Expedited Petition to Approve Compromise of Disputed Claim or Pending Action or Disposition of Proceeds of Judgment For Minor or Person With a Disability March 14, 2024 (2024)

 
Preview
 e MC-350EXATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER: 300727 P ANAVE: Seth Bradlev. Esa. SupertoPUEEH G California,FIRM NAME: Eason & Tambornini SacramentoSTREET ADDRESS: 1234 H Suite 200 iTELEPHONE NO.: (916) 438-1819 FAX NO.: waltmosEMAIL ADDRESS: Seth@capcitvlaw.com )ATTORNEY FOR (Name): Plaintiff By , DeputySUPERIOR COURT OF CALIFORNIA, COUNTY OF Sacramento 24CVO04897 STREET ADDRESS: 720 Oth Street MAILING ADDRESS:CITY AND ZIP CODE: Sacramento, CA 95814 BRANCH NAME:CASE NAME: CASE NUMBER: Mason v. Medina No hearing date is requested. PETITION FOR EXPEDITED APPROVAL OF COMPROMISE OF ] vewmeone CLAIM OR ACTION OR DISPOSITION OF PROCEEDS OF JUDGMENT FOR MINOR OR PERSON WITH A DISABILITY DEPT. TIve: NOTICE TO PETITIONERYou must use this form to request expedited court approval of a qualifying (1) compromise of a minor's disputed claim, (2) compromiseof a pending action or proceeding in which a minor or a person with a disability (including a conservatee) is a party, or (3) disposition ofthe proceeds of a judgment for a minor or person with a disability. (See Code Civ. Proc., § 372; Prob. Code, §§ 3500, 3600-3613.) Youmay request expedited approval only if (1) you are represented by an attorney; (2) the statements in items 3a, 3b, 3c, 3d, 3e, 3f, andeither 3g(1) or 3g(2), below, are true and accurate; and (3) the court does not otherwise order.If your compromise or judgment qualifies and you choose to use this form, the court may consider and act on your petition without ahearing. If your compromise or judgment qualifies for expedited consideration but you choose not to use this form or your compromiseor judgment does not qualify for expedited consideration, you must use Petition for Approval of Compromise of Claim or Action orDisposition of Proceeds of Judgment for Minor or Person With a Disability (form MC-350), and the court will schedule a hearing.1. Petitioner (name or pseudonym®): Virginia Mason is the (check all boxes that apply): Parent [__| Guardian ad litem* [__]| Guardian [__| Conservator [] Other (specify relationship): of the claimant identified in item 2. (*Petitioner may appear under a pseudonym only if appointed as guardian ad litem under that pseudonym. (See Code Civ. Proc., § 372.5.))2. Claimant (name): Matthias Mason a. Address: 4909 Gardenia Way, Sacramento, CA 95841 b. Date of birth: 08/19/2009 c. Age: 14 d. Minor or [__] Person with a disability (If the claimant is an adult with a disability who (1) has capacity to consent to the order requested and (2) does not have a conservator of the estate, check e. and f. and ensure that the claimant personally reads and signs item 21. (Prob. Code, § 3613.)) e. Has the capacity, within the meaning of Probate Code section 812, to consent to the requested order. f. Does not have a conservator of the estate.3. Qualification for Expedited Approval a. The claimant's claim or action is not for damages for the death of a person caused by the wrongful act or neglect of another. b. No portion of the net proceeds of the judgment or settliement in favor of the claimant is to be placed in a trust. c. There are no unresolved disputes concerning liens to be satisfied from the proceeds of the judgment or settlement. d. Petitioner's attorney did not become involved with this matter, directly or indirectly, at the request of a party against whom the claim is asserted or a party's insurance carrier. Petitioner's attorney is not representing, employed by, or associated with a defendant in this matter or an insurance carrier. All defendants that have appeared in a pending action on the claim are participating in the proposed compromise or the court o has made a final determination that all settling parties entered into the settlement in good faith. g. (1) The judgment described in item 4c (exclusive of interest and costs) or the total settlement described in items 11 and 12 payable to the claimant and all other persons named in item 12 is in the amount of $50,000 or less; or (2) The settlement described