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HomeMy WebLinkAboutMINUTES - 03271984 - 1.27 CLA314 Board Action BOARD CB SUPERVISORS Cr COyl'RA COSTA COMM CN07am A March 27, 1984 Claim Against the County, or District ) NNICE TO CIATNWr governed by the Board of supervisors, ) The copys t ma ed to you is your Routing Endorsements, and Board ) notice of the action taken an your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to aDvernment Code Section 913 and 915.4. Please note all oVarnings'. Claimant: Robert Smith 1234 65th Avenue, Oakland , California 94621 County Counsel Attorney: Charles A . Bonner 409 13th Street , 17th Floor FEB 2 2 1984 Address: Tribune Tower Oakland , CA 94612 Martinez. CA 94553 Amount: Unspecified By delivery to clerk on Date Received: -Feb . 17 , 1984 By mail, postmarked an Feb . 14 , 1984 I. FRLM: clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Feb . 22 , 1984 J.R. OESSON, Clerk, By qty e�U . Ma li II. FROM County Counsel TO: Clerk of the Board of Supero sons (Check only one) 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. clerk should return claim an ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: _ By: Deputy County Counsel III. FRONT: Clerk of the Board TO: (1) County 1, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD Ottffit By unanimous vote of Supervisors present (X) 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: MAR 2 7 1984 J. R. CLS.SON, Clerk• ,'�kBy, .�-,.c� Deputy Clerk WARM G (Gov. Code Section 913) Subject to certain exoepticns, 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 Ooaernoesut 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim 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. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed DATED:'MART 84 J. R. C[&WN, Clerk, By 1- Deputy Clerk CC: Cou,'nty Adninistrator (1) County Counsel (2) 000039 040-03a CLAIM :,AIM TO: BOARD OF SUPERVISORS OF CONTRA C CWF-L8rAWYapp11cation to: Instructions to ClaimantClerkotthe Board .O.Box 911 Martinez,California 94553 A. Claims relating to causes of action for death or for injury to .person or to personal property or growing crops must be presented not later than the 100th day 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. (Sec. 911.2, Govt. Code) 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, California 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 he filed against each public entity. . E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end this form. RE: Claim by )Reserved f ' ing stamps ROBERT SrtITH ) RECEIVED ) r=r , Against the COUNTY OF CONTRA COSTA) J. R. OLSSON or DISTRICT) CLERK BOARD OF SUPERVISORS F1 In name ) CONTRA COSTA CO. By. ........ ::..... epyty The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 15 .000_ and in support of this claim represents as follows: December 14 or 15 1983 --Q ____�_______ __ ________T_T_____________ 1____ 1__ 1. When, did the damage or injury occur? (Give exact date and hour] au --- --- -- -------------------- W ere id the damage or injury occur? (Include-city and county) *See attached pages for answer to #3. 3. How 'did the damage or injury occur? (Give lull-details, use extra-- sheets if required) *See attached pages for answer to #4. 4. What particular act or om�ss�on on the part of county or district officers, servants or employees caused the injury or damage? 000040 1, (over) r •5. What are the names of county or district officers, servants or employees causing the damage or injury? • Unknown at this time. - - - 'F--T----------- --- --T------ - -•� -- ------------- 6. W�iat-da-mage-----or--in3uries do you claim resuSte�? ZG�ve ull extent of injuries of damages claimed. Attach two estimates for auto damage) See #'s 3. & 4. 7. How was the amount claimed above computed? (Include the estimate amount of any prospective injury or damage. ) Unknown at this time. 8. Names and addresses of witnesses, doctors and hospitals. Unknown at this time. �S. List the expenditures you made on account of this accident or in3ury: DATE ITEM AMOUNT Govt. Code Sec. 910.2 provides: "The claim signed by the -claiman SEND NOTICES TO: (Attorney) or by some person on his behalf. Name', and 'Address of Attorney CHARLES A. BONNER Claimant's Signature 409 '13th Street, 17th Floor 1234 65th Avenue, ' Tribune Tower Address Oakland, California 94612 Oakland, California 94621 Telephone No. (415) 465-6462 Telephone No. 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, town, city district, ward or village board or officer, authorized to allow or pay the. same if genuine, any false or fraudulent claim, bill, account, vouches or writing, is guilty of a felony. " 2• 000041 FEBRUARY 61 1984 4 ' SMITH, ROBERT Page 3 3. On December 14 or 15, 1983, Mr. Robert Smith was arrested by ,San Francisco, police officers on a four year old warrant from Martinez , CA. for P.C. 434 . Said warrant should not have been active at that time since the P.C. Section 484 case that the warrant was issued on was dismissed in 1982 in Court in Martinez , CA. Mr. Smith was held in San Francisco City Jail for approxi- mately two (2) days subsequent to the aforesaid arrest on December 14 or 15, 1983. Mr. Smith' s case was dismissed by a judge on December 19, 1983 because the case had been dismissed before in 1982. Apparently, the 4 year old warrant for P.C. Section 484 (petty theft) was never taken out of the computer in Martinez by Contra Costa County or its employees, and therefore the San Francisco police officers arrested Mr. Smith pursuant to that 4 year old warrant. Mr. Smith was fired from his then place of employment due to failure to report to work on the days that he was held in San' Francisco Jail subsequent to his arrest on December 14 or 15, 1983. 4. Contra Costa County and its employees failed to remove from a martinez computer a warrant for P.C. Section 484 subsequent to that case being dismissed in 1982 in Martinez , CA. This aforementioned failure to properly remove said warrant caused Robert Smith to suffer imprisonment for approximately two (2) days in December 1983 after he was arrested on the aforesaid warrant in San Francisco, and also caused Robert Smith to lose his job due to his inability to report to work while he was imprisoned. Mr. Smith also has incurred damages for emotional/mental pain and suffering. 3• 000042 i — Qin BOAR CP SDPEMSM CF COiflTtA C08M CODNPY, CNW7aW1X BOARD ACTION March 27 , 1984 Claim Against the Oaa:ty, at District ) NMCE TO CLKINW governed by the Hoard of Supervisors, ) "m cops► s t ma ed to you is your Routing Endorsements, and Hoard ) notice of the action taken an your claim by the Action. All Section references are ) Hoard of Supervisors (paragraph IV, bell )a, to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant.- Thomas G . Medwick, 516 Mt . Davidson Court , Clayton, CA 94517 County Counsel Attorney: FEB 2 4 1984 Address: Martinez, CA 94553 Amort: $45. 19 By delivery to clerk on 2-23-84 Date Received: — . 2-�3-84 By mail, postmarked on 2-21-84 I. FFM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: 2-23-84 J.R. CSSSON t Clerk, By Deputy I.T. KP1 T/ R. Cal houn FROM: County Counsel 7O: Clerk of the Board of Super sons (Check only ane) �( ) 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. Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: a"7- - By: Deputy County Counsel III. PROI: Clerk of the Board TO: (1) County Cassel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BMM �Et By unanimous vote of Supervisors present ( X ) This claim is rejected in full. (/ ) Other: I certify that this is a true and correct copy of the Boar 's Order entered in its minutes f #a date. f /� Dated: 1V(AR 2 191 4 J. R. CWSON Clerk, By r�,.� r ✓, n.�z, ;. Deputy Clerk 10RNM (Oov. Code Section 913) Subject to certain emaeptions, you have only six (6) months from the date this notice was personally served or deposited in the mail .to file a court action an this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in aminecstion with this matter. If you want to consult an attorney, you should do so immediately. V. FROM: Clerk of the Hoard TO: (1) Casty Counsels, (2) County Administrator Attached are copies of the above claim. Iiia notified the claimant of the Board's action on this claim by mailing a copy of this document, and a ,a , thereof has been filet] and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to'claimant. 1^ '� mm: ma 2 7 1984 J. R. CES". Clerk, By 4Qe � Deputy Clerk cc: County Administrator (1) County Counsel (2) 000043 0O CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions --o Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day 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. (Sec. 911. 