HomeMy WebLinkAboutMINUTES - 01082008 - C.25 (11) APPLICATION TO FILE LATE CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNI , 2
i BOARD ACTION
Application to File Late Clai ) NOTICE TO APPLICANT ' ZaS�
Against the County, RoutingSEC 1 4 2007
.�axe a
) e copy of this document mailed to you is your
Endorsements, and Board Acti066UNTY CoUNB�,notice of the action taken on your application by
R
(All Section References are to A TII 2Z CALIF. the Board of Supervisors (Paragraph III, below),
California Government Code.) 1 given pursuant to Government Code Sections 911.8
and 915.4. Please note the "WARNING"below.
i
Claimant: JOSEPH DANIEL J ; ELIJA JOHN J ; BEM K. JARAMEUD: DANIEL J.
JARAMMM; AND DANIEL DAVID JARAMILIA, by and through his Successpr-In Interest Betty K. Jaramillo
Attorney: JAY P. RENNEISEN
LAW OFFICES PF JAY P. RENNEISEN
Address: 10131 jan Miguel Drive, Ste., 210
Walnut Creek, CA 94596
Amount: By delivery to Clerk on: December 14, 2007
I
Date Received: December 14, 2007 By mail,postmarked on:
I. FROM: Clerk of the Board of Supervisors TO: County Co nsel
Attached is a copy of the above noted Application to File Late Claim.
DATED: { a JOHN CULLEN Clerk,By: JL�(� DEPUTY
II. FROM: County Counsel TO: Clerk of theiBoard 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: 0 SILVANO B. MARCHESI, County Counsel, By: � .� DEPUTY
III. BOARD ORDER By unanimous vote of Supervisors present
(Check one only)
( ) This Application is granted (Section 911.6).
V--�This Application to File Late Claim is denied (Section 911.6).
I certify that this a true and correct copy of the Board's Order entered in its minutes for this date.
DATEQ== ip .Q,/yj�dOHN CULLEN, Clerk, By: 00, DEPUTY
WARNING (Gov. Code §911.8)
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 provisions of Government Code Section 945.4 (claims presentation requirement). See
Government Code Section 946.6. Such petition must be filed with the court within six (6) months from the date
your apQjication for leave to present a late claim was denied.
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.
IV. FROM: Clerk of the Board TO: (1) County Counsel (2) County Administrator
Attached are copies of the above Application. We notified the applicant of the Board's action on this
Application by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's
copy of this Claim In accordance with Section 29703.
DATED: JOHN CULLEN', Clerk,By: DEPUTY
V. FROM: (1) County Counsel (2) County Administrator TO: Clerk of the Board of Supervisors
Received copies of this Application and Board Order.
DATED: of 4AVr County Counsel, By: ,�� .•ys�
—r
County Administrator,By:
APPLICATION TO FILE LATE CLAIM
This warning does not apply to claims which
are not subject to the California Tort Claims
Act such as actions in inverse condemnation,
actions for specific relief such as mandamus or
injunction, or Federal Civil Rights claims. The
above list is not exhaustive and legal
consultation is essential to understand all the
separate limitations periods that may apply.
The limitations period within which suit must
be filed may be shorter or longer depending on
the nature of the claim. Consult the specific
statutes and cases applicable to your particular
claim.
The County of Contra Costa does not waive any
of its rights under California Tort Claims Act
nor does it waive rights tinder the statutes of
limitations applicable to actions not subject to
the California Tort Claims Act
r
OFFICE OF THE COUNTY COUNSELSILVANO B. MARCHESI
SE L
COUNTY OF CONTRA COSTA ��, ------ COUNTY COUNSEL
Administration Building s�
651 Pine Street, 91h Floor SHARON L. ANDERSON' •,+
CHIEF ASSISTANT
Martinez, California 94553-1229
(925)335-1800 GREGORY C. HARVEY
(925)646-1078(fax) x� °� ''
VALERIE J. RANCHE
ASSISTANTS
z =Ati
COSrA COU�� l+Y
December 27, 2007
Writer's Direct Dial:
925.335.1885
Via Facsimile 925-955-1601
Jay P. Renneisen
LAW OFFICES OF JAY P. RENNEISEN
1931 San Miguel Drive, Suite 210
Walnut Creek, California 94596
Re: Application for Leave to Present Late Government Tort Claim,
filed December 14, 2007
Dear Mr. Renneisen:
This confirms our receipt of your Application for Leave to Present Late Government Tort
Claim regarding the death of Daniel David Jaramillo on December 17, 2006. Your initial
Government Tort Claim filed on behalf of the same claimants on June 12, 2007 with Contra
Costa County was timely. Contra Costa County is the appropriate government entity to file a
claim against either the Contra Costa Regional Medical Center or the Antioch Health Center. If
your only intent with the present Application to File Late Claim is to add the Antioch Health
Center, your initial claim is sufficient.
Your Application to File Late Claim is set to be heard by the Board of Supervisors on
Tuesday, January 8, 2008. Based on your submission, our office will recommend that the Board
deny your Application. If you wish to withdraw your Application,please let me know no later
than 5:00 p.m. January 2, 2008. If we do not hear from you, your Application will proceed
through the normal channels.
Jay P. Renneisen
December 27, 2007
Page 2
Please also note that your time to file a lawsuit runs from the notice of denial of your
initial claim, July 11, 2007.
Very truly yours,
SILVANO B. MARCHER
COUNTY COUNSEL
By:
Monika L. Cooper
Deputy County Counsel
OFFICE OF THE COUNTY COUN!. SILVANO B. MARCHESI
COUNTY OF CONTRA COSTA � ,---_ ��' COUNTY COUNSEL
Administration Building
651 Pine Street, 9" Floor ';� ���* SHARON L.ANDERSON
Martinez, California 94553-1229 * -' - . CHIEF ASSISTANT
n�
GREGORY C. HARVEY
0. +h3I1�1��11 �=ti
(925)335-1800 VALERIE J. RANCHE
�'�� a�a 'T' ■ ;,�
(925)335-1866 (fax) ,'O ASSISTANTS
SpA_coUl`�
FACSIMILE COVER PAGE
Date: December 27, 2007
Deliver To: Jay P. Renneisen Fax No.: 925-955-1601
Law Offices of Jay P. Renneisen
From: Monika L. Cooper
Deputy County Counsel
Number of Pages(Incl. Cover Page): 3
For Voice Contact Call: (925) 335-1885
For Return Facsimile Messages: (925) 335-1866
The pages comprising this facsimile transmission contaiCLONFIDENTIAL INFORMATION from the Office of the County Counsel,
Contra Costa County. This information is intended solely for use by the individual or entity named as the recipient hereof. If you are not
the intended recipient,be aware that any disclosure,copying,distribution,or use of the contents of this transmission is prohibited. If you
have received this transmission in error,please notify us by telephone immediately so we may arrange to retrieve the transmission at no cost
to you.
RE: Claim re Daniel David Jaramillo
ENCLOSURE: Letter from Monika Cooper dated 12/27/07
REMARKS:
f✓J Original Will Not Follow.
( J Original Will Follow By: [ ] U.S. Mail
[ ] Inter-Office Transmittal
[ ] Personal Delivery
[ ] Other:
RTH:\I:\TORT\RISK-MGT\CLAIMS\Claim Corres\Fax Renneisen re Jaramillompd
12127/2007 16:21 FAX 925 335 1866 CONTRA COSTA CTY COUNSEL Z001
TX REPORT
TRANSMISSION OK
TX/RX NO 4670
CONNECTION TEL 99551601
CONNECTION ID
ST. TIME 12/27 16:20
USAGE T 01'05
PGS. SENT 3
RESULT OK
OFFICE OF THE COUNTY COUNSEL fiE___L SILVANO B. MARCHESI
COUNTY OF CONTRA COSTA �' COUNTY COUNSEL
Administration Building *" _
651 Pine Street, 9"Floor _ � • SHARON L.ANDERSON
Martinez, California 94553-1229 - ;* CHIEF ASSISTANT
GREGORY C.HARVEY
(925)335-1800
O� - "'- �i�11I`=: VALERIE J.RANCHE
+--•�• �e a '•�' ,`. .,�
(925)335-1866 (fax) N ,40 ASSISTANTS
S7A,
co
FACSIMILE COVER PAGE
Date: December 27, 2007
Deliver To: Jay P. Renneisen Fax No.: 925-955-1601
Law Offices of Jay P. Renneisen
From: Monika L. Cooper
Deputy County Counsel
Number of Pages(Incl. Cover Page): 3
For Voice Contact Call: (925) 335-1885
For Return Facsimile Messages: (925) 335-1866
The pages comprising this facsimile transmission contaiCONFIDENTIAL INFORMATION from the Office of the County Counsel,
Contra Costa County. This information is intended solely for use by the individual or entity named as the recipient hereof. If you are not
the intended recipient,be aware that any disclosure,copying,distribution,or use of the contents of this transmission is prohibited. If you
have received this transmission in error,please notify us by telephone immediately so we may arrange to retrieve the transmission at no cost
to you.
