HomeMy WebLinkAboutClaim 736 - L.Cameron __--
CITY OF PALM DESERT
CITY CLERK DEPARTMENT
STAFF REPORT
REQUEST: CLAIM AGAINST THE CITY (#736) BY LINDA CAMERON IN AN
UNSPECIFIED AMOUNT
SUBMITTED BY: Rachelle Klassen, City Clerk
DATE: July 10, 2014
CONTENTS: • Staff Report
• Recommendations of Claims Adjusters and Staff
• Claim No. 736
Recommendation
By Minute Motion, reject the Claim and direct the City Clerk to so notify the
Claimant.
Background
Based on a review of the subject Claim and the recommendation of the Claims Adjuster,
Risk Manager, City Attorney, and staff, it is recommended that the Claim be rejected.
Discussion of this item should be held in Closed Session pursuant to Government Code Section
54956.9(b), potential litigation.
Fiscal Analysis
City of Palm Desert participates in the self-insurance pool of the California Joint Powers Insurance
. Authority (CJPIA). Action to reject the subject Claim does not have a fiscal impact on the City at
this time.
Submitted by: roved:
Ra elle D. Klassen, M , City Clerk hn M. Wohlmuth, City Manager
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Attachments (as noted)
CITY COUNCIL AC�ION
APPROVED '� DF,NiED
RECEIVED OTHER
MEETI G DATE 7���r
AYES: ��9�'1'��,;%�!K� (� � ��h�Kr
NOES: °�
ABSENT: ..�ietiC
ABSTAIN: � �
VI�,RIF[ED BY• �k Y�m
Original on Tile with City Clcrk's Office
L���� � RE�EIYED
� CiT Y CLERK'S t?FFICE
CARL WARREN & COMPANY p A�-M OES ER�T. (��
Clairns Man��;ernent and Solutions �01� Jt1N 23 PM �: 4e.
June 18, 2014 . '
COPY TO • 1�..�
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TO: City of Yalm Desert �AjE_ �p- Z�-/
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AT'TI;NrI�IC)N: ftachelle D. Klassen, MMC, City Clerk
RE: Claim : Cameron v. Palm Desert
Claimant : Linda Cameron
Member : City of Palm Desert
Date Rec'd by Mbr : 1/7/14
Date of Event : 12/19/13
CW File Number : 1877551 PMQ
Pleasc� allow this carrespondenc� to acknowlcdge receipt ot the captioned claim. Pleas�: take the
l�c�llowin�;actiUn:
• CLAIM RF,JF,CTInN: Send a standard re,jection letter to the claimant.
Please include a Froof of'1Vlailin�; with your rej�ction n��tice to the claimant. Ai1 exemplar capy
c�f� Prac�i��of Mailing is attached. I'lea�e prc�vide us with a copy of the Notice o�f Rejection and
co�y al'fhe Froof af Mailing. 1f y<�u have any yuestions feel free to contact the assi�ned adjuster
or tlie undersigned supervisor.
Very truly yours
CARL WARREN& COMPANY
R�chard D. Marc�ue
Richard D. Marque
Supervisor
AN EMPLOYEE-OWNED COMPANY
770 S. Placentia Avenue i Placentia, CA 92870
P. O. Box 25180 i Santa Ana, CA 92799-5180
www.carlwarren.com i Te1: 714-572-5200 i 800-572-6900 i Fax: 866-254-4423
CA License No.2607296
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Ci��irns Mana�ement and Solutions 2014 JAN I 6 ��1 �Q: S�
January 8, 2014
GOVERNMEN'I'AL FNTiTY PRFLIMINA.RY REPORT
TO: rl Warren& Company
PO ox 25180
Santa na, CA 92799-5180
Principal: CJPIA Our File: 1$77551
City: Palm Desert Date of Loss: 12-19-2013
Claimant: Linda Cameron Date Received: 1-8-2014
> Facts: 'The claimant is a 66 year old woman, visiting from Washington State. She tripped
and fell on a city sidewalk,falling onto face.
