envelope, acknowledging your receipt of the referenced Claim.. Thank you for your considerat' d cooperation. Ve t my yours, N H. ROUDA RHR:tjs enc. Receipt of the above-referenced claim is hereby acknowledged. Dated. Signature Title > _ C� z zz tit 4 3 yM' 0 m p & r m { � 404, a mi +� * 00 _Z ( h J,� T to i✓ L! / y.+ m iiz� roxcr i ro � o > K m CSD -»» ft o tiG ib W y, w LO -� to WEa Cp G rt • r w 104 0 ! 0 ! � F AMENDED CIAIM BOAR13 OF SUEERY5ORS. OF CONIRA COSTA COUNT, C L URNIA BOARD AO E December 1, 1998 Crim Against the County, or District Governed by the Board of Supervisors, Rm ting Endorsements, ) NOTICE TO CLAIMANT and Bond Action. All Section references are to } The copy of this document mailed to you is your California Government Codes. i notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV belovk given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $25,000.00 N 0 V 18 1998 CLAIMANT: Co""TEL i9 F. Dana Matteri MASTMEZCAI.►F ATTORNEY: DATE RECEIVED: November 13, 1998 ADDRESS: 5030 San Pablo Dam Rd. , Apt. 1 BY DELIVERY TO CLERK. ON: November 13, 1998 EI Sobrante, CA 94803 BY MAIL POSTMARKED: Hand-Delivered L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BACHELOR, Cler l Dated: November 18, 1998 By: Deputy r It. FROM County Counsel TO: Clerk of the Board of Supervisors {Vribis 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). { vf Other: — Dated: 0 LJLW IL,. Deputy County Counsel IIT. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) { } Claim was returned as untimely with notice to claimant (Section 911.3). IVB BOA1tD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: /. 1 f1 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 NUEUNG 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: JOQ/ J l"Ir By: PHIL BATCHELOR By Deputy Clerk CC: County Counsel County Administrator ..:. ...... . AM 4e.4q' d-45 4- Cie fii s Somw or BVPZR4IioRS OF CORTJL% COSTA COMITY XNATRUCTIONS 22 CLh A. Claims relating to causes of action for death or for injury to person or to personal property or #rowing crops and vhioh &ecru* 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; It 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. (Gov't Cede 911.2.) S. Claims must be filed with the Clark of the Board of Supervisors at its office in Room 506, County Administration building, 651 piste Street, Martinez, CA 08553. C. if claim is against a district governed by the board of Supervisors, tathar than the Couity, Uz nano 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. S. 2raud. $ee penalty for fraudulent claims, Panel Code See. 72 at the end of this form. �r�rre*,r��:�,�+�ss��rf+��►�,e ���r:����:�e��►s�rfts��e�e��t+rer,►tsr:eas�e�rtrft +e RE: Claim By Reserved for Clark' filin a z A M, > Mel ry 4 Alkinst the County of Contra Costa) ' or ) � d ; Soo, 5-'Y y4i } ctj CLE c. i��na •y ARD OF SU � CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the suss of $,.1. r' .n ,�; and in support of this claim represents as follows: I. 'when did the damage, or injury occur? (Give exact date and hour) ftq ri, Wig qbD& 2 11her d dt2tt2te) dmaQe o rt urs, rIrtcLuds e d +o untyr 7 { _2. Now drd the daxn�� r f3�YYV, euz? Give #u +eta s t e ra r�J M � / Y+y1 Af E`� a pa ar act o om sion on th part of county or district of icars, servants or employees cause the injury or dam e' vL Y V�DW 01 4 t (over) ......................................................................................................1.1.11,111.11 ............................................................. . ...................... what are the names of county or distric officers, servants or of opployeas ca the damaa* or. injury )Pfe7 �tcyd 1012 AJof4-i&r7 Uri I All Lai lfityk.::�Lacdr )�Z S�1"Y J 6n&4,5C5T V 1.!S'Fy:L 6. what -latagi or %niuri s -do you await resulted? 1(clive. f 411 oxtehl of injuries or damages claimed. Attach two estimates for auto damagle. ) Q ibli*s Oft W n- K\U K lets 7. Now was the 4blaimed above computed? (Xndludo t a stimatod I 6nt 4 amount of any prospective injury or damage. ) "I S.Vames sod addresses re of witnesses, doctors capitals and V- ic!25, 9. List the expenditures you made on account of this accident or injury. Gov. Cod* Sec. 920.2 provides *Th* claim must be signed by the claimant or by some person on his SEND NOTICIS TO: -(AtJer-n#Y) -1 behalf." Name and Address of Attorney tclaiment n tura) of w , Te2*phon* No. Telephone No.- XMIC2 taction 72 Of the Penal Code provides: Zvory 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 vriting, Is Punishable *itber by Imprisonment In the County Jail for a period Of not more than one year, by & fine of not *xoo*ding one thousand ($2*000L) # or by both such Imprisonment an I d fine, or by imprisonment In the state prison, by a fins of not exceeding ton thousand dollars ($10#000, or by both such imprisonment and fine. ..............