RE: Claim re Daniel David Jaramillo
ENCLOSURE: Letter from Monika Cooper dated 92/27/07
REMARKS:
f
I Jay P. Renneisen(Bar No. 173531)
LAW OFFICES OF JAY P. RENNEISEN
2 1931 San Miguel Drive, Suite 210
Walnut Creek, California 94596
3 Telephone: (925) 280-8900
4 Facsimile: (925) 955-1601
5 Attorneys for Claimants
6
7
STATE OF CALIFORNIA
8
3 9 COUNTY OF CONTRA COSTA
_
c 10
3 11 Claims of: APPLICATION FOR LEAVE TO
z ¢ 3 PRESENT LATE GOVERNMENT TORT
U ° 12 JOSEPH DANIEL JARAMILLO-CARRANZA; CLAIM
z ELIJA JOHN JARAMILLO-CARRANZA;
13 BETTY K. JARAMILLO; DANIEL J. [Government Code Section 911.4, et seq.]
JARAMILLO; and DANIEL DAVID
r o 14 JARAMILLO,by and through his Successor-In- DECLARATION OF JAY P. RENNEISEN
N N Interest Betty K. Jaramillo, IN SUPPORT
Claimants,
E � ' 16
O 0 : against �Q P—I SM "2:
S
3 g 17 RECEIVED
00 18 CONTRA COSTA COUNTY; CONTRA
N COSTA COUNTY BOARD OF DEC 1 4 2001
19 SUPERVISORS; FELICIA TORNEBENE, M.D.;
CONTRA COSTA HEALTH SERVICES; CLERK BOARD T SUPERVISORS
a 20 ANTIOCH HEALTH CENTER; and DOES 1 CONTRA COSTA CO.
through 20, inclusive,
21 Government entities/employees.
22
23 The above named Claimants,by and through their counsel herein, respectfully submit to the
24 above named Government entities/employees, the following APPLICATION FOR LEAVE TO
25 PRESENT LATE GOVERNMENT TORT CLAIM pursuant to Government Code Section 911.4, et
26 seq., along with the accompanying DECLARATION OF JAY P. RENNEISEN IN SUPPORT and
27 the attached Exhibits "A"though"C"which include Claimants' proposed Government Tort Claim as
28 Exhibit"C".
-1-
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM; DECLARATION IN
SUPPORT
•
I APPLICATION
2 A. Introduction
3 This office represents claimants Joseph Daniel Jaramillo-Carranza(age 6), Elija John
4 Jaramillo-Carranza(age 3), Betty K. Jaramillo, Daniel J. Jaramillo and Daniel David Jaramillo, by
5 and through his successor-in-interest Betty K. Jaramillo (hereafter"Claimants"), with respect to
6 personal injury and wrongful death claims arising out of the death of Daniel David Jaramillo
7 ("Daniel") via doctor prescribed methadone overdose on December 17, 2006.
0 8 Joseph Daniel Jaramillo-Carranza(age 6) and Elija John Jaramillo-Carranza(age 3) are the
9 surviving minor children of Daniel who tragically lost the love and support of their father. Betty K.
G
10 Jaramillo and Daniel J. Jaramillo are the parents of decedent Daniel and they directly witnessed
W �
11 Daniel's dying and death via doctor prescribed methadone overdose on December 17, 2006.
U
U p
w 3 12 Claimants previously presented a Government Tort Claim dated June 12, 2007, a copy of
U •
w13 which is attached hereto as Exhibit"A", identifying the necessary information regarding Claimants'
14
claims against the Contra Costa County, et al., arising out of the doctor prescribed methadone
ro
W � a
15 overdose of their loved one, Daniel. Attached hereto as Exhibit"B" is a true and correct copy of the
U .> .0
16 notice of rejection of Claimants' claim which was mailed on July 11, 2007.
O "
8 17 Since the time of the original tort claim, this office subsequently obtained medical records
a � 0?
N 18 clarifying that, although the prescribing physician (Dr. Felicia Tomebene) was at the Contra Costa
.-. N
19 Regional Medical Center when she first began treating and prescribing medications for Daniel in
C
0
C.
20 2006, she was physically at the Antioch Health Center in Antioch when she actually prescribed the
H
21 methadone that caused Daniel's death.
22 Claimants respectfully maintain that their original Government Tort Claim is sufficient
23 pursuant to Government Code Section 910 and that said claim is and will continue to be valid.
24 However, in an abundance of caution, Claimants respectfully seek leave to present a new late
25 Government Tort Claim, a true and correct copy of which is attached hereto as Exhibit"C", which
26 clarifies where Dr. Tornebene was located when she prescribed the methadone.
27 B. The Orieinal Government Tort Claim
28 On June 12, 2007 this office presented a Government Tort Claim, a copy of which is attached
-2-
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM;DECLARATION IN
SUPPORT
I hereto as Exhibit "A", on behalf of Claimants. That claim stated that Claimants are informed and
2 believe that Daniel died as a result of, inter alia, the negligent prescription of methadone for Daniel
3 by Dr. Felicia Tornabene, who is an employee of Contra Costa County. Claimants stated that Dr.
4 Tornebene prescribed the medication for Daniel on December 12, 2006 while he was under her
5 medical care. Claimants stated that the prescription was negligently ordered, given by, instructed by
6 and/or advised by Dr. Tornebene and that Daniel was not otherwise properly informed regarding the
7 precautions, instructions and dangers of such prescription. As such, claimants stated that they are
E 8 informed and believe that the negligence of Dr. Tornabene was a substantial factor in causing
3 9 Daniel's untimely death at 29 years of age on December 17, 2006.
10 C. The New Late Claim
C, C
z 11 Claimants respectfully maintain that their original Government Tort Claim is sufficient
d
W U a
z12 pursuant to Government Code Section 910 (and any other applicable statute) and that said claim is
U •
r 13 and will continue to be valid. However, at the time the original claim was presented, Claimants'
oR �
14 counsel believed that Dr. Tornebene was at the Contra Costa Regional Medical Center when she
11 N N
O
In 6 15 prescribed the methadone for Daniel and that information was indicated in the original claim. As
uA .€
w € 16 stated in his declaration, below, Claimants' counsel subsequently received medical records from
O "
7 •
S 17 Contra Costa County Health Services which indicate that, although Dr. Tornebene was working at the
a � C?
M
N 18 Contra Costa Regional Medical Center when she originally treated and prescribed medications for
N
19 Daniel, she was at the Antioch Health Center when she actually prescribed the methadone in
0
20 question. Both the Contra Costa Regional Medical Center and the Antioch Health Center are part of
H
21 Contra Costa Health Services and, as such, Claimants maintain that the original Government Tort
22 Claim is sufficient for their medical malpractice and wrongful death claims herein. However,
23 Claimants' counsel wants to make sure no technical defenses will be argued with respect to the
24 claims he is bringing on behalf of his clients, who are two minor children who lost their dad, and their
25 grandparents who witnessed the death of their son.
26 Accordingly, Claimants respectfully request leave to present the new late claim attached
27 hereto as Exhibit"C". The new late claim does not change the basics of Claimants' claims, but
28 rather, simply clarifies that Dr. Tornebene was at the Antioch Health Center when she prescribed the
-3-
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM; DECLARATION IN
SUPPORT
I methadone for Daniel. [Please compare Exhibit"A" with Exhibit"C"].
2 D. Claimants' Application For Leave To File Their New Late Claim Is Timely.
3 Claimants respectfully submit that their present application is timely. Government Code
4 Section 911.4 (b) states that the application shall be made "within a reasonable time not to exceed
5 one year after the accrual of the cause of action".
6 Here, the proposed new late claim simply clarifies that Dr. Tornebene was not physically at
7 the Contra Costa Regional Medical Center, as previously believed by Claimants' counsel, but rather,
0 8 she was operating out of the Antioch Health Center when she prescribed the methadone for Daniel. It
9 was only after Claimants' counsel subsequently received various Contra Costa Health Services
10 records, and then reviewed them in detail while in the process of preparing a civil complaint, that he
11 learned that Dr. Tornebene was actually at the Antioch Health Center when she prescribed the
za
W Up
z 'Q
0 12 methadone for Daniel. Thus, the delay has been reasonable in that it was due to an honest belief that
U •
WS 0 13 Dr. Tornebene was at the Contra Costa Regional Medical Center when she made the prescription.
o� N
14 Moreover, Daniel's death occurred on December 17, 2006 and, as such, Claimants' causes of
tiN N
W
's, = 15 action will accrue, at the earliest, on December 17, 2007. Thus, the one year deadline for making the
U .> .�
w W. 16 application has not yet expired and Claimants' application herein is timely. [As shown in the
O = .
8 17 attached proof of service, Claimants' application is being hand served on December 14, 2007 which
a � 0?
� o
18 is less than a year post Daniel's death].
- N
19 E. The Application Should Be Granted Due To Mistake, Inadvertence And
G
0
20 Excusable NeElect.
F
21 Claimants respectfully request that their application be granted. In this regard, Government
22 Code Section 911.6 states as follows:
23 (b) The board shall grant the application where one or more of the
24 following is applicable:
25 (1) The failure to present the claim was through mistake,
26 inadvertence, surprise or excusable neglect and the public entity was
27 not prejudiced in its defense of the claim by the failure to present the
28 claim within the time specified in Section 911.2.
-4-
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM;DECLARATION IN
SUPPORT
I Here, Claimants respectfully point out that the failure in the original claim to clarify that Dr.
2 Tornebene was at the Antioch Health Center, and not the Contra Costa Regional Medical Center as
3 previously thought, was due to mistake, inadvertence and excusable neglect. As stated in the
4 declaration below, Claimants' counsel presented the original tort claim while under the good faith
5 belief and understanding that Dr. Tornebene was operating out of the Contra Costa Regional Medical
6 Center at the time she prescribed the methadone for Daniel. Claimants' counsel did not know until
7 the medical records were obtained and reviewed that Dr. Tornebene was actually at the Antioch
E 8 Health Center when she prescribed the methadone. The mistake, inadvertence and excusable neglect
3 9 on behalf of claimants' counsel were understandable since Daniel was at the Contra Costa Regional
G
c 10 Medical Center, and in fact was in-patient there,when Dr. Tornebene first began treating and
11 prescribing medications for him. In any event, Claimants' counsel has attested under oath that the
z ¢
W U p
W 3 12 failure to make the clarification in the original tort claim was in fact due to his mistake, inadvertence
U •
W 13 neglect.
and excusable ne
g
do 14 Also, the basic facts and circumstances of Claimants' claims (i.e., the doctor prescribed
15 overdose of methadone causing Daniel's death) have not changed. Accordingly, the government
U .>
16 entities have already been put on notice of Claimants' claims and there is no prejudice by granting
O "
d 8 17 Claimants leave to file their new late claim simply clarifying Dr. Tornebene's specific location when
04
� o
18 she negligently prescribed the methadone, etc.
19 F. The Application Should Also Be Granted Due To The Fact That Claimants
0
20 Joseph Daniel Jaramillo-Carranza (age 6) and Eliia John Jaramillo-Carranza (age 3) Are
F
21 Minors.
22 Government Code Section 911.6 also states that"The board shall grant the application where .
23 The person who sustained the alleged injury, damage or loss was a minor during all of the time
24 specified in Section 911.2 for the presentation of the claim." Here, as attested to in the declaration of
25 Claimants' counsel below, Joseph Daniel Jaramillo-Carranza is 6 years old and Elija John Jaramillo-
26 Carranza is 3 years old and, as such, the showing under Section 911.2 is established. Accordingly,
27 Claimants respectfully request that their application be granted.
28 H
-5-
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM; DECLARATION IN
SUPPORT
I G. Claimants Very Respectfully Request That Their Application Be Granted.