2, Govt. Code) 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 (or mail to P.O. Box 911, Martinez, .CA) , 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 end of this form. RE: Claim by ) Reserve( ' fnr r 4 statues RECEIVE Against the COUNTY OF CONTRA COSTA) 4 . , J. R. OLSSON or DISTRICT) CLERK B94RD Of S PERVISORS Fill in name) ) w The undersigned claimant hereby r,Lakes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: --------------------------------------------------------- en1. Whdid the damage or injury occur? (Give exact date and hour) 1 q g(A f�vP P pvk G RM ---- r�RT------- -- P n e -----�-- ----------------------- - 2. Where did the damage or injur occur? (Include city and county) CA ------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details, use extra sheets if required) w i R fV0 L-. W \AA 4A 4\Ow rn -T-� P, e R t rin pin R -------------=---- ----------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? S rn�A 1..L �► o` P� s �-+�r.1 u r t��-(� S `rte-v�b d U v�R��c��c i r�6 sue eco bLA Clio( . //a �Ps rie cp /--. (over) -MO 5. What are- the •names of county or district officers, servants or employees causing the damage or injury? ---- -- ------------------------------------------------------ 6 -What-da-mage----or--injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) 1457 -7 -10 ------------i------------------------------------------------------------ 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. ------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT ************************************************************************** Govt. Code Sec. 910.2 provides : "The claim signed by thclaimant SEND NOTICES TO: (Attorney) or b some person on hi behalf. " Name and Address of Attorney � . G Claimant' s Si nature SIt� VWIV nfflUIAddress D Telephone No. C)Orle Telephone No. *******************************************U Azv-, ** 3 *** 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " 00004 A.DLER AUTOMOTIVE CENTERS DATE •1813 MT.DIABLO BLVD.,WALNUT C K.CALIF.94696 • PHONE 933-2833 ACCT.1M. r INV-NO, SOLD TO W C 12015 ADDRESS CHECK CASH CHARGE REC.ON ACCT. OTHER CITY - PHONE } .6 �/ vy7 C:.! MAKE EAR- y ODE P.O.NUMBER SPEE METER READING CE O DUN' < ;i;' 1 rs.e 3DESCRIPTION `m s_. xic E 'HCl 1 l f.: t `tt } F "r TOTAL LABOR : PARTS f§MERCHANDISE ABOVE MERCHANDISE RECEIVED IN GOOD ORDER SALES TAX` w _ t It is hereby agreed that the purchaser Is to pay all collection and attorney's fees and other costs in connection _ with collecting this account,and that title to any items purchased shall remain with the seller until the total 1+ r �B�R"; , 1 Price is paid. In the event of failure to pay the account when due the seller shall have the right to repossess t.,.,t., ".`,;_„- said items with or without legal process,or may enforce the Payment of the balance due thereon with accrued Interest. qEE REVERSE SIDE -<+ 'r. l� A M 000046 1 CLMN BOW OF SQP=I90RS CLQ OCR= COBB1 CMW2, OLIIKIVIIA BOARD ACTION March 27 , 1974 Claim Against the County, cc District ) li0TiC8 1C CLRD4 TP governed by the Board of Supervisors, ) The copyt as ed to you is pour Routing Endorsements, and Board ) notice of the action taken on Your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, bele), to California Government Codes ) given pursuant to Government Code Section 913 and 915.6. Please note all 'Warnings•, Claimant: Brent Jon Garcia, 1824 Paul Lane , Concord, CA 94520 County Counsel Attorney: FEB 2 4 1984 Address: Martinez, CA 94553 Amount: $144. 45 By delivery to clerk on 2-23-84 Date Received: -2-23-84 By mail, postmarked an 2-21-84 I. FROM: clerk of the Board of Supervisors 70: County Course Attached is a copy of the above-noted claim. Dated: 2-23-84 J.R. OISSCK, Clerk, By Deputy e yCaInoun II. FRCM: County Counsel 70: Clerk of the Board of Supervisors (Check only ane) (X) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAIIS 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. 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: ; s/i Deputy County Counsel III. FROM: Clerk of the Board TO: (1) Count 1, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD OEM By unanimous vote of Supervisors present (Y) This claim is rejected in full. ( ) Other: I certify that the is a true and correct copy of the Board's order entered in its minutes for this date. Dated: MnR 2 71984 J. R. aLSSON, Clerk, By Deputy Clerk IQ►*M G (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 an this claim. See Government Code Section 965.6. You may seek the advice of an attorney of par choice in connection with this matter. If you want to consult an attorney, you should do no immediately. V. FROM: Clerk of the Board TOt (1) County Counsels, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this' claim 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. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. mm:_ MAR 2 7 1984 J. R. CL.SSON, Clerk, By A Q�-�. P l'l� rx,Z�� �� . Deputy Clerk cc: County Administrator (1) County Counsel (2) 00.0047 OOO CLAIM CLAIM TO: ' BOARD OF SUPERVISORS OF CONTRA COS ', ur o igFigTen ' I application to: Instructions to Claimant fb SoX 911 rtinP2,California 94553 A. Claims relating to causes of action for death or or injury to 9/53 person or to personal property or growing crops must be presented not later than the 100th day 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. (Sec. 911.2, Govt. Code) 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, California 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. _ f E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end o his form. RE: Claim by ) Reserved for�Clerk s fAling stamps fire tUT Z-0 1v q RRL° iR ) RECEIVED Against. the COUNTY OF CONTRA COSTA) or C ov nTx ?a L�� DISTRICT) J. R. oLssow (Fill in name) ) CLe:K BO OF SUPERVISORS B, TR The undersigned claimant hereby makes claim against the County o ontra Costa or the above-named District in the sum of $ 14144, Y.$ and in support of this claim represents as follows: ----------------=------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) a7-�3 _r._ao_(tlrl 2- _ ---- - --- -------- ---- -------- ---- --- -- - - --------- Where did the damage or injury occur? (Include city and county) 3. -----�ow Q v n tR�---or---in--j---ury-------occur?---(Give------------------------------ . Hdid thehe damage full, details, use extra sheets if -required) elv r- oF- Rr_ fco,S'e _rano le_`_C1sz2h i What .particular act or omission on the part of county -or _district, : officers , _ servants or employees caused the injury or., damage? .= i ,'_ e u 1';"c.5 /05 (over) . 00004-8 „5. What are the names of county or district officers, servants or employees,,causing the damage or injury? ------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) � f} NT•,,� ShecS _rT�Swc-- ,�oxeeS' 7. How was the amount claimed above computed (Include the estimated amount of any prospective injury or damage. ) -�- Tort S_ L o� T--------------------------------- 8. Names and aldresses of witnesses, doctors and hospitals. n ---------------------------- ------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. ” Name and Address of Attorney m Claiant' s i ature i".2 e Address Telephone No. Telephone No Lf '] 5 -i1Og 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" ..town, _city district,- ward or- village board or officer,-authorized oto -allow or pay the same if genuine; any -false or fraudulent claim, bill,'-account , voucher, or writing, is, guilty of a 'fe'�ony. " , 000049 • Board Action �- CUUM March 27 , 1984 MW OF SMOMSM O Cam col'2P1R. CALMMMUM Claim Against the county, or District ) 14MCE TO CEAD1M governed by the is YOM Routing it -1,rsementsa and Board of s� ) notice the action taken on your laim by the Action. All Section references are ) Board of Supervisors (Paragraph Iv, below), to California Government codes ) given pursuant to Goverment code Section 913 Lawrence D . James and 915.4. Please note all "Rulings". Claimant: 1471 Hopkins Street, Berkeley, CA 94702 County Counsel Attorney: E . M. Cadwallader c/o Law Offices of David B . Rosenthal FEB 2 2 1984 Address: 145 Park Place , Pt . Richmond , CA 94801 Martinez. CA 94553 Amount: $116 .-00 By delivery to clerk on Date Received: -Feb . 21 , 1984 By mail, postmarked an Feb. 3 , 1984 I. FROM: Clerk-of the Board of Supervisors 70: County Counsel Attached is a copy of the above-noted claim. Dated: Feb . 