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HomeMy WebLinkAboutMINUTES - 05021989 - 1.2 (2) AMENDED CLAIM /r �. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA 111 �,�aim Against the County, o,pftistrict governed by) BOARD ACTION the Board of Supervisors,,4uting Endorsements, ) NOTICE TO CLAIMANT 4ay.'.2 , 198 9 and Board Action, All Section references are to ) The copy of this document mailed to you"is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: JOHN M. STIGLICH County CourlsEl c/o Willard E. Stone APR' 71989 ATTORNEY: Attorney At Law 1211 Newell Ave. #124 Date receivedNia � Z CA 94553 ADDRESS: Walnut Creek, CA 94596 BY DELIVERY TO CLERK ON April l , Vfz hand .del, BY MAIL POSTMARKED: n0 envelope 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: April 17 , 1939_ gy: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: G�' ��g BY: Deputy County Counsel 7� III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full, (/ \) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: MAY 2 198 p�' PHIL BATCHELOR, Clerk, By. eputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6, You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately, AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. MAY 5 1989 1 ee� Ze Dated: BY: PHIL BATCHELOR by ����"bty Clerk CC: County Counsel County Administrator Amended Claim By: JOHN M. STIGLICH Against the County of Contra Costa , Contra Costa Health Plan , Walter Zaks , M.D . , Merrithew Memorial Hospital and other unknown medical health providers. The following claim is presented on behalf of the Claimant pursuant to the provisions of Government Code §910 and in support of said claim represents as follows: a. The name and post office address of the Claimant is JOHN M. STIGLICH, 2011 Pine Street, Martinez , California 94553 . b . The Post Office address to which the person presenting the claim desires notices to be sent is as follows : WILLARD E. STONE, Attorney at Law, 1211 Newell Avenue Suite 124, Walnut Creek, California 94596. c. The date, place and other circumstances of the occurance or transactions which gave rise to the claim asserted are as follows: On December 28 , 1988 , Claimant was advised by Jean B . deRernion , M . D . Professor of Surgery/Urology, Chief , Division of Urology, U.C.L.A . School of Medicine that a urinary problem which he had had for several years was due to bladder neck hypertrophy. This condition had been earlier diagnosed by Dr . Walter Zaks of the C .C .H .P . Urology Clinic as a stress syndrome and the Claimant was prescribed Valium and no other treatment or F R EVE'l%Y E P APR, 14 1999 J?� PH! AT, ELOR CLEC cc 6O QR iSOr? T 1 — . �Qy_.. C. a.ty care was provided until July of 1988, when the Claimant was referred by the Contra Costa County Health Services to Gregory G . Fouts , M.D . who performed a transurethral resection of the bladder neck which alleviated Claimants uriniary problem and discomfort. d . A general description of the indebtedness , obligation , injury, damage or loss incurred so far as it may be known at the time of presentation of the claim is as follows : As a result of the failure of the Contra Costa Health Plan, Merithew Memorial Hospital , Dr . Zaks and other medical practitioners , to properly diagnose and treat Claimants urinary problem, he suffered bodily injury, mental suffering and emotional distress caused from urinary hesitancy, difficulty of emptying, feeling of incomplete voiding, nocturia and other urinary problems. e . The name or names of the public employee or employees causing the injury, damage or loss presently known to the Claimant are as follows: County of Contra Costa , Contra Costa Health Plan , Contra Costa Health Services , Merithew Memorial Hospital, and Walter Zaks, M.D. f . The amount claimed as of the date of presentation of the claim , would rest within the jurisdiction of the Superior Court. g . Claimant attaches hereto and incorporates herein by reference a copy of the original claim filed with the Clerk of the Board of Supervisors on March 31 , 1989. -2- Dated: April 14 , 1989 WILLARD E. STONE, Attorney for Claimant JOHN M. STIGLICH -3- WILLARD E. STONE ATTORNEY AND COUNSELOR AT LAW ! SUITE 124,-1211 NEWELL AVENUE WALNUT CREEK, CALIFORNIA 94596 r : TELEPHONE (415) 935-1711 i ' March 31 1989 1f1!'R 311989 't IELOR P E3A�F.SU E Clerk of the Board of Supervisors CL:: AF { County of Contra Costa �_„�.