Government Code Requirements:
a) Date Verified Claim Fi[ed: 1-7-2014
b; Aetion by Public Entity: City to defer response.
c) Statute of Limitations: 12-19-2015
Possible Co-Defendants: Investigation pending.
Liabili : The City responded to the accident location and identi�ed a tripping hazard, a 1.5
inch ledge. Please note the concrete section that was raised, is a different color from the rest
of the sidewalk,the city denied pouring the conerete for the colored section.
Damaees: The injuries appear to be soft tissue to the face and head.
Claim• Reserve•
1}LBI—Linda Cameron $10,000.00
Comment/Wark to be Completed: 1}Inspect and photograph accident location. 2}
Obtain claimant version,theory of liability and extent of darnages. 3) Conduct City
inves#igation as warranted.
Our further report will follow shortly.
Very Truly Yaurs,
CARL WARREN&CO.
Pete McNulty
�Sc: City of Palm Desert Attn. Rachelle Klassen �., �
cc: CJPIA-Attn.: Executive Directar ���'Y�� " '' ` �� � '�'J'��"�
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AN EMPLOYEE-OWNED Ct�MPANY
770 S. Pi2centia Avenue t Placentia, CA 92$70
P. O. Box 25980 i Santa Ana,CA 92799-518�
www.cariwarren.com i Tel: 7i4-572-5200 i 8d0-572-fi900 � Fax:866-254-4423
CA License No.2607296
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TO. CJPIA (c/o CARL WARREN & CO.), CITY MANAGER, �IYY AT�'OR�1�Y, :
DIRECTOR OF PUBLIC WORKS, RISK MANAGER
FROM: CITY CLERK
DATE: JANUARY 7, 2014
SUBJECT: CLAIM Nt�.'7�� =CLAIM AGAINST THE CITY BY LINDA CAMERON IN AN
UNSPECIFIED AMOUNT
The attached Claim No. 736 is being transmitted to you for the following:
❑ Information only.
or
'L�, Review and rec4mrn�ndatior�:fo the Claims Review Committee for any action
required by the City of Palm Desert.
We would appreciate your report, if requested, by February 7, 2014, for timely response
to the Claimant.
Note: Ff you have any information that would be helpful in the processing of this Claim,
please provide it to me so that I may forward it on to the City's third-party Claims Adjus ers,
Carl Warren & Company. , � � `,��:b� ���
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RACHELLE D. KLASSEN, MMC �
CITY CLERK
Attachment (as noted)
�:� �FIkIf�UNIIttY1�N11Fitlt
~ ASSIGNED CLAIM N0.���„
CLAIM AGAiNST TH@ CIYY OF PALM DESERT
(For Damage(s) to Person(s) or Personal Property) �!T Y R�����`.,.r�
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l''!P', '.tE-..� � ���'�� ���l,,:�.
Received by: �" �e�.__ I/�'�-cv1�.` -�.____ ;1-�i
. 2014 JAN -� ��! 9: 22
via: U.S. Mai! Inte�vffice Mall Over-the-Counter `'"�
A CLAIM MUS BE FILED WI H HE CI Y CLERK O H CITY OF PALM DE ER WI HIN SIX
bAONTHS AFTER �IHICH THE INCIDENT� C1R EVENT OCCURRED. BE SUR� YOUR CLAIM IS
AGADVST THE CITY � PALM D�SERT, NOT ANOTk1ER PU�LIC ENTITY. WHERE SPACE iS
INSUFFI�IENT, PLEASE USE AI�pI1IUNAL �'AP�R AND ID�NTIFY IhiFORMATtON BY
PARAGRAPH NUMBER. COMPLETED CLAIMS MUST BE MAII.ED OR DEL:IVE1tED TO THE CITY
CLERK, CITY O� PALM DES�RT, 73-510 FRED WAItING DRIVE, PALM DPS�R7',���1�92260.