2 Claimants again respectfully note that their original claim is sufficient and that the present
3 application, in truth, is simply an effort to make sure there are no procedural arguments to be debated
4 once their claims are presented in the Superior Court. As such, the present application is likely more
5 of an effort simply to make doubly sure Claimants' claims are protected.
6 Claimants also respectfully note that a denial of their application would require the
7 unnecessary time and expense of a petition to the Superior Court which, based upon the showing of
8 mistake, inadvertent and excusable neglect, along with the age of Daniel's minor children, would
U
9 certainly be granted. Under these circumstances, Claimants and their counsel respectfully request
10 the peace of mind of being granted leave to present the new late tort claim and that the new tort claim
C
z a 11 be deemed presented pursuant to Government Code Section 912.2.
W " 12
z U . Respectfully submitted,
= 0 13
G �
3 14 DATED: December 14, 2007 LAW OFFICES OF JAY P. RENNEISEN
row
W
O 's
= 15
By
>
16 JAY P. RENNEISEN
O Attorneys for Claimants
8 17
18
� N
N
19
0
20
F
21
22
23
24
25
26 //
27 H
28
-6-
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM; DECLARATION IN
SUPPORT
1 DECLARATION OF JAY P. RENNEISEN IN SUPPORT
2
3 I, Jay P. Renneisen, declare as follows:
4 1. I am an attorney at law licensed to practice before all courts of the State of California
5 and am the attorney claimants herein. I make this declaration based upon my own personal
6 knowledge and, if called upon to do so, I would and could competently testify to the facts stated
7 herein.
8 2. All of the factual statements in the above application are true and correct to my
3 9 knowledge, information and belief.
c10 3. Attached hereto as Exhibit"A" is a true and correct of the Government Tort Claim
11
zdated June 12, 2007 that I presented to County of Contra Costa, et al. At the time of presenting the
¢
W U p
w 3 12 claim I was under the understanding and belief that Dr. Tornebene was physically at the Contra Costa
FS 13
Regional Medical Center when she prescribed the methadone in question for Daniel David Jaramillo
a3 � 14
("Daniel"). As such, that understanding on my behalf was reflected in the original tort claim as
�+N N
o S ;; 15 shown in the attached Exhibit"A".
U .> .rZ
M 16 4. Attached hereto as Exhibit"B" is a true and correct copy of the notice of rejection of
Ow
3 •
S 17 Claimants' claim which was mailed on July 11, 2007.
a � 0?
-' 0018 5. Subsequent to filing the original tort claim I obtained Daniel's medical records from
M
O �
N
19 the Contra Costa Health Services. I have now reviewed those records and they indicate that, although
G
0
20 Dr. Tornebene was working at the Contra Costa Regional Medical Center when she originally treated
H
21 and prescribed medications for Daniel, she was at the Antioch Health Center when she actually
22 prescribed the methadone in question. As such, my original understanding that Dr. Tornebene was at
23 the Contra Costa Regional Medical Center was mistaken. Accordingly, the failure in the original
24 claim to indicate that Dr. Tornebene was at the Antioch Health Center when she prescribed the
25 methadone for Daniel was due to my own mistake, inadvertence and neglect. Had I know the facts as
26 they were later revealed by the medical records, I would have indicated in the original tort claims that
27 Dr. Tornebene had prescribed the methadone from the Contra Costa Health Services' Antioch
28 satellite facility as opposed to the medical center in Martinez.
-7-
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM; DECLARATION IN
SUPPORT
1 6. My mistake, inadvertence and neglect in this regard were not in bad faith, but rather,
2 were understandable and excusable given the fact that the person who actually received the
3 prescription, Daniel, has passed away(and therefore could not clarify the information) and given the
4 fact that Daniel was in fact originally treated by Dr. Tornebene and prescribed medication while he
5 was at the Contra Costa Regional Medical Center. The error in not making the clarification in the
6 original tort claims was due to my mistake, inadvertence and excusable neglect and, respectfully,
7 Claimants' claims should not be negatively impacted simply because I, as Claimants' counsel, was in
E 8 error regarding Dr. Tornebene's location when I presented the original tort claim. Indeed, the error
9 was made honestly and it was only after I received and reviewed the Contra Costa Health Services
10 records that I discovered that Dr. Tornebene was actually at the Antioch Health Center when she
11 prescribed the methadone that ultimately killed Daniel.
za
W Up
z � 3 12 7. Attached hereto as Exhibit"C" is the late new Government Tort Claim that Claimants'
U •
G 13 request be filed. As shown in the document, this new claim clarifies that Dr. Tornebene was at the
14
Antioch Health Center when she prescribed the methadone in question for Daniel. As explained
ro
NN
O
�, 15 above, the failure to present this claim(in the form of the attached Exhibit"C") earlier was due to my
U .>
t � 16 mistake, inadvertence and excusable neglect. I honestly thought Dr. Tornebene was at the Contra
O .
d 8 17 Costa Regional Medical Center when she prescribed the methadone but my understanding in that
CIO
18 regard was, as show by the medical records subsequently received and reviewed, in error. I
19 respectfully request that my error, inadvertence and neglect in this reward we excused and that
C
0
2.
20 Claimants be allowed to file the new claim.
F
21 9. Also, I note that there would be no prejudice by allowing Claimants to file their new
22 late claim. Via the prior claim the government entities have already been put on notice of claimants'
23 claims. Indeed, the original claim stated that Daniel died as a result of, inter alia, the negligent
24 prescription of methadone for Daniel by Dr. Felicia Tornabene,who is an employee of Contra Costa
25 County. The original fully gave notice that Dr. Tornebene prescribed the medication for Daniel on
26 December 12, 2006 while he was under her medical care and that the prescription was negligently
27 ordered, given by, instructed by and/or advised by Dr. Tornebene and that Daniel was not otherwise
28 properly informed regarding the precautions, instructions and dangers of such prescription. As such,
-8-
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM;DECLARATION IN
SUPPORT
I Claimants' original claim filly apprised the government entities of Claimants' position that the
2 negligence of Dr. Tornabene was a substantial factor in causing Daniel's untimely death at 29 years
3 of age on December 17, 2006. Under these circumstances, and considering that the original claim has
4 already been reviewed by the County, there would be no prejudice in allowing the new late claim
5 clarifying Dr. Tornebene's location when she made the prescription.
6 9. I can and do attest under penalty of perjury that my client Joseph Daniel Jaramillo-
7 Carranza is 6 years old and his brother, my other client Elija John Jaramillo-Carranza, is 3 years old.
0 8 As such, they are minors and pursuant to Government Code Section 911.6 the late claim should be
9 allowed.
C
10 I declare under penalty of perjury that the foregoing is true and correct and that I executed this
C
C, e
11 declaration on December 14, 2007, at Walnut Creek, California.
za
W " 12
z � • ZL�
w ; o 13
3 N Y i. RENNEISEN
14
tiN N
O 's's; ; 15
w4 .g
wA 16
O
a � 17
a � 0?
00� o
N 18
W)
N
19
0
20
N
21
22
23
24
25
26
27
28
-9-
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM; DECLARATION IN
SUPPORT
EXHIBIT A
LAW OFFICES OF
JAY P. RENNEsEN
ATTORNEY AT LAW
1931 San Miguel Drive,Suite 210
Walnut Creek, California 94596
Telephone: (925)280-8900 • Facsimile: (925)955-1601
www.renneisenlaw.com
June 12, 2007 JUN �o
CCEAke
VIA HAND DELIVERY coNTRo os gPFgV�so
Board of Supervisors Co. Rs
County of Contra Costa
County Administration Building, Room 106
651 Pine Street, Martinez CA 94553
Contra Costa Regional Medical Center
And Felicia Tornabene, M.D.
c/o Board of Supervisors
County of Contra Costa
County Administration Building, Room 106
651 Pine Street, Martinez CA 94553
Re: Government Tort Claim Re: Death of Daniel David Jaramillo
Decedent's Name: Daniel David Jaramillo
Decedent's Date of Birth: October 7, 1977
Decedent's Date of Death: December 17, 2006
Name(s) of Claimants: Joseph Daniel Jaramillo-Caranza, Elija John
Jaramillo-Caranza, Betty K. Jaramillo, Daniel
J. Jaramillo and Daniel David Jaramillo by and
through his successor-in-interest Betty Jaramillo
County Employees: Felicia Tornabene, M.D. and staff at Contra Costa
Regional Medical Center
Dear Board of Supervisors and County of Contra Costa:
This office represents claimants Joseph Daniel Jaramillo-Caranza, Elija John Jaramillo-Caranza,
Betty K. Jaramillo, Daniel J. Jaramillo and Daniel David Jaramillo, by and through his successor-in-
interest Betty K. Jaramillo,with respect to personal injury and wrongful death claims arising out of the
death of Daniel David Jaramillo via doctor prescribed Methadone overdose on December 17, 2006.
Joseph Daniel Jaramillo-Caranza (age 5) and Elija John Jaramillo-Caranza (age 3) are the
surviving heirs and minor children of Daniel David Jaramillo. These two children tragically lost the
love and support of their father. Betty K. Jaramillo and Daniel J. Jaramillo are the parents of
decedent Daniel David Jaramillo. Daniel's parents directly witnessed his dying and death via doctor
prescribed Methadone overdose on December 17, 2006 and suffered severe emotional distress
thereby.
LAW OFFICES OF
Board of Supervisors
County of Contra Costa JAY P. RENNEISEN
June 12, 2007
Page 2 ATTORNEY AT LAW
The postal address for each of the claimants is 3108 Barmouth Drive, Antioch, CA 94509.
However, we request that all further communication concerning these claims be addressed to
claimants' counsel as follows:
Jay P. Renneisen, Esq.
