1 UBALDI & McPHERSON LLP

Michael V Ubaldi, Esq , SBN 072986

2 Dennis P McPherson, Esq , SBN 128879
455 University Avenue, Suite 360
3 Sacramento, CA 95825
Telephone (916)265-4555
4 Facsimile (916)265-4568

5 Attorneys for Defendant CATHOLIC

HEALTHCARE WEST MEDICAL FOUNDATION
6
7
8 SUPERIOR COURT OF CALIFORNIA
9 COUNTY OF SACRAMENTO

10
11 DAVID SCHUMACHER, Case No 34-2009-00033548

12 Plaintiff, DECLARATION OF DENNIS P.

McPHERSON IN SUPPORT OF
13 vs DEFENDANT CATHOLIC
HEALTHCARE WEST MEDICAL
14 TAN PHAM, M.D , CATHOLIC HEALTHCARE FOUNDATION'S MOTION FOR
WEST MEDICAL FOUNDATION, MERCY SUMMARY JUDGMENT, OR IN
15 MEDICAL GROUP, YOUTHOLOGY, ALCHEMY THE ALTERNATIVE, SUMMARY
WORLDWIDE, LLC, JEFFREY GUNTER ADJUDICATION
16
Defendants
17 / DATE: 11/2/10
TIME: 2:00 p.m.
18 AND RELATED CROSS-ACTION DEPT: 53
19
Date Action Filed: 2/3/09
20 Trial Date: Not Set
21
22 I, DENNIS P McPHERSON, declare as follows'
23 1 I am an attorney at law, duly licensed to practice before all the courts in the
24 State of California, and am a partner in the firm Ubaldi & McPherson, LLP, attorneys of
Ubaldi &
McPherson 25 record for Defendant CATHOLIC HEALTHCARE WEST MEDICAL FOUNDATION. I have
LLP
26 personal knowledge ofthe matters contained in this declaration, and if called to testify as

1-
Declaration of Dennis P McPherson, Action No 34-2009-00033548
 1 to such matters, I could and would competently do so

2 2 Attached as Exhibit "A" is a true and correct copy of Plaintiff's complaint filed

3 in February of 2009

4 3 Defendant Gunter was dismissed from the case Defendant Youthology

5 recently entered into a settlement with Plaintiff

6 4 Attached as Exhibit "B" are true and correct copies of Plaintiff David

7 Schumacher's medical records from his February 2008 appointments with Dr Tan Pham

8 5 Attached as Exhibit "C" are true and correct copies of Plaintiff David

9 Schumacher's medical records from Mercy General Hospital

10 6 Attached as Exhibit "D" is the expert declaration of Paul William Rork, M.D ,

11 in support of Defendant CATHOLIC HEALTHCARE WEST MEDICAL FOUNDATION'S

12 motion for summary judgment, or in the alternative, summary adjudication

13 7 Attached as Exhibit "E" is the expert declaration of Patnck Joseph, M D , in

14 support of Defendant CATHOLIC HEALTHCARE WEST MEDICAL FOUNDATION'S

15 motion for summary judgment, or in the alternative, summary adjudication

16 I declare under penalty of perjury that the foregoing is true and correct and that I
17 executed this declaration on the Day of August, 2010, at Sacramento, California
18
19 PUM/^^
Dennis P McPherson
20
21
22
23
24
Ubaldi &
McPherson 25
LLP
26

-2-
Declaration of Dennis P McPherson, Action No 34-2009-00033548
 1 Schumacher v Pham, I^AD , e t a l
Sacramento County Supenor Court Case No 34-2009-00033548
2
3 PROOF OF SERVICE

4 I am a citizen of the United States, over the age of 18 years, and not a party to or
interested in the within entitled cause I am an employee of Ubaldi & McPherson LLP, and my
5 business address is 455 University Avenue, Suite 360, Sacramento, CA 95825 On this date, I
served the following document DECLARATION OF DENNIS P. McPHERSON IN
6 SUPPORT OF DEFENDANT CATHOLIC HEALTHCARE WEST MEDICAL
FOUNDATION'S MOTION FOR SUMMARY JUDGMENT, OR IN THE ALTERNATIVE,
7 SUMMARY ADJUDICATION

8 by placing a true copy thereof enclosed in a sealed envelope with postage thereon
fully prepaid, in the United States Post Office mail at Sacramento, California,
9 addressed as set forth below

10 XXX by personally dehvenng, or causing to be delivered, a true copy thereof to the

person and at the address set forth below
11
XXX by causing a true copy thereof to be delivered to the party or parties at the
12 address(es) listed below, by and/or through the services of FACSIMILE

13 Attornevs for Plaintiffs: Counsel for Tan Pham. M.D. and Mercv
Robert Heintz, Esq Medical Group
14 6121 Oak Avenue Dominique A Pollara, Esq
Carmichael, CA 95608 Kat Todd-Schwartz, Esq
15 Phone (916)486-1147 SCHUERING ZIMMERMAN SCULLY
Hand Delivery TWEEDY & DOYLE
16 400 University Avenue
Sacramento, CA 95825
17 Counsel for Youtholoqy Phone (916)567-0400
lan Stewart, Esq Fax (916)568-0400
18 Gregory Lee, Esq Hand Delivery
WILSON ELSER MOSKOWITZ EDELMAN &
19 DICKER
555 South Flower Street, Suite 2900
20 Los Angeles, CA 90071
Phone (213)443-5100
21 Fax (213)443-5101
Via Facsimile
22
23 I am familiar with the business practice of UBALDI & McPHERSON LLP with regard to
collection and processing of documents for mailing with the United States Postal Service The
24 documents descnbed above were sealed and placed for collection and mailing on the date stated
Ubaldi & below Pursuant to said business practices, documents were deposited with the United States
McPherson 25 Postal Service in Sacramento, California, that same day in the ordinary course of business I
LLP certify by the act of filing or service that the onginai document was produced on paper purchased
26 as recycled

Proof of Service, Action No 34-2009-0003548

 1 I declare under penalty of perjury that the foregoing is true and correct and that this
declaration was executed at Sacramento, California on August 18, 2010
2

4
f / JenfiifdrN Ubaldi ^'-^
5

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24
Ubaldi &
McPherson 25
LLP
26

Proof of Service, Action No 34-2009-0003548

EXHIBITA
 PLD^WOI
ArrORNEV OR PARTY IMTHOUT A n O R N E Y f N m Sntt Bmnuni6ef I U Idllmsl rawcawrruwoM.r
"" ROBERT HEFNTZ 152277
6121 OAK AVE CARMICHAEL CA. 95608

TEUPHOWNO 916 486-1147 FAXNO tOfHonlt

EJKAIL AOORESS ( O f M n l )

ATTORNEY FOR f«»ll»> PLAIhfTIFF

SUPERIOR COURT OF CAUFORNIA, COUNTY OF
STREET At»ftEss 720 N I N T H STREET
MAIUNO AOORESS
OCT 1 3 2009
CITY ANOflpC006 SACRAMENTO C A, 95 814
BRANCHNAME SACRAMENTO SUPERJOR COURT
PUVINTIFF DAVID SCHUMACHER
3eo»W Cioik
TAN PHAM, M.D. CATHOLIC HEALTHCARE
OEFENOANT
WEST MEDICAL FOUNDATION, MERCY
ZZl DOES TO Kxy^EDICAL GROUP, YOUTHOLOGY, JEFFREY
GUMTE
COMPLAINT—Personal Injury, PropMty Damage. Wrongful Deatti
m AMENDED (Num/tef^: ONE
Type Cc/Mc* all that apply):
C Z I MOTOR VEHICLE C Z ] OTHER (spoclt^: PROD, M E D M A L .
I I Property Damage I 1 Wrongful Oeath
m Personai Itijury t I Otfwr Dainages fspec^W:
Jurisdiction (check all that appty): CASE NUMBER Q' ^

I I ACTION IS A UMITED CIVIL CASE

Amount demancled I I does not exceed $10,000 34-2009-00033^48
I I exceeds $10,000, but does not exceed $25,000
r7~l ACTION IS AN UNLIMITED CIVIL CASE (exceeds $26,000)
I I ACTION IS RECLASSIFIED by this amended complaint
I I from limited to unlimited
I I from unnmited to limited
1 Plaintiff Cname o/-namesj D A V I D SCHUMACHER
alleges causes of action against defendant (nama ornames)
ALL
2 This pleading, including attachments and exhibits, consists of thefoltowingnumber of pages 11.
3 Each plaintiff named above is a competent adult
a I I except plaintiff Cnamej
(1) I I a corporation qualified to do business in California
(2) I I an unincorporated entrty (d9scnt>e)
(3) I I a public enbty (descnbe)
(4) I I a minor I I an adult
(a) 1 I for whom a guardian or conservator of the estate or a guardian ad litem has been appointed
(b) I I other (speafy)
(5) I I other (specify)
b I I except plaintiff Cnamej
(1) I I a corporation qualified to do business in California
(2) I 1 an unincorporated entrty (descnbe)
(3) I I a public entity (descnbe)
(4) j I a nrunor I I an adult
(a) I I fer whom a guardian or conservator of the estate or a guanJian ad litem has been appointed
(b) I I other CspeciW
(5) I I other (speafy)

I 1 Infomiation about additional plaintiffs who are not competent adults is shown in Attachment 3
Pogtloli
f o m Aopravwl for Opmnal U M
JwMul Council of C«(ifQm« COMPLAINT-Personal Injury. Property CaaeelCMlPneaaun i * a 1}
wMorcouiMo ca gov
Pt.0-PI4ai [Rsv Jinuarr 1 1007] Damage, Wrongful Death
ARMiKan LegHNa), I n c
•MMf FonRsMtifWtow oofit
 CASE NUMaEA
SHORT TITLE
SCHUMACHER V TAN PHAM M.D. st.al 34-2009-00033548

4 I I Plaintiff fnamej
IS doing busmess under the fictitious name (speafy)

arid has complied with the fictitious business name laws

5 Each defendant named above is a natural person

a I K I except defendant (name)- CHW c C S except defendant (name) YOUTHOLOGY
(1)1 X I a business organization, form unknown (1)1 X I a business organization, form unknown
(2)r ~1 a corporation (2)1 I a corporation
(3)]' I an unincorporated entity (descntse) (3)I, I an unincorporated entity (describe)

(4) I I a public entity (descntie) (4) I I a public entity (descnbe)

( 5 ) • other Cspec//y>- FOUNDATION (5)1 I other (specify)

b I X I except defendant (name) MERCY MED. GROUP. d. tX I except defendant (name)

(1)I y I a business organization, fom\ unknown (1) 1 X I a business organization, form unknown
(2)1 I a corporation (2) 1 I a corporation
(3)1 1 an unincorporated entity (descnbe) (3)1 I an unincorporated entity CdescnbeJ'

(4)1 ,t a public entity (describe) (4)1 I a public entity (describe)-

(5) I I other (speafy) (5)CT] other Cspeo/yj

I I Information about additional defendants who are not natural persons is contained in Complaint—Attachment 5

Tne true names and capacities of defendants sued as Does are unknown to plaintiff

i xl Defendants who are joined pursuant to Code of Civil Procedure section 382 are (names) All
De-endants i r i c i u d i n g DOES a c t e d a s a g e n t s , e m p l o y e e s , s e r v a n t
J o i n t venturers, successors m i n t e r e s t , successor corp-
o r a t i o n , c o - c o n s p i r a t o r , l e s s o r o r e n t i t y w i t h each d e f e n d a n t .
This court IS the proper court because
a I X I at least one defendant now resides m its junsdictional area
b i \ the orincipal place of business ofa defendant corporation or unincorporated association is in its jurisdictional area
c I X I injun/ to person or damage to perscnal property occurred in its jurisdictional area
<i I ! other (specify)

I J Plaintilf ts required to connpl/ with a claims statute, and

a I I plaintiff has complied with applicable claims statutes, or
b I I pl,.'>intiff IS excused from complying because (specify)

u u l | 1 | ( l > . » J,,lv
COIVIPLAINT—Personal Injury, Property O.imago, VVrongful Oeath @EB "'**•
 PLO-PI-001
SHORTTITLE CASENUMBER ^

SCHUMACHER V. TAN PHAM. 34-2009-00033^8

10 The fbllowing causes of action are attached and the statements above apply to each (eadn complaint musf have one or moro
causes of action anached)
a CZD Motor Vehide
b. K l General Negligence
0 I I Intentional Tort
d \yCi Pnxlucis Liability
a r I Premises Liability
f d i Other (speafy)
y-f^^' MEDICAL MALPRACTICE

11 Plaintiff has suffered

a. I "^ I wage loss
b I I loss of use of property
c 1 ^ I hospital artd medical expenses
d. \ / \ \ genetai damage
e I I property damage
f I /'sl loss of eaming capacrty
g I Y\^ other damage (speafy)

FUTURE MEDICAL B I L L S i^'

12 r I The damages daimedforwrongftil death and the rslatKinships of plaintiff to the deceased are
a I I Iisted in Attachment 12
b I I as foltows

13 The relief sought in this complaint is within ttte junsdicbon of this court

14 Plaintiff praysforjudgmentforcosts of suit,forsuch relief as ts fair, just and equitable, and for
a (1) I )^ I compensatory damages
(2) I I puniDve damages
The amount of damages is (in cases for personal injury or wrongful death, you must check (1))
(1) I X.I accoidmgtoproof
(2) I I in the amount of $
15 [_X1 The paragraphs of this complaint alleged on Infomiation and behef are asfoltows(specity paragrafih numbers)

ALL PARAGRAPHS AND CAUSES OF ACTION.