TO THE HONORABLE MAYOR AND CITY COUNCIL, City of Palm Desert, Cali�ornia:
The undersigned resp�ctfully submit(s) the following claim and information relative to damage(s) to
person(s)and/or personal property:
l. CLAIMANI' INFORMATt0�1: � .
NAME L 1✓lo�l, [ AI�Y�P(^D/1 .
, -
ADDRESS -- �
PHONE NO.��� . ,,�_ ^�ATE BIRTH: ' `-�- -�- . . .
SOCIAL SEC�JR ,�f0. - - DRIVER'S�tCENS 1'VO. � �
2. Name, teleph�ne number and post o#fice address to which claimant desires notices to be
sent, if other than above:
�s � �-�' �c�..( -�� �'ljla.�-�i .
� t
3. Occurrence or event from which the clairn arises:
a. DATE: �12�, l3 b. TIME: 7%DD �/I�! c. PLACE (exact and specific
location) ^ ,aEW � ,Q-✓
A
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d. How and under what circurinstances did damage or injury octur? �pecify the particulac
occurrence, event, act or omrnission �rou claim caused the injury or damage. (Lise
additiona! paper if necessary.) 5� . . -��� � � � ��P
e. What particular action by the City, or its employees, caused the alleged damage or
injury? . � GC.G � D
.n - r
r
G
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Page 1 of,2
4. Give a general description af the indebtedness, obligation, injury, damage, or loss incurred
so far as it may be known at the time of presentati9n of the claim. Yf there were no
injuries, state "no injuries": _ SP�p, u.�{-a eG�-
S. Give the name(s) of the City employee(s) causing the damage or injury: �_�4/�1 O LU n
6. Name and address of any other person(s) injured: _ CA rl�h�w yj
7. Name and address of the owner of any damag�ed property: ___ /l�(�
8. Damages claimed:
a. Amount claimed as of this date; $ 5ee.. �{-�p,� ,��p,� rcv� .�, ��
b. Estimated amount of future costs: $ u„
c. Total amount claimed: $ �
d. Basis for computation of amounts claimed include copies of all bills, invoices,
estimates, etc.):
9. Names and addresses of all witnesses, hospitaCs, doctors, etc.:
� S P P cr � P� ��
10. Any additional information, including police report , which might be helpful in considering
this claim: Q .'�-1,r_ ,�,.�,P ��
i 7—
WARNING:IT LS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM! PENAL CODE 72;
INSURANCE CODE 55b.1).
I have read the matters and statements made in the above claim, and I know the same to be true of
my own knowledge, except as to those matters stated upon inforrnation or belief as to such matters
I believe the same to be true. I certify under penalty of perjury that the foregoing is TRUE AND
CORRECT.
� Signed t ' (rp� day of _ ,20 1�, at .�� ��-� �
G�IlL�-
SI A URE OF CLAIMAINT SIGI�IATURE OF CLAIMANT
Office of the City Clerk, Palm Desert, California DOC. NO.�� DATE FILED ��--�1
Page 2 of 2
9.�/��� ..������
LINDA CAMERON ATTACHMENT 1
OCCURRENCE 12/19/13
3d I was waiking north on the sidewalk. I had walked down Mesa View and
turned north on Portola. I had walked a long way on the sidewalks which are quite
wide and regular along those streets. Suddenly, I came to a section of cement
(approx 5'X 8') that was raised from the surface of the previous section. That
whole raised section is a different color, indicating that it was poured at a different
time, possibly a. replacement section. On the south side of that section it is quite
raised, out of character for the entire length of sidewalk which I had walked. The
raised section caught my toe/foot and i fell directly on my face. It happened so
quickly and so abruptly the whole impact of my fall was to my face, right eye and
head.
4 Major injury and trauma to head, right eye and nose. Orbital bone on right eye
bruised and numbness lingers (nerve damage). Five stitches to eye lid below
orbital bone. Nose bled profusely, numbness, tenderness and swelling. Frequent
flashes in right eye. Initial exam by ophthalmologist did not show retinal tear but
still under watch as flashes continue. Blurry vision and headaches.