-----=- 651 Pine Street. Martinez , CA. 94553 Re: John M. Stiglich IF Gentlemen: I have been retained by Mr . John M.; Stiglich to represent him in connection with a claim which he asserts . against the Contra Costa Health Plan and other named respondents pursuant to the Arbitration procedure set forth ! in the Health Plan Service Agreement (No.27-019) . The mature of the claim is as follows:. In June 1987 , claimant was seen at the CCHP. Urology Clinic by Dr. Zaks concerning a urinaryproblem which he had experienced for several years and which had originally been treated at the Martinez facility of Kaiser Permanente Hospital . Mr . Stiglich informed Dr . Zak's that he had symptoms of urinary hesitancy, difficulty emptying, feeling of incomplete voiding, nocturia and hesitancy. He was diagnosed 'at that' time as suffering from a stress syndrome and given Valium., On April 19 , 1988 , he was examined by Jean B. deKernion , M.D . Professor of Surgery/Urology,' 'Chief, . Division of Urology, U.C.L.A. School of Medicine and Shlomo Raz, M.D(. also of the division of Urology at U.C.,L.A. School of Medicine. Based on their findings it was determined that Mr . Stiglich was suffering from intermittent urinary stream with incomplete bladder emptying and significant post void residuals . The symptoms were attributed to bladder neck hypertrophy. Based on these findings which were confirmed by Gregory G. Fouts , M.D. the physician to whom Mr . Stiglich had been referred by the Contra Costa County Health Services, surgery was performed and a transurethral resection of the bladder neck was performed. f1 r 6 I Clerk of tPe Board of Supervisors March 31 , 1989 Page 2 As a result of the failure of the Contra Costa Health. Plan , 'Dr. Zaks and other medical practitioners, Mr.. Stiglich has suffered bodily injury, mental suffering and emotional distress resulting in monetary damages exceeding the juris- dictional limit of the Small Claims Court and therefore asserts a claim against the following: a County of Contra Costa'. b. Contra Costa Health Plan. cr' Dr. Zaks . d. Other physicians and medical health providers, the true names and capacities of such persons are unknown to the claimant at this time. e: Merrithew Memorial Hospital . Pursuant to the provisions of the Health Plan Service Agreement, ,?the Claimant demands the matter ,be set for. Arbitration. The address designated by the Claimant for service of notices and other papers is .as follows: Willard E. Stone, Esq. , as attorney for John M. Stiglich, 1211: Newell Avenue, Suite 124, Walnut Creek, California 94596 . Ver ly ours, W L D S ONE WES:es ccs Mr . Stiglich Hand Delivered i i i C a a. CLAIM BOARD OF'SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Ltlaim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 2, 1989 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please d�b�ll�11�Y"Q�nLj� '( CLAIMANT: JOHN M. STIGLICH , ,9$� c/o Willard E. Stone APIR, ` -ATTORNEY: 1211 Newell Avenue #124 Martinez, CA 94553 Walnut Creek, CA 94596 Date received ADDRESS: BY DELIVERY TO CLERK ON March. 31, 1989 hand del . BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. A ril 4 1989 PPHHIL BATCHELOR, Clerk DATED: P , BY: Deputy4��; . "�/� L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: y c7 `�, B Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of, the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: John M. iglich c/o Willar V Stone 1211 Newell AVenue #124 Walnut Creek, CA'94596 Re: Claim of JOHN M. STIGLICH Please Take Notice As Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910. 2, or is otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. X 3 . The claim fails to state the circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name(s) of the public employee(s ) causing the injury, damage, or loss, if known. X 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000) . If the claim totals less than ten thousand dollars ($10,000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf. 7 . Other: VICTOR J. WESTMAN, County Counsel By Deput4&-toilntCouns CERTIFICATE OF SERVICE BY MAIL C.C.P. §§ 1012, 1013a, 2015 .5; Evid. C. §§ 641, 664 My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s) addressed as shown above (which is/are place(s) having delivery service by U.S. Mail) , which envelope(s) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S. Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: � , � '�q , at Martinez, California. T cc: Clerk of the Board of Supervisors (or ginal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 .4, 910 . 8) WILLARD E. STONE ATTORNEY AND COUNSELOR AT LAW SUITE 124, 1211 NEWELL AVENUE WALNUT CREEK, CALIFORNIA 94596 TELEPHONE (415) 935-1711 March 31 , 1989 MAR 31199 MELOR Clerk of the Board of Supervisors Ger P h A�F SU E "(SG«3 County of Contra Costa 651 Pine Street By Martinez , CA. 94553 Re: John M. Stiglich Gentlemen: I have been retained by Mr . John M. Stiglich to represent him in connection with a claim which he asserts against the Contra Costa Health Plan and other named respondents pursuant to the Arbitration procedure set forth in the Health Plan Service Agreement (No.27-019) . The nature of the claim is as follows: In June 1987, claimant was seen at the CCHP Urology Clinic by Dr. Zaks concerning a urinary problem which he had experienced for several years and which had originally been treated at the Martinez facility of Kaiser Permanente Hospital . Mr. Stiglich informed Dr . Zaks that he had symptoms of urinary hesitancy, difficulty emptying, feeling of incomplete voiding, nocturia and hesitancy. He was diagnosed at that time as suffering from a stress syndrome and given Valium. On April 