-....... CI AI M i3( A RIS t>F SLS' `;�VISORS C3P 1�I'T`RA C`C?STA C :>JNTY,CA I;I ORNTA BARD AC11December 1, 1998' Claim Against the County, or District Governed by } the Board of Suervisors, Routing Endorsements, } NOTICE TO CLAIMANT and Board Action. All Section references are to l The copy of this document mailed to you is your California Government Codes. } notice of the action taken on your claim by the Aa 7_ � -7M Board of Supervisors. #Paragraph IV below), given pursuant to Government Cts Section 913 and 915.4. Please note all "Warnings". atAMOUNT: $25,000.00 vRtNz COUNSEL` CLAIMANT: Dana Matteri A'T'TORNEY: DATE RECEIVED: November 6, 1998 ADDRESS: 5030 San Pablo Dam Rd. , Apt. 1 BY DELIVERY TO CLERK ON: November 6, 1998 El Sobrante, CA BY MAIL POSTMARKED: Hand-Delivered L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. November 9, 1998 PHIL BA LOR, Clerl Dated: By. Deputy E � - � IL » MOCounty Counsel M 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: tV CZ44�-4� Deputy County Counsel Ill 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 Counsel County Administrator ........ .... _ Cl'aiz "to: XoAn of SVPZRVISORE OT CC+MA COSTA COMMY XNeTargTION6 TO CLhig " A. 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 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 craps and which accrue on or after 9anuary ' 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. (Gov't Code 911.2.) 8. Claims must be filed with the Clerk of the board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Kartineg, CA 98553. C. If claim is against a district governed by the Board of Supervisors, rath4r than the County, the nave of the District a:hould to filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Frgud. See penalty for fraudulent claims, Penal Code Sec. 72 at the and of this form. RE: Claim By Reserved for Clerk's filing stamp aIMLACL } RECEIVED Against the County of Contra Costa) or a(F ct) caRKOA of SUP�, ERVICOORS i name f� CONTRA COSTA CO The undersigned claimant hereby makes claim against the County Contra Costa or the above-named District in the sura of $ and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 17, i c4q�- 2. er did th dama e or in ury� oc Include c nd c unty) b 3. Now did the damage r, J)WY cur? (Give full de pi s; a ra or i re r+«d) �' J. ' V rV10 - r pt Ore,,\){� - " l a pa cu ar act o omi Sion on the part of county or district officers, servants or *mployees causal the injury or dame e? (over) : . `What are the names of county or distric officers, servants or app loyees ca4sinng the damage or_ j ury' 16 rl Y,�-'V wf� U , v ; 5. What -damage or injuries do you claim resulted? (Give f 411 oxtelit 4 P� of injuries or damages claimed. Attach two estimates for auto damage. ) ?. Hoer was the o t aimed above computed' (Inc ude V e +kstima ed , amount of any prospective injury or damage.} �� Pilo $«�ames arkd addresses of witnesses, doctors and ospitals 9. List the expenditures you wade on account of this ;,accident or injury. AMOUN } Gov. Code Sec. 910.2 provides } *The claim must be signed by the } claimant or by some person on his NOTICESSEND " Nasse and Address of Attorney0/1&1 JVdJJZA'/ } } (Claim'ant's Signature) dwo AIM} } (Address } Telephone No. } , } Telephone Na.61 - •#!##!!f#ff#f#!fliff ##!#f# b�M`ZCE Section 72 of the Penal Code provides. Zvery person who, with intent to defraud, presents for allowance or for payment to any stage board or officer, or to any county, city or district board or officer, authorised 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 (81,004) , 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. AMENDED CLAIM BOdRD OF SJUJIMOR,S OF CONTE COSTA C+LAEX1Y. C N A r lEIARDAC?llt Deeeber BOARD /1998 Claim Against the County, or District Governed by the Board of Supervisors, Routing Endorsements, NOTICE TO CLAI N.T. and Board Action, All Section references are to ) The copy of ttis document mai d to you is your California Government Codes. 1 notice of the action taken your claim by the Board of Supervisors. (Par aph IV below!, given pursuant to Goverment Section 913 and 73) 915.4. Please nota aft arnings". AMOUNT: $25,000.00 N O V 13 1998 CLAIMANT: Dana Matteri GCfUNTYManYllal: �.t�,CZOV 3P ATTORNEY: DATE RECEIVED: No 13, 1998 ADDRESS: 50301 San Pablo Dam Rd. , Apt. 1 BY DELIVERY TO CL November 13, 1998 El Sobrante, CA 94803 BY MAIL POS band—delivered L FROM: Clerk of the Board of Supervisors TO: County o sel Attached is a copy of the above-noted claim. November 13 1998 PHIL B LOP, Clerk Dated: By: Deputy H. FROM: County Counsel M Clerk of the Board of u rs ( ) This claim complies substantially with Sections 910 and 9 0.2. ( } This claim FAILS to comply substantially with ion 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 reyur�pclaitn on ground that it was filed late and send warning of claimant's right to apply for leave to preset am (Section 911.3). 