9 No witnesses at the scene of accident. No traffic stopped and I was in shock and
dazed while trying to stand up. I remember fumbling to get my phone out of my
"fanny pack" to call my husband for help. Blood was running down my face onto
my clothes, shoes, and sidewalk. I remembered I had a paper towels in my pocket
and then pressed them on my eye and nose to control the bleeding. I was able to
walk to the Living Desert to get help. A female, older woman working at the
Living Desert membership window (Donna Hansen) gave me ice to apply to my
eye and tissue to wipe myself before my husband arrived to take me to Eisenhower
Medical Center ER. She let me sit down in the office because I was shaking so
badly.
Witnesses, hospitals, doctors, etc.:
Donna Hansen— attendant at Living Desert
Eisenhower Medical Center Emergency —Rancho Mirage, CA
Dr. Andrus, Eisenhower Urgent Care —Rancho Mirage, CA
Dr. Matthew Kirk, Ophthalmologist, La Jolla, CA (Scripps Medical Center)
Dr. Greg D., Shannon P.A. — Eisenhower Urgent Care — Rancho Mirage, CA
Robert Haberkorn—Haberkorn Chiropractic
_ �.,,��,� Q r� �r��_ _ ______ --
(Patient initial) I untlerstand that Eisenhower Medical Center is not in my health plan's network or is nat a preferred
provider (point of service option) does not have a referral or authorization from my primary care provider or health plan
has agreed not to submit a ciaim to my insurance plan at my request. t may have to pay more, or i may have to pay the
full charge. If uninsuretl or potentially in need of financial assistance, I agree to complete a hospital financiai assistance
application and submit requirecl supporting documentation needed to determine eligibility for full or partiai financial
assistance.
Ph sician Are independent Contractors
ent Initial) All physicians and surgeons providing services to me, inclutling the radiologist, pathologist,
emergency physician, anesthesioloqist and others, are not employees or agents of the hospital. They have been granted
the privilege of using the hospital for the care and treatment of their patients, but they are not employees or agents of the
hospital.
i understand that I am under the care and supervision of my attending physician. The hospital and its nursing staff are
responsible for carrying out my physician's instructions. My physician or surgeon is responsible for obtaining my
informed consent, when required, to medical or surgical treatment, special diagnostic or therapeutic procedures, or
hospital services provitled to me under my physician's general and special instructions.
.��N�ti to Consumers:
Patient Initial) Medicai doctors are licensed and regulated by the Medical Board of California, Patients may
obtain information or complain about a California Medicai doctor at 1-800-633-2322 or www.mbc.ca.gov.
Receipt of Additional Hospital Specific Addendums
Tlie undersigned acknowledges receipt of the following:
�` �atient Rights and Responsibilities Opt Out
* otice of Privacy Practices (NPP) Patient Initial
Message from Medicare Abo�t Your Rights
Financial Assistance Pamphlet and Application Packages (If Applicable)
Release of Infiormation
The hospital will obtain the patient's consent antl authorization to release medical information, other than basic
information, concerning the patient, except in those circumstances when the hospital is permitted or required by law to
release information.
I acknowledge my healthcare information may be disclosed for purposes of communicating results, findings, and care
decisions to my family members antl others responsible for my care or designatetl by me. I will provide those intlividuals
wi rivacy code specifietl by the Hospital.
��� atient initial Privacy Code o 101
�
Will expire on discharge. Qnly good for this admission
Agreement
The undersignetl certifies that he/she has read the foregoing, receivetl a copy thereof, and i the patient, the patient's
gal presentative�r i�.duly author' by the p 'en ,s t patienYs general agent to exe t�qve and accept it terms.
�� �v l� �� r J �Cc, .
�
Date Time Patien arent/Guartlian/Responsible party If other th patient, indicate relationship
.��
Witness Witness - Required only when signer makes their mark
A COPY OF THIS DOCUMENT IS TO BE GIVEN TO THE PATIENT AND ANY QTHER PERSON WHO SIGNS THIS DOCUMENT.