Law Offices of Jay P. Renneisen
1931 San Miguel Drive, Suite 210
Walnut Creek, CA 94596
Tel: 925-280-8900
Fax: 925-955-1601
Email: ipr(a-)renneisenlaw.com
Claimants are informed and believe that the event that lead directly to the death of Daniel David
Jaramillo ("Daniel") and the claims herein was the negligent prescription of Methadone for Daniel by
Dr. Felicia Tornabene and Contra Costa Regional Medical Center on or about December 12, 2006
while he was under their medical care. Claimants are informed and believe that said prescription
was negligently ordered, given by, instructed by and/or advised by Dr. Tomebene and the Contra
Costa Regional Medical Center and that Daniel was not otherwise properly informed regarding the
precautions, instructions and dangers of such prescription. Claimants are informed and believe that
the negligence of Dr. Tomabene and the Contra Costa Regional Medical Center was a substantial
factor in causing Daniel's untimely death at 29 years of age on December 17, 2006.
The negligent prescription was given to Daniel while he was a patient at the Contra Costa
Regional Medical Center in Martinez on or about December 12, 2006. Later that week on
approximately December 14, 2006 Daniel went to Lake Tahoe with his parents. On December 17,
2006 while in Lake Tahoe Daniel was found in his hotel room unresponsive and, after efforts to
resuscitate him were unsuccessful, Daniel was pronounced dead. It was later determined via an
autopsy that Daniel died as a result of "Acute methadone intoxication." A copy of Douglas County
(Nevada) Autopsy Report No. 136506 is attached.
Also attached is a Government Tort Claim form that has been completed and signed for
claimants herein. Please be advised that the Clerk for the Board of Supervisors has advised this
office that the Board of Supervisors for Contra Costa County is the proper govemmental entity/office
for presentation of my clients' governmental tort claims arising out of the negligence of Dr. Tomebene
and/or Contra Costa Regional Medical Center. If another governmental entity or office should
receive notice of my clients' claims herein we respectfully ask that you advise the undersigned as
soon as possible. Also, in the event my clients' claims are in any way procedurally defective or
insufficient, we respectfully ask that you inform the undersigned as soon as possible.
Yours truly,
LAW OFFICES OF JAY P. RENNEISEN
Jay P. Renneisen
JPR:bb
Endosures
CC: Betty and Dan Jaramillo
BOARD OF ST 7,RVISOIOOS TO CLAIM 'CONTRA COSTA CLINTY
Iii.,rRUC
or
A. A claim relating to a cause of action for death or for injury to person orto
accrsonal ual of the o erty
n six months after of
growing crops shall be presented not later than
action shall be presented not later than one year
action. A claim relating to any other cause of
after the accrual of the cause of action.
(Gov. Code § 911.2.)
B. Claims must be filed with the Clerk of the Board of supervisors
upC visors at its office in Room 106,
County Administration Building, 651 Pine Street, Marti
3.
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.
... ............................mann■...mama t...............t mama.■ ...........
RE: Claim By: Reserved for Clerk's filing stamp
Joseph Daniel Jaramillo-Caranza, Elija )
John Jaramillo Caranza Betty
K.
Jaramillo, Daniel J. Jaramillo and ) RECEIVED
Daniel David Jaramillo
Against the County of Contra Cosla or JUN 1 2 CUU 1
District)
CLERK BOARD OF SUPERVISORS
(Fill in the name)Felicia Tornabene, MD ) CONTRACOSTACO.
✓Contra Costa Regional Medical Center
The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named
pp
district in the sum of$
In excess of and in support of this claim represents as follows:
$25,000
1. When did the damage or injury occur? (Give exact date and hour)
Daniel David Jaramillo's death by doctor prescribed Methadone overdose occured
nn December 17, 2006. The Methadone was negligently prescribed/given on
December 12, 2006.
2. Where did the damage or injury occur? (Include city and county)
The negligent prescription was given to decedent Daniel David Jaramillo at Contra
Costa Regional Medical Center in Martinez, Contra Costa County. The death occurred
in Lake Tahoe, Nevada.
3. How did the damage or injury occur? (Give full details; use extra paper if require
Decedent's death via doctor prescribed Methadone overdose (acute Methadone
intoxication) .
4. What particular act or omission on the part of county or district officers, servants, or employees
caused the injury or damage?
Negligent prescription, instructions and/or warnings regarding Methadone orderedt3Y
health care providers for Daniel David Jaramillo.
5 What are the names of county or district officers, servants, or employees causing the
damage or injury?
Felicia Tornabene, MD and Contra Costa Regional Medical Center and staff.
6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages
claimed. Attach two estimates for auto damage.)Wrongful death claims by decedent's
children, personal injury and wrongful death claims by decedent's parents who
witnessed the death and personal injury claims by decedent's successor in interest.
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.) The amount in controversy is well in excess of the
unlimited jurisdiction minimum of $25,000.
8. Names and addresses of witnesses, doctors, and hospitals: Dr. Felicia Tornabene, staff
at Contra Costa Regional Medical Center, hotel staff, officals in Lake Tahoe
Neveda, see autopsy report.
9. List the expenditures you made on account of this accident or injury:
DATE TIME AMOUNT
■. ........■0....00......00......0.0....■t.w....t......■........00......■ 0200. 0 ■000.91
Gov. Code Sec. 910.2 provides "The claim shall be
signed by the claimant or by some person on his
behalf"
SEND NOTICES TO: (Attorney) 1
Name and address of Attorney 17
Jay P. Renneisen Esq. ) � By Jay P. Renneisen
(Claimant's Signature)
Law Offices of Jay P. Renneisen) Attorney in fact for all claimAnts
1913 San Miguel Dr. Suite 210 ) 1931 San Miguel Dr. Suite 210
Walnut Creek, CA 94596 ) (Address)
Tel: 925-280-8900 ) Walnut Creek, CA 94596
)
Fax: 925-955-1601 )
Telephone No. ) Telephone No. 925-280-8900
. . Musson .. ............. .........meson................................... . Non . .......l
PUBLIC RECORDS NOTICE:
Please be advised that this claim form, or any claim filed with the County under the Tort Claims Act, is subject to
public disclosure under the California Public Records Act. (Gov. Code, §§ 6500 et seq.) Furthermore, any
attachments, addendums, or supplements attached to the claim form, including medical records,are also subject to
public disclosure.
an 0 Eon sun EON ME momassomy a mosomemomm NONE as MEMO mammon a OMEN
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 dollars ($1,000.00), 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.
AUTOPSY PROTOCOL
JARAMILLO, Daniel D 1365-06 A-DOU
DATE OF DEATH: December 17, 2006; 1215 Hours
DATE OF AUTOPSY: December 18, 2006 at 1015 Hours
CONSENT GRANTED BY: Douglas County Sheriff/Coroner
AUTOPSY PERFORMED AT: Washoe County Coroner's Office
INVESTIGATOR: Steve J. Woods
PATHOLOGIST: Katherine P. Raven, M.D.
FINAL PATHOLOGIC DIAGNOSES
1. Acute methadone intoxication.
2. Cardiomegaly, severe, with four chamber dilatation.
3_ Morbid obesity.
4. Pleural adhesions, right.
OPINION
The cause of death in this 29 ye2rod attributed to an acute methadone
l
intoxication in combination with a severely enlarged heart
J
Katherine P. avers IVl . Date Signed
Pathologist
Ellen G. 1. Clark, D.
Pathologist
PAGE
Casc Type A
Dalc 12/18/06 Case No. 136506 Record Of Death
Other Agency Description DOUGLAS COUNTY NV .ti!`SHOp Washoe County
Name JARAMILLO DANIEL DAVID roG Medical Examiner/
y Coroner
Alius 10KirmanAv
' PO Box 11130
J+14 (Of Reno.N V 89520
Address 3108 BARMOUTH DRIVEANTIOCH CA 94509 (775)785.6[14
Age 29 YEARS Approx. N Sex M Race W DOB 10/07/1977
Marital Status N SSN 572-47-2859 Occupation UNEMPLOYED
Reported By SMITH SGT. BERNADETTE Date 12/17/2006 14:12
Report Agency DOUGLAS CO. S.O.
Investigator at Scene: Date
Identified By DANIEL JARAMILLO FATHER VISUALLY
Next of Kin JARAMILLO DANIEL Relationship FATHER
Address SAME AS DECEASED Phone. 925-778-2511
Notifications: Date: 12117/2006 12:15 Who: AT SCENE
How Notified IN PERSON Property Receipt: 9343
Mortuary Preference FITZHENRY'S FUNERAL HOME Requested By ON CALL
Found Dead.
Circumstances and Medical History Summary Location
Date/Time
Injury or Illness HORIZON HOTEL AND CASINO k 1224 50 U.S. HWY 50 STATELINE,N 12/17/2006 11:25
Transported by N/A
Emergency Room/Hospital
Death Occurred HORIZON HOTEL AND CASINO#1224 12/18/2006 08:10
Death Decision By DEP.ANTHONY FRIBERG Phone. 775-782-9911
Phone.
Private Physician FELICIA TORNEBENE M.D.
Hospital Post Mort Exam Dr. Concent
Date
Coroner's Consultation
P. RAVEN,M.D. Date 12/18!2006 10:15
Autopsy: A Conducted B : KATHERINE
Immediate Cause of Death: ACUTE METHADONE INTOXICATION WITH ASSOCIATED CARDIOMEGALY
Due to,or as a consequence of: I r [j ~�, ^•
Due to.or as a consequence of:
Other Conditions'.
Accident,Suicide,1-lomicide.or Date of Injury Injury at Work Place of injury Accident,
at home.farm.
Undetermined Street.factory,office bldg..etc
12/17/2006 11:25 N HOTEL
ACCIDENT
1-low Injury Occurred INGESTED PRESCRIPTION MEDICATION
Location HORIZON HOTEL AND CASINO:1224 50 U.S.HWY 50 STATELINE,NV
g/dL E
Toxicology Etoh Level
toh From Etoh"type
Copies To
DOUGLAS CO. S.O.CASE 406-2182T
PA Notified N
WCS$Notified N
See Subsequent Narrative Report PaRe(s)
Record of Death Narrative
JARAMILLO, DANIEL DAVID 1365-06A-DOU
The following information was obtained from Sgt. Bernadette Smith of the Douglas County
Sheriffs Office.
The 29-year-old victim arrived at the Horizon Hotel and Casino by automobile with his parents
on 12/14/06 frorn their residence in Antioch, California. His previous medical history includes
hypertension and Methamphetamine use. He used ethanol occasionally. Family members
stated that the victim did not use tobacco. A package of cigarettes was found in the victim's
hotel room.