22 , 1984 J.R. O SSON, Clerk, By / :d"' Deputy II. FROM: County Counsel T0: Clerk of the Board of Supery sons (Check only one) (X) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAnS 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. Clerk should return claim on ground that it was filed f late and send warning of claimant's right to apply for leave to present a late `i claim (Section 911.3). t ( ) Other: I Dated: 2- Z z - By: Deputy County Counsel I III. FROM: Clerk of the Board 70: (1) ty counsel, (2) county Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). W. BOAS ORDEtt By unanimous vote of Supervisors present (X) This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered n is minutes for this date. n Dated: MAR 2 719R4 J. R. OiSSON, Clerk, By yv t4- L-o . Deputy Clerk T4e,*MIG (Gov. code Section 913) Subject to certain exoeptians, 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 Goverment code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. V. PROK: Clerk of the Board 10: (1) county counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action an this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's oopy of this Claim in accordance with section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. ' r DATM: M11R 9. 7 1984 J. R. OEMON, Clerk, By fl", I Deputy Clerk "cc: County Administrator (1) County Counsel (2) r'. ^ ^54 CLAIM -LAI" 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 must be presented not later than the 100th day 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. (Sec. 911. 2, Govt. Code) 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 (or mail to P.O. Box 911, Martinez, _CA) . 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 ent_ty, separate claims must .be filed against each public entity. E. Fraud. See penalty for fraudulent claims , Penal Code Sec. 72 at end of this form. RE: Claim by ) Reser stamps Lawrence D. JamesIT R E Against the COUNTY OF CONTRA COSTA) or DISTRICT) CLERK BOA;;D , Coni Fill in name) ) B ®• The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 116. 00 and in support of this claim represents as follows: -----R� -------age or ---------------- ----exact------------------- 1. When did the damage or in3�cur? (Give exact date and hour) D ll�� 7017 Gl l L71'L -7 3 ------ ----T-------------------------------- --------------------------- 2. Where did the damage or injury�ocpur? (Include city nd county) -------------------------------------------- -------- ' ------- 3. How did the damage or injury occur? (Give fulls, use extra sheets if required) Clothing lost - my clothing was placed in sheriff' s dept . for safe keeping. Oyvat -7 CL,-�%J 0`q �� 't, j ,LF) ------------ -�=�-g- ------------------------------------- 4. What par icular act or omission on the part of county or district ;officer's , servants or employees caused the injury or damage? ��hile incarcerated at Contra Costa Co . Jail , my clothing was placed on clothing rack 31 at the jail and was placed in sheriff' s department possession for safe keeping. The Shex.iff' s department was negligent in their care, and my clothing was lost. -7 3to -a F--- &3 000051 5. What are the names of county or district officers, servants or employees causing the damage or injury? �.ae�► cL - C.o.Co 6 . What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) $116 for lost clothing. Estimates are not available . ------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective in ury or damage. ) 1 pr. white white tt shorts $00O 1 pr. blue Levis (brandnew) sz . 3J J- L -- $40 tube Blk. Harley T-shirt SZ . --XL 15 ------ 1 pr . Blue "Brooks" tennis shoes sz . r2 55 8. Names and adpd/resses of witnesses, doctors and hospitals. ------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Replacement of clothing `' ************************************************************************** Govt. Code Sec. 910. 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person. on his behalf. " Name and Address of Attorney E .M. CADWALLADER Claima t' Signatur c/o Law Offices of David B Rosenthal 145 Park PlaceAdd es91, Pt . Richmond ,Ca. 94801 / ,12 0 P bq 9 y 207_ Telephone No. 415-232-4700 Telephone No.- NOTICE o.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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " 000052 s11 Board Action March 27 , 1984 CL KM 21 BOARD OF SOPSMMSORS Qr C10NM COSTA COORIY, CALUPORM Claim Against the County, cr District ) 1aNI(E TO C[ADOW u Is YOM Routing 1Dnrned nddorsementsthe a and Boof ard s� ) notice the action taken on your c]aiim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Governoent Codes ) given pursuant to Government Code Section 913 and 915.4. Please rate all ONarnings'. Claimant: Michael Gerhart 3233 West Swain Road , Stockton , CA 95207 County Counsel Attorney: James H . Vernon , Esq . P . 0 . Box 410 FEB 2 2 1984 Address: San Ramon , CA 94583 Martinez, CA 94553 Amount: $1 , 000 , 000 . 00 By delivery to clerk an Date Received: —.Feb . 21 , 1984 By mail, postmarked an Feb . 14 , 1984 I. EMM: Clerk of the Board of Supervisors 10: County Counsel Attached is a copy of the above-noted claim. Dated: Feb. 22 , 1 984 J.R. C[SSCN, Clerk, By Deputy 9 II. FRCM: Canty Cmmsel TO: Clerk of the Board of Supery sors (Check only one) (/) 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 ratifying claimant. The Board cannot act for 15 days (Section 910.6). ( ) Claim is not timely filed. Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: - 2 7 - By: Deputy County Counsel SII: FROM: Clerk of the Board TO: ) County Counsel,, (2) Canty Administrator ( ) Claim was returned as untimely with notioe to claimant (Section 911.3). N. BOARD, By unanimous vote of Supervisors present (x) 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 1az Ais date. Dated: 2 J. R. CLS.SONp Clerk, By Deputy Clerk 99►RDM G (Gov. Cale 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 conunection with this matter. If you want to consult an attorney, you should do so immediately. V. FRCM: Clerk of the Board TO: (1) County Counsel, (2) Canty Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this docnnent, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed DIATFD:�MAR Z� 984 J. R. LESSON, Clerk, By yt(".-"a, , Deputy Clerk CC: County Administrator (1) County Counsel (2) 3 CLAIM V 'I 1 LAW OFFICE OF - IVED JAMES H. VERNON 2 P.O. Box 410 17 ; San Ramon, CA 94583 3 (415) 838-9400 s�onl .rr, F'1r M :SP SUPERVISORS4 LC, 5 In the Matter of the Claim of Michael Gerhart, Claimant 6 v 7 County of Contra Costa, Does I-VJ 8 9 Michael Gerhart hereby presents this claim to the County of Contra Costa 10 ursuant to Government Code Section 910. 11 1 . The name and post office address of claimant is as follows; 12 Michael Gerhart 13 3233 West Swain Road Stockton, CA 95207 14 2. The post office address to which claimant desires notice of this claim 15 o be sent is as follows: 16 James H. Vernon, ESq. P.O. Box 410 17 San RAmon, CA 94583 18 3. On November 7, 1983 on Marsh Creek Road, one mile east of Morgan Territory 19 Road, claimant received personal injuries under the following circumstances; 20 Claimant was a passenger in an automobile proceeding west on Marsh Creek Road, 21 a county roadway. Claimant's driver failed to negotiate a turn resulting a 22 collision with an automobile coming in the opposite direction. 23 4. The roadway on which the accident occurred was negligently maintained and 24 constructed in that the posted speed limit was excessive, the grade was inadaquat , 25 no warning signs were posted, and the roadway was unnecessarily narrow. 26 5. So far as it is known to claimant at the date of the filing of this claim, Y' 27 Michael Gerhart has incurred damages in the amount of $100,000.00 due to the fol- 28 16wing injuries: concussion resulting in probable brain injury. 000054 l 1 6. The true names of Does I-V are unknown to claimant, and claimant will 2 amend this claim to show their true names when they have been ascertained. 3 At all times Does I-V were the agents and employees of the County of Contra 4 Costa and were acting within the scope of their authority as agents and emplo- 5 yees and with the permission and consent of the County of Contra Costa. 6 7. At the time of presention of this claim Michael Gerhart claims damages 7 in the amount of $1 ,000,000.00, including medical bills and prospective loss of 8 earnings. The actual amount of damages is not ascertainable at this time due 9 to the nature in th injury incurred. 10 11 Dated: February 14, 1984 12 i 13 ries H. Vernon, Attorney for C imant 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 000055 C[" Board Action BO141tD 0P SOPSRVISORS Qr OORM C019M COUM. CALZFCRffA March 27 , 1984 Claim Agai.nbt the county, or District ) DU'1'ZCt3 To CLADOW governed by the Board of Supervisors, ) The copy of7s tma lea to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph W, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all 'Warnings'. Claimant: Brenda Nies County Counsel 3601 Clayburn Road , Antioch , CA 94509 Attorney: Robert H . Price , Esq . FEB 22 1984 2255 Contra Costa Blvd . , Suite #301 Address: Pleasant Hill , CA 94523 Martinez, CA 94553 Amount: $100 , 000 . 