in item 11 represents payment of the single-person policy limits of all liability insurance policies covering the defendants named in that item. The investigation described in Attachment 3 shows that all of those defendants are judgment-proof outside of their insurance coverage. (Describe investigation and results in Attachment 3.) Page 1of 7nessaoiramucss . PETITION FOR EXPEDITED APPROVAL OF COMPROMISE OF rrbaiecoi, 8 00 si 3613s, i g R CLAIM OR ACTION OR DISPOSITION OF PROCEEDS OF e T JUDGMENT FOR MINOR OR PERSON WITH A DISABILITY MC-350EXCASE NAME: CASE NUMBER: Mason v. Medina . Claim The claim of the minor or adult person with a disability: a. Is not the subject of a pending action or proceeding. (Complete items 5-23.) b. [_] Is the subject of a pending action or proceeding that will be compromised without a trial. (Complete items 5-23.) Name of court: Case no.: Trial date: c. [_] Is the subject of an action or proceeding in which a judgment has been or will be entered for the claimant against the defendants named below in the amount (exclusive of interest and costs) of (specify): $ Defendants (names: [ Additional defendants listed on Attachment4. [_] The judgment was filed on (date): (Attach a copy of the (proposed) judgment as Attachment 4c and complete items 13-23.) . Incident or accident The incident or accident occurred as follows: a. Date: 01/18/2023 Time: 2:53PM b. Place: Whitney Avenue in Sacramento County c. Persons involved (names): Adilene Medina Matthias Mason Additional persons listed on Attachment 5. . Nature of incident or accident The facts, events, and circ*mstances of the incident or accident are (describe what happened): Adilene Medina operated a vehicle that collided with a bicycle operated by Matthias Mason, causing injury. [ Continued on Attachment 6. . Injuries The following injuries were sustained by the claimant as a result of the incident or accident (describe): Claimant suffered lacerations to his face, a broken wrist, several abrasions to both arms and legs, abdominal pain, missing teeth and a possible concussion. [] Continued on Attachment 7. . Treatment The claimant received the following care and treatment for the injuries described in item 7 (describe): UC Davis by ambulance for emergent treatment, primary care at UC Davis, Pediatric Medical Associates, Capitol Oral Surgery, Lucas Orthodontics, Sutter Physicians, Methodist Hospital, and Johnson & Alto Dental Corporation. Please see attached medical records. Continued on Attachment 8.MC-350EX [Rev. January 1, 2021] Page 20f 7 PETITION FOR EXPEDITED APPROVAL OF COMPROMISE OF CLAIM OR ACTION OR DISPOSITION OF PROCEEDS OF JUDGMENT FOR MINOR OR PERSON WITH A DISABILITY MC-350EXCASE NAME: CASE NUMBER: Mason v. Medina9. Extent of injuries and recovery (An original or a photocopy of any doctor's report containing a diagnosis of the claimant's injuries or a prognosis for the claimant's recovery, and a report of the claimant's current condition, must be attached to this petition as Attachment 9. A new report is not necessary if a previous report accurately describes the claimant's current condition.) a. The claimant has recovered completely from the effects of the injuries described in item 7, and there are no permanent injuries. b. [_] The claimant has not recovered completely from the effects of the injuries described in item 7, and the following injuries from which the claimant has not recovered are temporary (describe the remaining injuries and symptoms): [] Continued on Attachment 9b. ¢. [_] The claimant has not recovered completely from the effects of the injuries described in item 7, and the following injuries from which the claimant has not recovered are permanent (describe the permanent injuries and symptoms): [ Continued on Attachment 9c.10. Petitioner has made a careful and diligent inquiry and investigation into the facts and circ*mstances of the incident or accident in which the claimant was injured; the responsibility for the incident or accident; and the nature, extent, and seriousness of the claimant's injuries. Petitioner understands that if the compromise proposed in this petition is approved by the court and consummated, the claimant will never be