1` ( ) Other: Dated: ��� �t 'c ' �2.__. eputy County Counsel 13L FROM: Clerk of the Board County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely Ab notice to claimant (Section 911.3). IV. BOARD ORDElb By animous vote of the Supervisors present: { ) This Claim is rejected in 11. { ) Other: I certify that this is 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 945.5. 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. AFFIDAVTP OF 11 AEU G I declare undr penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over ge 18; and that todayI deposited in the United States Postal Service in Martinez, California, postage fully prepaid a rtified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above.; Dated: ijy: PHIL BATCHELOR, Deputy Clerk CC. County Counsel County Administrator The Board of Supervisors Contra C County Administration Binding Costa gy'" co(510)335-I at O 651 Eine Street,Room 106 (�� t5io)335•tt300 Martinez,California 94553-1293 C o u n C Am ftW*,9 at DWWd "y* ta 8.UIIM ,2nd District °n Donna Garber,3rd Mtrict Mark DeSsu"Nr,41t District r� Jw Cancinrliiia,5th Dia4tict ey3UFK` Y p SlytJ TO: Dana Matted � r 5030 San Pablo Dam Rd., Apt#1 , EI Sobrante, CA 94803 j fj NOTICE TO C ILA MART (Of Late-Filed Claim) (Government Code Section 911.3) The claim you presented on November 13, 1998 to the Board of Supervisors of Contra Costa County, California, as governing body of the County of Contra Costa on May 13, 1998, has been reviewed by County Counsel and is being returned to you herewith because: — Your claim for an injury to person or personal property which arose on or before December 31, 1987 was not presented within 100 days after the event or occurrence as required by law. (See Government Code sections 901 and 911.2) X Your claim for an injury to person or personal property which arose on or after January 1, 1988 was not presented within six months of the event or occurrence as required' by law. (See Government Code sections 901 and 911.2) — Your claim relating to a cause of action other than injury to person, personal property or growing crops was not presented within one year after the event or occurrence as required by law. (See Government Code sections 901 and 911.2) Because the claim was not presented within the time allowed by law, no action was taken on the claim. Your only recourse at this time is to apply without delay for leave to present a late claim. (See Government Code sections 911.4 to 912.2 and 946.6) Under some H:\GROUPS\TORT\RISK-MGT\CLAIMS\LATE\NTCLATE.WPD circumstances leave to present a late claim will be granted. (See Government Code section 911.8) You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately. PHIL BATCHELOR, Clerk of the Board of Supervisors and County Administrator By: _ 9-0� �4� Depilty Clerk Dated: Enclosure 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 copy of the above Notice to Claimant (of Late Submitted Claim), addressed to the claimant as shown above. Date: / -�1' - ` ' By Phil Batchelor by Deputy Clerk H:\GROUPS\TORT\RISK-MGT\CLAIMS\LASE\NTCLATE.WPD 'Theon of uperwisors CC}C1tC �pyA"n�a�Sulam Costa } al Ph*S"et,Room 106 Martinez,Womia 90&3-1293 County &n ftwo,4lt Owd ONO*It,utm",a w Oftla MWk 04ftu ow.4th plata TO: Dana Matted 5034 San Pablo dam Rd., Apt#1 EI Sobrante, CA 94803 NOT.IQE TO CLAIMANT (Of Late-Filed Claim) (Government Code Section 911.3) The claim you presented on November 13, 1998 to the Board of Supervisors of Contra Costa County, California, as governing body of the County of Contra Costa on May 13, 1998, has been reviewed by County Counsel and is being returned to you herewith because: — Your claim for an injury to person or personal property which arose on or before December 31, 1987 was not presented within 100 days after the event or occurrence as required by lava. (See Government Code sections 901 and 911.2) _X_ Your claim for an injury to person or personal property which arose on or after January 1, 1958 was not presented within six months of the event or occurrence as required by law. (See Government Code sections 901 and 911,2) Your claim relating to a cause of action other than injury to person, personal properw or growing crops was not presented within one year after the event or occurrence as required by law. (See Government Code sections 901 and 911.2) Because the claim was not presented within the time allowed by law, no action was taken on the claim. Your only recourse at this time is to apply without delay for leave to present a late claim. (See Government Code sections 911.4 to 912.2 and 946.6) Under some H:\GROUPS\TORT\RISK-MGT\CLAIMS\LATE\NTCLATE.WPD circumstances leave to present a late claim will be granted. (See Government Code section 