19 , 1988, he was examined by Jean B. deKernion, M.D. Professor of Surgery/Urology, Chief, Division of Urology, U.C.L.A. School of Medicine and Shlomo Raz , M.D. also of the division of Urology at U.C.L.A. School of Medicine. Based on their findings it was determined that Mr . Stiglich was suffering from intermittent urinary stream with incomplete bladder emptying and significant post void residuals . The symptoms were attributed to bladder neck hypertrophy. Based on these findings which were confirmed by Gregory G. Fouts, M.D. the physician to whom Mr . Stiglich had been referred by the Contra Costa County Health Services, surgery was performed and a transurethral resection of the bladder neck was performed. Clerk of the Board of Supervisors March 31 , 1989 Page 2 As a result of the failure of the Contra Costa Health Plan, Dr. Zaks and other medical practitioners, Mr . Stiglich has suffered bodily injury, mental suffering and emotional distress resulting in monetary damages exceeding the juris- dictional limit of the Small Claims Court and therefore asserts a claim against the following: a. County of Contra Costa. b. Contra Costa Health Plan. c. Dr . Zaks . d. Other physicians and medical health providers, the true names and capacities of such persons are unknown to the claimant at this time. e. Merrithew Memorial Hospital. Pursuant to the provisions of the Health Plan Service Agreement, the Claimant demands the matter be set for Arbitration. The address designated by the Claimant for service of notices and other papers is as follows: Willard E. Stone, Esq. , as attorney for John M. Stiglich, 1211 Newell Avenue, Suite 124, Walnut Creek, California 94596. VWLD*S s, WE WES:es cc: Mr. Stiglich Hand Delivered 4 , - � CLAIM r T, 'BCrARD OF'SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 2, 1989 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $1, 050 . 00 Section 913 and 915.4. Please note all "Warnings". County Counsel CLAIMANT: BOOKER HALL 1538 3rd Street _ APR, 11989 ATTORNEY: Richmond, CA 94801 Date received )Martinez, CA :4553 ADDRESS: BY DELIVERY TO CLERK ON April 3 , 1989 BY MAIL POSTMARKED: March 29 , 1989 1. FROM: Clerk of the Board of Supervisors 70: County Counsel Attached is a copy of the above-noted claim. April 4, 1989 PPgjL ATCHELOR, Clerk DATED: p BY: Deputy I c L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 4IC�lx� BY:'25�z Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV, BOARD ORDER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. (/�) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. - Y 2 Dated: MAY 1989 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: MAY 5 959 BY: PHIL BATCHELOR by y Clerk CC: County Counsel County Administrator ^LAXY�i TCS• BOARD OF SUPERVISORS OF CONTRA CO�TtA 1 e ur i application to; Instructions to Claimant Clerk of the Board • P.O.Box 911 A. Claims relating to causes of action for death or tarn in3ury��t`o't533 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; ^ff .ce in R'10om 105 , CDunty ._Administratdon Building.651 Pine Stzeet, Martinez , California 94553.- C. 4553:C. If claim is against a district governed by the Board of Supervisors , rather than the County, the n.ame 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 pi,,:!-)lic entity. .- E. ntity. -E. Fraud. See penalty for fraueulent claims , Penal Code Sec. 72 at end of this form. RE: Claim by ) ReservV stamps Against the COUNTY OF CONTRA COSTA) APR ©3 1989 T T T a (Fil.i in name) B . The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ , 1,�_ ,Uc� ' and in_support of this claim represents as follows_ 5 - - OA 1. When did the damage or injury occur? (Give exact date and hour) _Muniu.Ez 2. Where 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) 4 What particular act or omission on the part of co;n-ty o district officers , servants or employees caused the injury or damage? (over) J '.:5..: :•f zat; ar.e..the,.names of county or district officers, servants or J employees::causing the damage or injury? ------ aA_. t���-. __ Y� _ __ was ._"9 __� vs�_ d ._SCAT_, 6. What damage or inj ri do you claim resulted? (Give full extent~ of injuries or damages claimed. Attach two estimates for auto damage) -------------- ? . 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. P _._---------------------------------•-------------------------------------- :� . List the expenditures you made on account, of this accident or in DATE I'T'EM AMOUNT Govt. Code Sec. 910 .2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some oerson on his behalf. " Name and Address of 'Attorney i -� „ - Claimant' s Sign ture Address Telephone No. Telephone No.(.ygS) 23 5 Z80 -,� NOTICE Section 72 of the Penal Code provides: "Every person who, with intert, to defraud, presentz 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. " i (Due*, MY, u �i �U is �s. �1t wL $A - kfaP-v U4 -'l.v� � ell A l w�l 4,t uue la - 5r�,r _ PID-L - .� � �5. a ,n s 1n� �" ccs t ?"Scwwok u ujvSw L�—auAz% PC- -",L, . _I "C�'& � . SGA Yv� - &L tv r GAS► m- w� t � s ..�r-3 .o-