00 By delivery to clerk on Date Received: —Feb. 21 , 1984 By mail, postmarked on Feb . 1 5 , 1984 I. FROM: Clerk of the Board of Supervisors 70: County Counsel Attached is a copy of the above-noted claim. Dated: Feb. 22 , 1984 J.R. CE S.SON, Clerk, By Deputy anne U . Maglio II. FROM: County Counsel TO: Clerk of the Board of Supery sons (Check only one) ( ) This claim complies substantially with Sectiones 910 and 910.2. This claim FAIIS to oamply 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. Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: Deputy County Counsel III. FROM: Clerk of the Board 70: (1) County Couns141j, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD alffit By unanimous vote of 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 th s date. �1 Dated: MAR 2 71984 J. R. LESSON, Clerk, By �,cJ �'Vj.G�^ c,u o , Deputy Clerk MNG (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 smatter. If you want to consult an attorney, you should do so immediately. V. FROM: Clerk of the Board T0: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. we notified the claimant of the Board's action on this claim by mailing a copy of this docwennt, and a memo thereof has been filed and endorsedion the Board's copy of this Claim in accordance with Section 29703. ( ) A warring of claimant's right to apply for leave to present a late claim was mailed to claimant. p DATED: MAR 2 7 1984 J. R. CLSSON, Clerk, By e�,.v I( ��2a� �� . qty Clerk cc: County Administrator (1) County Counsel (2) 000056 c CLAIM i 1 The Scranton Law Firm 2 2255 Contra Costa Boulevard, Suite 301 RECEIVED LNTRACOSTA JCO, Pleasant Hill, Ca. 94523 4 (415) 612-7777 t=K 5Attorney for Claimant B 6 7 B CLAIM AGAINST A PUBLIC ENTITY 9 10 In the Matter of the Claim of 11 BRENDA GAIL NIES, ) ) 12 ) 13 CLAIM FOR DAMAGES 14 Against the, ) (Govt. Code Section 910 et. seq . , 15 1`County of Contra Costa ) ) 16 j!j 1 . I, Robert H. Price, Esq. 17 i the undersigned, present this claim for damages as a person acting 18 i on behalf of the claimant. 19 ; 2 . I desire notice relative to this matter to be sent to 20 I' my following business address : 2255 Contra Costa Blvd. #301, 1 21 I Pleasant Hill, Ca. 94523 22 J . The name and address of claimant are: Brenda Nies, is 23 3601 Clayburn Road, Antioch, Ca. 94509 24 !I 4 . The date and place of the occurrence that gave rise to 25 ;; this claim are as follows: Loveridge Road at the intersection 26 I with the Pittsburg-Antioch Highway. -1- 000057 u i . It i y 1 5 . The circumstances of the occurrence which gave rise tc 2 I the claim are : Confusion as to whether traffic was proceeding 3 Ivia traffic signals or directed by deputy sheriff. As a result 4 of the subsequent confusion the accident occured. 5 6 , I 7 I 8 6 . A general description of claimant' s injuries, damages 9 and lossess incurred so far as is now known are as follows : 10 ; Injury to head, neck and left shoulder. Surgery on left shoulder, 11 I loss of wages from January 1, 1984 and continuing. 12 13 14 7 . If known, the name(s) of the public employee(s) causin; 15 I� said injuries, damages and losses is/are: Cunningham, 16 f Deputy Sheriff Contra Costa County, Badge #39126, 651 Pine Street, 17 �I Martinez, Ca 94553. I 18 l 8 . The amount claimed as of the date of presentation of 19 �j this claim consists of general damages and special damages relati" 20 �I to claimant ' s injuries and property damage and loss of use of same 21 f� in amounts unknown at this time but in the aggregate not less that i 22 li $100 ,000 . 00 and exceeding the jurisdiction of the Municipal Court 23 I of the State of California . Claimant reserves the right to insert III 24 II said amounts when same are ascertained . I 25 II DATED : February 15, 1984 Si laimant or Person 26 i Acting on ehalf of Claimant -Robert H. Price, Esq. li -2- 000058 r , PROOF OF SERVICE BY MAIL (C.C.P. 1013A, 2015 . 5) STATE OF CALIFORNIA COUNTY OF CONTRA COSTA I am a citizen of the United States and a resident of the county of Contra Costa. I am over the age of eighteen years .and not a party to the within above entitled action. My business address is 2255 Contra Costa Boulevard, #301 , Pleasant Hill , CA 94523. On February 15 , 1984 I served the within CLAIM FOR DAMAGES (Govt. Code Section 910 , et. seq. ) on the parties in said action, by placing a true copy thereof enclosed in sealed envelope with postage thereon fully prepaid, in the United States mail at Pleasant Hill, California, addressed as follows: Clerk of the Board of Supervisors Contra Costa County 651 Pine Street Martinez, CA 94553 I, Joan M. Ritter, - .certify (or declare) , under penalty of perjury that the foregoing is true and correct. Executed on February 15, 1984 at P1 san Hill, California. 000059 BOAPfl CP SUPF.N190M (CI[w OMORM COB141 Comff, CRMU IA BOARD ACTION March 27 , .19 84 Claim Against the County, cc District ) NNICB TO CIAVOW ilo�uting bkddorsementsrned by the ,, and of Supervisors,, and s ) notice the action taken an your you aim by is the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.6. Please rate all 'i"unty Counsel Claimants Diane Pioletti, 1587 Peters Street , San Leandro, CA Attorney: FEB 2 4 1984 Address: Martinez. CA 94553 Hand delve ed Amount: Unspecified ' By delivery go clerk on 2-23-84 Date Received: 2 - 2 3-8 4 By mail, postmarked on I. FRCM: Clerk of the Board of Supervisors 10: County Counsel Attached is a copy of the above-noted claim. Dated: 2-23-84 J.R. O[SSON, Clerk, By � Deputy iI. FRC24: County Counsel Ti Clerk Board of Super sors (Check only one) ( ) This claim complies substantially with Sections 910 and 910.2. S% ) This claim FAI1B 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 riot timely filed. Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ,!- By: Deputy County Counsel III. FRIM: Clerk of the Board TO: (1) Countytimant (2) County Administrator Claim was returned as untimely with notice (Section 911.3). I�V. BOARD By unanimous vote of Supervisors present (x ) This claim is rejected in full. ( ) Other- Icertify that this is a true and correct copy of the Bear 's order entered in its minutes for this date. I - 1', � Dated: MAR 9. 714Rd J. R. CLSSON, Clerk, By y d Vto✓L�,� c) , Deputy Clerk iQ1tWW (Gov. Code Section 913) Subject to certain exceptions, you have only sins (6) months from the date this notice was personally served or deposited in the ndl .to file a cart action on this claim. See Government Code Section 965.6. 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 inmediately. V. FROM: Clerk of the Board T0: (1) County Oonsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim 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. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. DATED: MAR 2 7 1984 J. R. C[88oN, Clerk, By -� ���� , Deputy Clerk cc: County Administrator (1) County Counsel (2) 0000(;0 e CLAIM CY,"AIM TC: 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 must be presented not later than the 100th day 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. (Sec. 911. 2 , Govt. Code) 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 (or trail. to P. O, Box 911, Martinez, CA) 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 end his form. RE: Claim by )Reserved for Clerk' s filing stamp_s / ) RECEIV Against the COUNTY OF CONTRA COSTA) I or DISTRICT) •�t r c_s oi. Fill in name) ) CLCF.K 6, D Of /uf ERV.:. as ONi A �R,CQ! _. sv..... .. .../..... _p The undersigned claimant hereby makes claim agains T n y o on ra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: -----------id----------------------- 1. When dthe damage or injury occur? (.Give exact date and hour) ----- -----'r------------ -- ---injury oc----------------------------------- 2. Were did the damage or injury occur? (Include city and county) --------------------------------=---------------- -----.--------------- 3. How did the damage or injury occur? (Give full details, use extra sheets if required) ..---- •-----------------------T----••--------------------""---------------- 4. What particular act or omission on the part of county or district officers , servants or employees caused the injury or daAage? 000061 � . 5. What are the names of county or district officers, servants or employees causing, the damage or injury? -------- ------------------------------------------- 6 What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) ------------------------------------------------------------------------- 7 . How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. --------------------------------------------------------- ---------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Govt. Code Sec. 910. 