911.6) You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately. PHIL BATCHELOR, Clerk of the Board of Supervisors and County Administrator By: gav-%-, Depi5ty Clerk Dated: Enclosure Affidavit o fltn 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 copy of the above Notice to Claimant (of Late Submitted Claim), addressed to the claimant as shown above. Date: //-�l' � By Phil Batchelor by ►�� Deputy Clerk H:\GROUPS\TORT\RISK-MGT\CLAIMS\LATE\NTCLATE.WPD ... CIAIM BOARD AM Dec 1, 1998 Claim Against the County, or District Governed by } 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 California Government Codes. } notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given ► pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $ 2,000,000 CLAIMANT: Richard Palacio M�aB�1tv` �CA L1 ' ATTORNEY: DATE RECEIVED: ADDRESS: 901 Court Street BY DELIVERY TO CLERK ON: Martinez CA 94553 BY MAIL POSTMARKED: Oct 19, 1998 L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATC� R, Clerk Dated: AWVA, 1998 By: Deputy H. FROM: County Counsel TO: Clerk of the Board of Supervisors (14'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 se 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: fit{-` By: -,z 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). W. 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:_ �.r .Js '1' 16 PHIL BATCHELOR, Clerk, By . '�— eputy 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 MAIIJNG 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:-I, , (� � `_ By: PHIL BATCHELOR By ," , ZJJ Deputy Clerk CC: County Counsel County Administrator Claim oto a BOMW Og SVPZRQIIORS ©P CONTRA COSTA COUNTY I1�UCTIOSSTO C�.�►INAM ;1. 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 before December 31, 1987, must be presented not later than the •lOCth 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 rolatinq to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Gov't Code 911.2.) a. 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, *_.*:e name of the Vistrict 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. Fr Set penalty for fraudulent claims, Penal Code Sec. 73 at the and of this form. t���r���r+e���r�r�r�f�t:+�ti+rr#�r�r,��r+tf,r��rtt��>�retr��+���si�s�t�r�,�st,►�rf+�,es,r��t�s�r� RE: C14, 8y Reserved for Clerk's filing stamp ) Against the County of Contra Costa) or ) ' 2 91 ) District) , (Fill in name) } The undersign*d claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of afaao'oV and in support., of this claim represents as follows: 1. whe "' did the damage or injury occur? (Give exact date and hour) i. ' re did the damage or injury occur? (Include city find county) ,r "2, 3. Bow did``' the damage .br injury-'occur? (Give full detai st use extra paper if required) 4. What particular act or omission on the rt of OjOunty or district officers, servant* or employs** caused the injury or damage? (over) 5. what are the names of county or district officers, servants or employees causing the damage or injury? 6. Wha_ damage or injuries do you claim resulted? Give full extent of injuries or damages claimed. Attach two estimates for auto damage. ) .<< .F"�^- :v< '...4.. .. .•:,k 2. :,9 ;.4..., ,1¢ �"` +.,... aS, p x 1 y. b, "s F 7. How was the mount Claimed above computed? {Include the estimated' amount of any prospective injury or damage. } a. Names and addresses of witnes es, doctors and hospitals. Id .F x I C.y� 9. List theexpenditures you made on account of this accident or injury.� � AM�?UNT Gov. Code sec. 920.2 provides } "The claim must be signed by the claimant or by some person on his SEND -NOTICES TO: fAttorney) I * Name and Address of Attorney } f p } (claimant's Signature) } (Address) } Telephone Na. Telephone No. •######+�tr#:lf�lt:*+��r��#�#irt�#1�Rtt######�l�r##+i�l1t##t#i###!##�##l+�t,tir#f NICE Section 72 of the penal Code provides: (very 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 Imprisomiant 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 impprisonmsnt 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. Z � 1 s s 1 t �. F- OA co t S to o Zo W CIM - etl;llRD Am December 1, 1998 Claim Against the County, or District Governed by the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this dDcmmit mailed to you is your California Government Cods. } notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $7,997.18 O C T CO Y CCi# . C CLAIMANT: Joyce Tetreault OURN iiNT&ANLSIF ATTORNEY: DATE RECEIVED: October 29, ',1998 ADDRESS: 13700 San Pablo Ave. , #2309 BY DELIVERY TO CLERK ON: October 29, 1998 San Pablo, CA 94806 October 27, 1998 BY MAIL POSTMARKED: L FROM: Clerk of the Board of Supervisors TO. County Counsel Attached is a copy of the above-noted claim. October 30 1998 PHIL B �� Clerk Dated: By: Deputy IL FROM: County Counsel TO. Clerk of the Board of Supervi ors (0 This claire complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are sur 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:_ !:-'mLrtlA DeputyCounty Counsel M. FROM: Clerk of the Board M. 