Date SA/^'T-
ROBERT HEINTZ ESQ.
CTYPE OR PRINT NAMei

puvpijjoi (R« jonuBiy 1.2007] COMPLAINT—Poisonal Injury, Proparty ^^'-— \ l ~~ Pm*ior3

Damage. Wrongful Oeath
SHORT TITLE -^ CASE NUMBER

SCHUMCAHER V . CHW

ONE C A U S E O F A C T I O N — G e n e r a l Negligence Page

(number) *" "

ATTACHMENT TO C S Complaint • Cross-Complamt

(Use a separate cause of acbon form for each cause of acbon)

GN-1 Plaintiff Cname; D A V I D SCHUMACHER

alleges that defendant Cnamej YOUTHOLOGY, J E F F R E Y GUNTER

j T ] Does 1 to ^ —

was the legal (proximate) cause of damages to plainbff By the following acts or omissions to act, defendant
negligently caused the damage to plamtff
on Cdafej ON OR ABOUT 2/4/2008
at Cp/aceJ. SACRAMENTO CALIFORNIA

(descnpbon of reasons for liability)

PLAINTIFF WHILE USING DEFENDANTS PRODUCT YOUTHOLOGY, CLINICAL ESSENTIALS,
90 SECOND WRINKLE EYE SERUM CONTRCTED NECROTIZING FASCIITI'S, SEPSIS, AND
PERMENENT DISFIGUREMENT, INTERNAL ORGAN INJURY AND SCARING AROUND
PLAINTIFF'S EYES, AND OTHER INJURIES. DEFENDANTS AND EACH OF THEM
MANUFACTURED OR ASSEMBLED,DESIGNED OR MANUFACTURED COMPONENT PARTS AND/OR
PROCESSES, MARKETED, ADVERTISED, FAILED TO TEST, AND WARRANTED THE
PRODUCT TO BE SAFE FOR PUBLIC USE.
PLAINTIFF USED THE PRODUCT IN THE MANNER INTENDED BY DEFENDANTS AND IN A
MANNER THAT IT WAS NOT READILY APPARENT TO PLAINTIFP WOULD INVOLVE
SUBSTANCIAL DANGER. DEFENDANTS AND EACH OF THEM, WERE RESPONSIBLE FOR THE
SAFETY OF THE PRODUCT. THESE DEFEMDAMTS INCLUDING BUT NOT LIMITED TO
MANAGERS, DESIGNERS, MANUFACTURERS, SUBCONTRACTORS, SUPERVISORS AND
OWNERS OF THE PRODUCT WERE SOLEY RESPONSIBLE FOR THE SAFETY OF THE
PRODUCT SOLD TO THE PUBLIC.

AT THE TIME OF THE ACCIDENT DEFENDANTS AND EACH OF THEM WERE SO CARELESS
AND NEGLIGENT IN [MANUFACTURING, MARKETING, INSTRUCTING ITS USE, DESIGNING
THIS PRODUCT AS TO ALLOW THIS PRODUCT TO BECOME A DANGEROUS
INSTRUMENTALITY.

DEFENDANT AND EACH GF THEM WERE UNDER A DUTY TO INSURE THAT THIS PRODUCT
WAS WARRANTED TO BE SAFE FOR PUPBLIC USE AND WOULD NOT CAUSE BODILY
INJURY TO PLAINTIFF OR OTHERS.

AS A DIRECT AND PROXIMATE CONSEQUENCE/CAUSE OF DEFENDANTS NEGLIGENCE IN

THE MARKETING PRODUCTION, MANUFACTURING, WARRANTING, ASSEMBLY,
ESTING,DESIGNED, OWNERSHIP AND CONTROL OF SAID PRODUCT. PLAINTIFF
SUFFERED SEVERE AND EXTENSIVE PERSONAL INJURIES, EMOTIONAL DISTRESS,
FUTURE MEDICAL EXPENSES, LOST WAGES, IN A SUM TO BE PROVEN AT TRIAL

Pomi Appiovo<j lor Opuonal Use

Judicial Counol ol CaMoma
eifsctne Jonusiiy I 198? l U B l W~ I ^
Rute082i(3> CAUSE OF ACTION—General Negligence VS&L-k^ ccpwsu
 PU)-PMN)1(6)
CASE NUMBER
SHORTTITLE
SCHUMACHER V.TAN PHAM, M.D. 34-2009-00033548

TWO CAUSE OF ACTION—Products Uability Page _

(number)
ATTACHMENTTO CZU Complaint C Z I Cross - Complaint
(Use a separata cause of action foan foroach cause of acbon)
Piamtiff Cnamej DAVID SCHUMACHER

Prod L'l On or about CtfafeJ 2/4/200S plaintiffwas injured by the following product
Y O U T H O L O G Y , C L I N I C A L ESSENTIALS, 90 S E C O N D W R I N K L E E Y E S E R U M .

Prod L-2 Each of the defendants knew the product would be purchased and used without inspectionfordetects
The product was defective when it left the control ofeach defendant The product at the time of intury
was being
I I used in the manner intended by the defendants
I / I used in the manner that was reasonat>ly foreseeable by defendants as involving a substantial danger not
readily apparent Adequate wamings of (he danger were not given
Prod L-3 Plaintiff was a
r 7 ~ l purchaser of the product I / I user of the product
I I bystandertothe use of the product I I other C«)ee»/yj

PLAINTIFFS INJURY WAS THE LEGAL (PROXIMATE) RESULT OF THE FOLLOVVING

Prod L-4 I / I Count One—Stiict liability ofthe foilowing defendants who
a I / I manufactured or assembled the product CnamesJ
Y O U T H O L O G Y , JEFFREY G U N T E R

CZjDoes 1
b I / I designed and manufactured component parts suppliedtothe manufecturer (names)
Y O U T H O L O G Y , JEFFREY G U N T E R

CZ3 Does 5 to i O
c C Z n sold the product to the pubhc CnamesJ
YOUTHOLOGY, JEFFREY GUNTER

E D Does 10 to 15
Prod L-5 CZD Count Two—Negligence of the following defendants who owed a dutytoplaintiff (names)
Y O U T H O L O G Y , JEFFREY G U N T E R
C Z I Does J S to 20
Prod L-6 CZD CountThree—Breach of wananty by the following defendants Cna/nesJ
Y O U T H O L O G Y , JEFFREY G U N T E R
CZD Does 2 0 to 2 5
a I / I who breacited an impbed warranty
b I 1 who breached an express wananty which was
I-. .1 wntten I I oral '
Prod L-7 I I The defendants who are liable to plaintiffsforother reasons and the reasons for the liability are
I I Iisted in Attachment-Prod L-7 I I as follows

FonnAeoeowdlofOjiioralUi* CAUSE OF ACTION—ProdUCtS Liability Co<i»o»CMPraeoaun>;J«5l2

JudMtl Counol otCaMOnM ' wwwcouitaieeaaor
PUM>I4»I(S| [RBV Jamiuy 1 2007) , ,
Affla>1eanLas^Met.lne.
«M«r FsnnttMHMIOMf oom
 CASB ^lUMOgA
SHORT nrus
SCHUMACHER

_Thre£__ CAUSE O F ACTION—General Negligence Page _ £ .

(numo^ri

ATTACHMEMT TO S Complairt • Cross-Complamt

(Use a separate cause of action form far each cause of acbon)

GN-1 Plaintiff fnamej DAVID SCHUMACHER

alleges that defendani Cnamej TWi PHAM M.D CMHOLIC KSALTHCAP.E WEST MEDICAL
CATI-IOLIC HEALTHCARE WEST MEDICAL rOU>IDi\TIOM, MERCY
MEDICAL GROUP,

m Ooes SO to - J M

was the legal (proximate) cause of damages to plaintiff. By the following acts or omissions to act, defendant
negligently caused the damage (o piamtllf
on CrfafeJ: ON OR ABOUT 2/S/2008
at Cp/acej: SACRAMENTO CALIFORNIA
'i

(descnption of reasons for liability)

PLAINTIFF WHILE UNDER TKE CARE OF DEFENDANTS TAN PH.aiM:CATKOLIC
HE.ALTHCARE WEST MEDICAL FOUNDATION, AND MERCY MEDICAL GROUP,CONTRACTED
NECROTIZING FASCIITIS AND SEPSIS. AT ALL TIMES IT IS BELIEVED THAT TAN
PHAM M.D. WAS AN EMPLOYEE OF CATHOLIC HEALTHCARE WEST MEDICAL FOUNDATION,
MERCY MEDICAL GROU? PSD THAT TKS HOSPIT-AL AND FOUNDATION WERE SOLEY
RESPONSIBLE FOR TKS ACTS 0? ITS EMPLOYEES AND SAJIITATICN OF ITS FACILITV
AJD STAFF.
THE INFECTION WAS SO SEVERE A.s TO CAUSE SERIOUS ?ERSON".i^ INJURY TO
Pli.IMTIFr. FLAINTIFF'; IMJURIES WERE C.^lUSED 5Y THE ^:ZGlIGE^lC£ 0?
0IFEMD.2-.NTS EMPLOVEES ZY. EXPOSING PLAINTIFF TO MECRCTIZIMG F.^-SCIITIS
lE.ii:rNG ALSO TO SErSI= .i.N"D PERtMENSNT INJURY f-SD SCA?.I^:G PLAIMTIrr
INCORPORATES HE?.£I^i =i" REFERENCE EACH A^HD EVERY .=•.LlEC-.-.T:0^i CONT.VINED I>;
PLAINTIFF'S COMPL.i.INT .^N'D FURTHER ALLEDGES.
DEFEMD.I>:TS A>rD EACH O F T H E M BREACHED A DUTY OF C.^iJ'.E, SKILL, .IILITY,
TRAINING, KYGSNE PROTOCOLS, AND/OR LE.^RNING EXPECTED C? DEFEND.iNTS, .=--ND
E.A.C:-' Or THE:-', C O M M O N TO MEDICAL PRACTITIONERS ?y,D/0? HE.i.lTH C.^.=l£
= .=OViDES.S DEFEND.i-^ITS JU'iT) EACH OF THEM NEGLIGENTLY TPE.A7ED, C.^RID FC?,
n.^.c-NosED., f''rs:;:AGNosir, INFECTED, IMPROPERLY WEDIC.-.TED, FAILE:? TO C = T . - I : :
:>:ro=N'ED C0L\SE:rT. =?.E~C?.:=ED V^O^C.^WTION .^ND'OR T?E.-T^ E:;T, ?=.;}•.ICED CCNT=.-.
:>:DICATED ^'EDIC-TICXS E . ^ I L E D T O ? ? O ? E R L V TEST/EJ'".-_••' ?i.ii:-:TiFE,NEGLIGENT!:
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VEGLrOENTLY TOW.iRD =1^INTIFF
0ErEMD.i.^iT3 .-_S3 E.M-. OE THEM WERE UIIDER A DUT i TC INSURE T^'.M
Pl.iI.NTIFF 'fi.\5 NCT ENTEJTED WITH NECPOTIIfNC F . i S C I I T I S , ^ -3S?:Ti>L SZ'J^ViZ
o : s z \ s r . ^-^"0 T O I>ISC;".I T : - E s-jiiT.i.R-; c o N D i r r o N o ? T - E - Z S ? : ~ - ^ A>.'I) I T S
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S'JCr i :<J>CiyiZ^. - 3 70 \ 0 " C - V S E S O O E L ; INJCR'-. TO PLAINTIF? ':=" c r - E ' s - ^ .-
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A SU>\ TO BE PPO'/ZN' -\: T^.r^L
CASE NUMBER: 34-2009-00033548 SCHUMACHER v. TAN PHAM

FOURTH CAUSE OFACTION

COMPLAINT FOR PERSONAL INJURIES MEDICAL MALPRACTICE

COME NOW plaintiff, DAVID SCHUMACHER, and alleges as and for a Fourth

Cause ofAction against defendants, and each of them, as follows:

1. At all times relevant herein, plaintiffwas a resident of the State of

Califomia.