3 3-s�-B-6-�8�--- --
0 0 2 6�4 4 3 a � : EISENHOW ER MEDICA L CENTER
� 39000 Bc,b FTope Dr.,Rancho Mirage,CA 92�70
ex: F Date of Birth: :
hysician: 888 ER,MISC PxYszcsArr COND{TIC?NS OF ADMISSION
2/19/13 Aq e: 66 �
OiSTRIBUT!ON �an+ MEDICAL RECOAb, ?ert 2 PATIENT OR LEGAL HEPRESENTATIYE P89@ 2 01 2 REORDER#OQ1768 REV.5/12
'AMERON,LINDA
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EI��NHC�WER 1V�EDI�AL �EI�TER
��I��c�l�h C;czr-e As It S�.oulc� Bf�
Urgent Care Rancho Mirage
Rancho Mtraqc Mi�dical Centcr, /7/HO Country Club Dnvc HJD3,Rancho Mirage,Cafiforma 977JD
I'hone !bU BS�1 .3!�9_d t��x: /6U b/� 38��
Patient's Name: ACameron, Linda
Caregiver's Name: Dr.Andrus
Special Instructions:
#1 apply bacitracin ointment to wound once a day.
#2 return in 5 days for suture removal.
#3 if increased headache nausea vomiting or change in symptoms go to ED ASAP
Acute Wound Care
WHAT YOU SHOULD KNOW:
An acute wound is an injury that causes a break in the skin.
INSTRUCTIONS:
Medicines:
. NSAIDs help decrease swelling, pain, and fever. This medicine is available with or without a
doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If
you take blood thinner medicine, always ask your primary healthcare provider (PHP) if NSAIDs
are safe for you. Always read the medicine label and follow directions.
. Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how
much to take and how often to take it. Follow directions. Acetaminophen can cause liver
damage if not taken correctly.
. Antibiotics may be given to prevent or treat an infection caused by bacteria.
. Take your medicine as directed. Contact your PHP if you think your medicine is not helping
or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the
medicines, vitamins, and herbs you take. Include the amounts, and when and why you take
them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in
case of an emergency.
Follow up with your PHP as directed: You may need to return to have your stitches or staples
removed, wound checked, or bandage changed. Write down your questions so you remember to
ask them during your visits.
Wound care:
. If your wound was closed with thin strips of inedical tape, keep them clean and dry. The strips
of inedical tape will fall off on their own. Do not pull them off.
https:/!www.micrc>medexsolutions.com/carenotes/librarian/ssl/true/ND T/CNotes/CS/lA... l2/19/2013
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Haberkorn Chiropractic
73-725 EI Paseo Dr.,Suite 21A
Palm Desert, CA 92260
(760)346-9400
http://www.haberkornchiropractic.com
Linda Cameron
Sale Date: 12/23/2013 - 2:17 PM
Sale ID: 5873
Soid By: Haberkorn, Robert
Chiropractic Follow Up, 30 min (Exp: $
1 12/22/2014) 0.00
1 30 Minutes (98940,97140) (Exp: �65.00
12/22J2014)
Subtotal: $65.00
Tax: $0.00
Total: $65.00
Payment Method Amount
Visa/MC $65.00
LINDA CAMERON
Visa- **�
Authorization #:
LINDA CAMERON
Customer Copy
We appreciate your business - if you purchased a
series, please note the expiration date.
Please retain this receipt for your records.Thank
you!