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: 1 _ PHIL BATCHELOR, Clerk, By � &L&_ , 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. AFFIDA'Vff OF MAEUNG I declare under penalty of perjury that'I am now, and at all tunes 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: 2 By: PHIL BATCHELOR By- 4,&& Deputy Clerk tZ CC: County Counsel County Administrator Claire to I NOAU or svnxvts ai at 003rTa 1 COSTA iomy ago+' '" ZM Claims relating to causes 0 action for death or for i urry to person or to personal property or a�ri�q crops and which ace - e on or before December 311 1917# arust be' presented not later than the .100th day after the accrual of the as ! of action. Claiass rel4ing to causes or action for death or for u ryy to person or to personal property or growing crops and which ecru* on or after aTa�'fuary l l JOSS r must be presented not later than: ix months after the accrual at the cause at action. Clamus relatijW to any other cause of action a►ust bs presented not later than ore year after the accrual at the cans* of action. (om►#t Code 011.2 � b. Claims must be filed with thA Clork of the board of Supervisors at its office in V.0cm, 166, County Againistration building, i5i Via* Street, rtin*x" CA 14353. C. If claim is against a distar goveacned 'by the board o f Supervisars; rather than the County# th! of the District should be filled in. C. it the claim is against mo than one public entity,, separate claims must be filed against .each lie +entity. t, ZZAMda seta penalty for traululeat claims, penal Codo< tie. 72 at the end of this form JM: Claim yt e Tetreault Reserved for Clerk"* filing stamp< 13700 San Pablo Ave:, 2309 (RECE,1VgEDAgainst the Comity of ContraCosta) or bi trict) CLERK BOARD Cr"SUPER "SORS (Fill in name)The Contra Costs or the claimant he aby�Distrrict in thk** claim e scum o ainst �'� "County and in supportof this aleft represonts as follows: 1. 94007440 the damage or in ury 00"R (Sive "act data and hour) 4-27--98, 1440 to 1700, b t also in Meerrithew Hospital afterwards due to damaging, statemen s in their reports 3. Where did the damage or jury occur? (Include it an t Richmond Crisi Facility; .aRzchmond. Merrithew osiital Mz s. Sow did Mdamage or fs� Occur? (dive' full datai s; use extra A' er M"#1")evennts they did not even witness,, elaborating beyond actual participants about causes for certain, conti conditons (e.g. , 14/ vil'ent viol* with RPD ; required 3 emts and 3 #. icaulax act or emission on the riot � officers, servants or esep eyses caused the i jury o y d"ago? &J t 1 ♦' � ��-"..-';i�� � 11 "i..is+t"� � vE., c.� ..-. yt ,_i i ih? r 1 Cs fir.-t c r S e_2. 7 S'v tie . i to 4- g -�- Z ;3M- (�r4Vlr) C �{A.,,.. �`, '�1+'ti+:._. 1„iia. )`...�..-„"J�r`v'•..l�h_+.may Rmksx police officers. .,. /IIZX//// . Dishonest report.or extremnely misleading report "Placed in w/c in 4 pt rexstraints by staff because of "violence" . I was certalNLY not at all violent or physically uncooperative at the Richmond facility and an ind pendent assessment by their facilitiy would not have justified restraintsx. Not only was I in restraints; they administered a shot of three depressant drugs _;<without my consenti while I was in restraints. This is a contradioction of the legal basis for emergency medication. I could not possib17 have presented a physical threat after being placed in restrainst The report justified their not soliciitiubng mty consent by stating I was capable of •ent--this is quite extreme. .. �, I have been experiencing harassment; much of the harassment, itis my understanding and belief, is coming thfrom the Health w department, wghieh implicates this county facilitiy. I had not sat that day: The time in restraints, sitting perfectly S' -A K in a wheel chair, would have made about one hour's worth of V ,,\%- c ' sitting for the day. fOne of the staff members said of the \14yF" ^. , RMHC >st 'aff {a general statement, obviously) , "we are toes" / resumably plural of "co" . , which certainly means at least -sit--for compelling people to sit. } Report itself indicates poor understznding of the uses of emeergency medication, seeming also to justify its use because 41 I was not answering all of their questions. I was not violent with them. I may have spoken ;somewhat loudlt qt Jheejr faciltiyt, but I often speak loudly. I did not yell If people in general are experiencing distress due to"day", they should: be conscious aof this and sensitive; to kiclX it, Delusional to experience ..day" as harassment? Their reports actually called me violent alsthough they were witness to _none; their report is to blame for the restrictions placed upon