The victim was hospitalized from 09/16/06 until 11/10/06 for a "collapsed lung with fluid, and
blood clots in his leg." The victim was reportedly on a mechanical ventilator for approximately
one month during that hospitalization.
Medications observed in the victim's hotel room included Methadone, Coumadin, Amitriptyline,
Atenolol and Acetaminophen. An empty prescription container labeled with Oxycodone
contained Coumadin. Sgt_ Smith advised the count of medications was correct.
Daniel and Betty Jaramillo, parents of the deceased, report that they were unable to contact the
victim by telephone in his hotel room since 1055 hrs. on 12/17/06. They did not receive an
answer at the victim's hotel room door and telephoned security personnel for assistance.
Horizon Hotel Security Department personnel responded and opened the locked room with their
passkey. They found the victim unresponsive with "shallow" respirations lying in a supine
position on his bed. Security personnel telephoned 911 for assistance.
Personnel from the Tahoe Douglas Fire Department and Douglas County Sheriff's Office
responded. They moved the victim from the bed to the floor of the hotel room. Cardiopulmonary
resuscitation and advanced cardiac life support therapy was initiated. Resuscitation efforts were
unsuccessful. Deputy Anthony Friberg of the Douglas County Sheriff's Office made the death
decision at the scene of the incident at 1215 hrs. on 12/17/06.
Parents of the deceased report that the victim was in their hotel room until 0230 hrs. on
12/17/06 consuming a prime rib sandwich. He left their hotel room to return to his room_ The
victim's parents report that he did not have any health complaints while at their hotel room.
Physical examination revealed no evidence of acute trauma.
Autopsy in this case is requested by the Douglas County Sheriff Coroner's Office.
Steve J. ods
Deputy Coroner
Vernon CO. McCarty WS1i
Washoe County Coroner
PAGE 1
AUTOPSY PROTOCOL
JARAMILLO, Daniel D 1365-06 A-DOU
EXTERNAL EXAMINATION
IDENTIFICATION
An autopsy is performed on the body of Daniel D. Jaramillo at the Washoe County
Coroner's Office, Reno, Nevada on the 18th day of December, 2006 at 1015 hours.
Identification of the deceased is the responsibility of the Douglas County
Sheriff/Coroner's Office. The body is identified at the time of the examination by a
Coroner's tag with the deceased's name and case number.
CLOTHING:
The body is received clad in the following items:
1. A pair of men's black boxer brief style underwear.
GENERAL DESCRIPTION:
The body is that of a normally developed, morbidly obese male who appears slightly
older than his recorded age of 29 years, weighs 389 pounds and measures 76 inches in
height. The body is cold to touch and has been previously refrigerated. Rigor mortis is
3-4+ in the extremities and difficult to break. There is partially fixed purple red livor
mortis over the posterior surfaces of the body. The body is well-preserved and not
embalmed.
The scalp is covered by brown hair that measures up to 1.5 inches. There is bilateral
frontal recession. There is marked congestion of the face. There is also vomitus on the
face. There is an airway tube seen in the right naris, The eyes are natural and the
sclerae are white. The conjunctivae are congested without petechiae and the irides are
brown. The ears and nose are normally formed. There is a goatee style 1/4 inch brown
beard and moustache. The mouth contains natural dentition in the upper and the lower
jaw. There is a moderate amount of clear brown fluid in the oral cavity. The neck is
unremarkable. The chest is normally developed and the abdomen is morbidly obese
with cutaneous striae across the abdomen.
The upper extremities are normally formed as are the hands. The nail beds are slightly
cyanotic and the nails are trimmed without overhang. The lower extremities are
normally developed with a paucity of body hair distally and also brown stasis changes of
the skin which extends onto the feet. There is black adhesive material seen on the left
foot. The soles of the feet are calloused
pd normal cial body body hairfhe d distribution.
genitalia are those of a normal male with two testes a
The back is normal.
PAGE 2
AUTOPSY PROTOCOL
JARAMILLO, Daniel D 1365-06 A-DOU
SCARS AND DISTINGUISHING MARKS:
1. On the right upper arm, on the deltoid region, is a large dark colored tattoo of
what appears to be a skull with a snake around the skull_
2. On the left upper arm, is a multicolored tattoo of a skull with a hat on it.
EXTERNAL EVIDENCE OF MEDICAL THERAPY:
1. There are EKG monitor pads seen on the trunk and also on the upper extremities.
2. There is a plastic airway device in the right naris.
3. There are defibrillator pads seen on the anterior and posterior trunk.
4. There is a needle puncture mark with overlying gauze seen in the right antecubital
fossa.
INTERNAL EXAMINATION
HEAD:
Reflection of the SCALP shows the usual scattered reflection petechiae. The calvarium
is intact. Removal of the calvarium in the usual fashion shows the epidural space to be
normal. Likewise, no collections of subdural blood are present. The BRAIN is removed
in the usual manner and weighs 1,560 grams. The LEPTOMENINGES are smooth and
glistening, and the gyri demonstrate their usual orientation and configuration. The
vessels at the base of the brain are normally disposed and no anomalies are identified.
Serial sections of the brain show the cerebral cortical ribbon to be intact. The usual
anatomic landmarks of the cerebrum, midbrain, cerebellum, pons and medulla
demonstrate no abnormalities. Removal of the DURA from the base of the skull shows
the usual anatomical features without abnormalities. The pituitary fossa is
unremarkable. The foramen magnum
t he tranon a
asectts v viewed through the forahe nrmal meon and n
thefirst
portion of the spinal cord at the level of
magnum is unremarkable.
NECK:
The organs of the NECK are removed
h hyoid booc ne one oa laryngeal dissection structures are dentfed.
No fractures or hemorrhages of hey
No intramural hemorrhages are identified.
BODY CAVITIES:
The body cavities are opened in the usual manner. The PLEURAL and PERITONEAL
SURFACES are smooth and glisteSing excepnrematfor rkable.vere The adhesions MEDIASTIright NUMpleand
ural
cavity. The PERICARDIUM
PAGE 3
AUTOPSY PROTOCOL
JARAMILLO, Daniel D 1365-06 A-DOU
RETROPERITONEUM show the usual anatomical features. The leaves of the
DIAPHRAGM are intact and the organs are anatomically disposed. There is no internal
evidence of injury.
ORGAN SYSTEMS
CARDIOVASCULAR SYSTEM:
The HEART weighs 600 grams. Examination of the epicardium shows it to be intact.
The chambers demonstrate their usual shape and configuration with four chamber
dilatation and enlargement. The CORONARY ARTERIES are normally disposed and
there are only scattered atherosclerotic streaks present throughout the course of all
vessels. Cut surfaces of the MYOCARDIUM show a normal color and no thickening of
the ventricular walls identified. The VALVES are intact with the usual anatomic
relationships. The AORTA follows
its
unremarkablee The the
GREAT VESSELS of tOhe
VESSELS are normally disposed and
venous return are in their usual positions and unremarkable.
RESPIRATORY TRACT SYSTEM:
The LARYNX and TRACHEA show no abnormalities and are continuous in the usual
manner with the primary BRONCHI. The secondary and tertiary BRONCHI, likewise
are unremarkable. The RIGHT LUNG weighs 880 grams and the LEFT LUNG weighs
890 grams. The PLEURAL SURFACES are smooth and glistening. Cut surfaces show
vidence
moderately congested andTheretisuno consolidationpd to 'nk parenchyma with no or enlargement of the air
of natural disease orspaces
injury.
The PULMONARY VESSELS are normally disposed and unremarkable.
HEPATOBILIARY SYSTEM:
The LIVER weighs 3,970 grams with a smooth, glistening surface. Cut surfaces show
the usual anatomical landmarks with an overall slightly yellow parenchyma. The
GALLBLADDER contains approximately 10 cc of bile and no abnormalities are
demonstrated in the BILIARY TREE.
LYMPHORETICULAR SYSTEM:
The SPLEEN weighs 440 grams with a smooth, glistening capsule and an
unremarkable parenchyma with e at
show noe usual anatomical feures. The Hpatho pathologic
US is
involuted and replaced by fat. Th LYMPH NODES where
change.
PAGE 4
AUTOPSY PROTOCOL
JARAMILLO, Daniel D 1365-06 A-DOU
URINARY TRACT SYSTEM:
The RIGHT KIDNEY weighs 250 grams and the LEFT KIDNEY weighs 280 grams. The
cortical surfaces are smooth and glistening with good preservation of the cortex and
good corticomedullary differentiation. The PELVES show the usual anatomical
relationships and are continuous into normal appearing URETERS which insert into an
unremarkable BLADDER containing approximately 100 cc of urine.
INTERNAL GENITALIA:
The PROSTATE is unremarkable for age.
GASTROINTESTINAL TRACT:
The PHARYNX and ESOPHAGUS are unremarkable and the STOMACH contains
approximately 1,000 cc of partially digested food with large chunks of what appear to be
white meat. The mucosal lining
the
SMALL and ILARGEand
INTESTINEuare unrema unremarkable
into a normal
duodenum and small bowel. The
and the APPENDIX is present.
ENDOCRINE SYSTEM:
The PITUITARY, THYROID, ADRENALS and PANCREAS are unremarkable.
MUSCULOSKELETAL SYSTEM:
The musculature is normally developed and the bony structures demonstrate their usual
relationships. The abdominal FAT measures 5 inches at the level of the umbilicus. No
other abnormalities are noted.
SPECIMENS RETAINED:
1. Peripheral and central blood, urine, vitreous, DNA spot card and tissue stock.
2. Two microscopic cassettes are submitted.
3. Peripheral blood and urine is sent for toxicology.
MICROSCOPIC DESCRIPTION
HEART: Perivascular fibrosis.
LUNG: Thickened blood vessels and septae.
LIVER: Moderate mixed macro and microvesicular steatosis.
KIDNEY: Autolysis.
PAGE 5
WQSHOE COUNTY SHERIFF'S OFFICE
w MICHAEL HALEY, SHERIFF
FORENSIC SCIENCE DIVISION
M 911 PARR BLVD.
r
a RENO, NV 89512
(775) 328-2800
Laboratory Number. -L6733-06-0
Page I of 1
Decedent: JAR.AMILLO, DANIEL D.