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney Claimant' s Signature Address Telephone No. Telephone No. ************************************************************************** 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account , voucher, or writing, is guilty of a felony. " 000062 ��. Board Action ' CLAIM! March 27, 1984 BOARD OF MFffiti S36 Or NIRA COM COUNTY. CALIFORNIA Claim Against the County, or District ) I47TIC8 TO CL%ugw governed by the Board of Supervisors, ) The copyof s itma led to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Gmrnmmnt Code Section 913 and 915.4. Please note all 'Warnings'. Claimant: United Services Automobile Association-Bay Area Office (Auto Claims ) 20863 Stevens Creek Blvd . , Bldg . B-4 Attorney: Cupertino , CA 95014-2195 ( Insured: Louis M. Schultz II ) Address: County Counsel Amount: $608 . 80- By delivery to clerk on FEB 2 2 1984 Date Received: -�e b . 21 , 1 984 By mail postmarked on Feb . 15 , 1 ��;;:ei, CA 94553 Certifiied Mail P 30 I. FROM: Clerk of the Boarg of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. k:�=�Dated: Feb . 22 , 1984 J.R. OLSSCN, Clerk, By 40 a% Deputy II. FRC14: County Counsel TO: Clerk of the Board of Super sons (Check only one) ( ) This claim complies substantially with Sections 910 and 910.2. This claim FAILS to oomply 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. 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: AD - - By: Deputy County Counsel III. FR04: Clerk of the Board TO: (1) County 1, (2) Canty Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD Q> (t By unanimous vote of Supervisors present ( ) This claim is rejected in full. (/ ) Other: I certify that this s a true and correct copy of the Board's Order entered n is minu Dated: 2 ` J. R. O[SSW, Clerk, By Deputy Clerk NRFOINIG (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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) Canty Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim 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. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to DATED: MA S J. R. O[&M, Clerk, By `^� . Deputy Clerk cc: County Administrator (1) County Counsel (2) 000063 CLAIM Robert F. McDermott, President Brig. Gen.. USAF (Retired) USIAA February 15, 1984 RECEIVED Clerk of the Board of Supervisors P. 0. Box 911 t Martinez, CA 94553 J. R. OLSSON - CLERK BOARD OF SUPERVISORS CONT$A OSTA CO. 8Y. ............. ......... .........Deputy RE: Our Claim Number: 2-653 125 08 52 Our Policyholder: Louis M. Schultz II Date of Loss: January 6, 1984 Location: Crow Canyon Road, San Ramon Your Insured: Kenneth George Boomer, Contra Costa County Sheriff Your Claim Number: E 793506 Gentlemen: Our investigation indicates that your insured is responsible for this accident. We submit our subrogation claim for $ 408.80 plus $ 200.00 deductible which totals $ 608.80. To substantiate our loss, supporting papers are enclosed. If you have any questions, please contact this office at 800-662-0705. Sincerely, EaMoran ta, Claims Representative United Services Automobile Association—Bay Area Office(Auto Claims) 000064 20863 Stevens Creek Blvd. Bldg.B-4 Cupertino CA 95014-2195 Telephone: (408) 446-4707 AFFIDAVIT OF PAYMENT BY USAA I certify that I have examined the claim file of the below referenced insured and that a payment draft was issued as follows: USAA Member (Policyholder): d6t"('� —o)' Member Number: 12 S-09'5o'21--, Claim Number: Date of Loss: —//6 Payee: Applicable Coverage: // LJ �0 ©""��`'� Draft Number: LDDF/6 i7k Draft Date: Amount of Draft: Yai-' Lf-0 Bank: I THE STATE OF COUNTY OF Before me the undersigned authority on this day personally appeared known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that _he executed the same for the purpose therein expressed. My commission expires on the day of 119— . Notary Public County, . 716 REV.6.79 000065 137-4380 Board Action CLAIM March 27 , 1984 BOARD Cf+ SOPMTSORS CF QN1'RA C09TA COmmy CALIPC MA Claim Against the County, or District ) RMC8 TO CLRIN Jtd1' governed by the Board of Supervisors, ) The copys t ma ed to you is your Routing Endorsements# and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph ID, below). to California Dovernnent Codes ) given pursuant to Government Code Section 913 and 915.4. Please no�e all 'Warnings'. Claimant: Wanda Colston ( deceased) , Doris Brennan , aren Benson unty counse, Hilda Reese , George Brennan , Jr . co Attorney: 2448 Hickory Drive , Concord , CA 1984 Trembath , McCabe , Schwartz , Evans & Levy FEB 2 2 Address: Professional Law Corporation94553 2885 Concord Blvd . , Concord , CA 94519 �a �net. CA Amount: $100 '000 . By delivery to clerk on Date Received: - Feb . 21 , 1984 By mail, postmarked an Feb . 16 , 1984 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Feb. 22 , 1984 Dated: J.R. OLSSON, Clerk, By � Deputy � II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) ( This claim complies substantially with Sections 910 and 910.2. This claim FAIIS 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. 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: r Dated; By: Deputy County Counsel t III. FROM: Clerk of the Board T0: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). I N. BOARD aEM By unanimous vote of 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. I Dated: MAP 2 7 1.9R� J. R. O[SSCI�I, Clerk, By�� c Q�-� ) 1�1�u�a . 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 ofyyour choice in connection with this matter. If you want to consult an attorney, you should do so immediately. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a mem thereof has been filed and endorsed an the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to DATED: MAclaimant. 9 7 994 J. R. C[.SSON, Clerk• By � � • Deputy Clerk cc: County Administrator (1) County Counsel (2) �3® r10 CLAIM V V 4 t 1 STEVEN RIESS TREMBATH, McCABE, SCHWARTZ , EVANS & LEVY 2 Professional Law Corporation 2885 Concord Boulevard 3 Concord, California 94519 Telephone : (415) 687-3450 4 • '• � RL ": '~ VE 5 r- 6 J. r,. c..ssom 7 9P SUPERVISORS =ACO. e .. _oepity 8 9 10 Claim of 11 WANDA COLSTON, deceased, DORIS CLAIM FOR PERSONAL BRENNAN, KAREN BENSON, HILDA INJURIES 12 REESE and GEORGE BRENNAN, JR. (GOVERNMENT CODE §910) 13 vs. 14 CONTRA COSTA HEALTH SERVICES DEPARTMENT 15 / 16 TO THE CONTRA COSTA COUNTY HEALTH SERVICES DEPARTMENT: 17 You are hereby notified that WANDA COLSTON, deceased, DORIS 18 BRENNAN, KAREN BENSON, HILDA REESE and GEORGE BRENNAN, JR. , whose 19 addresses are 2448 Hickory Drive , Concord, California, claim 20 damages from the Contra Costa County Health Services Department 21 in the amount, computed as of the date of presentation of this 22 claim, of $100 ,000 . All correspondence regarding this claim 23 should be directed to the law offices of TREMBATH, McCABE, 24 SCHWARTZ , EVANS & LEVY, Professional Law Corporation, 2885 Concord 25 Boulevard, Concord, California 94519 . 26 This claim is based on personal injuries and wrongful death TREMBATN. MCCABE. SCHWARTZ CNWA9PDRA.PTwZ A EVANB rPOfD OPPOPAOON V o o067 lGI5 CONCORDePD O.'t CAL-1OP--- YAS-O / r r Y �l . I sustained by claimant on or about November 14 , 1983 , at Los 2 Medanos Community Hospital , 2311 Loveridge Road, Pittsburg, 3 California 94565. Claimants assert that the Contra Costa 4 County Health Services Department and its employees improperly 5 and negligently examined and treated the deceased which 6 proximately led to her death on or about November 14 , 1983. 7 The names of the public employees causing claimant' s injuries 8 and death are unknown. 9 The amount claimed, as of the date of presentation of 10 this claim, is computed as follows : 11 Funeral expenses $ 21000 .00 12 Loss of earnings Unknown 13 General damages Unknown 14 TOTAL AMOUNT CLAIMED $100 ,000 .00 15 Dated: February 15, 1984 16 TREMBATH, McCABE, SCHWARTZ , EVANS & LEVY Professional Law Corporation 17 18 By <zo A 4 19 t v ss IrtForneys for Claimants 20 21 22 23 24 25 26 I..O^KE, O. TR[►(o ATN. MCCA8e. �(�s`n` /}�1[}�( SCHWARTZ Q EVANS -2- O V V O V v eR11.6,rO..l .M ........... (O,! CO.ED.o pOVI(v.NO .t CO.CO.O.C.EvO..0 Ml. � y PROOF OF SERVICE BY MAIL- CCP 1013a, 2015.5 1 I declare that: 2 1 am$&cesx:aXxf/employed in)the county of .. . . . .. .ContZ4i. .Co$t4. . . . . . . . . . . . . .. . .. .. . . . .California. ICOUNTT WHERE MAILING OCCURREDI 3 1 am over the age of eighteen years and not a party of the within entitled cause; my (business/i6Se)address is: 4 .. . . . .28851 .Concord..Boulevard,..Conc.rd . .. .. ... . . .. . . 