2. At all times material herein, defendants, CATHOLIC HEALTHCARE

WEST MEDICAL FOUNDATION, MERCY MEDICAL GROUP and each of them,

were health care providers organized and existing under the laws of the State of

Califomia, with their principal places of business in the County of Sacramento, State

of California, and now are, and at all times herein mentioned were, engaged in

operating and managing a general hospital, clinic and/or medical care facilit> in the

County ofSacramento, State ofCalifomia.

3. At all times material herein, defendants. TAN PHAM, M.D. and each of

them, were physicians and surgeons duly licensed to practice medicine and'or perfoim

surgerv in the State ofCalifomia, Countv ofSacramento. and held themselves out to

possess that degree of skill, ability and leaming, common to medical practitioners in

said community

4. The true names and capacities of defendants, and each of them, sued

herein a^ DOES I through 100, inclusive, arc preicntl"> unknown to piaintitTs uho
 PAGE 2.

Iherefore sue said defendants by such fictitious names, pursuant to Code of

Civil Procedure Section 474. Plaintiffis informed and believes and thereon allege that

the fictitiously named defendants, and each of them, are negligently or in some manner

legally responsible to plaintiff for the events and happenings herein referred to and

proximately caused damages to plaintiffs as set forth herein.

5. Plaintiff is infonned and believes and thereon allege that each of the

defendants was the agent, partner, joint venturer, co-conspirator, corporate successor,

lessor, lessee, and/or employee ofeach ofthe remaining defendants, and others named

herein as Doe defendants, and in doing the acts or things alleged, herein were acting

within the course and scope of said agency, employment and/or other relationship

stated herein.

6. Commencing on or before 2005, plaintiff, DAVID SCHUMACHER,

employed defendants, and each of them, for medical needs and/or necessities. Said

defendants, and each of them, at said time and place undertook said employment

and/or undertook and agreed to diagnose, care and treat plaintiff and to do all things

necessary and proper in connection therewith, and said defendants, and each of them,

thereby entered into a patient/physician employment relationship, individuallv. and by

and through their agents and employees. Said defendants, and each of them, agreed to

provide such medical attention to plaintilT for compensation vvhich plaintiff agreed to

pav

7. In the course of providing medical services, attention, treatment and/or

 care for plaintiff. DAVID SCHUMACHER, defendants, and each of them,

failed to exercise that degree of due care and/or skill, common to medical practitioners

and/or health care providers in said specialty, thereby breaching the duty owed by said

defendant, and each of them, to plaintiff to exercise that degree of care, skill, ability

and/or leaming expected of said defendants, and each of them, and/or common to

medical practitioners and/or health care providers in said specialty. Further, said

defendants, and each of them, so negligently treated, cared for, diagnosed,

misdiagnosed, infected, improperly medicated, failed to obtain informed consent,

prescribed medication and/or treatment, operated upon, advised, observed, managed,

controlled, examined, made and/or failed to make disclosure of relevant infonnation,

performed surgery upon, battered and/or otherwise acted negligently towards plaintiff,

also including negligent hiring and management of co-defendants, that he was caused

to and did experience injury and damage as stated herein. The conduct of defendants,

and each of them, complained of herein includes, but is not limited to. Prescribed

contra-indicated medications, and'or infecting or failing to diagnosis plaintiff with

a Strep A infection, necrotizing faciitis and sepsis, failed to properly treat/test or

diagnosis plaintiffs conditions leading to multiple surgeries.

8 As a legal result of the negligence, carelessness, and wrongdoing of

defendants, and each of them plaintiff. DAVID SCHUMACHER, has been injured in

his health, strength and activity and has sust^iined grievous injury to his hodv and

profound bhock and injury to his person and nervous sysiem, ali ol whieh injunes

resulted in great mentil. physical and nervous pain and suffering Said injuries will

Page 3,
 result in some permanent disability to plaintiff, all to his general damage in a

sum as yet uncertain, in excess ofthe minimum jurisdiction ofthis court. Plaintiff will

seek leave ofcourt to plead and prove general damages, according to proof at time of

trial, together with interest and/or prejudgment interest thereon at the legal lawful rate.

9. As a fiirther direct and legal result of the negligence, carelessness and

wrongdoing of defendants, and each of them, plaintiff, DAVID SCHUMACHER, has

been in the past and will be required in the future to employ physicians and surgeons

for examination, treatment surgeries and care. The exact amount of said medical

expenses are unknown to plaintiff and plaintiff will seek leave of court to plead and

prove the exact amount of said expenses at time oftrial, together, with interest and/or

prejudgment interest thereon at the legal lawful rate.

10. As a further direct and legal result ofthe negligence, carelessness and

wrongdoing of defendants, and each of them, plaintiff, has been prevented from

attending to his usual occupation, and/or will be so prevented in the future, all to his

further damage in an amount unknown. Plaintiff vvill seek leave ofcourt to plead and

prove the exact amount of said lost wages and lost eaming capacity, according to proof

at time of trial, together with interest and/or prejudgment interest thereon ai the legal

lawful rate.

11. Plaintiffs will also seek prejudgment interest on all items of damage

including general and special damages. These will include, but are not limited to. past

and future medicals expenses, any lost wages and lost earning capacity, and anv and all

'incidental and compensatory damages as permitted b> law. See CCP §685 010(a) and
Paqe 4 .
CCP §3291.

WHEREFORE, plaintiffs pray for judgment against defendants, and each of

them, as hereinafter set forth.

WHEREFORE, plaintiffs pray for judgment against defendants, and each of

them, as follows: '

General damages in excess ofthe minimum jurisdiction ofthis court, according

to proof at time oftrial;

Medical and incidental expenses, according to proof;

•J

Damages for loss of eamings or eaming capacity, past, present and fiiture,

according to proof;

Incidental expenses incurred as a result ofthe above incident; or interest and/'or

prejudgment interest on all damages sought and/or incurred herein at the legal

lawful rate;

For costs ofsuit incurred herein;

and For such other and further relief as mav be proper

Dated
• V^/o?
PAGE 5
EXHIBIT B
 QUEST DISCOVERY SERVICES
www.questds.com

Ordered By LAURA J . SMITH

For MICHAEL V. U B A L D I , ESQ.

if you have any questions or require the onginai subpoena and it is not contained within these records, please
contact our Client Services Department at (916) 483-7030

Case DAVID R. SCHUMACHER

VS.
TAN P H A M , M.D., ET A L .
Case Number 34200900033548
File Number 373-1904
From MERCY MEDICAL GROUP
3000 Q STREET
SACRAMENTO, CA 95816
ATTN: CUSTODIAN OF RECORDS

Records of DAVID R. SCHUMACHER

Claim Number 306496
Insured CATHOLIC HEALTHCARE
Date of Loss 02/05/09
CDS File Number SAS908742

Quality • Uniformity • Excellence • Service • Teamwork

 AFFIDAVIT Check # 933498
File # SAS908742
.uant to Califomia Evidence Code 1561 & 12.

READ, SIGN, DATE, ATTACH TO YOUR RECORDS, AND SUBMIT TO DEPOSITION OFFICER Quest Discovery Services
P.O. 80X214267
SACRAMENTO, CA. 95821-0267
(916) 483-7030 or (800) 477-6886
Title of Case DAVID R. SCHUMACHER VS. TAN PHAM, M.D., ET AL.
Attorney for DEFENDANT UBALDI & MCPHERSON, LLP
Attorney for PLAINTIFF LAW OFFICE OF ROBERT HEINTZ

DATE OF DEPOSITION Tuesday November 24, 2009

RECORDS PERTAINING TO DAVID R. SCHUMACHER DOB:05/07/42 SSN:527-58-0804

I, THE UNDERSIGNED, BEING THE DULY AUTHORIZED CUSTODIAN OF THE RECORDS AND HAVING THE AUTHORITY TO CERTIFY THE
RECORDS DECLARE THE FOLLOWING THE ATTACHED ARE THE RECORDS OF MERCY MEDICAL GROUP AND THAT THESE RECORDS ARE
KEPT IN THE REGULAR COURSE OF BUSINESS AND SUCH BUSINESS IS A TYPE OF BUSINESS IN WHICH IT IS CUSTOMARY TO KEEP SUCH
RECORDS, THE RECORDS WERE PREPARED BY PERSONNEL OF THE BUSINESS WITH ACTUAL KNOWLEDGE OF THE MATTERS STATED IN
THE RECORDS AND THAT THE ENTRIES CONTAINED IN THE ATTACHED RECORDS WERE MADE AT OR NEAR THE TIME OF THE ACTS,
CONDITIONS OR EVENTS DESCRIBED

TRUE COPIES
D Pursuant to Evidence Code Section 1560(b) the attached copy is a true, legible and durable
copy of the records described in the Subpoena

IGINAL RECORDS
rsuant to Evidence Code Section 1560(e) the original records described in the Subpoena were delivered to the attomey or the
attorney's representative for copying at the witness' place of business

CERTIFICATION OF NO RECORDS
D That a thorough search of our files revealed no documents, records or other materials called for in the Subpoena and that no such records exist with the
information provided (Please give a detailed explanation )

D Requested records existed at one time but have since been purged
D Records do not exist for the time frame specified
I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND
CORRECT
AFFIDAVIT OF PROFESSIONAL PHOTOCOPIER
SIGNATURE- ^ly C.^gg^^'g^^^^ SECTION 22462 of Business and Professions Code

PRINTED N v / ^ / •fije^ C ^ V/^^y^ I solemnly affirm that I am the attorney's representative and that I
made true copies of all the original records delivered fo me by the
TITLE ^/£{^sy^ -^s^y Custodian of Records of the within named location, and these
records will be distnbuted to the^uthonzed persons or entities
Executed on ' ^ ^ 9 a t ^ S ^ ^ ^ ^ ^ ^ ^ C a l i f o m i a
Executed on .
IN
REPLY MERCY MEDICAL GROUP At
PLEASE 3000 Q STREET
REFER SACRAMENTO, CA 95816 Signature
TO ATTN: CUSTODIAN OF RECORDS

W S A S 9 0 8 7 4 2 S M S
AFFIDAVIT
 QUEST DISCOVERY SERVICES
www.questds.com

Ordered By LAURA J . SMITH

For MICHAEL V. U B A L D I , ESQ.