me at Merrithew and possibly for the length of my stay They are indifferent to myn depression, which can haappen ,from continued harassment . This staff is unoprofessional. S. What are the names of cc unty or district officers, servants or employees causing the d aqe or injury? I Gandhi, Davis, Ansel 1- 0. that damage or injuries o you claiU resulted? (Gi!v fu11 extent of injuries or damages a aimed. ltttarh .for auto damage.) /Future diffic lty getting ea Damage to reputation (espe Tally during day when private information is leaked on a routine bas s) . Moneatary lieability lburden 7. How was the amount claim* above aonputed? �Ynclud+r the estimated account of any'prospectiv injury or damage.) kBill s as the basis. But theirn false reports and flack of concern about my evere depression make me increase •. d aQdrasses of v *sees, doctors and hospit-Us. I cannot access many of these because the information is not readily available ard I do not have access at this point to a "spy" who can tell mE enough about who knows what' , who saw q;mow exp+endltures YOU Sade an account of tbis' accident or injury. rr+e���t+e�a�r�►+��+�rr����r�t��e�rt#�t�►� •r�►art#t��tstr���►s�r��r��r���t��t�,�M�r,�,r�tsr*�t�►� j Gov. Code dac. 910.4 provides "The dais* must be aligned by the claimant or by some person on his Name and Address of Attorney y (Claimant's S i#nature) ,r .YiYYfpl � �/ � Y -iIIYWWWr•IAlI®� WYWWIMIi r (Address) Telephone No. Telephone No. se:,r�r�,e�+r�,��,e#�e+��r,�s+�+e,��e�rs• '��:�aee,e�rsr��r���#�r+�r�:#+�+��►s�r:�+��s�+��►�r ON section 72 of the 9wrrral Code Druid*$: svesry person who, with ant to defraud, presents for allowance or for payment to any stage rd or off icer, or to any oounty, city or district board or officer, authorized to allow or pay the same if genuine, grey false or fsravd ont Claim, trill, account# voucher, or Writing, is punishable •itbe by LWr,isonment in the eounrty jail for a period of not Arora than year, by a time of mot oxeseding one thouaarrdl,OtiO , or by such imprisonment and fine, or by iseprisonment in the state p Loon, by a fine of not 4Wa0edinq ten thousand dollars ($10,,000,, *1 by both such imprisonment and fires. PAGE N CONTRA COSTA HEALTH SERVICES 3 r 25tX3 ALHAMBRA AVENUE TY�P-OFTl. OATS C)F 8141 jLL MARTINEZ,CALIFORNIA 94553 -6500 (510)313 ISP PATIENT NAME PATIENT NU SE x MIF ADMISSION WE C»9C►+ANC3E pA F DAYS, AMOUNT ENCLOSED $ $T�t8A 3LT JOYCE 104015 �} E+ 46 1341 w7l98 't�4l3Q P 98 3 , --- '"- 04WAAKE COMPANY MAW GWWP NO. PCIIICY N4JM41EPI JARANTOR JOYCE: TETREAULT 1PRIVATE PAY NAME 13700 'SAN P'ASLO AV #2309 AMo SAN PABLO AVB ( + SAN PABL4, ICA 94006 it f a i I I � 29534 6517090--33--0003 i 3473. 24 _1 3470. 24 PAT NT.NUI iI PLEASE REFER TO PATIENT ADOITIONA PATIENT BILLING MAY I t NECESSARY fOR ANY NUMBER ON ALL INOUIRJES CHARGES N POSTED WHEN THIS BILL WAS PREPARED.OR 3..475. 24 AND CORRESPONOENCE. If INSURAt! CARRIERS OO NOT PAY ANY PART OF Till �� Y �� �� f 3 J AMOUNTS S. WN UNOER ESTIMATED INSURANCE COVERAGE. 1 Mala►chow spayab o t4?.`CONTRA C08TA HEAL H S RViCES,59$Canter Ava^uo.Sults.100,Mar0nax,till$4003 »� i "AmorWan M dloal gssponsa File 73328 P.O. Box 80000 San Francisco,CA 94160-332£3 Collection Letter June til, 1998 st♦ JOYCE TETREAULT 13744 SAN PABLO AVE APT -- 23{ 9 SRN PABLO CA 94806-3780 Il�l���iM#Irl�It���rll+=irk#� r::t�w1r11+rtli#��1la::� }del AMERICAN MEDICAL RESPONSE FIDE 73329 P.O. BOX 60000 SAN FRANCISCO, CA 94160-3329 Patient Name: JOYCE TETRE ULT Account Number: 000056330 Trip Number: HATSBO 7€I70 0 Hate of Service: April 27, 1 98 Balance Past due: 523.35 Dear JOYCE TETREAULT: Our attempts to contact you regarding an outstanding invoice have been unsuccessful. To avoi further action by our collection department please pay the b lance due immediately. To discuss payment options lease contact one of our 'billing specialists at 1-800-267-53 5. ** **** **** we accept VISA Mastercard and Discover '*'****** **** ikiE**�r�r��r#�rtr*tk*,ot�iftsitit�kil^ltit,NrlEirit ****�iti�**�it9t**��t*��*��k*�k'Jtlttc**it#r*�kik�lkitit� Thank you for your cooperaULon. Thank You, Customer Service 1 �r..- POSTAGE PAID SAN i OCT 27, 98 U'WrIONTArla. OUNT 0 0005983-05 C t; r +f/9vZail'< ': �" r r $/fi y v� /Cr �i'.✓�G 4r r f a.}, v Y�"f l r rr '_ / 'ria F ' /'`� 3 i i � ^ ✓ �fv� a'`3'f g-&4: l& <Yrf`�or ri�f•. „h ,� 'h ��A<�,�,r}fr3;<.