Agency: WASHOE CO. CORONER'S OFFICE
Agency Case Number: 1365-06-A-DOU
Source Condition Date Collected
Specimens Received
Peripheral Postmortem 12/18/2006
Blood 12/18/2006
Urine
Urinary Bladder Postmortem
Blood: Peripheral Collected: 12/1 2006 10:30 0.28 mg/L
Methadone Trace
Amitriptyline present
Lidocaine None Detected
Amphetamine/Methamphetamine
None Detected
Benzodiazepines None Detected
Cocaine/Cocaine Metabolite None Detected
Ethanol None Detected
Opiates None Detected
Organic Acids/Neutrals None Detected
THC-Metabolite
1 1 Date
William H.Anderson, Ph.D.
Chief Toxicologist
EXHIBIT B
CLAIM
B RD OF SUPERVISORS OF CONT COSTA COUNTY e,,Yat
BOARD ACTION: JULY 10, 2007
Claim Against the County,or District Govenied by )
the Board of Supervisors, Routing Endorsements,, •) NOTICE TO CLAIMANT
and Board Action. All Section ref es ate to
�j, ) The copy of this document mailed to
California Goventment Codes. @' )" you is your notice of the action taken
(J!L' lad on your claim by the Board of
Supervisors. (Paragraph IV below),
.0 given Pursuant to Government Code
AMOUNT: IN EXCESS OF $25,000. Section 913 and 915.4. Please note all
JOSEPH DANIEL JARAPIILLO—CARANZA, "Warnings".
CLAIMANT: ELIJA JOHN JARAMILLA—CARANZA,
BETTY K. JARAPIILLO, DANIEL J.
JARAMILLO AND DANIEL DAVID JARMCLLO JUNE 12,2007
ATTORNEY: JAY P. RENNEISEN Esq. DATE RECEIVED:
LAW OFFICES OF JAY P. RENNEISEN JUNE 12, 2007
ADDRESS: 1913 SAN MIGUEL DR., STE.2113Y DELIVERY TO CLERK ON:
WALNUT CREEK, CA 94596 HAND DELIVERED
BY MAIL POSTMARKED:
FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
JUNE 12, 2007 JOHN CULLEN, Cler
Dated: By: Deputy
It. FROM.: County Counsel TO: Clerk of the Board of S Pervisors
(0,4h—is 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 retunt 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: 6, /�"07 By: Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2)
( ) Claim was returned as untimely with notice to claimant(Section 911.3).
IV. OARD ORDER: By unanimous vote of the Supervisors present
(� This Claim is rejected in full.
O Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
Date o OHN CULLEN,CLERK, By eputy Clerk
WAR N Gov. code section 913)
Subject to certain exceptions,you have only six(6)months lironn the date this notice was personally served
or deposited in the mail to file a count action on this claim.See Govennnent Code Section 945.6.You may
seek the advice of an attontney of your choice in connection with this matter. ll'you want to consult an
attorney,you should do so Immediately. *For Addlffotal Warning See Reverse Side ofTlris 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 certilled copy of this
Board Order and Notice to Claimant,addressed to the claimant as shown above.
Dated: // -v JOHN CULLEN,CLERK By Deputy Clerk
l_ IVD � Sa>
EXHIBIT C
BOARD OF ST '.RVISORS OF CONTRA CLAIMANT COUNTY
TRUCTIONS TO
to personal
A. A claim relating to a cause of action for death an for injury months person after the raccrual of the property a se of
growing crops shall be presented not later
f action shall be presented not later than one year
action. A claim relating to any other cause o
after the accrual of the cause of action.
(Gov. Code § 911.2.)
B. Claims must be filed with the Clerk of the Board ofSupervisors
94553t its office in Room 106,
County Administration Building, 651 Pine Street, Martinez
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.
■.. ..............................■■.............................■ ■ ■0.009.....■1
RE: Claim By: Reserved for Clerk's filing stamp
Joseph Daniel Jaramillo-Caranza, Elija )
John Jaramillo Caranza Betty
Jaramillo, Daniel J. Jaramillo and )
Daniel David Jaramillo
Against the County of Contra C a or j
District)
(Fill in the name) Felicia Tornabene, MD , )
NTIpC
v"Contra costa !-{6ALT•1SCQvIcESj P` oES ti��a
kEAt,TFt C�NTEQ.� ftr+�GovMty E,r,.P�9yGE.S P
The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named
district inthesum of$
In excess of and in support of this claim represents as follows:
$25,000
1, ive exact date and hour)
When did the damage or injury occur? (G
Daniel David Jaramillo' s death by doctor prescribed Methadone overdose occured
on December 17, 2006. The Methadone was negligently prescribed/given on
December 12, 2006.
2. Where did the damage or injury occur? (Include city and county)
The negligent prescription was given to decedent Daniel David Jaramillo at
T�}� T
AWJ0e_(-1 tF_,N, l' Center in ANrloc.N , Contra Costa County. The death occurred
in Lake Tahoe, Nevada.
3. How did the damage or injury occur? (Give full details; use extra paper if required)
Decedent's death via doctor prescribed Methadone overdose (acute Methadone
intoxication) .
4. What particular act or omission on the part of county or district officers, servants, or employees
caused the injury or damage?
Negligent prescription, instructions and/or warnings regarding Methadone ordered 93
health care providers for Daniel David Jaramillo.
5 What are the names of county or district officers, servants, or employees causing the
damage or injury?
Felicia Tornabene, MD and AtfliO4 Nf.ALTA Cs_�NTE12 ANo-TtVIZ staff. 006 f-�.
6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages
claimed. Attach two estimates for auto damage.)Wrongful death claims by decedent's
children, personal injury and wrongful death claims by decedent's parents who
witnessed the death and personal injury claims by decedent's successor in interest.
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.) The amount in controversy is well in excess of the
unlimited jurisdiction minimum of $25,000.
8. Names and addresses of witnesses, doctors, and hospitals: Dr. Felicia Tornabene, staff
at I.IvT1vCH 1-EEAt,TI-t Center, hotel staff, officals in Lake Tahoe
Neveda, see autopsy report.
9. List the expenditures you made on account of this accident or injury:
DATE TIME AMOUNT
. . Now SEEM.....manseONES.............................................mosmaSEEM amm....,
Gov. Code Sec. 910.2 provides "The claim shall be
signed by the claimant or by some person on his
behalf"
SEND NOTICES TO: (Attorney) 1
Name and address of Attorney )
Jay P. Renneisen Esq. Z-----4sy Jay P. Renneisen
(Claimant's Signature)
Law Offices of Jay P. Renneisen) Attorney in fact for all claimEmts
1913 San Miguel Dr. Suite 210 ) 1931 San Miguel Dr. Suite 210
Walnut Creek, CA 94596 ) (Address)
Tel: 925-280-8900 ) Walnut Creek, CA 94596
Fax: 925-955-1601 )
Telephone No. ) Telephone No. 925-280-8900
PUBLIC RECORDS NOTICE:
Please be advised that this claim form, or any claim filed with the County under the Tort Claims Act, is subject to
public disclosure under the California Public Records Act. (Gov. Code, §§ 6500 et seq.) Furthermore, any
attachments, addendums, or supplements attached to the claim form, including medical records,are also subject to
public disclosure.
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 dollars ($1,000.00), 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.
LAW OFFICES OF
JAY P. RENNELSEN
ATTORNEY AT LAW
1931 San Miguel Drive, Suite 210
Walnut Creek, California 94596
Telephone: (925)280-8900 • Facsimile: (925)955-1601
www.renneisenlaw.com
December 13, 2007
VIA HAND DELIVERY
Board of Supervisors
County of Contra Costa
County Administration Building, Room 106
651 Pine Street
Martinez CA 94553
Contra Costa Health Services
And Antioch Health Center
And Felicia Tornabene, M.D.
c/o Board of Supervisors
County of Contra Costa
County Administration Building, Room 106
651 Pine Street
Martinez CA 94553
Contra Costa County
651 Pine Street, 11th Floor
Martinez, CA 94553
Re: Government Tort Claim Re: Death of Daniel David Jaramillo
Decedent's Name: Daniel David Jaramillo
Decedent's Date of Birth: October 7, 1977
Decedent's Date of Death: December 17, 2006
Name(s) of Claimants: Joseph Daniel Jaramillo-Carranza, Elija John
Jaramillo-Carranza, Betty K. Jaramillo, Daniel
J. Jaramillo and Daniel David Jaramillo by and
through his successor-in-interest Betty Jaramillo
County Employees: Felicia Tornabene, M.D.; staff at Contra Costa
Health Services and Antioch Health Center; and
Does 1-25
Dear Board of Supervisors, County of Contra Costa and Above Addressees:
This office represents claimants Joseph Daniel Jaramillo-Carranza, Elija John Jaramillo-
Carranza, Betty K. Jaramillo, Daniel J. Jaramillo and Daniel David Jaramillo, by and through his
successor-in-interest Betty K. Jaramillo, with respect to personal injury and wrongful death claims
Board of Supervisors LAW OFFICES OF
County of Contra Costa
December 13,2007 JAY P. RENNEisEN
Page 2 ATTORNEY AT LAW
arising out of the death of Daniel David Jaramillo ("Daniel") via doctor prescribed Methadone
overdose on December 17, 2006.
Claimants previously presented a Government Tort Claim dated June 12, 2007 identifying the
necessary information regarding claimants' claims against the County of Contra Costa, et al., arising
out of the doctor prescribed methadone overdose of their loved one, Daniel. Since that time
claimants' counsel has obtained medical records clarifying that, although Dr. Tornebene was at the
Martinez Medical Center when she first began treating and began prescribing medications for Daniel
in 2006, she was physically at the Antioch Health Center in Antioch when she actually prescribed the
methadone that caused Daniel's death. Claimants maintain that their original Government Tort Claim
is sufficient pursuant to Government Code Section 910 and that said claim is and will continue to be
valid. However, in an abundance of caution, claimants have sought to present this claim herein
clarifying the specifics of their claim. (Please see accompanying application for leave to file late
Government Tort Claim.)
Joseph Daniel Jaramillo-Carranza (age 6) and Elija John Jaramillo-Caranza (age 3) are the
surviving heirs and minor children of Daniel David Jaramillo. These two children tragically lost the
love and support of their father. Betty K. Jaramillo and Daniel J. Jaramillo are the parents of
decedent Daniel David Jaramillo. Daniel's parents directly witnessed his dying and death via doctor
prescribed Methadone overdose on December 17, 2006 and suffered severe emotional distress
thereby.