5 On. . . . February. 15., . 19 8.4. . . . . . .. .I served the attached. . . .CLAIM.TQR ,P)ERSWN . , . . . . . iDATEI 6 INJURIES (GOVERNMENT CODE §910) 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . onthe. . . GQuntY. o€. .Contra, ,Costa. . . . . . . . . 8 in said cause, by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid,in the 9 United States mail at . . . . . . . .Concord,. .Cal if ormia. . . . . . . . . . . . . . . . . . . . . . . . . addressed as follows: 10 CLERK OF BOARD OF SUPERVISORS 651 Pine Street 11 Martinez , California 94553 12 13 14 15 16 17 18 19 20 21 22 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct, and that 23 this declaration was executed on 24 February 15 , 1984 . . . ,. , . ,at . . . . . .. . . , . Concord . .. . . . . . .. . . . . . . .California. IDATEI IPLACEI 25 28 Betty J. Leiser j AQA ITTPE OR PRINT NAMEI IG ATURE 000069 BARON PRESS FORM No.23 REV,AUGUST 1061 1 AMENDED CEM Bmm Cir SQpERVIsm CF AN CDBPA C1mm, Q+Lm+OgJI1m 7, t c,F y q' J Claim Against the Cbtnty, os District ) W7PICE 10 CLRDVM governed by the Board of Supervisors, ) The copy of7s tma ed to you is your Routing Endorsements, and Board ) notice of the action taken an your claim by the Action. A11 Section references are ) Board of Supervisors (Paragraph IV, bele+), to California Government Codes ) given pursuant to Government Code Section 913 Claimant: Brenda Gail Nies and 915.4. Please note all 'Warnings'. Attorney: The Scranton Law Firm County Counsel 2255 Contra Costa Blvd . , Suite 301 Address: Pleasant Hill , CA 94523 MAR 0 7 1984 Amount: Unspecified By delivery to clerk on Martinez, CA 94553 Date Received: Ka rch 2 , 1984 By mail, postmarked on March 1 , 1984 I. F'RCM: -clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: March 2 , 1984 J.R. LESSON, Clerk, By Deputy e en arino II. FRIM: County Counsel TO: Clerk of the Board of Supery sons (Check only one) This claim o mplies 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. Clerk should return claim on ground that it was filed late and sena warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD CFM By unanimous vote of Supervisors present ( This claim is rejected in full. ( ) Other: I oert fy that this is a true and correct copy of the Board's Order entered in its minutes for this date. 7 Dated: MAR i'o`n J. R. CESSCN, Clerk, By Z�te� , I )-vLaItt cU, Deputy Clerk MNG (Gov. Code Section 913) Subject,t:o 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. V. FROM: Clerk of the Board 70: (1) Ooumty Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a maw thereof has been filed and endorsed an the Board's oopy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. ,U DATED: MAR 9. 71984 J. R. WSON, Clerk, By Deputy Clerk cc: County Administrator (1) County Counsel (2) .000070 CLAIM -- 1 THE SCRANTON LAW FIRM RECEIVED 2255 Contra Costa Boulevard, Suite 301 2 Pleasant Hill, Ca. 94523 MAR c;F 1984 3 (415) 682-7777 ol.sso" ARD OF..SUPERVISORS +� 4 Attorney for Claimant 5 6 7 8 CLAIM AGAINST A PUBLIC ENTITY 9 in the Matter of the Claim of ) 10 ) 11 BRENDA GAIL NIES, ) AMMENDED CLAIM FOR DAMAGES 12 ) (Govt. Code Section 910 et.seq. 13 ) ) 14 Against the, ) 15 County of Contra Costa ) 16 17 COMES NOW CLAIMANT BRENDA GAIL NEIS, ammends original claim 18 for damages filed February 21, 1984, and incorporates into 19 paragraph #4 of said claim the date of accident, December 8, 1983 20 21 22 23 24 DATED: March 1, 1984 S i a imant or Person 25 A on be alf of Claimant. -Robert H. Price, Esq. 26 27 28 000071 PROOF OF SERVICE BY MAIL (C.C.P. 1013a, 2015.5) STATE OF CALIFORNIA COUNTY OF CONTRA COSTA I am a citizen of the United States and a resident of the county of Contra Costa. I am over the age of eighteen years and not a party to the within above entitled action. My business address is 2255 Contra Costa Boulevard, Suite 301, Pleasant Hill, CA 94523. On March 1, 1984 I served the within AMENDED CLAIM FOR DAMAGES on the parties in said action, by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, in the United States mail at Pleasant Hill, CA, addressed as follows: Clerk of the Board of Supervisors Contra Costa County 651 Pipe Street Martinez , CA 94553 1 ISANDRA LEWIS , certify (or declare) under penalty of perjury that the foregoing is true and correct. - Executed on March 1, 1984, at Pleasant Hill, CA. 0000'72 Scranton Law Firm 2255 Contra Costa Boulevard, Suite 301 Pleasant Hill,California 94523 (415) 682-7777 March 1, 1984 Clerk of the Board of Supervisors `f Contra Costa County 651 Pine Street Martinez , CA 94553 Case Title : NIES v COUNTY OF CONTRA COSTA Action No. : N/A Gentlemen : we have enclosed the following documents : AMENDED CLAIM FOR DAMAGES Please issue the Summons and File the Complaint ( ) Please file the enclosed NXX4 .. Please have the Judge sign ( ) Enclosed is our check for $ ( ) Additional remarks : Please return endorsed copies to us in the envelope provided. Ve`rtr 1 yours, MICHAEL C. SCRANTON MCS/RHP/sl encl 0000' 3 Michael C. Scranton, A Professional Corporation APPLJCATION TO FILE LATE CLAIM Y • BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFO_rVM BOARD ACTION Application to File Late ) NOTE TO APPLICANT March 27 , 1984 Claim Against the County, ) The copy of this document mai ed to you is your Routing Endorsements, and ) notice of the action taken on your application by Board Action. (All Section ) the Board of Supervisors (paragraph III, below) , references are to California ) given pursuant to Government Code Sections 911.8 Government Code.) ) and 915.4. Please note the "Warning" below. County Counsel Claimant: Susan & Edwin Hodges FEB 2 4 1984 Attorney: Anne T . Harvey (Lawless & Harvey) Four Embarcadero Center Maltinez, CA 94553 Address: Thirty-Seventh Floor San Francis-co, California 94111 Amount: $21,2011818. 13 Hand delivered By delivery to Clerk on 2-2244 Date Received: 2-22-84 By mail, postmarked on I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted Applicatio to File late Claim. DATED: 2-22-84 J. R. OLSSON, Clerk, By� . Deputy Kely R. Calhoun II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6) . GC ) The Board should this Application to File a Late Claim (Section 911.6) . 14 DATED: 72- Yy JOHN B. CLAUSEN, County Counsel, By . Deputy III. BOARD ORDER By unanimous vote of Supervisors present (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. DATED: MAR-2 7 IgQJ. R. OLSSON, Clerk, By 1�) , Deputy WARNING (Gov't.C. 5911.8) If you wish to file a court action on this matter, you must first petition the appmpriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation re- quirement) . See Government Code Section 946.6. Such petition must be filed with the court within six (6) months from the date your applica- tion for leave to present a late claim was denied. You may seek the advice of any attorney of your choice in connec- tion 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 Acmunistrator 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 mere thereof has been filed'-and endorsed on the Board's Dopy of this Claim in accordance with Secfion 29703. DATED: MAR 2 7 1984 •J. R. OLSSON, Clerk, By �l�=f��, n � . 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: County Counsel, By County Administrator, By 0000'74 APPLICATION TO FILE LATE CLAIM 1 .ANNE T. HARVEY 2 LAWLESS & HARVEY Four Embarcadero Center ��E I T�D 3 Thirty-Seventh Floor R �/ San Francisco, California 94111 Telephone : (415) 391-7555 � j�^a 44 Attorneys for Claimants 5 J, R. OLSSON .RK BOARD Of SUPERVISORS CO ....De utY 6 7 8 CLAIM OF SUSAN HODGES and ) APPLICATION FOR LEAVE 9 EDWIN HODGES , ) TO PRESENT LATE CLAIM ON BEHALF OF CLAIMANTS 10 vs . ) (Section 911 . 4 of the Government Code) 11 CONTRA COSTA COUNTY ) 12 To the Board of Supervisors of Contra Costa County: 13 1. Application is hereby made pursuant to Government 14 Code §911 . 4 for leave to present a late claim founded on causes 15 of action for wrongful death and personal injury which arise out 16 of the death of claimants ' daughter Kara Hodges on February 23 , 17 1983 . Claimants believe that the cause of action did not accrue 18 until February 7 , 1984 . However , this petition for late claim 19 is being filed because a claim was not presented within the 100 20 days period referred to in Section 911. 2 of the Government Code 21 following the death of their daughter . For additional 22 circumstances relating to the cause of action, reference is made 23 to the proposed claim attached to this application. 24 2 . The failure to present this claim within the 100 25 days period referred to in Section 911. 