>/ 7'k �?.T" f } f R 4 'A.t� 4)„S y,¢3,.' } r r r2j2xj3b"�'�cc ,. C I AIlVI BOARD OF SUEERVMORS OF CWTA_.OUNTY, CALIFORNIA WM D AO December 1, 1998 Claim Against the County, or District Governed by � the Board of Supervisors, Routing Endorsements, 1 NOTICE TO CLAIMANT and Board Action. All Section references are to The copy of this docurneritmailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below(, given pursuant to Governrmnt Code Section 913 and �5 915.4. Please note'all "Floorings" AMOUNT: $3-475.24 dt CLAIMANT: Joyce TetreaultCpuNTy COUNSEL Ntt�t4EZ CALIF. ATTORNEY: DATE RECEIVED: November 2, ;1998 ADDRESS: 13700 San Pablo Ave. , 2309 BY DELIVERY TO CLERK ON: November 2, 1998 San Pablo, CA 94806 October 30, 1998 BY MAIL POSTMARKED: L FROM: Clerk of the Berard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BA HELOR, Clerk Dated: November 2 1998 By: Deputy ��__ 11. FROM: County Counsel TO: Clerk of the Board of Supervi ors ( vl�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 �oclaimant's right to apply for leave to present a,late claim (Section 911.3). 4, 1 Other: Po,' hens n-?e J,, 4,7d r 00 7'70,?.f,, a rte. C n/-7 C114gj."'n Is m /w -f67 65 ,2a T Dated: By:.. 2_ Deputy County Counsel JIL 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. A > Dated:_12�:1 PHIL BATCHELOP, Clerk, By e-�--iU , Deputy Clerk WARNING (Gov. code section 9 ) 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. AFFEDAVTP 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:_+ f-'­2- P'Yl ' By: PHIL BATCHELOR By Z— Deputy Clerk CC: County Counsel County Administrator ....................................................................................................................... ...............................I...............- VICTOR 1WESTMAN DEPUTIES: COUNTY COUNSEL CONTRA COSTA COUNTY PHILIP S.ALTHOFF JANICE L.AMENTA OFFICE OF THE COUNTY COUNSEL SHARON L.ANDERSON ANDREAW.CASSIDY ARTHUR W.WALENTA,JR. COUNTY ADMINISTRATION BUILDING VICKIE L. DAWES ASSISTANT COUNTY COUNSELMARKE S.ESTIS 651 PINE STREET,9th FLOOR MICHAEL D.FARR MARTINEZ, CALIFORNIA 94553-1229 LILLIAN T.FUJtI SILVANO B.MARCHESI DENNIS C.GRAVES ASSISTANT COUNTY COUNSEL GREGORY C.HARVEYJANET L.HOLMES KEVIN T KERR GAYLE MUGGLI BERNARD L.KNAPP EDWARD V.LANE,JR. OFFICE MANAGER MARY ANN MASON PAUL R.MUNIZ PHONE(925)335-1800 PHILIP J.NORGAARD FAX(925)646-1078 VALERIE J.RANCHE DAVID F SCHMIDT DIANA J.SILVER NOTICE OF UNTIMELINESSESS BARBARA N.SUTLIFFEJACQUELINE Y WOODS AS TO A PORTION OF THE CLAIM TO: Joyce Tetreault 13700 San Pablo Avenue, #2309 San Pablo, CA 94806 RE: Claim of Joyce Tetreault Please Take Notice as Follows: In regards to the claim you submitted on October 30, 1998,portions of your claim are timely and portions are untimely. The portions of your claim prior to Al2ril 30, 1998 that you presented against the County of Contra Costa governed by the Board of Supervisors fail to comply substantially with the requirements of California Government Code Sections 901 and 911.2, because they were not presented within six months after the event or occurrence as provided by law. Because the portions of the claim prior to April 30, 1998 were not presented within the time allowed by law, no action was taken on those portions of your claim. The claim was forwarded to the Board for action on the timely portions of the claims. Your only recourse at this time is to apply without delay to the County of Contra Costa governed by the Board of Supervisors for leave to present a late claim as to the claims which are untimley. See Sections 911.4 to 912.2, inclusive, and Section 946.6 of the Government Code. Under some circumstances, leave to present a late claim will be granted. See Section 911.6 of the Government Code. You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately. VICTOR J. WESTMAN, COUNTY COUNSEL L By: nika L. Cooper Deputy County Counsel H:\GROUPS\TORT\RISK-MGT\CLAIMS\UNTIMELY\TETREAUL.WPD Page 1 mum 01P SM31M 07 ODOM Dun OWN" A. Claire relating to causae of on ter death or for i�ie� o Ctor* or to personal pro"rty or iof Qre s and Which aw Dear 33 l 1087, suet too "t later than the .100th day atter the accrual of the a of action. claim rtlatuq to caueas of action for death or fear jury to person or to personal property Or growing crops and Which rum on or after fanuary 1, 1908, Suet be prosented not later than Y months after the 606Vval of the caue* of action. Clap rslatuw axey other aauaa at at out be presented not later than Iran after the accaval the onuse of action. (Gw*t Coda 911.3 s. Claims suet be filed with !•h lark of the Ward of � 3rars at its offive its Room los, County inieetration building, s tits Star+eet# agrtiaos, Cdr 94553. c. 3t claim is against r distri yyovermA by the toard of supervisors, rather than the County, the of the District should be filled in. D. If the claim is against mor an one public entity, asparats claims suet be filed against each lie entity. t. ZrAnd, Sea penalty ter tra Mint Claims, lea»al Cod! $OZ. 73 at the endOf this fors. 3t: Claim ay Mssery od ter Clark• filing stamp Joyce Tetreault r San Pablo, CAS 94 806 � against the 'county of Centr Costa) or 3 NOVr ` n tricrt) .r.r.rrrrrwr+r+rrr.r�rr..rrr (Fill in Flame) � _,._.:. ..,..... Th* undersigned claimant he "Y makes claim against the County of Contra Cast& or the above- d District in the slum of .S.,A and in support of this Cls sag a ! llo�rsa $3475. 