The postal address for each of the claimants is 3108 Barmouth Drive, Antioch, CA 94509.
However, we request that all further communication concerning these claims be addressed to
claimants' counsel as follows:
Jay P. Renneisen, Esq.
Law Offices of Jay P. Renneisen
1931 San Miguel Drive, Suite 210
Walnut Creek, CA 94596
Tel: 925-280-8900
Fax: 925-955-1601
Email: 0pr(a)renneisenlaw.com
Claimants are informed and believe that a substantial factor that lead directly to the death of
Daniel David Jaramillo ("Daniel") and the claims herein was the negligent prescription of Methadone
for Daniel by Dr. Felicia Tornabene, Contra Costa Health Services, Antioch Health Center and other
county staff on or about December 12, 2006 while he was under their medical care. Claimants are
informed and believe that said prescription was negligently ordered, given by, instructed by,
prescribed by and/or advised by Dr. Tornebene, Contra Costa Health Services, Antioch Health
Center and other county staff and that Daniel was not otherwise properly informed regarding the
precautions, instructions and dangers of such prescription. Claimants are informed and believe that
the negligence of Dr. Tornabene, Contra Costa Health Services, Antioch Health Center and other
county staff was a substantial factor in causing Daniel's untimely death at 29 years of age on
December 17, 2006.
The negligent prescription was given to Daniel while he was a patient at the Antioch Health
Center in Antioch, California on or about December 12, 2006. Later that week on approximately
Board of Supervisors LAW OFFICES OF
County of Contra Costa
December 13,2007 JAY P. RENNESEN
Page 3 ATTORNEY AT LAW
December 14, 2006 Daniel went to Lake Tahoe with his parents. On December 17, 2006 while in
Lake Tahoe Daniel was found in his hotel room unresponsive and, after efforts to resuscitate him
were unsuccessful, Daniel was pronounced dead. It was later determined via an autopsy that Daniel
died as a result of "Acute methadone intoxication." A copy of Douglas County (Nevada) Autopsy
Report No. 136506 is attached.
Also attached is a Government Tort Claim form that has been completed and signed for
claimants herein. Please be advised that the Clerk for the Board of Supervisors has advised this
office that the Board of Supervisors for Contra Costa County is the proper governmental entity/office
for presentation of my clients' governmental tort claims arising out of the negligence of Dr.
Tornebene, Contra Costa Health Services, Antioch Health Center and other county staff. If another
governmental entity or office should receive notice of my clients' claims herein we respectfully ask
that you advise the undersigned as soon as possible. Also, in the event my clients' claims are in any
way procedurally defective or insufficient, we respectfully ask that you inform the undersigned as
soon as possible.
Yours truly,
LAW OFFICES OF JAY P. RENNEISEN
-712'— -
Jay P. Renneisen
JPR:db
Endosures
AUTOPSY PROTOCOL
JARAMILLO, Daniel D 1365-06 A-DOU
DATE OF DEATH: December 17, 2006; 1215 Hours
DATE OF AUTOPSY: December 18, 2006 at 1015 Hours
CONSENT GRANTED BY: Douglas County Sheriff/Coroner
AUTOPSY PERFORMED AT: Washoe County Coroner's Office
INVESTIGATOR: Steve J. Woods
PATHOLOGIST: Katherine P. Raven, M.D.
FINAL PATHOLOGIC DIAGNOSES
1. Acute methadone intoxication.
2. Cardiomegaly, severe, with four chamber dilatation.
3. Morbid obesity.
4. Pleural adhesions, right.
OPINION
The cause of death in this 29 year old
maleis heart.attributed to an acute methadone
l
intoxication in combination with a severelyenlarged
Katherine P. aven NI` Date Signed
Pathologist
V lark `D•
Ellen G. I. Clark,
Pathologist
PAGE1
Datc 12/18/0b Case No. 136506 Case Type A Fda
aeh
Other Agency Description DOUGLAS COUNTY NV 0"4?110F
ty
ner/
Name JARAMILLO DANIEL DAVID
Alias v
ox30
Reno.NV 89520
Address 3108 BARMOUTHPRIVE ANTIOCH CA 94509 (775)785-6114
Age 29 YEARS Approx. N Sex M Race W DOB 10/07/1977
Marital Status N SSN 572-47-2859 Occupation UNEMPLOYED
Reported By SMITH SGT.BERNADETTE Date 12/17/2006 14:12
IT
Report Agency DOUGLAS CO. S_0.
Investigator at Scene: Date
Identified By DANIEL JARAMILLO FATHER VISUALLY
Next of Kin JARAMILLO DANIEL Relationship FATHER
Address SAME AS DECEASED Phone_ 925-778-2511
Notifications: Date: 12/17/2006 12:15 Who: AT SCENE
How Notified IN PERSON Property Receipt: 9343
Mortuary Preference FITZHENRY'S FUNERAL HOME Requested By ON CALL
Pound Dead:
Circumstances and Medica]History Summary
Location Date/Time
Injury or Illness HORIZON HOTEL AND CASINO 41224 50 U.S. HWY 50 STATELINE,N 12/17/2006 11:25
Transported by N/A
Emergency Room/Hospital
Death Occurred HORIZON HOTEL AND CASINO#1224 12/18/2006 08:10
Death Decision By Phone. 775-782-9911 DEP.ANTHONY FRIBERG Phone.
Private Physician FELICIA TORNEBENE M.D.
Hospital Post Mort Exam Dr. Consent
Date
Coroner's Consultation Date 12118'2006 10:15
Autopsy: A Conducted By: KATHERINE P. RAVEN,M.D.
Immediate Cause of Death: ACUTE METHADONE INTOXICATION WITH ASSOCIATED CARDIOMEGALY
Due to.or as a consequence of: f ^�
Due to,or as a consequence of:
Other Conditions'
Accident,Suicide.llomicide.or Date of Injury Injury at Rork Place of Injun•-at home.farm.
Street.factor',office bldg..etc
Undetermined 12(17/2006 11:25 N HOTEL
ACCIDENT
1-10,,v Injury Occurred INGESTED PRESCRIPTION MEDICATION
Location HORIZON HOTEL AND CASINO 41224 50 U.S. HWY 50 STATELINE,NV
Toxicology 6toh Leve]
g/dL Etoh From Etoh Type
Copies To
DOUGLAS CO. S.O.CASE 406-8182T PA Notified N
Vr'CSS Notified N
Sec Subsequent Narrative Report Pape(s)
Record of Death Narrative
JARAMILLO, DANIEL DAVID 1365-06A-DOU
The following information was obtained from Sgt. Bernadette Smith of the Douglas County
Sheriffs Office.
The 29-year-old victim arrived at the Horizon Hotel and Casino by automobile with his parents
on 12114/06 from their residence in Antioch, California. His previous medical history includes
hypertension and Methamphetamine use. He used ethanol occasionally. Family members
stated that the victim did not use tobacco. A package of cigarettes was found in the victim's
hotel room.
The victim was hospitalized from 09/16/06 until 11/10/06 for a"collapsed lung with fluid, and
blood clots in his leg." The victim was reportedly on a mechanical ventilator for approximately
one month during that hospitalization.
Medications observed in the victim's hotel room included Methadone, Coumadin, Amitriptyline,
Atenolol and Acetaminophen. An empty prescription container labeled with Oxycodone
contained Coumadin. Sgt. Smith advised the count of medications was correct.
Daniel and Betty Jaramillo, parents of the deceased, report that they were unable to contact the
victim by telephone in his hotel room since 1055 hrs. on 12117106. They did not receive an
answer at the victim's hotel room door and telephoned security personnel for assistance.
Horizon Hotel Security Department personnel responded and opened the locked room with their
passkey. They found the victim unresponsive with "shallow" respirations lying in a supine
position on his bed. Security personnel telephoned 911 for assistance.
Personnel from the Tahoe Douglas Fire Department and Douglas County Sheriff's Office
responded. They moved the victim from the bed to the floor of the hotel room. Cardiopulmonary
resuscitation and advanced cardiac life support therapy was initiated. Resuscitation efforts were
unsuccessful. Deputy Anthony Friberg of the Douglas County Sheriff's Office made the death
decision at the scene of the incident at 1215 hrs. on 12117106.
Parents of the deceased report that the victim was in their hotel room until 0230 hrs. on
12/17/06 consuming a prime rib sandwich. He left their hotel room to return to his room. The
victim's parents report that he did not have any health complaints while at their hotel room.
Physical examination revealed no evidence of acute trauma.
Autopsy in this case is requested by the Douglas County Sheriff Coroner's Office.
Steve J. ods
Deputy Coroner
Vernon O. McCarty Da Si ed
Washoe County Coroner
PAGE 1
AUTOPSY PROTOCOL
JARAMILLO, Daniel D 1365-06 A-DOU
EXTERNAL EXAMINATION
IDENTIFICATION
An autopsy is performed on the body of Daniel D. Jaramillo at the Washoe County
Coroner's Office, Reno, Nevada on the 18th day of December, 2006 at 1015 hours.
Identification of the deceased is the responsibility of the Douglas County
Sheriff/Coroner's Office. The body is identified at the time of the examination by a
Coroner's tag with the deceased's name and case number.
CLOTHING:
The body is received clad in the following items:
1. A pair of men's black boxer brief style underwear.
GENERAL DESCRIPTION:
The body is that of a normally developed, morbidly obese male who appears slightly
older than his recorded age of 29 years, weighs 389 pounds and measures 76 inches in
height. The body is cold to touch and has been previously refrigerated. Rigor mortis is
in the extremities s thapartially
well-preserved livore red
mortis over the poterior surfaces of the body. The body is adnot
embalmed.
The scalp is covered by brown hair that measures up to 1.5 inches. There is bilateral
frontal recession. There is marked congestion of the face. There is also vomitus on the
face. There is an airway tube seen in the right naris. The eyes are natural and the
sclerae are white. The conjunctivae are congested without petechiae and the irides are
brown. The ears and nose are normally formed. There is a goatee style 1/4 inch brown
beard and moustache. The mouth contains natural dentition in the upper and the lower
in the oral
jaw. There is ahe chests normallyte ountdeve oped andf cler brown dthe abdomen is Imo bfe neck 'is
idly obese
unremarkable. The c
with cutaneous striae across the abdomen.