2 of the Government Code 26t following the death of their daughter was through mistake, 27 inadvertence , surprise and excusable neglect (as claimants were 28 unaware of certain facts regarding causation of their daughter ' s - 1 - 000075 1 death and their damages) and Contra Costa County was riot 2 prejudiced by this failure (as it' was aware of the circumstances i 3 of death) as more particularly shown in the attached declaration 4 of claimant Susan Hodges . 5 3 . This application is being presented within a 6 reasonable time after the accrual of this cause of action , as 7 more particularly shown in the attached declaration of claimant 8 Susan Hodges . j 9 WHEREFORE, it is respectfully requested that this t. 10 application be granted and that the attached proposed claim be 11 received and acted upon in accordance with Sections 912. 4-913 of 12 the Government Code. 13 Dated : February 22, 1984 14 LAWLESS & HARVEY 15 t. 16 by 17 Anne T. Harvey J Attorney for Claimants 18 E 19 Note : The address to which notices relating to this application 20 are to be sent is : �. r 21 Anne T. Harvey 22 Lawless & Harvey Four Embarcadero Center 23 Thirty-Seventh Floor San Francisco, California 94111 24 25 E 26 i . 27 i• r. 28 r. f . - 2 - 0000'76 i 1 ANNE T. HARVEY 2 LAWLESS & HARVEY Four Embarcadero Center 3 Thirty-Seventh Floor San Francisco, California 94111 4 Telephone : (415) 391-7555 5 Attorneys for Claimants 6 7 8 CLAIM OF SUSAN HODGES and ) . DECLARATION OF SUSAN 9 EDWIN HODGES, ) HODGES IN SUPPORT OF APPLICATION FOR LEAVE 10 vs . ) TO PRESENT LATE CLAIM 11 CONTRA COSTA COUNTY ) - i 12 I , Susan Hodges , declare : , 13 1 . I am the mother of Kara Hodges who was born on '.. 14 December 2 , 1982 and the wife of Edwin Hodges , and a claimant in 15 the above matter . 16 2 , On February 23, 1983 , 1 took my daughter Kara Hodges ' 17 to the facility of the Contra Costa County Health Department on 18 School Street in Pittsburg where the staff there administered a 19 DPT immunization and 'oral polio vaccine to her . My daughter 20 died on February 23, 1983 several hours after receiving the 21 immunization. 22 3 . Contra Costa County and its health department were 23 immediately notified of the death and the circumstances 24 surrounding it. Although I was shocked by my daughter 's sudden 25 and unexpected death, I was informed by county employees that 26 her death was not a result of the immunization she had received 27 and that the timing of her death with reference to the 28 immunization was coincidental. The County Coroner was informed F - 1 - 000077 � 1 of circumstances of the .immunization; however , the Coroner ' s 2 Report listed my daughter ' s death-as "Sudden/Unexplained i 3 Death" . Following an autopsy, the Coroner 's Findings dated 4 March 14 , 1983 stated the medical cause of her death to be 5 "Sudden Infant Death Syndrome" . It does not attribute her death 6 to the immunization. A true and correct copy of the Coroner ' s 7 Report and Coroner ' s Findings are attached as an exhibit to this j r 8 declaration . 9 4 . Following the statements made by the County . 10 employees , not until February 1984 did I or my husband have a 11 reason to believe that our daughter 's death resulted from the 12 immunization she received from the County. In February 1984 for 13 the first time it came to our attention that there were facts l 14 and a study which showed a link between the immunization which � 15 our daughter received and sudden infant death . We first became f 16 aware of this after we were informed of a television news t 17 broadcast that had appeared on February 6, 1984 on KPIX. r. 18 Neither my husband nor I are physicians or have had medical 19 training . On January 18 , 1984 , my daughter ' s former 20 pediatrician had informed .me for the first time that any future 21 children of ours should not be given the immunization which our ) t 22 daughter Kara had received . However , he did not tell me it had 23 caused her death or that he attributed our daughter ' s death to f 24 it. Prior to February 7 , 1984 we did not have a basis for i 25 suspecting or for a belief that the immunization had 'caused F 26 injury or death to our daughter . 27 5. I was present prior to and at the time when the i 28 immunization was administered to my daughter . Based on the r r - 2 - 000078 1 information provided to me by the County, I did not realize what 2 E would happen to my daughter . I was present with my daughter 3 later , and had her taken to the hospital where she died on 4 February 23 , 1983. 5 6 . Less than one month following my daughter ' s death , 6 my husband and I were informed that her death was a result of 7 "Sudden Infant Death Syndrome" (see Coroner 's Findings) . On 8 several occasions after my daughter 's death , a Contra Costa r 9 County social worker came to my home and spoke to me . Less than 10 two months after my daughter 's death , she informed me that it 11 was coincidental that my daughter died after the immunization 12 and that it did not result from the immunization. We did not i 13 have a reason to doubt the truth of the statements made to me . 14 7 . At no time prior to my daughter ' s immunization or 15 subsequently until February 7 , 1984 were we informed or became 16 aware that the immunization was even possibly linked to a 17 condition sometimes referred to as sudden infant death syndrome. 18 8. I have personal knowledge of the facts contained in { 19 this declaration. 20 , I declare under penalty of perjury under the laws of the j 21 State of California that the above and foregoing is true and 22 correct and this declaration is executed on February 22, 1984 , i 23 at San Francisco, California. 24 25 ` 26 27 Susan Hodges 61 28 0000'79 3 - �. CONTRA COSTA COUNTY OFFICE OF SPERIFF -CORONER CASE NUMBER _ CR 83-135 - CLASSIFICATION AREA BEAT SHIFT DAY DATC A TIME REPORTED: 1 CORONERS REPORT * * * WED 2-23-83 2020 hours AME OF DECEASEO- FIRST NAME MIDDLE NAME LAST NAME: DATE A HOUR OF DEATH: KARA ELil ARFTH DGES 2-23-83 1831 hours AKA - SCR RACE HT. WT. HAIR EYES BUILD �OA-2- AGE — UNDER I YEAR UNDER ]A-OURS 9 L MOS. DA S HOURS MINUTES F CAU 241' 6850 Brn Blu Med 82 * 2 2� _ SOCIAL SECURITY NUMBER OTHER I.D. IMARKS-SCARS-TATS-URry ERS LICENSE NUMBER- ETC. REASON FOR BEING CORONER CASE — n/a n/a Sudden/Unexplained death BIRTHPLACE ICITY J STATE I: CITIZEN LAST OCCUPATION LAST CMPLOYER INAME-ADDRESS,TELEPHONE: Walnut Creek Ca. Yes NA USUAL RESIDENCE ICITY-COUNTY-STATEI: - CITY LIMITS! 4360 San Ilii uel Circle Pittsburg, Contra Costa County, CA Yes PLACE OF DEATH INANE HOSPITAL OR INSTITUTION A ADDRESS-IF OTHER LOCATION GIVE ADDRESS) CITY LIMITS I Los Iledanos Hospital E.R. Yes PERSON -NO DISCOVERED DECEASED INAME,ADDRESS,CITY,COUNTY,STATE-BUSINESS A RCSIDENCE TELEP-ONE): Dr. Jessup, Los Medanos Hospital E.R. PERSON REPORTING DEATH (NAME,ADDRESS,CITY,COUNTY,STATE-BUSINESS A RESIDENCE TELCPHONEI: Officer Ringgenberg, Pittsburg Police Department PLACE OF INJURY(ADDRESS OR DESCRIBE LOCATION) DISTANCE FROM RES.101LESP DATE-TIME OF INJURY AT WORK INJURY n/a INFO TYPE OF PREMISES OR LOCATION: HOW INJURY OCCURRED: REGULAR PHYSICIAN INAME-ADOR ESS-TELEPHONE I: 934-7337 DATE LAST VISIT: NATURE OF ILLNESS: MEDICAL Dr. Morgan, 1822 San Miguel Dr._ W.C. , CA well baby check , HISTORY TREATMENT A MEDICATION ILIST PRESCRIPTION NUMBERS): NAME,ADDRESS A TELEPHONE OF NEXT OF KIN IN ORDER OF SURVIVAL: RELATION TO DECEASED: I NEXT Susan Hodges-, S.A.D. 427-1245 Mother OF KIN NAME OF PERSON MAKING NOTIFICATION AGENCY NOW I LD&T;E6 TIME: Dr. Jessup hospital personD BODY REMOVED TO: REQUESTED BY/ORDERED BY: RELATIONSHIP: Central Morgue C. Mould Deputy Coroner DECEASED IDENTIFIED BY INAME-ADDRESS): RELATIONSHIP: LOCATION-DATE_TIME: NOK Mother POD/TOD one lavendar colored juniper, one white undershirt one pair white booties, one soiled PROPERTY AND - .paper diaper. CLOTHING INVENTORY BY: INVENTORY WITNESSED BY: C Mould I I OTHER INVESTIGATIVE AGENCY (NAME): ASSIGNED OFFICERS 6 NUMBERS: CASE FILE NUMBER: PittsburgPolice Department Officer Ringgenberg C83-0924 HOUSE ROOM VEHICLE CONDITION CORONERS SEAL n/a n/a n/a n/a VEHICLE IMAKE-MODEL-YEAR-LICENSE NUMBERI TOWED TO: ORDERED BY: n/a n/a 000080 COR -6 :. . .A .