If you have any questions or require the original subpoena and it is not contained within these records, please
contact our Client Services Department at (916) 483-7030

Case DAVID R. SCHUMACHER

VS.
T A N P H A M , M.D., E T A L .
Case Number 34200900033548
File Number 373-1904
From MERCY MEDICAL GROUP
3000 Q STREET
SACRAMENTO, CA 95816
ATTN: CUSTODIAN OF RECORDS

Records of DAVID R. SCHUMACHER

Claim Number 306496
Insured CATHOLIC HEALTHCARE
Date of Loss 02/05/09
CDS File Number SAS908742

Quality • Uniformity • Excellence • Service • Teamwork

 Check # 933498
AFFIDAVIT File # SAS908742
.uant to California Evidence Code 1561 & 127

READ, SIGN, DATE, ATTACH TO YOUR RECORDS, AND SUBMIT TO DEPOSITION OFFICER Quest Discovery Services
P.O. 80X214267
SACRAMENTO, CA. 95821-0267
(916) 483-7030 or (800) 477-6886
Title of Case DAVID R. SCHUMACHER VS. TAN PHAM, M D., E T A L
Attorney for DEFENDANT UBALDI & MCPHERSON, LLP
Attorney for PLAINTIFF LAW OFFICE OF ROBERT HEINTZ

DATE OF DEPOSITION Tuesday November 24,2009

RECORDS PERTAINING TO DAVID R. SCHUMACHER DOB:05/07/42 SSN.527-58-0804

I, THE UNDERSIGNED, BEING THE DULY AUTHORIZED CUSTODIAN OF THE RECORDS AND HAVING THE AUTHORITY TO CERTIFY THE
RECORDS DECLARE THE FOLLOWI.ivJG THE ATTACHED ARE THE RECORDS OF MERCY MEDICAL GROUP AND THAT THESE RECORDS ARE
KEPT IN THE REGULAR COURSE OF BUSINESS AND SUCH BUSINESS IS A TYPE OF BUSINESS IN WHICH IT IS CUSTOMARY TO KEEP SUCH
RECORDS, THE RECORDS WERE PREPARED BY PERSONNEL OF THE BUSINESS WITH ACTUAL KNOWLEDGE OF THE MATTERS STATED IN
THE RECORDS AND THAT THE ENTRIES CONTAINED IN THE ATTACHED RECORDS WERE MADE AT OR NEAR THE TIME OF THE ACTS,
CONDITIONS OR EVENTS DESCRIBED

TRUE COPIES
(Zl Pursuant to Evidence Code Section 1560(b) the attached copy is a true, legible and durable
copy of the records described in the Subpoena

IGINAL RECORDS
rsuant to Evidence Code Section 1560(e) the original records descnbed in the Subpoena were delivered to the attorney or the
attorney's representative for copying at the witness' place of business

CERTIFICATION OF NO RECORDS
n That a thorough search of our files revealed no documents, records or other materials called for in the Subpoena and that no such records exist with the
information provided (Please give a detailed explanation )

[D Requested records existed at one time but have since been purged
D Records do not exist for the time frame specified
I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND
CORRECT
AFFIDAVIT OF PROFESSIONAL PHOTOCOPIER
SECTION 22462 of Business and Professions Code

I solemnly affirm that I am the attorney's representative and that I

made true copies ot all the ongmal records delivered to me by the
{^S:^^ - J ' S T / Custodian of Records of the within named location, and these
records will be distributed to the^uthonzed persons or entities
Executed on ^ ^ ^ 9 a t ^ ^ ^ ^ ^ O ^ ^ C a l i f o m i i
Executed on . ^ ^ /AJ£^^ § __. 5 ^ i : i O S. _ . _.
IN
REPLY MERCY MEDICAL GROUP At
PLEASE 3000 Q STREET
REFER SACRAMENTO, CA 95816 Signature
TO ATTN: CUSTODIAN OF RECORDS

S A S 9 0 8 7 4 2 S M S
AFFIDAVIT
 373-1904 )08742 SUBP-OIO
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name Slale Barnumber. and address) FOR COURT USE ONLY
MICHAEL V. UBALDI, ESQ SB# 072986
UBALDI & MCPHERSON, LLP ATTORNEYS AT LAW
455 UNIVERSITY AVENUE
SUITE 360
SACRAMENTO, CA 95825
TELEPHONENO 916/265-4555 FAXNO fOpdona/; 916/265-4568
E-MAIL ADDRESS (Opiional)
ATTORNEV FOR (Name) DEFENDANT/CATHOLIC HEALTHCARE WEST MED FOUND.
SUPERIOR COURT OF CALIFORNIA
STREET ADDRESS COUNTY OF SACRAMENTO
MAILING ADORESS 720 NINTH STREET
CITY AND ZIP CODE SACRAMENTO, CA 95814
BRANCH NAME SACRAMENTO COURTHOUSE-UNLIMITED CIVIL JURISDICTION
PLAINTIFF/ PETITIONER DAVID R. SCHUMACHER

DEFENDANT/ RESPONDENT TAN PHAM, M.D., ET AL.

DEPOSITION SUBPOENA CASE NUMBER

FOR PRODUCTION OF BUSINESS RECORDS 34200900033548

THE PEOPLE OF THE STATE OF CALIFORNIA, TO (name, address, and telephone number of deponent, ifknown):
Custodian of Records For. MERCY MEDICAL GROUP ATTN: CUSTODIAN OF RECORDS
3000 Q STREET SACRAMENTO, CA 95816 916/733-3332
1 YOU ARE ORDERED TO PRODUCE THE BUSINESS RECORDS described in item 3, as follows:
To (name of deposition officer) Quest Discovery Services (916)483-7030
On (date) 11/24/09 At (time) 9:30 A M.
Location (address) 4600 ROSEVILLE ROAD. SUITE 200 NORTH HIGHLANDS. CA 95660
Do not release the requested records to the deposition officer prior to the date and time stated above.

a I^X^I by delivering a true, legible, and durable copy of the business records descnbed in item 3, enclosed in a sealed inner
wrapper with the title and number of the action, name of witness, and date of subpoena clearly wntten on it The inner
wrapper shall then be enclosed in an outer envelope or wrapper, sealed, and mailed to the deposition officer at the
address m item 1
b I I by delivenng a true, legible, and durable copy of the business records descnbed m item 3 to the deposition officer at the
witness's address, on receipt of payment m cash or by check of the reasonable costs of prepanng the copy, as determined
under Evidence Code section 1563(b)
c I I by making the original business records descnbed in item 3 available for inspection at your business address by the
attorney's representative and permitting copying at your business address under reasonable conditions dunng normal
business hours
The records are to be produced by the date and time shown in item 1 (but not sooner than 20 days after the issuance of the
deposition subpoena, or 15 days after service, whichever date is later) Reasonable costs of locating records, making them
available or copying them, and postage, ifany, are recoverable as set forth in Evidence Code section 1563(b) The records shall be
accompanied by an affidavit of the custodian or other qualified witness pursuant to Evidence Code section 1561
The records to be produced are described as follows:
RE: DAVID R. SCHUMACHER 008:05/07/42 SSN:527-58-0804

O ^ Continued on Attachment 3
4. IF YOU HAVE BEEN SERVED WITH THIS SUBPOENA AS A CUSTODIAN OF CONSUMER OR EMPLOYEE RECORDS UNDER
CODE OF CIVIL PROCEDURE SECTION 1985.3 OR 1985.6 AND A MOTION TO QUASH OR AN OBJECTION HAS BEEN
SERVED ON YOU, A COURT ORDER OR AGREEMENT OF THE PARTIES, WITNESSES, /\WO CONSUMER OR EMPLOYEE
AFFECTED MUST BE OBTAINED BEFORE VOU ARE REQUIRED TO PRODUCE CONSUMER OR EMPLOYEE RECORDS.
DISOBEDIENCE OF THIS SUBPOENA MAY BE PUNISHED AS CONTEMPT BY THIS COURT. YOU WILL ALSO BE LIABLE
FOR THE SUM OF FIVE HUNDRED DOLLARS AND ALL DAMAGES RESULTING FROM YOUR FAILURE TO OBEY.

Date issued 10/30/09

MICHAEL V. UBALDI. ESQ. • /S/

(TYPE OR PRINT NAME) (SIGNATURE OF PERSON ISSUING SUBPOENA)

Attorney For DEFENDANT/CATHOLIC HEALTHCARE WEST MED FOU^C

(TITLE) =

(Proof of service on reverse) page i of 2 §

Form Adopted for Mandatory Use Code ol Civil Procedure,§§ 2020 410-2020 440,
Judicial Counol of California DEPOSITION SUBPOENA FOR PRODUCTION Civil Code, §15(a)(e),
SUBP-OlO[Rev January 1, 2007] OF BUSINESS RECORDS Govemment Code § 68097 1
 Attachment 3
File #: SAS908742

MERCY MEDICAL GROUP ATTN: CUSTODIAN OF RECORDS

Pertaining To: DAVID R. SCHUMACHER

Date of Birth 05/07/42

Sociai Security No.: 527-58-0804

ALL DOCUMENTS RELATING TO PATIENT'S MEDICAUDENTAL HISTORIES;

COMPLAINTS; SYMPTOMS; EXAMINATIONS; FINDINGS; DIAGNOSIS;
PROGNOSIS; SIGN-IN SHEETS; PHOTOGRAPHS; VIDEO TAPES; TREATMENT;
PHYSICAL THERAPY; INCLUDING WITHOUT LIMITING THE GENERALITY OF
THE FOREGOING, ALL CORRESPONDENCE INCLUDING BUT NOT LIMITED TO
OTHER WRITTEN OR GRAPHIC MATERIAL.
 d Information Sheet
Quest Discovery Services

I affirm under penaity ofperjury that ali ofthe records delivered to me by tiie Custodian of Records will be delivered
to the authorized persons or entities
Executed on DEC 1 4 2009 at San Jose, CA 95131
Signature VzaiOMVi^VA/"

AFFIDAVIT UNDER EVIDENCE CODE 1561 (c)

p PAs one ofthe attorney's representatives, 1 affirm, under penalty ofperjury, that the attached copies are true copies
ofall the records delivered to me for copying by the Custodian of Records.
Q Not applicable
DEC 1 4 2009
Executed on at San Jose, CA 95131, Santa Clara County
Signature I^ZO^Mv^t^VAX' Registration Number 58

DATE RANGE OF RECORDS

Enclosed records are subsequent to (date) or prior to (date)

COMMENTS ON COPY QUALITY

a This file contains several poor quality copies due to custodian's poor quality originals or microfilm We were
unable to produce better copies
• We presentiy are trying to obtain better copies ofthe page(s) Iisted below When we receive the page(s), we wil
forward them to you at no additional charge

ADDITIONAL MATERIAL
a Enclosed are additional records
a Some material was too large to be bound in this booklet It is packaged under separate cover
Note:

CERTIFICATE OF NO RECORDS/BILLS/X-RAYS
Q We have received a certificate of no records and/or bills from the custodian
• We have received a certificate of no x-rays from the custodian
Sometimes, such a certificate is not accurate While reviewing other information, you might encounter evidence to
the contrary If that is the case, piease provide us with details, and we will reopen the file and pursue records further

Ifyou have questions, please contact our Client Services Department.

These records were assembled carefully by_ Margarita

Htxniim PiUf HI/yiA/9

Prxi\i.iHt\ ( (tiriro
 Mercy Medical Group - Sacramento
3000 Q Streel
Sacranienlo.CA 95816
(916) 733-3333

Patient: .SCI lUM ACI ICR. DAVID R Agc/UGB 6 7 JTS n7-May-ll>42

709 EAST RANCH RD. EIMRN: 254511
SACRAMENIO. CA 95S2.S OMRN: 254511
Home: (9]6)486-4SS6
Work: (916)481-2824

Results
Lab Accession « 25200817291 Collected: 2/5/2008 4:2S:0OPM
Ordering Provider: To\'ar,Sonya Resulted: 2/5/2008 4:28:00PM
Performing Locaiion: **ln Office Verified By: <Verirication Not Reqwired>
AutoVcrifv: N

Rapid Strep A <ln Oftlcc) Stage: Final

Test Result Units Flag Reference Range

Rapid Strep A Test neg N
Loti? 176409 N

Primed by: GAVIOLA, JENNIFER | 11/17/2009 1:52:00PM Page I of 1

35
 itChartNote
Mercy Medical Group
3000 Q Strect ~
Sacramento CA 9S816
(916)733-3333

Paiicm: DAVID R. SCHUMACHER MRN; 254511

709 EAST RANCH RD. WMH MRN: 02536071
Sex: M
SACRAMENTO, CA 95825
Home: (916)486-4886
Work: (916)481-2824

Encounter Date: Feb 6 2008 11:30AM

Chief Complaint
• F/l) Swollen L eye
Vital Signs
Recorded by Tovar,Soii>'a on 05 Feb 2008 04:03 PM
BP: 130/86.
HR: 92 b/mjn.
Height: 69 in. Weight: 195 Ib, BMI: 28.8kg/in2.
Recorded by STOVAR on 06 Feb 2008 11:40 AM
Temp- 96.9 F.
Allcrgif»-
No Kno\\ii Drug Allergy.
Current iVIcds
Vicodin 5-500 MG Tablct.TAKE TABLET 3 TIMES DAILY; RPT
Motrin 600 MG TabIcl:TAK.E I TABLET 3 TIMES DAILY.; RPT
Anntriptylinc HCI 10 MG Tablet.TAKE 1 TABLET BEDTIME nuy take tw-o; Rx
Cilalopram Hydrobromide 20 MG Tablct;TAKE 1 TABLET DAILY for depression.; Rx.
Acfi%'c Problems
Cemcalgia (723.1)
Chronic Renal Faihirr: (5S5.9)
Gastritis (535.50)
Insomnia (780.52)
Male Erectile Disorder (302.72)
Nephrolilliia.sis (592.0).
I»SH
None.
Family H.\
Family liision' ury\.symptontalic Coronary Arteriosclerosis; m 63
Family history orSiroke S}'ndrome.
Pcrsonal Hx
No Smoking.
HPI
A 65-year old who has been using Rclin cream below both eyes for the lasl few days. Noticed s\s-elling pain aroimd
the left eye, it started today, pain level is about a 6/10. Denies any fevers or chills. Vision onrighteye is 20/30, left
eye is 20/30.