�f 2 12/23/2013 2:17 i'M
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CAMERON, LINDA; DOB: 11/15/1947; ID11:0002674433
"�
a
�� Office Visit Summary on 12/24/2013 at 11:59 AM
Patient: CAMERON, LINDA M Sex: Female DOB:
Clinician of record: Shannon PA, Greg D. Location: Eisenhower Express Clinic Rancho
Mirage
Subjective
Med LiSt!un•!inncli/ic�cf/)rc?:{?013 lre��ic wed:Uc�c?4?0l3
conju�atcd csU�ogcns Or�il,Orul taking
progcstcronc Vagl,Vabl taking
Preferred Pharmacy
Walgrccns Dru�Storc 04756 44830 Montcrcy�vc[PALM Df;S1;RT,44R40 MONTT;RLY AVIij Ph: 760-674-0716 Fax:
760-674-R287
Created from:Eisenhower Express Clinic Rancho Mirage,72780 Country Club Drive, Bldg.B Ste 203,Rancho Mirage,CA,
92270(760)674-3844
Created on 12/24/2013 at 11:59 Page 1 of 1
C1VOtCti�111 ,>ySlClll r���,u i v� �
,
� EISEl\TH��NER I��TEDI�.�.L ��l�TER
Hecx�th �'�c�l� As It Sj�c�u�d Be�
Urgent Care Rancho Mirage
Rancho Mirage Medical Cenler, 72780 Country Club Drive 8203, Rancho Mirage, CaliforNa 92270
Phonc 760-834-3593 Fax: 760-674-3845
Patient's Name: Cameron
Caregiver's Name: gshannon
Specia 1 Instructions:
Apply OTC anti-scaring med as as directed
2013 Truven Health Analytics Inc. This patient education document was created using the MICROMEDEX(R)
�tem and may contain MICROMEDEX proprietary information.
Diagnosis - AfterCare(R) Instructions(Urgent Care), English (SaveNote version)
Generated on Tuesday, December 24, 2013 11:58:46 AM
is important to keep the u pdated medication list you were given today,
cluding over the counter medications, with you at all times to share with
�ur healthcare provider at each visit or in case of an emergency situation.
you had any lab work done during today's visit, we will contact you only for
�normal results and/or if any change in treatment is needed.
�ave received and understand the instructions in this handout.
itient/Guardian
gnature
aff Signature Time:
ps://www.micromcdexsolutions.com/carenotes/librarian/ssl/true/NI� "I'/CNotes/CS/508D33/DiJPLIC... 12/24/2013
FOLLOWI NG ARE TWO
E-MAI LS i N RESPONSE TCJ
TH E FI RST REPORT OF
THE INCIDENT GIVING
RISE TO CLAIM
���
Related to Claim No . 736 -
LINDA CAMERC� N
Klassen, Rachelle
From: Longman, Beth
Sent: Monday, December 23, 2013 1:45 PM
To: Mendoza, Grace
Cc: Klassen, Rachelle;Aryan, Steve; Greenwood, Mark; Hernandez, Carlos
Subject: RE: Ciaim Against the City
Hetlo Ali,
I spoke with Carlos regarding this incident and he had David Reyes visit the site. David reported that the sidewalk panel
in question did appear ko be recently replaced, however, it is colared concrete and i#was not work that was performed by
the City.
1f I receive further information, !will pass it on.
Beth Longman
City of Ralm Desert
Public Works Department
73510 Fred Waring Drive
Palm Desert, CA 92260
760-776-6450
From: Mendoza, Grace
Sent: Monday, December 23, 2013 10:27 AM
To: Greenwood, Mark
Cc: Longman, Beth; Klassen, Rachelle; Aryan, Steve
Subject: Claim Against the City
Good Morning Mark:
You may have the following information, because the lady was directed to us for the Claim Form after talking to
someone in Public Works.
Ms. Linda Cameron requested a Claim Against the City and would be in tomorrow to submit it,and she planned to
attached photographs as well.
She said there was a square of cement(5x6 feet)that was raised higher than the rest of the sidewalk,and she believed
that it must have been replaced recently. She said if someone went out there now, her blood is still there. She fell and
had to be taken to the ER. She showed me her bruised right eye. She said it needed to be fixed, because it can happen
again, and she was only walking.
The best description she could give me was that it was on the west side of Portola, it was past The Living Desert, but
before the Reserve—before the left-turn pocket to the reserve.
If you have further questions—she can be contacted at 805-680-3268.
Grace L Mendoza, Deputy City Clerk
City of Palm Desert
73510 Fred Waring Drive
Palm Desert,California 92260
(760j 346-0611 Extension 487