�.. N TY C7•r i._E OF :HERIFF-CORONER SUPPLEMLK T AL Ok.CONTINUATION REPORT L A,SSI FIC ATION DATE OF ORIGINAL REPORT CASE FILE 2-23-83 CR 83-135 NAME OF DECEASED PLACE OF DEATH DATE OF SUPPLEMENT HODGES, KARA E. Los Hedanos Hospital 2-23-83 WITNESSES: (NAME. ADDRESS. RESIOENGE AND'SUSINESS TELEPHONE) 2. I. t. S• This case deals with the sudden, unexplained, death of a 22 month old White female infant. I was initially contacted by Officer Ringgenberg of the Pittsburg Police Department. Officer Ringgenberg advised me that the D had been found unresponsive by the NOK when she went in to check on her while she was taking a nap. He advised me that the NOK apparently then picked the child up, took her next door to a neighbor' s house and police and ambulance were summoned from that location. He advised me that the D was then transported to the hospital , Code Blue, with CPR in progress. Officer Ringgenberg next advised me that the NOK had indicated that the D had no childhood illnesses, however, earlier this date had been taken to the Pittsburg Health Clinic for a Diphtheria shot and a polio vaccine (oral vaccine) , He further advised me that at that time one of the personnel at the clinic had noted that the child had a slight runny nose. Officer Ringgenberg next advised me that the D had ••• been seen by Dr. Plorgan approximately one month ago for a well baby check and was due for a 2nd folio).;-up visit within the next week. I then went to Los Medanos Hospital and after arriving there obtained copies of the emergency room records. While in the emergency room I again spoke with Officer Ringgenberg who advised me that there was no further information at this time. I then made removal of the D. While still at the hospital I was advised by the E,R, staff that they had attempted to place an I .V. in both the right and left ankles of the D, however, had been unable to. I was advised that both of those injection sites were circled in blue pen to I indicate their locations. They further indicated that there was a third injection i site apparently from the Diphtheria shot earlier this date. N.F. I . i C. Mould CM/jj At 0830hrs, 2-24-83 1 was contacted by Ed HODGES, father of the D. He advised me that the D. had been suffering from a slight cold, but seemed to be almost over it. He also advised me that the D. had been -at the Pittsburg Clinic at approx. 1415 on 2-23-83. • F NFI/C.R.M. 1 I i oa.J081 1 CORONER'S FINDINGS IN THE MATTER OF THE CORONER'S FINDINGS ON THE BODY OF KARA ELIZABETH HODGES Deceased . I, Richard K. Rainey,Sheriff-Coroner of Contra Costa County, certify: That on this date at Contra Costa County, State of California an investigation was made into the death of the above named person; that inquiry was made into the circumstances attending said death, and in what manner, where and when said death occurred; and that findings of said investigation are : Name of Deceased . Kara Elizabeth Hodges 2 mos 21 days Sex Female Age Race. Caucasian Nativity California Date of Death February 23, 1983 Time of death 1831 hmirs Place of Death Los Medanos Hospital , Pittsburg, California Medical Cause of Death , SUDDEN INFANT DEATH SYNDROME Death was caused by Natural causes Medical Examination by David J. Francis M D Identification by Susan Hodges - mother Richard K. Rainey, Sheriff-Coroner Contra Costa County r TY (Govt . C. §27491 . 5) U'Ui82 COR - #11 1 ANNE T. Y.f:RVEY 2 LAWLESS & HARVEY Four Embarcadero .Center 3 Thirty-Seventh Floor San Francisco, California 941.11 4 Telephone : (415) 391-7555 5 Attorneys for Claimants 6 7 8 CLAIM OF SUSAN HODGES and ) CLAIM FOR PERSONAL 9 EDWIN HODGES , ) INJURIES AND WRONGFUL DEATH 10 vs . ) (Government Code Section 910) 11 CONTRA COSTA COUNTY ) 12 To the Board of Supervisors of Contra Costa County : 13 You are hereby notified that claimants Susan Hodges and 14 Edwin Hodges , whose address is 4360 San Miguel Circle , 15 Pittsburg , California claim damages from Contra Costa County.•in 16 the amount of $21 , 201, 818 . 13 computed as follows as of the date 17 of the presentation of this claim. 18 This claim is based on personal injuries sustained 19 following the administration of a DPT immunization and oral . 20 polio vaccine by the Contra Costa County Health Department at 21 its facility and by its staff on School Street in Pittsburg. 22 The immunization and vaccine were administered to Kara Hodges , 23 the daughter of Susan Hodges and Edwin Hodges on February 23, 24 1983, who was at the time 2 months and 21 days old . The mother , 25 Susan Hodges , oras g permitted , present at and witnessed the • Ft 26 immunization and vaccination; the mother was also present prior 27 to and at the time of the death of Kara Hodges. The minor child 28 Kara Hodges died on February 23 , 1983 following administration l - G o 0083 1 of the immunization .-nd vaccination . Prior to the administra- 2 tion of the vaccine and immunization, Kara .Hodges had been in 3 good health and she sustained no traumatic event following the 4 immunization. It is believed that the immunization and 5 vaccination administered by the Contra Costa County Health 6 Department caused the. death of Fara Hodces . 7 The Contra Costa County Health Department and its 8 employees administered the vaccine and immunization which caused 9 the death of the minor child and damage to claimants. Also, 10 they failed to fully and adequately warn claimants , and in 11 particular , the mother , Susan Hodges , of the possible effects 12 and adverse reactions to the medication ; they failed to obtain 13 the mother ' s informed consent ; they failed to fully advise-.. 14 claimants regarding the. sions and symptoms to be noted in 15 determining the existence of an adverse reaction ; they failed to 16 take adequate precautions to determine whether in fact Kara 17 Hodges should be administered the vaccine and immunization; they 18 overpromoted the immunization and vaccination as safe for 19 children of Kara Hodges ' age ; they failed to provide sufficient 20 warning as to those persons to whom such immunization and 21 vaccination was contraindicated ; they committed battery on Kara 22 Hodges in administering the immunization ; they acted negligently 23 in administering the immunization to Kara Hodges . 24 The name (s) of the public employees causing the injuries 25 to the claimants and to the decedent are unknown to the Fa 26 claimants . 27 Claimants became aware of a possible causal link between 28 the immunization administered by the County and their daughter ' s _ 2 _ 000084 . .- 1 death on February 7 , 19`' 4 . 0n that date they wr—re informed of a 2 TV broadcast the previous day regarding a study which showed a 3 link between the type of immunization received by their daughter 4 and sudden infant death . Prior to that time they had been 5 informed by county employees , including the County Coroner and a 6 social worker , that her (4-path ;;as not the result of the 7 immunization and that the timing of her death was coincidental 8 to the immunization. At no time prior to their daughter ' s 9 immunization or subseaently until February 7 , 1484 were 10 claimants informed or aware that the immunization was even 11 possibly linked to a condition sometimes referred to as sudden 12 infant death syndrome . It is believed that the cause of action .13 did not accrue prior to February 7 , 1984 . 14 The injuries sustained by claimants , as far as known as 15 of the date of presentation of this claim, consist of the death 16 of their daughter Kara Hodges , including but not limited to loss 17 of her care , comfort , society and affection and loss of .18 earnings . Also medical expenses of her treatment prior to death 19 and burial expenses . Also claimed are damages for emotional 20 distress , pain • and mental suffering for the mother , claimant 21 Susan Hodges , who was present at and witnessed the injury to her 22 daughter and her death . 23 The amount claimed as of the date of presentation of 24 this claim is computed as follows : 25 a . Wrongful Death tt 26 Loss of earnings (estimated) . . . . . . . . $1 ,200 ,000.. 00 27 Loss of society and affection. . . . . . . 10 ,000 ,000 . 00 . 28 3 - 1 Bair ial ex.n,•ns<s 2 Pittsburg Funeral Chanel 333 . 13 3 Holy Cross Cemetery 4 Marker . . . . . . . . . . . . . . . . 225 . 00 5 Plot . . . . . . . . . . . . . . . 194 . 00 6 Flowers 50 . 00 802 . 13 7 b. N,edical expenses on February 8 23 , 1983 for Kara Hodges 9 East Contra Costa 10 Ambulance 216 . 00 11 Los Medanos Hospital 12 (approximate) . . . . . . . . . 800 . 00 1 ,016 . 00 13 c. General damaoes for injury to 14 Susan Hodges (estimated) . . . . . . . . . . . . 101000 , 000 . 00 15 Total amount claimed as of date of 16 presentation of claim is . . . . . . . . . . . . . . $21 , 201 , 818 . 13 17 Claimants reserve the right to amend the amounts _ 18 estimated above in accordance with proof. 19 All notices or other communications with regard to this 20 claim should be to claimants in care of their attorney as 21 follows : 22 Anne T. Harvey 23 Lawless & Harvey Four Embarcadero Center 24 Thirty-Seventh Floor San Francisco, California 94111 25 Dated: February 22 , 1984 LAWLESS & HARVEY 26 27 by ( � 28 Anne T. Harvey Attorney for Claimants - 4 000086