PHYSICAL EXAMINATION
No acute distress. Extraocular muscles intact. Pupils equal, round, reactive lo light. No conjunctival injections. No
photophobia. There is cdetna over thc low part oflhe lefl eye and the little pari in thc medial part ofthe left upper
eyelid. Il is non lender. Does feel erythema but feels very soft. Notnccessariiy tender to palpation. Whitish littie

Printed By: JENNIFER GAVIOLA 1 of 2 1 I/J 7/09 2:52:47 PM

158
 nChart Note

Patieul: DAVID R. SCHUMACHER MRN: 254511

Encounter: Feb 6 2008 11:30AM WMH MRN: 02536071

pale ill color. No wannth.

ASSESSMENT/PLAN
SUSI'ECr CONTACT DERNIATITIS FROM RETIN CREAM.
Use prednisone taper over two weeks starting 60 mg. Tlie eye itself is not affected, nuinly thc skin. He is to call
back if ii does not improve..
It w-as wrinkle cream and not rclin cream. Does feel edematous not erythematous on exam. Amended By: TAT^ N
PHAM ; O2/12/20OS 3:33 PM PST.
Tests
Vision Scrccii:

Riglu Eye: 20 / 30
Left Eye: 20/30.
Signature
Signed By: TAN N PHAM MD; 02/07/2008 11:59 AM PST.
Signed By: TAN N PHAM MD; 02/I2/200S 7:54 PM PST.

TAN N. PHAM M.D.

Primed By: JENNIFER GAVIOLA 2 of 2 11/17/09 2:52:47 PM

159
 ItChartNote
Mercy Medical Group
3000 Q Street ~
Sacramento CA 95816
(916)733-3333

Paticiit: DAVID R. SCHUMACHER MRN: 254511

709 EAST RANCH RD. WMH MRN: 02536071
Sex: iM
SACRAMENTO, CA 95825
Home: (916)486-4886
Work: (916)481-2824

Encounter Date: Feb 5 2008 3:15PM

Chief Complaint
• Sinus congestion, sore throat, swollen glands
Vital Signs'
Recorded by STOVAR on 05 Feb 2008 04.03 PM
BP: 130/86,
HR: 92 b/min.
Height: 69 in. Weight: 195 Ib, BMI: 28.8 kg/in2.
Allcrgie.s
No Known Dniu Allcrgj'.
Current iMcds
Vicodin 5-500 MG Tablet;TAlCE TABLET 3 TIMES DAILY; RPT
Motrin 600 AIG TabIet;TAKE 1 TABLET 3 TIMES DAILY.; RPT
Amitriptj-line HCI 10 MG Tablet.TAKE 1 TABLET BEDTIME may take two; Rx
Citalopram Hydrobromide 20 MG TabIet;TAKE 1 TABLET DAILY for depression ; Rx-
Active Problems
Ccn'icalgia (723.1)
Chronic Renal Failure (585.9)
Gastritis (535.50)
Insomnia (7S0.52)
Male Erectile Disorder (302.72)
Nephrolithiasis (592.0).
PSH
None.
Family H.v
Famil)' histor>' of Asymptomatic Coronary Arteriosclerosis; m 63
Family history of Stroke S>iidromc.
Personal Hx
No Smoking.
HPI
A 65yo who complains of sore throat especially on therightside with fatigue over the last week and svvoUcn glands
on the righl side, denies any fevers, chills, not much coughing or runny nose. Also has a history of chronic renal
failure. Previous labs reviewed. Continues to have chronic neck pain, 7/10 in intensity, worse at nighl especially
wiien he sleeps a ccriain way. Some relief with (lie Vicodin. no side effects from the Vicodin.

EXAMINATION
General: No apparent distress. HEENT: No nasal discharge. Oropbaryax mild crytliema especially on thc right
side, no exudate. Neck: Supple, some tender adenopathy anteriorly, right side. Heari: Regular rate and rhytlim
without munnurs, rubs or gallops. Lungs: Clear to auscuhation, wilhout wheeze, rales. Musculoskeletal: Fair range
of motion ofthe neck. Numul motor sensation both amis.

Printed By: JENNIFER GAVIOLA 1 of 2 11/17/09 2:52:48 PM

ICO
 nChart Note

Patient: DAVID R. SCHUMACHER MRN: 25451!

Encounter: Feb 5 2008 3:15PM WMH MRN: 02536071

ASSESSMENT AND PLAN

UPPER RESPIRATORY INFECTION. He had a rapid strep which was negative. Continue over-the-counter. Take
ViciKlin for pain. Increa.se llnid intake, rest. Call back if worsens. His uvula was midline, nothing to indicate
abscess al (his lime.
CHRONIC RENAL FAILURE. Check Cheni-7, CBC. PSA.
CHRONIC NECK PAIN. Continue Vicodin. Avoid aggravating activities. He did get some help with physical
ihchipy in the past..
Results
Rapid Strep A(lnOnicc) 05 Feb 200S 04:28 PM
- Rapid Strep A Test: neg
- Lot#: 176409.
Signature
Signrd By. TAN N PHAM .MD; 02/06/2008 5:14 PM PST.

TAN N. PHAM M.D.

Primed By: JENNIFER GAVIOLA 2 of 2 11/17/092:52:48 PM

161
EXHIBITC
DECLARATION OF CUSTODIAN OF RECORDS SWARAN DWARKA

I, SWARAN DWARKA, declare as follows:

1. I make this declaration on the basis of my own personal knowledge, and if

called upon to testify to the facts stated herein, I could and would
competently do so.
2. I am the Director ofthe Health Information Management Department ("H.I.M.
Department") at Mercy General Hospital. In this capacity, I am a duly
authorized custodian of records for the records maintamed on patients
treated at Woodland Memonal Hospital.
3. A patient chart is maintained on each patient treated at Mercy General
Hospital. This chart is maintained by the H.I.M. Department at Mercy General
Hospital.
4. The documents and entries in document pertaining to a patient are prepared
at or near the time of their occurrence by persons with knowledge ofthe
circumstances or events.
5. The documents attached hereto are true and correct copies of documents
from the patient chart of David Schumacher, maintained in the regular course
of business by Mercy General Hospital.

1 declare under penalty ofperjury, under the laws ofthe State ofCalifomia, thatthe
foregoing is true and correct and that 1 executed this declaration on the l^ day of
August 2010, at Sacramento, California.

SWARAN DWARKA
 02S3t ...'3^ ^"V*^
• /y<76 - 2IMi T-S\ >if>» Inc. t (tt /.• ttr CIKI k u/ft»;iii(i>.'5 fttnti/a»/i f'i n.%-iitiv< ^CHiJHiCHE'l, O t V i O ^.
43 CnK-r.ll I I<>.|IIIH1 H8 3S28S K t>5 '5 ,^J"0«
3 ^ 6 5 PHAU KD , TAN N
EMERGENCY PHYSICIAN RECORD
Skin Rash / Insect Bite / Abscess (5)
TIME S E E N : _ l £ 7 a on amVii ROOM: _ W^ EAlSAnrral ROS
:"AJ£{>iin"""
,i»i..

H l S T O R l A N > , . i i y c ! a ! ! ) spouse paramedics consT

ClSea&che^
AGE ^•> G ) / F RACE. cKflk„
_ H X / _ E X A M LIMITED BY: ENT
sore throat
HPI hoarset^oicc changc_ CVS
lump in^hroat ches^aln
chief complaint—/^skin rash / leiion|^ ' ^ n d c r / swoilen^rgy
PULMONAKT GI/GU
Inieci bile / sting possit>1e insect bite cough.^ abdominal pain
spuium_ n w i S x i vomiting,
<honn^i-of breath_ diarfT)«a
problems urinating
genitaYsore / discharge.
7-Z^-^^—-
^wr-i-kM'trtr-

time course:
g«tx bctctr and w o n : at. omu
stjll present / better
tlnngtnj too&D vi\;b (ime
worse
gone no.v

location:
gcneralned (^Tacial^ neck trwnk upper extremity fi/L P A S T HX ^negative
lower extremity R / L ' pen'rectal axillary R / L diaC^tu Type I Type 2_ allc7g}>4o poison wy
diet / oral / insuhn chielJen pox '
high bloStJpressure_j___ strcp^hroat
cardisc disease 1 shingte.
AU CHF CAH HJVf^sitrve.
hereditary^ngtocdema

; identified c a u s e ? no yes ^ossibl]^

: Y/Jiei)^ yusT pnor to iymptom omel
: Exl>oiure (context)- iurged-M /.Prcstcdurj^s _none
Medication food Qiher
; onttbioiic slieJI/rsh bee / wosp stmg
flsptnn nuts ont bne
NS.MD soybeans spider / msea biie
• ACF. inhibitor eggs poison hry / ook
tlsdi.i:LUisiis ^none AUec&es _f^KOA.
ASA NSAID aceuminophen see nurtes note
Olher yj infectious illness antibiotics BCP's
;• <^::^.. CrOzrV-C ' ^Q^P^ detergent
U..£-ii
: LocfltrffO: home work.

socrAj iT»Slfc«r
smi , drug uJeV abtlre-_
Similar symptoms previously. (cfOi

FAMILY H X atopic allergy. .asthma.

Reccndy seen / treated by d o c t o r .