The upper extremities are normally formed as are the hands. The nail beds are slightly
cyanotic and the nails are trimmed without overhang. The lower extremities are
normally developed with a paucity of body hair distally and also brown stasis changes of
the skin which extends onto the feet. There is black adhesive material seen on the left
foot. The soles of the feet are calloused two have
es{es anddno mal body haiicial ulceration. Tdistribution.
he
genitalia are those of a normal male w
The back is normal.
PAGE 2
AUTOPSY PROTOCOL
JARAMILLO, Daniel D 1365-06 A-DOU
SCARS AND DISTINGUISHING MARKS:
1. On the right upper arm, on th a snitoi aeouod the skarge dark colored tattoo of
what appears to be a skull
2. On the left upper arm, is a multicolored tattoo of a skull with a hat on it.
EXTERNAL EVIDENCE OF MEDICAL THERAPY:
1. There are EKG monitor pads seen on the trunk and also on the upper extremities.
2. There is a plastic airway device in the right naris.
3. There are defibrillator pads seen on the anterior and posterior trunk.
4. There is a needle puncture mark with overlying gauze seen in the right an
fossa.
INTERNAL EXAMINATION
HEAD:
Reflection of the SCALP shows the usual scattered reflection petechiae. The calvarium
is intact. Removal of the calvarium in the usual fashion shows the epidural space to be
normal. Likewise, no collections of subdural blood are present, The BRAIN is removed
in the usual manner and weighs 1,56D grams. The LEPTOMENINGES are smooth and
glistening, and the gyri demonstrate their usual orientation and configuration. The
vessels at the base of the brain are normally disposed and no anomalies are identified.
Serial sections of the brain show the cerebral cortical ribbon to be intact. The usual
anatomic landmarks of the cerebrum, midbrain, cerebellum, pons and medulla
demonstrate no abnormalities. Removal of the DURA from the base of the skull shows
the usual anatomical features without abnormalities. The pituitary fossa is
unremarkable. The foramen magnum
demonstrates
transection as viewedhe nrmal through the foon and rfirst
portion of the spinal cord at the level o he
magnum is unremarkable.
NECK:
The organs of the NECK are removed h o tl bf,one otl laryngealoc ana layered d ssection is uctures are dent fed.
No fractures or hemorrhages of the y
No intramural hemorrhages are identified.
BODY CAVITIES:
ual TONEAL
The body cavities are opened in the nusexce t forseve e adhesr. The io s ofdt the right pleural
SURFACES are smooth and glistening P
cavity. The PERICARDIUM is unremarkable. The MEDIASTINUM and
PAGE 3
AUTOPSY PROTOCOL
JARAMILLO, Daniel D 1365-06 A-DOU
RETROPERITONEUM and he9
show the usual anatomical features. The leaves of the
DIAPHRAGM are intact organs are anatomically disposed. There is no internal
evidence of injury.
ORGAN SYSTEMS
CARDIOVASCULAR SYSTEM:
The HEART weighs 600 grams. Examination of the epicardium shows it to be intact.
The chambers demonstrate their usual shape and configuration with four chamber
dilatation and enlargement. The CORONARY ARTERIES are normally disposed and
there are only scattered atherosclerotic streaks present throughout the course of all
vessels. Cut surfaces of the MYOCARDIUM show a normal color and no thickening of
the ventricular walls identified. The VALVES are intact with the usual anatomic
relationships. The AORTA follows iusual course and ts
The the GREAT VESSELS of origin of the O e
VESSELS are normally disposed and
venous return are in their usual positions and unremarkable.
RESPIRATORY TRACT SYSTEM:
The LARYNX and TRACHEA show n abnormalities
and tertiary tinuous in BRONCHIthlikewise
e usual
manner with the primary BRONCHI. Thee oLUNG hs
are unremarkable. The RIGHT LUNG weighs 880 grams and the LEFT
surfaces s how
890 grams. The PLEURAL SURFACES are smooth and glistening.
moderately congested and edematous deep red to pink parenchyma with no evidence
of natural disease or injury. There is no consolidation or enlargement of the air spaces.
The PULMONARY VESSELS are normally disposed and unremarkable.
HEPATOBILIARY SYSTEM:
The LIVER weighs 3,970 grams with a smooth, glistening surface. Cut surfaces show
the usual anatomical landmarks in 10 overallof slightly bland nopabnormalities are
GALLBLADDER contains approximately
demonstrated in the BILIARY TREE.
LYMPHORETICULAR SYSTEM:
The SPLEEN weighs 440 grams with a smooth, glistening capsule and an
unremarkable parenchyma with the usual anatomical ntures. The oted show noHpatho pathologic
US is
involuted and replaced by fat. The LYMPH DES where
change.
PAGE 4
AUTOPSY PROTOCOL
1365-06 A-DOU
JARAMILLO, Daniel D
URINARY TRACT SYSTEM:
The RIGHT KIDNEY weighs 250 grams and the LEFT KIDNEY weighs 280 grams. The
cortical surfaces are smooth and glistening
with
PELVES preservation
usual aof the onat mical
and
good corticomedullary differentiation. The
relationships and are continuous into normal
1xing 00 cc of uERe wh+ ch insert into an
unremarkable BLADDER containing approximately
INTERNAL GENITALIA:
The PROSTATE is unremarkable for age.
GASTROINTESTINAL TRACT:
ns
The PHARYNX and ESOPHAGUS are unrmaVthlarge hunks of wd the OhatappeartoCH +be
approximately '1,000 cc of partially digested food
white meat. The mucosal lining of the stomach is ARGEtact and is 1NTESTINEuare unrema unremarkable
into a normal
duodenum and small bowel. The SMALL and
and the APPENDIX is present.
ENDOCRINE SYSTEM:
The PITUITARY, THYROID, ADRENALS and PANCREAS are unremarkable.
MUSCULOSKELETAL SYSTEM:
The musculature is normally developed and the b0at the level of therate their umbilicus.sual
No
relationships. The abdominal FAT measures 5 inches
other abnormalities are noted.
SPECIMENS RETAINED:
1 Peripheral and central blood, urine, vitreous, DNA spot card and tissue stock.
2. Two microscopic cassettes are submitted.
3. Peripheral blood and urine is sent for toxicology.
MICROSCOPIC DESCRIPTION
HEART: Perivascular fibrosis.
LUNG: Thickened blood vessels and septae.
LIVER: Moderate mixed macro and microvesicular steatosis.
KIDNEY:
Autolysis.
PAGE 5
WA-;HOE COUNTY SHERIFF'S OFFICE
w MICHAEL HALEY, SHERIFF
FORENSIC SCIENCE DIVISION
r+ 911 PARR BLVD-
RENO, NV 89512
(775) 328-2800
Page I of 1
Laboratory Number. -L6733-06-0
Decedent: JARAMILLO, DANIEL D.
Agency:
WASHOE CO. CORONER'S OFFICE
Agency Case Number: 1365-06-A-DOU
Source
Specimens Received
Con dition Date Collected
Blood Peripheral
postmortem 12/18/2006
Urinary Bladder
Postmortem 12/18/2006
Urine
Blood Peripheral Collected. 12/18!2006 10:30
0.28 mg/L
Methadone Trace
Amitriptyline Present
Lidocaine None Detected
Amphetamine/Methamphetamine None Detected
Benzodiazepines None Detected
Cocaine/Cocaine Metabolite None Detected
Ethanol None Detected
Opiates None Detected
Organic Acids/Neutrals None Detected
THC-Metabolite
v'w Date
William H-Anderson, Ph.D.
Chief Toxicologist
I
1 PROOF OF SERVICE
2
I,the undersigned,declare:
3
I am a citizen of the United States of America,am over the age of eighteen(18)years,and not a party to the
4 within action.I am an employee of the Law Offices of Jay P. Renneisen,and my business address is 1931 San Miguel
Drive, Suite 210,Walnut Creek,California 94596.
5
On December 14,2007,1 caused to be served the following document(s):
6
APPLICATION FOR LEAVE TO PRESENT LATE GOVERNMENT TORT CLAIM
7
DECLARATION OF JAY P. RENNEISEN IN SUPPORT
8
DECEMBER 14, 2007 GOVERNMENT TORT CLAIM
3 9
on the parties involved addressed as follows:
G 10
o Board of Supervisors Contra Costa Health Services
rn 3 11 County of Contra Costa And Antioch Health Center
W <3 County Administration Building,Room 106 And Felicia Tornabene,M.D.
A 12 651 Pine Street c/o Board of Supervisors
w � 3
Z • Martinez CA 94553 County of Contra Costa
WG S 13 County Administration Building, Room 106
3Contra Costa County 651 Pine Street
14 651 Pine Street, 11th Floor Martinez CA 94553
N N Martinez,CA 94553
off, = 15
U ; : BY FACSIMILE: By use of facsimile machine telephone number 925-955-1601,I served a copy of the within
M
16 document on the above interested parties at the facsimile numbers listed above.
O
S 17 BY MAIL: I caused each envelope,with postage thereon fully prepaid,to be placed in the United States mail at
a g ° Walnut Creek,California. I am readily familiar with the business practice for collection and processing of mail
Moo
18 in this office;that in the ordinary course of business said document would be deposited with the US Postal
N Service in Walnut Creek on that same day. I understand that service shall be presumed invalid upon motion of a
19 party served if the postal cancellation date or postage meter date on the envelope is more than one day after the
date of deposit for mailing contained on this declaration.
20
BY OVERNIGHT DELIVERY: I caused each envelope,with delivery fees provided for,to be deposited in a
21 box regularly maintained by UPS/FEDERAL EXPRESS. I am readily familiar with The Law Offices of Jay P.
Renneisen's practice for collection and processing of correspondence for overnight delivery and know that in
22 the ordinary course of The Law Offices of Jay P. Renneisen's business practice the document described above
will be deposited in a box or other facility regularly maintained by UPS/FEDERAL EXPRESS or delivered to an
23 authorized courier or driver authorized by UPS/FEDERAL EXPRESS to receive documents on the same date
that it is placed at The Law Offices of Jay P.Renneisen for collection.
24
xxx BY PERSONAL DELIVERY: I caused to be served each document listed above by hand to each addressee
25 above.
26 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on December 14,2007,at Walnut Creek,California.
27
28 Jay P.Re eisen
-1-
PROOF OF SERVICE
I