24 " C.0 V.44 14/127/98 throb4f 1a ear i ury occur (sieve "act to hour) _. 11he a did the d qe or uty Ser? (tnofid +s ty a minty) IM os ` � '� amage During hospitalization 3. Now did the dams oac� d +vo 1 data e� +ass ra paprz 3f reguradj ss key ewi tc while Keys we a in star overzealous to diagnose me s psychotic, especially as chronically so. Relatively indifferent to serious depression I have been experiencingto. extreme ;dot invent of m well-being. 4. Nkat particular act or " Ion on the part of county or d ftr 'ct' officer$, •orvante *at DY"s caused the injury et dasags? Distorted rephrasing of my ds in many instances, often neglecting details of facts that would support my speculation or conclusion. `'bad' is prettyob�rious in s parte of the county; and staff ' of t 6' p r i � 1B8A% d Vrovide a real soya, custody. one set of eys did not fit the lh+en W Sou Nbt on l v me s n }, c�._d • �t" ar+r as iNabo o + ' dfWtj� jJJ 'C.P. r nt ►f 1AA-t„JA,-V,, e410y`ei oaueinq the d pe or injsaary' { w 4iot A. Mental, W. Posher, S. Ra r i. Mteat a e or In var es Ra acesulted (*Iv' e t-11 sxterst O1' Injuries or dtmaga e� aimed. t> fuel eritiasatiri toaw auto Jea0pardi2es m well-being in any future iediczl carelirs my $billity to t insurance, employment, to be treatedwith dignity in comm ity; -fv 7. pav was the e�eavnt 01 aabove Wit" (inclvdt then ' ret sated aso rot Of any prospoetiv Injury or dwasgoe.) Hospital bill a. sasea and addresses of Y mei, do+N toari and 8aap tali. !. El$t U# eacperufitures "t da on account of this ;ccid*nt or injury. Gov. Code sec. 910.2 provides WThi claim suet be eeiq»ed by the claisant or by soma person on his w Name and Address, of Attorns V(Cl} ) oisant.a dlWutu r*) } Joyce Tetreault 13700 j" Av2309 ? San Pablo, CA 9480 Telephone No. � Telephone section Tl of the panel +hod +rmt previdoes ivory person Wm a with to defraud, para�eents tor allow moo or for payment to any state rd or officer* or to ariy ee ►ty, cityoar district board or officer *Uthortaaeed t* allenr or pay the ease if genuine, ony talse or tra end *lots, bill„ account, voucher, or Writuvo is Van,is"ble at by IMCA"a met In tb* OOWtY Jail torr a period of 1114t sora t '�! 31"ro a tbw of riot +sat one tltouiaaad $1#000) or b'y $UOh�risoNment as rims or by Jxpria+omwnt to the state f#an, bY a tine of not earvoedint ten thousand dollars ($10,000, or by bath such Ispariso »t and l3amr. ONTRA COSTA HEALTH SERVICES PAGE"� BI TE OF lkL t 2500 AL HAMBRA AVENUE _ ! MARTINEZ,CALIFORNIA 94553 +' l (510)31 M500 P PATIENT NAME PAnE*T NUWIBEA SEX AGE I ADWVCM DATE OwtriAROE DATE't DAYS. AMOUNT EWLOSED TRSAULT JOYCE.. - 4/39 F 46 104/27/98 / INSURANCE COMPANY NAME QROUp Nn. POLICY NUMBEfl RANTOA ,JOYCE TETREAULT PRIVATE PAY IAMt 13700 00 SAN PALO AV #2309 AND SAN PABLO AVE OREW SAN PABLO, CA 94806 _. PLEASE RETURN T P PORTION WITH YOUR PAYMENT 29934 6317890-93-0003 347$. 24 3479. 24_ LEA5E REFER TO PATIENT AOF1IT$ONAt TIENT BILLING MAY BE NE09SSARY FOR ANY PATIENT N t ..— --#NUM9EI4{Nf ALL INQUIRIES CsfARIi€#NO POSTED MIN€N TFIi3 FILL WAS PREPAIIE£t.OR 3 p .!� .i 51 AND CORRESPONO*NCE. IF INSURANC CAARIERS Dd NOT PAY ANY PART OF THE j PLEASE�Ay TM AMOUNT 3475. 24 AMOUNTS SHO VN UNDER ESTIMATED INSURANCE COVERAGE. Nhka c#Wka payabls t0:CONTRA COSTA 146ALTT SERVICES.595 Cant*r Avanua,SuMta 30t,MaMnai,CA 94553 ii 00 • i � ii J • t_ ; 9 �► � • i 004 0 00 7; 6 'C I�Mco%I i CSA W /!l,'Jli►"lll► af��lt� ii�a�ril�s+r+rt�ltr.�A+is�,,,:"tM�r''�#r,:. 00 00C. 11041. so 0' 4 10 , i� _ • i • ti 04, tai ! 00 100 CLAIMS BOARD OF suPERvisogs OF CONTRA COSTA COUNTY* CA.LwogNLA BOARD ACII December 1, 1998 Claim Against the County, or District Governed by ► the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to 1 The copy of this document mailed to you is your California Goverment Codes. ! notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below}, Oven pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $75.00 CLAIMANT: O C T 7 1998 Gwynn Wallace COUNry COUNSEL. ATTORNEY: MARTIfi f-hCEIVED: October27, 1998 ADDRESS: 17 Hartwell Street BY DELIVERY TO CLERK ON: October 27, 1998 Crockett, CA 94525 Hand--delivered BY MAIL POSTMARKED: L FROK Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BA HELOR, Clk� Dated: October 27, 1998 By. Deputy II. FROM County Counsel TO: Clerk of the Board of Supervisors (V-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: Dated: 5' By: 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). N. 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:_ (� 1 2�� PHIL BATCHELOR, Clerk, By L_ 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. AFFWAVTT OF MAEUNG 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:_ leC. By: PHIL BATCHELOR By - Deputy Clerk CC: County Counsel County Administrator