Nurse I MD • !
{ HISTORY- Nurte sign after recotding ROS, PPSH. Physician mibal ahei reviewinB
j with patient and confirnimg ot revrsmo all elamenls '

__41i
 urtinf A«/;me»rfltviewod p, Q VitiJtRcviewcd O •<\ O
LABS & PROCEDURES
D Nurtii
: CBC Chemistries
; nomwi except sees v Glue »'<
nsrwat cncpi n
PHYSICAL EXAM : WBC ' L - ' T "r3- BUN -YY
General Appearance :Hgb_auJ„ lymphs__L^ K
Na__tiA
i.3r Crcat_3'.-.f_
no acute distress mild /moderate /> : Hct ) 5 : ^ monos_7ZL Cl / ^ 2» Ca
alert _^^iout_^ethargic : PUtrJets ««•__>, /iC02 - M
SKIN cyanouc / diaphoretic / pallid / jaundiced
wamfc dry abs\E^s /"t^oder indurateflioM^ INCISION AND DRAINAGE OF ABSCESS
nmlVplor pointing puctuont »^j>ythem^y/<ympftongto
AnesUiesia Prep f Procedure
_local skin p r e p .
skin rash / erythema / lesion /plaque Idocaine IX 2% epi b'carb incised abscess with blade
maiaaix 0.25M 0 S % purulent drainage large/unoO
(ocotipn: T>f sedation I analgesia irrigated cavity
p r < ^ d to break up loculations
pulse oximetry _ packed wiih gauze
scalp / ears . cardiac monitor. obtained cultures / gram stain
neck onterior / posterior . '• D see coascjoui sedidon
_trunk chert/obdomen/bock, PROGRESS
extremities Time unchanged improved re-examined

(ftgnaec
symmetric / SSitimetriL^
^ ^ ^ ^ ^ ^ ^
macular f papular / macutopaputar
fine / confluent / patchy
^
urxicariat /^gi^thematous^petechial

wrtft: ,„Decuxscd wwh Djvd -/rkmn

__y*ill sec P«'t^'.«'{j^/''OJprtal_/oj
lymBbawgitj Counseled pjoentiramily regarding: Additional history from
f'Tn'duraoon / thickening tab /rad. nstAs dtogiKaix monageititixt famif corccaker paromtdks
scaling / well detined border ditposilhn netd for foBow-up
weeping / mflammauon / crusting pnor records ordered -
rough texture like sand paper. CRfT CARE TIME fcxdL-dng apomu^bia&le proci
^skift-Une dtstnbubon like pityriasis " 30-74 nun 7S-Ni4 nun
rosea
Rx given_
EXTREMITIES _dcscribed above .
—'nm\ inspection _ede[na hands / orms / legs / pBdDl_ ..-^ CUNICAL IMPRESSION
_ ^ o r m a l ROM
^ ^ on-tender

EEMT
no pedal edema

•^eyes r«?tfTiftpcction
_J»ps / gums nml
^scleral icterus / injected conjunctivae
^^^EOM palsy / anisocoria
pharyn^MLerytiicma / swa
Skin Rash
Allergic Reaction - acute
Hwes / Urticaria
Erythema Multiforme
Drug Rash
Systemic Infection
Mcningococcemia
Sepsis
Toxic Shock Syndrome
Rocky Mounuin Sponed Fever
t
Contact Dermatitis Lyme Disease
"gRarynx nml
Poison hry Disseminated Goiiococcemia
NECK stiff neck / meningisrnos
Soft Tissue Infection Syphilis
trachea midline iymphadenopaihy
Cellulitis Impetigo
_^iio swelling Scarlet Fever
Abscess ctrtaneous
RESPIRATORY wheezes / rales / rhonchi_ Streptococcal Associated Rash
pionidol periiectol
_^rto resp. distress Chicken Pox
Hidndenltis Suppurativa
• ^ r c a d i sounds nml Herpes Zoster
Other
CVS tachycardia / bradycardia Viral Illness »"
Eczema Psoriasis C
.^rpg rate.rhyihm ^murmur grade lb sys/dios_ PityrlasU^^ea
insect Bite(s) / Sting / Scabies
heart sounds nml
ABDOMEN tenderness.
_^bn-tendcr hepatomegaly / splenomegaly^
^ n o organomegaly
DISPOSI
W^ Qhome
S: idmlctcd D transferred
tran:ic . Xr /?

K"
Time
RECTAL rectal tendemess / mass / drainage.
non-tender _^ . CONOITION- nchanged.Q In^KQved lobt^.

NEURO/PSYCH disoriented t o penon / ploce / l«ne_

_^dncnted x3
_ ^ o o d / affect nml
" ^ N ' s nml as tested
3 f i o motor / snsry deficit
SI.III Until/Inwcl UitcMhsCcs<-t3
^depressed affect
HPtPA
facial d r o o p .
^weakness / sensory loss.
^ W M t t c n Addendum Q Proj DiJemplatc Complete
W^ 414
 OJtrv-^
^^-xy 4" Mercy f'^f 02S2cu/ ACCt.f eS352S5
SDiuXtCKER. DAV19 R.
At.ter,.i ra-
\,Q_x -.4 ineniljei; ol ( i | IW Refer .".a- FULWIOER '•'H . THGC.AS S 5797
.°re AtjT, i;0:
"
MERCY ' JENERXL EMERGENCY
GENERAJL EMEKC DEPARTMENT
DATE
.•-.-ORDER =- - v - - . ; < - - ^ ^ V , X C ' - ^ ' - - -,ORDER-: .:;;:' n : ^ ^ - ^ Tii:^..--';'^./ -> />J-.vv,..-^'^-^^::-:.^v<|
EKG i M O M G . ' . :^V:',•V>:1^•^•.>^•-*; .:.-.,/- :: I r i f l f M l i i n . ' , ?--.>:'--v
Repeat EKG in 30 Minutes Chest P R
C ; ^ Pulse OX_JI> Abd Series
02 L Spine level - ^
Monitor Hip L R
^ I^NS Loc|t> Pelvis
IxAllS @ ml/hf -
IV @ ml/hr rimaMiiiii" • y - ^ i r t : ^ '-'''•i:^-^^ A?v-"''f»' \ ^ •?.. -
Foley Shoulder R L Femur R L -.--' '
xV?:^:=':-";;--^ - ''-•'A •'%'' •^-' ^v^ >?'rV^ Clavide R L Knee R L
Hamonaia&d Bank S«nt Humerus R L Tib/Fib . R L. " - '
•c CBC.^ ElbovK R L Ankle R L
PT/PTT Wrisl R L Foot R L ,
T^>e& Screen Hand R L
Type & Cross • units' finfer y' " •

RHType
_ k-i Q r ^ y ^ y ^ - > < ^ - - i L : -^ j.^^-y>f x ^ Z ^ i S s v ^ ; ^ - ,/ -^2^/;
i';- -• -" ' • . -
SSin L ^ . / H n ^ j R ^ ^ //l/^.^-Jb^-:M-^ 1
Cervical Spine S r -
ABG onRA or L YT.'t^^ * -•;
/ • Chest . :•• -., -. : -:
Chtmlstrv,/ Sent Abdomen/Pelvis " 1 • >-

-4 ChertiJ>. ,,- »ih'rtiiT>vH5^^-,-:^:^ T3-^rK#^-:-.f-r. ^-r-?-^*-?

Doppler Carofel " , -
\ \ ,.-
rir ..
Troponin' Doppler Leg R L A / V • " ,'
Myoglobin - llfciMinifil - - - i r i i n - V - l ^ i=>r'^:ivJ^ -r^^: .'Vj \ ,' >^'_'^ -"
Amylase'.- Abdomen - Pelvic - . ' "" ^ '
Lipase , Gallblader 0 0 ,- -S' '- .'- ,"
LFT - •;, Renal R L
BNP / ,-' - -- " .qi^^ij-ri-e 0-y\^:;^^^^$$:ii?^-:-^;iC^^^^S^:^f^'r^r.'^.t^m^m%
s. •• _> '
ESR -^ . •• "^^ ..
Micro Sent
Magnesium .' '.' Blood C&S 1 2 ^v^-
Ammonia.: - UAdip

0
•*. I- i ---, ' •»

Lactic" Acid'>" ' - ". UA Micro (CIF) . ' \ ' '- - ' • ^ " - ••

HOG Quant - Urine C&S ;.^i^. '

Unne HCG ' - i
l/Ocalh \ " _ -__ 'i-t

UDAB , void '-, ' • '" , ' ' -•" ''^,'''

ETON \ GC/Chlamydia - . -
- Salicylate Wet Mount s'" .^

Acetaminophen Stool WBC / ' < K . i

Dilanlin •
Stool C&S • • - ,

Oicjoxln Stool O&P ' Old Recofds . ^

• PerSPPO R N Signature

MD Signature (^ ~f
Time

Z__Time..^J2yJ2
it.
_S fc,"

MO Order Form (emptale xls

his^^m^ JLJUL
 t'311111-31106 ^•S^2Ly" Iru- CirtU- or elicit affirmuinvs hachlasli Vt iKsmiws

2? CriH'iul lll>.^MI~l
•j|iCH«'
EMERGENCY NURSING RECORD
Skin Rash / Abscess
TIME T O ROOM; .mb ROOM- 6
T R I A G E DATE
resuscitation emergeht 1^ urgent
INITIAL T I M E
delayed minor
TDOb INITIAL A S S E S S M E N T
GENERAL A P P E A R A N O I "^
TIME

no acute distress ' I crii)fl / moderate / severe distress.

^lert
D.O.B-^.^|J|5Z^J_AGE:J^_ (Ql F anxious / decreased LOC_
HISTORIAN (patierijLil^^medicsl^family
*RUNCTIONAL / NUTRITIONAL ASSESSMENT
ARRIVAL M Q I B I J X ^ ^ U U ^ O B ) carried gurney walked o r W C /^dependent ADL assisted / total care
PCP; none T u H j S ^ ^appears well obese/malnourished
^TETANUS: current / referral „ nourished / hydrated recent w e i ^ t loss / gain_
tetanus.
SPIRATORY mild / moderate / ssvere distress.
Dacceptabic t o share PHI with family / friends present
1^0 r ^ p distress wheezing / crackles / stridor
TREATMENT PTA IV O, _nml breath snds decreased breath sounds

CVS .bradycardia / tachycardia..

bst blood j^lucose .jV^iguUr rate _ _pulse deficit
^pulses strong
VITALS Weight__.._, ..^ 1-,-^ ^ ^
SKIN
B P a a ^ / . L ^ P.l\£VRRU^tempfQJS 0 h skin warm & dry i«eciiagram_ /'P-^s
SaO, 4(3 i^J^lPi— intan i C s ^ H / erydiema / l e s i o n S f ^ f ^ ^ ^
P A I N L E V E L current: ^ HO mSc j ^ - ^ /tO accepiible3 /ID
quality ^ location _"-

CHIEF COMPkWNT J ^ . Q L l Q ^ S ^ h C i
surted^^/Zirs Aoys ogo f j j j l ^ ^ , ^ Q.^^JL-^Al^
—^——;r"V^c^<^^fe^ '—
XB\JCL
new meds
chemical e x p o s u r e .

rash / lesion / abscess ._ _ A J ^ £ ! 1 ^ ' ' Vjjollen j

possible insect bite ^e"'"" / «f»"*- KEY: T=Tend*mej« S=SweIiing E=Erythemi B=BurT)
A = Abrasion V=Vc$ide$ Lsc=Laccr2i>on
shortness of brcaih_

9 itchy
recent illness exposure
PAST MEDICAL HX negauve
recent camping exposure. EXTREMITIES
non-tender
_fiiU ROM
See Diagram.
joint pain
edema
heart disease / HTN / kidney disease / serzure / CVA / asthnui /
COPO / CA / diabetes: insufin ^no edema limited R O M .
NEURO
^oriented x 3 disoriented to person / place / time.
C pa«>iiiger§^;noneX3(>Mv\k:.i^
,(^l,<^^4:^^lgOgL/-—'- moves all extremities decreased L O C ,

S O C I A L HX 7^ ADDITIONAL FINDINGS
srnk)ker ppd drygs / a l c o h o L M S t t ' .
* T B ex^isjure / s y m p t o m ; _, .
* a b u j e screening- has O a i n o t B w n a v i c t i m '
• see abuic » l g o r i t h m _ _ f c u I i .