able to recover any more compensation from the settling defendants named below even if the claimant's injuries turn out to be more serious than they now appear.11. Amount and terms of settlement To settle the claim in 4a or 4b, the defendants named below have offered to pay the following amounts to the claimant: a. The total amount offered by all defendants named below is (specify): $ 250000.00000000 b. The defendants and amounts offered by each are as follows (specify): Defendants (names) Amounts State Farm Insurance for Uninsured Motorist Coverage $ 250000.00000000 $ $ $ [] Additional defendants and amounts offered are listed on Attachment 11b. c. The terms of settlement are described on Attachment 11c. (If the settlement is to be paid in installments, both the total amount and the present value of the settlement must be included.)12. Settlement payments to others a. No defendant named in item 11b has offered to pay money to any person or persons other than the claimant to settle claims arising out of the same incident or accident that resulted in the claimant's injury. b. [_] One or more of the defendants named in item 11b have also offered to pay money to a person or persons other than claimant to settle claims arising out of the same incident or accident that resulted in the claimant's injury. (1) The total amount offered by all defendants to others is (specify): $ (2) [ Petitioner would receive money under the proposed settlement. (3) The settlement payments are to be apportioned and distributed as follows: Other plaintiffs or claimants (names) Amounts PP PP [ Additional plaintiffs or claimants and amounts are listed on Attachment 12. (4) [] The settlement payments are apportioned between the claimant and each other plaintiff or claimant named above on a pro rata basis, based upon the special damages claimed by each. The special damages claimed by each other plaintiff or claimant are specified on Attachment 12. (5) [_] Reasons for the apportionment of the settlement payments between the claimant and each other plaintiff or claimant named above are specified on Attachment 12.MC-350EX [Rev. January 1, 2021] Page 3of 7 PETITION FOR EXPEDITED APPROVAL OF COMPROMISE OF CLAIM OR ACTION OR DISPOSITION OF PROCEEDS OF JUDGMENT FOR MINOR OR PERSON WITH A DISABILITY MC-350EXCASE NAME: CASE NUMBER: Mason v. Medina13. Claimant's medical expenses—including expenses paid by petitioner, Medicare, Medi-Cal, and private insurers—that are to be paid or reimbursed from the proceeds of the settlement or judgment Totals (1) Total medical expenses before any reductions: $ 12066.51000000 (2) Total medical expenses paid (include payments by private insurance, Medi-Cal, or Medicare): ($ 10909.89000000 ) (3) Total of negotiated, contractual, or statutory reductions, if any: ($ 1156.62000000 ) (4) Total amount of medical expenses to be paid or reimbursed from proceeds: $ 10909.89000000 (5) Total amount of statutory or contractual liens, if any: $ 3469.89000000 (Identify each medical expense payer and the amount each paid, and explain any differences between items 13a(1), (4), and (5) in Attachment 13a.) 1) None of the claimant's medical expenses have been paid by Medicare. (2) [_] Medicare paid some or all of claimant's medical expenses. In full satisfaction of its lien rights, Medicare will be reimbursed in the amount of: $ (Attach a copy of the final Medicare demand letter or letter agreement as Attachment 13b(2).) (1) [_] None of the claimant's medical expenses have been paid by Medi-Cal. (2) Medi-Cal paid some or all of claimant's medical expenses. (a) Notice of this claim or action has been given to the Director of Health Care Services. (Welf. & Inst. Code, § 14124.73.) A copy of the notice and proof of delivery is attached [__] was filed in this matter on (date): (b) In full satisfaction of its lien rights, Medi-Cal has agreed to accept reimbursem*nt in the amount of: $ 3469.89000000 (Attach a copy of the final Medi-Cal demand letter or letter agreement as Attachment 13¢(2).) [] The claimant's health plan is requesting reimbursem*nt for medical expenses paid under the plan. In full satisfaction of the plan's lien rights, it will be reimbursed in the amount of: $ (Attach statements from the plan showing expense payments and requesting reimbursem*nt.) Petitioner has paid claimant's medical expenses to be reimbursed in the amount of: $ 7440.00000000 (See instructions for item 15.) (1) [] There are no statutory or contractual liens for payment of the claimant's medical expenses. (2) [_] There are one or more liens from medical service providers for payment of the claimant's medical expenses. In full satisfaction of their lien claims, the lienholders have agreed to accept the sum of: $ (Select (1) or (2) below.) (1) [] Latest statements from all medical service providers are attached as Attachment 13g. (2) [_] All medical expenses have been paid by private insurance, Medicare, or Medi-Cal.14. Claimant's attorney's fees and all other expenses (except medical expenses), including fees or expenses paid by petitioner and claimant's attorney, to be paid or reimbursed from proceeds of settlement or judgment a. Total amount of attorney's fees for which court approval is requested: $ 62500.00000000 (If fees are requested, attach as Attachment 14a a declaration from the attorney explaining the basis for the request, including a discussion of applicable factors listed in rule 7.955(b) of the Cal. Rules of Court. Include a copy of any written attorney fee agreement in Attachment 14a.) b. The following additional items of expense (other than medical expenses) have been incurred or paid, are reasonable, resulted from the incident or accident, and should be paid or reimbursed out of claimant's share of the proceeds of the settlement or judgment: Items Payees (names) Amounts Sacramento Superior Court fees Eason & Tambornini $ 435.00000000 Administraitve Fees Eason & Tambornini $ 150.00000000 Medical Records Eason & Tambornini $ 196.20000000 CHP Report Eason & Tambornini $ 10.00000000 $ $ $ $ [ Continued on Attachment 14b. Total: $__ 791.20000000 c. [_] Costs of suit attributable to more than one settling plaintiff are not apportioned between them on a pro rata basis based on their gross settlement amounts. The apportionment of these costs is described and explained in Attachment 14c.MC-350EX [Rev. January 1, 2021] Page4of 7 PETITION FOR EXPEDITED APPROVAL OF COMPROMISE OF CLAIM OR ACTION OR DISPOSITION OF PROCEEDS OF JUDGMENT FOR MINOR OR PERSON WITH A DISABILITY MC-350EXCASE NAME: CASE NUMBER: Mason v. Medina15. Reimbursem*nt of fees and expenses paid by petitioner a. [_] Petitioner has paid none of the fees or expenses listed in items 13 and 14 for which reimbursem*nt is requested. b. Petitioner has paid the following total amounts of the claimant's fees and expenses for which reimbursem*nt is requested. 1) Medical expenses listed in item 13: $ 7440.00000000 (2) [_] Attorney's fees included in the total fee amount shown in item 14a: $ (3) [_] Other expenses included in the total shown in item 14b: $ (Attach proofs of the fees and expenses incurred and payments made, e.qg., bills or invoices, Total: $ 7440.00000000 canceled checks, credit card statements, explanations of benefits from insurers, etc.)16. Net balance of proceeds remaining for claimant The balance of the proceeds of the proposed settlement or judgment remaining for the claimant after payment or reimbursem*nt of all requested fees and expenses is (specify): $ 175798.9100000017. Summary a. Gross amount of proceeds of settlement or judgment for claimant: $ 250000.00000000 b. Medical expenses to be paid from proceeds of settlement or judgment: $ 10909.89000000 C Attorney's fees to be paid from proceeds of settlement or judgment: $ 62500.00000000 d. Expenses (other than medical) to be paid from proceeds of settlement or judgment: $ 791.20000000 Total fees and expenses to be paid from proceeds of settlement or judgment (add (b), (c), and (d)): ($ 74201.09000000 ) Balance of proceeds of settlement or judgment available for claimant after payment of all fees and expenses (subtract (e) from (a)): $ 175798.9100000018. Information about attorney representing or assisting petitioner a. The attorney isnot [_]is representing or employed by another party involved in this matter. (If you answered "is," identify the other party and explain the relationship in Attachment 