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Home My WebLink AboutMINUTES - 01152008 - C.10 AMENDED CLAIM ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: JANUARY 15, 2008 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 California Government Codes. ) you is your notice of the action taken NOTE: FIRST CLAIM FILED ON DEC on your claim by the Board of ) ,Supervisors. (Paragraph IV below), U given Pursuant to Government Code AMOUNT: $7,500.00 JAN 0 3 2008 Section 913 and 915.4. Please note all COUNTY COUNSEL "Warnings". CLAIMANT: LINTON McNEAL, JR. MARTINEZ CALIF. ATTORNEY: UNKNOWN DATE RECEIVED: JANUARY 03, 2008 ADDRESS: 2901 CENTER STREET, BY DELIVERY TO CLERK ON: JANUARY 03, 2008 RICHMOND, CA 94804 HAND DELIVERED BY MAIL POSTMARKED. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JANUARY 03 2008 JOHN CULLEN, C rk Dated: By: Deputy II. FROM: County Counsel T0: 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: Z/—ad By:'-- JDeputyCounty Counsel 11I. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) O Claim was returned as untimely with notice to claimant (Section 911.3). 1V. WARD 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. Date N CULLEN, CLERK, By Deputy Clerk W ING ( code section 913) .11 14 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 ou 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 pet jury 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 iu Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. ate !!�6 ,f_JOHN CULLEN, CLERK By Deputy Clerk i � OSS CLF JAN 0 3 4uuo So R CO Rq COST�'1 A p A 4 Cp RS r BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. A claim relating to a cause of action for death or for injury to person or to personal property or grotiving crops shall be presented not later than six months after the accrual of the cause of action. A claim relating to any other cause of action shall be.presented not later than ane year after the accrual of the cause of action. (Gov. Code § 911.2.) B. Claims must be filed with the Cle _.}f.the...B.Q Qf...Su y s sat 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 fiaudulent claims,Penal Code Sec. 72 at the end of this form. an l■■■■a Ina RE Inaa Inn■■ a•■IRE UK an a a a 0 a a I a[I a Ina aam G It nit C!a an[I io ILa a[[It l It ICE[1 RE: Claim By: Reserved for Clerk's filing stamp MR. LINTON MCNEAL jr. ) 2901 CENTER RICHMOND..CA. 94804. ) =- Against the County of Contra Costa or ) DEC 1 3 2007 CONTRA COSTA COUNTRY/RICHMOND HEALTH. NTER __� PR T SC' 7 T T 21 u lllliStrJc CLER};.QGI,R010 F Sl!; R�IISORS INMAN C0NTFAC0STP CO. (Fill in the name) ) 100 38 STRFFT RICH eNa GA. 945801 � The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district is the sum of$ 7, 500 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 10/12/07 AM 2. Where did the damage or injury occur? (Include city and county) 2901 CENTER street Richmond CA. 94804 CONTRA COSTA COUNT 3. How did the damage or injury occur? (Give full details;use extra paper if required) BREAKS IN MEDINCATION /THERAPEMTIC LEVELS/OPTIMUM TREATMENT 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? BREACH OF CONTRACT /PATICENS RIGHTs /MEDICAL/CO Pay THUR. MEDICAL INSURANCE CARRIER ADDICNAL ANSER AND INFORMATION ON PAGE #3""" 5 What are the names of county or district officers, servants, or employees causing the damage or injury? DR.PRISCILLIA HINMAM. THEASA HERANDEZES /PPTICES COORDINATOR MEDICAL RECORDS STAFF/ WINDON #3 ECT. . . 6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. -Attach two estimates for auto damage.) BODIY- INJURIES FROM METHADOME/WITHERAWARS ASWELL/SOMA WITHDP.AWAtRS ANSER ON ADDICNAL PAGE. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) BREAKS MEDICATION CAUSE BODLY IXJURIES DAMAGES /LOSS WAGE /MISSING DAYFROM SCHOOL/ect. . 3 TIME. WAGEPAIN SUFFERING. / $. Names and addresses of witnesses,doctors, and hospitals: CENTRAL PHARMACY /BOB/pHAMACIES CHILDRER /MOTHER /ect. . . 9. List the expenditures you made on account of this accident or injury: DATE T TV E AMOUNT 11/12/07 WAGE LOSS 6:00 PM 22;00 PER HOUR TIME 12 DAILY ONE WEEK .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) ) Name and address of Attorney ) (Claimant's Signature) 2901 CENTER STREET RICHMOND CA.. 94804 ) (Address) jSAME. . . .. . . . . Telephone No.CELL 510) 943-2073 )Telephone No. MESSAGE ■ a Egg a t t[t t t MIKE now[Box sa■K r a t[a l a a l a a Eggs sits a a■■a ata no a■a[a t[a[t a a l t a sun a t a a[a[a t[a t 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 at seq.) Furthermore, any attachments, addendums, or supplements attached to the claim form, including medical records, are also subject to public disclosure. ■ t a[t a a a a t a t a a a a a a a t a a a a ■ ■ Sol as a a a l a■■a a a a RUNIKKKKKKKEa lax lung Is[ata■a l a a t[l[[a t IF a t as NOTICE: Section 72 of the Penal Code provides: Every person v�,ho, 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. Naiative (continued) Answer to Question #3- Break medication which the foll owing will occur: Nausea, vomiting, chills, flu like synm toms muscle cramps, headache, obsessive bowel movement compliancy sus- tained drug/blood levels for therapeutic levels for optumum treat ment peaks and vallets steady state. Answer to Question #5- The problem with the Contra Costa Health Care system is that due to the inhouse pharmacy closing over 2 and 1 /2 years ago and there is .no administration for solving pro- blems on patients rights for quality health care. The system was PUL III place but it doesn' t work. Staff members know this as a well as administration personnel but due to budget cuts and the incompetence of new - handeling of patient files , as well as the patient care coordina- tors case overload etc. patients are suffering as well as their rights to quality health care clearly violating patient co-pay medical contract with ending solutions being severe consequences o the patient. Witness Name (Last, First, Middle) Address City/ZIP Phone (Include Area Code) Complainant's Signature Date X