INITIAL ACTIONS
TRIAGE REASSESSMENTS
Time Reassessment INIT
fTIME
.UN!1.|
I P band appBgd^j I D band verified
'owned blanket provided
I bandage applied w o t t o dry dressing
bed l o w posidon si'dc rails up x I x2
call light In reach head of bed elevated t i

R N Signoture, diZL .Complete Time; 2Kb Nurse Signotun Mil.:

.Time-I

Page 1 i>r2 * pmocel milable

41';
 ACTIONS VITAL SIGNS
INIT TIME BP P RR T SaOi Rhythm Pain Pupils INITJ
i TIME
1
1
! cardiac monitor 1 ! J?^ , (^J?^ ^ ^ . -sr CHO
/IO
ZI\
1 : pulse o x i m e t e r O, I rw • '•
1 • FS Glucose /IO
I ! ready f o r D r e v a l notified doctor / seen by Dr ; /IO
> .' restraints see documentation I no
1 . ! 1 ADDITIONAL N O T E ^ V ^
i
i i
.
t
1
S 8514
IV STARTS _. y^5i. a.Lt^ O/US-• . > > o ^ o /
" T / M E " # ~ "site", 'gauge ;' allempts ; complications i rNit J0 y'^ySGAh <g«<bg»fefcrl..y7^,^
'^SoTniJ7A'^r^i t i
.01.
IV / MEDICATION INFUSION RECORD
Start ! Solution/ Med IV Rate Slop iAmount
Time mUhr Time i Infused

• I Aesponse. noilhonte iammed

I ! Raponx: nochangoJ imprvted

vhio \J<^ V 9SD

Rejpomr.' iWchange
xhonge imprmed

PROCEDURES PROPgRTYTO
TIME'; INIT feaiieni J[_<amily security safe see patient tietongings list
assisted with IJID.
JL^-^ /jGJfoM ' JUb
1 : drain / Iodoform / n u ggure -^-
DISPOSITION
discliargcd lioms pal<e iQtstng home ME^unethlhome E^uncml
_verbal / w r i t t e n instructions / R X given t o patient
llibdrav.-' /sent by ED tech/nurse/lab verbalized understanding
by IV s t a r t / P h l e b o t o m y BC x I o r 2 ^learning barriers addressed
results back accompanied by / driver (^Jt//-^
awaiting physician r e v i e w
adjniltetl
adjn / transferred io_
• ^eport
p o to_ ume.
cleaned w o u n d applied abx ointment
tprtifei- documentauon completed
applied dressing / Band-Aid / elastic wrap notified family / police / ME :^
_.loh AMA / ELOPE / LWBS signed AMA sheet refused.
to Xray w/monitor / nurse / O, / tech physician notifiod of:

return to room
Bpyff^^HR A - ^ R / r - Temp3J::z ^o,_
paintevelatdiscKarge " " ^ /IO
""
MEDICATIONS
TIME Medication f Dose I Route Site INlTl CONDITION -
Td/TT J 03mL I IM , Unchanged ^improved ^stable ^other_
fot #: ex;>. dote momifac Depart Time! Mode, walk crutches W / C / U n t d t t r ) an>bulance

^^'i^^t^'i
Rcdomc no c/wnjc npcpi'vO /IO
^
O/jc/wrge Nurse ^ n o t u r e H / ^ ^ ^ , ^ ; ^ ^ ^ . (T^^
^ j • C c n t i n m t i o n Sh««t
l\Sl- i n m onn d Pan
Pain
Response.' no change
nn
/IO

I
Rc^ontc'

Rejponsc:
nodianje

nodmngc
rm impto'iTd Pam_

i m p n m d Paia_
/IO

/IO

.Skin ' K.ish Abscess - 27 Kcv. 03 / 07 Paee 2 i>r2 * protocol inilable

416
 ^P^ 10 2008 2:45Pn
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Cosmetics 3,6? ^'-,5 ^

DAVID S C H U M A Q I E R -1536071 [LSTWRD] - Operatiw R«poit - 02/08 08-.20 A M P i g e 1 of 2

ElyBium FINAL TRANSCRIPTION RESULTS FROM l»HS YOG CHART COPY

TRANSCRIPTION
Nanw: •CHUMACHER, DAVD R Age: B6 MRN or ID: asSHTI IU8TWRD]
Addrmi: 708 E RANCH ROAD Bom: 07-M«y-1»l2 MITUMOOIS (Or«i»ri*]
t A C f U I E N r o . C A M f t U Sac M
Homo: («1B)4«f>4an Wat'ie (t1fi)4Mw|«M
OidM«d RO'JTVtE by aURLES PEMtY
C o f ^ T o : BU5INEU OfFice
Op«r»tV« Report
ServiBtJPrKMurBOsIc-<!S^M>>aoeOS:20AM -
Mercy Genorvl HosfNial
Mwikal RAoord NumMr. MHS 002536071

DATE OF OPERATION: 02/07/2008

i SOCIAL SECURfTY NUMBER: 572'5«-0W4.

PREOPERATIVE DIAGNOSIS: NecrsttElns fludhtt and myositis of tta right
(oworcycSd.

POSTOPERATIVE DIAGNOSIS: Necniitlns tapttis and myooM* oTtho tight

lower ay«(id.

OPERATION: Cet»id«m«^ of devtttfMd right lower eycM and right

psriottiW region; debndafnant of left psrioibital regiOA.

SURGEON: Charte$ Pwry. M D.

CO-SUf%6EON: . . . .
ASSISTANT:
ANESTHESIOLOGIST:
ANESTHESIA: Gerwral.

ESTIMATED QLOOD LOSS: Noglig'ibte.

COMPLICATK3NS: None.

INOICATIONS / FINDINGS:
• 1. NMretic light lottar eyelid iMn.
2. Necretk: ietttowereyairi sMn extendng Into ihe cheek.
3. DeviMEad neootte means mvscie.
4. Oeviteflved naovlic left chedc-fiasal juiKtion skin.
6. Vatiia right oftlcularls ocui muecie on the ioiMr aepect
e. Nontracklng of neoroeie into the right l»tnponli> toeui.
INOCATiONS FOR PROCEDURE: Thie Is a 65-year-old gentleman who premnted
after hsving placed some anIiwrtnMe cream around hii eyea me pievious
severri d a ^ He was seen by an outside physician and presented In frank
sepals and M M debitdad urgenliy in Ihe operstina leom 24 hour* pievious. I
wasoonsuliedductD ei^anding necroeto ofthe right lower eyelid, and
svakiatton levealed fyanic neoosls of the eyelid sJdn snd periorMsl altin'
extending onto the right eheelt, left cheetc, end wtfi edema and awelhg of
the (smponfis fossa region.

SPECIMENS: Cuttuie of thc right lower eyetid » v i spedmens U the right

lower eyelid.

http8://inhs.axoIotI.com/EA/CItoical/a»y»aIisCosnicttcsECD.i»£'5S7bfl 156db99ecB8825... 2/11/2008

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 Apr 10 2008 2 : 4 5 P n c> > n « r „ . - ••
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Sit,,: 1 -«5 p^ JQ
DAVID SCHU^iIACHER - 2536071 [LSTWRP] - Opentive Reittit • 02/08 08:20 AM Page 2 of 2

DESCRIPDON OF PROCEDURE: The paVent Wis taitan to ihe operating IhealBf.

Undiif general anesthesia alter the fsoe wee preppad. using a 15 blade, the
devIWteed tissue was aniBed b0dc to M g h l red blcading. Using a 16
blade « d sdeaon. from the right io«Mreyeid and in (he euoouTKing
legions of the perioftfta that had been debrfCM ptevtauiiy, 9ie edges were
fieshensd untl bright red bieadlns was obMned. All the nei»oi>c dead
tissue waa defarided. The wound was Vwn liTig«M and diesaed vvilh
bacHradn solutien and moist vauze.
OiSPOSmON: The pstient was talcen to the SICU irt criikal oondiSon.
PROGNOSIS: Poor. The psMnt wiH requVe nnultipie nwonstruclive
opetaUons In ihe Atture it he'a to sumive his sepsis apiseda The 6«M
was ifiscusaod wffri Dr. Wong. Or. Msrtet. 88 won aa Katiy. the patianTs ex-
wife.

CHARLES PERRY. M.D.

fl CP:MedQrai3«31093 0 fl v l ^
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0:02/060006 T- 02^)80008
tmrmnntM «:15t
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t i j a i e n 2duaiotsss7S7..iS44iihq«) t
Tran-NMavtK-JDDR gois
CKlCAJBASF

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in
+c»v J 2,10
M e r c y General H o s p i t a l Patient Name: SCHUMACHER, David R '
4001J Street 'MR#: 02536071
Sacramento, CA 95819 Aixounttf: 8835285
(916)453-4441 Patient Location: Ml
(916) 453^397 (Fax) Sex: M D.O.B: 05/07/1942 Age: 65Y
Kai Ni, M.O. Adm/Disch: 02/07/2008
Medical Director Physician: KARA R/y<OCZY-BYUN

SURGICAL PATHOLOGY/CYTOLOGY REPORT

Collected Dale/Time: Received Date/Time: Accession*: M608-0832
02/07/200817:00:00 02/07/200818:20:00 « * . i . c s i » i u i i w. ivivawo W O J *
SPECIMEN: Right lower lid tissues

CLINICAL DAT/VPREV. ACC. NO.: MG08-0809 (periorbita! Ussue)

PREOP/POSTOP OX: F«ght lower lid fasciitis
PROCEDURE:

GROSS OESCRIPTION:
Receh/ed in formalin in a container labeled with the patient's name and "right lower lid
tissues" is a 2.5 x 2.0 X 0.8 cm aggregate of several Irregular pale tan po'ilions of sl(in. The specimens --
weigh 2 grams. The largest portion of sKin shows daric brown-red discoloration. The specimen is
sectioned and entirely submitted in one cassette.
CR:pm [02/08/2008]

fAlCROSCOPiC DIAGNOSIS:

LOWER LID TISSUES, RIGHT. EXCISION:

MULTIPLE PORTIONS OF BENIGN SKIN EXHIBITING EXTENSIVE
NECROTIZING ACUTE INFLAMMATION IN THE DERMIS AND
UNDERLYING SKELETAL MUSCLE AS WELL AS SECONDARY ,
VASCULITIS INVOLVING FOCALLY THROMBOSED VEINS AND
ARTERIAL VESSELS

COMMENT:
The findings are consistent wilh clinical impression of neaotizing fasciitis. Correlalion
wilh cultures is recommended.

S:
Ellen Sung, M.D., Pathologist
(Electronically Sfgned)
Verified: 02/11/200816:34:12

ICD-9: 682.9:785.4
CPT: 88305
DD: 2/11/2008:ES
TD: 2/11/2008.DE
Physicians: Charles Pcnry, M.D.

CHART COPY Page 1 of 1

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EXHIBIT D
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1
2 UBALDI & McPHERSON LLP
Michael V. Ubaidi, Esq.. SBN 072986
3 Dennis P. McPherson, Esq., SBN 128879
455 University Avenue, Suite 360
4 Saoramento, CA 95825
Telephone- (916) 265-4555
5 Facsimile: (916) 265-4568

6 Attomeys for Defendant CATHOLIC

HEALTHCARE WEST MEDICAL FOUNDATION
7
8 SUPERIOR COURT OF CAUFORNIA

S COUNTY OF SACRAIVIENTO

10
11 DAViD SCHUMACHER, CaseNo. 34-2009-00033548
12 Plaintiff, DECLARATION OF PAUL
WILLIAM RORK, M.D. IN
13 vs, SUPPORT OF DEFENDANT CHW
MEDICAL FOUNDATION'S
14 TAN PHAM, M.D., CATHOLIC HEALTHCARE MOTION FOR SUMMARY
WEST MEDICAL FOUNDATION, MERCY JUDGMENT, OR IN THE
15 MEDICAL GROUP, YOUTHOLOGY, JEFFREY ALTERNATIVE, MOTION FOR
GUNTER SUMMARY ADJUDICATION
16
Defendants.'
17
18 AND RELATED CROSS-ACTION Date Action Filed: 2/3/09
/ Trial Date: Not Set
19
20 I, PAUL WILLIAM RORK, M.D., DECLARE AS FOLLOWS:

21 1 I am licensed physician in the state of Califomia with a practice of urgent

22 care and fiamlly practice. My clinical practice Is In South LaKe Tahoe. I am board certifieci

23 by the American Board of Family Practice and have been licensed in the state of

24 California continuously since 1979. I completed my medical schooling atthe New Jersey
Ubaldi &
WEPharaiHi 25 Medical School, graduating in 1977 I then did one year of internship in medicine at W e l d
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26 County Hospital in Greely, Colorado, I then did two years of residency In family practice

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Dedaralion of Paul RorK, M,D; Action No 34-2009.000336^
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1 In Greely, Colorado, completing my residency in 1980.

2 2, In the course of approximately 31 years of practice In family practice

3 medicine I have evaluated literally hundreds of patients who have presented to me with
4 complaints involving sinus congestion, sore throat, swollen glands and fatigue. I have
5 also seen and evaluated hundreds of patients who have presented with complaints
6 regarding swelling around their eyes
7 3! in Apnl, 2010 I was retained by defendants CHW Medical Foundation to

8 review the medical records of David Schumacher and provide opinions on the standard
9 of care and causation as it pertains to the care and treatment given to David Schumacher
10 between February 5, 2008 and Febmary 6, 2008. More specifically, I reviewed the
11 medical records from the Medical Clinic of Sacramento pertaining to Dr. Pham's
evaluations of plaintiff on February 5 and 6,2008 plus some of ths initial medical records
12
of Mercy General Hospital where plaintiff presented on the evening of February 6"^. In
13
reviewing these records I have reached opinions on the standard of care and causation
14
applicable to tfie care and treatment rendered in those time frames.
15
4. On February 5,2008 David Schumacher presented to the Mercy Medical
16
17 Group and Dr. Pham with complaints of sinus congestion, sore throat and swollen glands.
18 David Schumacher further clarified in that visit noting that he had sore throat on the right
19 side with fatigue over the last week and swollen glands on the right side. He denied any
fever or chills in tliat visit. Dr. Pham conducted an examination noting of significance that
20
his nedc was supple with some tenderness of the cervical lymph nodes on the right side.
21
Dr. Pham had plaintrff undergo a rapid strep test. The results of the rapid strep test were
22
noted to be negative. Plaintiff was requested to continue to take his over the counter
23
medication, increase his fluid intake and get some rest. Me was asked to call back if his
24
UUMI& condition worsened Dr. Pham noted there was nothing to indicate a throat abscess in
McPherson 25
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his examination.
26

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DedaratkMi of Paul RorH, M.D,; Action No 34-2009-00033548
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1 5. Based upon my review of the records of plaintiffs presentation to Dr. Pham

2 on February 5, 2008, it is my opinion that Dr. Pham met the standard of care for the

3 treatment to plaintiff as a family practice physician, Dr. Pham's examination and

4 assessment of the patient is comprehensive and v/ell documented Given the

5 examination and symptoms, the diagnosis rendered by Dr. Pham appeared accurate and

6 based upon good exercise ofjudgment, skill and understanding at that time. As to the

7 rapid strep test, once that test came back negative, it was not the standard of care for Dr.
Pham to obtain a culture of David Schumacher's throat. Even if a culture had been
8
obtained, the culture results would not have yielded any growth to determine the nature
9
of the organism or a way to treat it until at least 24-72 hours later. Based on the
10
foregoing, it is my opinion that Dr, Tan Pham, M.D. met the standard of care in the care
11
and treatment of David Schumacher on Febiuary 5,2008
12
13 6. I have also reviewed the records of David Schumacher's presentation to
Tan Pham, M.D on February 6, 2008. On February 6, 2008 plaintiff wa$ seen by Dr.
14
Pham at approximately 12:30 p.m. with complaints of a swollen left eye. Or. Pham
15
conducted an examination showing the muscles around the eye were intact. The pupils
16
17 were equal, round and reacted to light. He had no Intolerance to light There was noted

18 swelling over the lower part of the left eye and in the middle part of the left upper eye lid.

19 This swelling was non-tender to palpation but noted to be slightly reddened. In thts visit

20 plaintiffis noted to have been using some type of anti-wrinkle or anti-aging cream around

21 the eyes. Dr Pham noted an assessment of suspicion of contact dennatitis from this
cream.
22
23 7. It is my opinion that Tan Pham, M.D. made tfye appropriate presumptive

24 diagnosis of contad dermatitis on February 6,2008 based upon the plaintifTs complaints
Ubolditk
McPMrsan 25
and Or Pham's examination. I further find that Dr. Pham did a comprehensive
UP
examination, appropriately documented his findings and met the standard of care in the
26

DeslBRKion ef Paul Roiii, M O., Acbon No. 34.2009-00033549

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. 1 care and treatment of David Schumacher on Febmary 6, 2008,

2 8. I have reviewed the medical records of Men:y General Hospital and find that

3 he presented to the Emergency Department at Mercy Oeneral at 20:05 with complaints

4 of increased symptoms to the eyes. The impression at that time was periorbital cellulitis,
5 a condition indicative of infection. The initial evaluations to Mercy General Hospital
• 8 indicate he had necrotizing fasciitis of the skin around his eyes and was almost
7 immediately set for surgery to debride this tissue. Necrotizing fasciitis of the orbital area
8 is an exceedingly rare condition. It is a condition that more often than not can only be
9 diagnosed by observation ofthe necrotizing fasciitis condition.
10 9. It is my opinion that any diagnosis of an infection around the eye could not

•11 have been made by Dr. Pliam on February 5, 2008, inasmuch as the symptom
12 presentation cleariy suggested there was no infection around the eye. The rapid strep
13 test was negative, in fact, it would have been below the standard of care fbr Dr. Pham
14 on February 5* to have prescnbed antibiotics to plaintifF because his symptom
15 presentation did not suggest a bacterial infection, and the rapid strep test was negative.
16 10. . It is also my opinion thatthe diagnosis ofnecrotizing fasciitis or any infection

17 around plaintiffs eyes could not have been made by Dr Pham on February 6, 2008,
18 Again, the symptom presentation did not suggest infection around the eye nor necrotizing
19 fasciitis. However, even rf antibiotics had been initiated by Dr. Pham at 12,00 noon on
20 February 6,2008, it is my opinion that the initiation of antibiotics would have had no effect
21 whatsoever on treating, slowing, or anresting the onset of infection of the necrotizing
22 fasciitis infection around plaintiffs eyes.
23 1 declare under penalty of perjury under the laws ofthe State of Caiifomia that the

24 foregoing is tnje and correct. Executed this ( ^ day of l\^fy*lif. 2010, at i ^ ^ M l

UD»l(|i£
McPhoison 25 f o ^ e V h a ^ . califomla.
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26 Paul yvillian^ Rork, M.D.
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i3eelaiabofl of Paul RorK, M<D.; Aelioif No 34-2009-00033546
EXHIBIT E
 1
.2 UBALDI & McPHERSON LLP
Michael V. Ubaldi, Esq., SBN 072986
3 Dennis P McPherson, Esq , SBN 128879
455 University Avenue, Suite 360
4 Sacramento, CA 95825
Telephone: (916)265-4555
.5 Facsimile: (916)265-4568

6 Attorneys for Defendant CATHOLIC

HEALTHCARE WEST MEDICAL FOUNDATION
7
8 SUPERIOR COURT OF CALIFORNIA

9 COUNTY OF SACRAMENTO

10
11 DAVID SCHUMACHER, Case No. 34-2009-00033548

12 Plaintiff, DECLAFIATION OF PATRICK

JOSEPH, M.D. IN SUPPORT OF
13 vs. DEFENDANT CHW MEDICAL
FOUNDATION'S MOTION FOR
14 TAN PHAM, M.D., CATHOLIC HEALTHCARE SUMMARY JUDGMENT, OR IN
WEST MEDICAL FOUNDATION, MERCY THE ALTERNATIVE, MOTION
15 MEDICAL GROUP, YOUTHOLOGY, JEFFREY FOR SUMMARY ADJUDICATION
GUNTER
16
Defendants.
17
18 AND RELATED CROSS-ACTION Date Action Filed: 2/3/09
/ Trial Date: Not Set
19
20 I, PATRICK JOSEPH, M.D., DECLARE AS FOLLOWS:
21 1. I am licensed physician in pnvate practice in San Ramon, California. 1 am
22 licensed to practice medicine in the state of California I have been licensed to practice
23 in the state of California continuously since 1974.
24 2. i attended medical school at West Virginia School of Medicine, completing
Ubaldi &
McPherson 25 my medical schooling in 1973. I then did two years of internship at Highland General
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26 Hospital in Oakland, California. I followed my internship with two years of residency in

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Declaration of Pafrick Joseph, M D , Action No 34-2009-00033548
 1 internal medicine at Highland General Hospital in Oakland, California Following my

.2 residency I had two additional years as Chief Resident in internal medicine at Highland

3 General Hospital. In 1977 I then undertook two years of fellowship training in infectious

4 diseases at University of California San Francisco. I am board certified in internal

5 medicine, infectious diseases and infection control

6 3 In January, 2010 I was retained by CHW Medical Foundation to review the

7 records of plaintiff David Schumacher from the Medical Clinic of Sacramento Medical

8 Group, and Mercy General Hospital as it pertains to care and treatment received by David

9 Schumacher in February, 2009. I have reviewed the records from Mercy Medical

10 Group/Medical Clinic of Sacramento and Mercy General Hospital pertaining to plaintiff's

11 care and treatment received in February, 2009. In reviewing said records, I have reached

12 conclusions as to issues of causation, which will be stated below.

13 4. In my pnvate practice I focus almost entirely on infectious disease issues.

14 I have over 30 years of experience in evaluating and treating individuals presenting with

15 infectious diseases I have treated and followed the care of hundreds of patients

16 presenting with staph infections as well as patients with necrotizing fasciitis. I am further

17 familiar with the epidemiology and prevalence of these organisms in a community and the

18 causes and progression of these conditions

19 5. From my review of the record, I note David Schumacher presented to the

20 Mercy Medical Group and Tan Pham, M.D. on February 5, 2008. On February 5, 2008

21 David Schumacher presented with complaints of sinus congestion, sore throat and

22 swollen glands. Plaintiff further clanfied his complaints to Dr. Pham, noting that he had

23 sore throat on the nght side with fatigue over the last week and swollen glands on the

24 right side He denied fever or chiils. Dr. Pham conducted a physical examination noting
Ubaldi &
the neck was supple with some tenderness at the adenoids on the nght hand side Dr
McPherson 25
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Pham assessed David Schumacher to have potential upper respiratory infection Plaintiff
26

Declaration of Patnck Joseph, M D , Action No 34-2009-00033548

 1 underwent a rapid strep test in the office which was found to be negative. Plaintiff was

.2 asked to increase fluid intake and rest and call back to the office if his condition

3 worsened.

4 6 David Schumacher then returned to see Dr. Pham on February 6, 2008,

.5 with the records noting the encounter with the physician at 12:30 p m In this visit he is

6 noted to be in follow up for swelling around the left eye. Dr Pham's physical examination

7 noted swelling over the lower part of the left eye and in the medial part of the left upper

8 eye lid This swelling was non-tender, reddened, but not tender to palpation.

9 7. I have also reviewed the medical records of Mercy General Hospital and

10 note that David Schumacher presented to the emergency department of Mercy General

11 Hospital at approximately 8 pm with complaints of pain and vomiting. At that point in

12 time David Schumacher was assessed to have an infection around the eyes and the

13 records indicate he was scheduled for surgical debndement in an attempt to clear the

14 infectious organism and spread of his necrotizing fasciitis.

15 8. From my review of these records, I have reached several opinions regarding

16 the issues of causation First, when David Schumacher presented to Dr. Pham on

17 February 5"" with complaints of sinus congestion, sore throat and swollen glands, it was

18 appropnate for plaintiff to receive a rapid strep test to determine if he was suffering from

19 strep throat. When this test is found to be negative, it is not the standard of care to

20 thereafter obtain a culture. However, had a culture been obtained, it routinely takes

21 between 24-48 hours for the cultured organism to grow out and be identified in order to

22 receive proper treatment Therefore, even if a culture was obtained on plaintiff on

23 February 5, 2008, by the time the culture was returned and the potentiai infectious

24 organism identified, plaintiffwould have already been suffering from and needing care for
Ubaldi &
his necrotizing fasciitis In this regard, it is my opinion there could not have been any
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identification and diagnosis of any infectious organism in and around plaintiff's eyes at
26

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Declaration of Patnck Joseph, M D , Action No 34-2009-00033548
 1 that juncture that would have stopped or arrested the growth of the infection around

.2 plaintiffs eyes or the subsequent spread of necrotizing fasciitis.

3 Finally, based upon my review of Dr Pham's records of February 5 and 6, 2008,

4 there is no indication on either of those visits when Dr. Pham sees David Schumacher

5 that he had an infection around his eyes or nor the onset or beginnings of necrotizing

6 fasciitis.

7 Based upon all of the above, it is my opinion the care and treatment rendered by

8 Tan Pham, M.D. at the Medical Clinic of Sacramento to plaintiff on February 5 and 6,

9 2008 did not cause or contribute to the onset of plaintiff's infection.

10 I declare under penalty of perjury under the laws of the State of California that the

11 foregoing is true and correct. Executed this -^ day of Mty^<jos>l~, 2010, at

12 Sacramento, California.

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Declaration of Patnck Joseph, M D , Action No 34-2009-00033548