18a. If the other party is a defendant, you must use form MC-350 for your petition and are not eligible for expedited consideration by the court. See item 3e on page 1 and Cal. Rules of Court, rule 7.950.5(a)(6).) The attorney has neither received nor expects to receive [__] has received or expects to receive attorney's fees or other compensation in addition to that requested in this petition for services provided in connection with the claim giving rise to this petition (if you answered "has received or expects to receive,” identify the person who paid or will pay the fees or other compensation, the amounts paid or to be paid, and the dates of payment or expected payment): Amount From Whom Paid or Expected (name) Date Paid or Expected Paid or Expected $ $ $ $ $ $ $ [] Continued on Attachment 18b. Total: $MC-350EX [Rev. January 1, 2021] Page 50of 7 PETITION FOR EXPEDITED APPROVAL OF COMPROMISE OF CLAIM OR ACTION OR DISPOSITION OF PROCEEDS OF JUDGMENT FOR MINOR OR PERSON WITH A DISABILITY MC-350EXCASE NAME: CASE NUMBER: Mason v. Medina19. Disposition of balance to claimant (check either a or b, then check each option requested and enter amount(s)): a. [_] There is a guardianship of the estate of the minor or a conservatorship of the estate of the adult person with a disability filed in (name of court): Case no.: (1) [] Petitioner requests that $ of the proceeds in money or other property be paid or delivered to the guardian of the estate of the minor or the conservator of the estate of the conservatee. The money or other property is specified in Attachment 19a(1). (2) [_] Petitioner is the guardian or conservator of the estate of the minor or the adult person with a disability. Petitioner requests authority to deposit or invest $ of the money or other property to be paid or delivered under 19a(1) in one or more insured accounts with financial institutions in this state or with a trust company, subject to withdrawal only on authorization of the court. The money or other property and the name, branch, and address of each financial institution or trust company are specified in Attachment 19a(2). (3) [_] Petitioner proposes that all or a portion of the proceeds not become part of the guardianship or conservatorship estate. Petitioner requests authority to deposit or transfer these proceeds as follows (check all that apply): (@ [1$ to be deposited in insured accounts in one or more financial institutions in this state, subject to withdrawal only on authorization of the court. The name, branch, and address of each depository are specified in Attachment 19a(3)(a). by 1% to be invested in a single-premium deferred annuity, subject to withdrawal only on authorization of the court. The terms and conditions of the annuity are specified in Attachment 19a(3)(b). (© 1% to be transferred to a custodian for the benefit of the minor under the California Uniform Transfers to Minors Act. The name and address of the proposed custodian and the property to be transferred are specified in Attachment 19a(3)(c). b. There is no guardianship of the estate of the minor or conservatorship of the estate of the adult person with a disability. Petitioner requests that the balance of the proceeds of the settlement or judgment be disbursed as follows (check all that apply): (1) [] A guardian of the estate of the minor or a conservator of the estate of the adult person with a disability be appointed and $ of money and other property be paid or delivered to the person so appointed. The money or other property are specified in Attachment 19b(1). 2% of money be deposited in insured accounts in one or more financial institutions in this state, subject to withdrawal only on authorization of the court. The name, branch, and address of each depository are specified in Attachment 19b(2). 3) $175798.91000000 of money be invested in a single-premium deferred annuity, subject to withdrawal only on authorization of the court. The terms and conditions of the annuity are specified in Attachment 19b(3). 4 1% be paid or delivered to a parent of the minor on the terms and under the conditions specified in Probate Code sections 3401-3402, without bond. The name and address of the parent and the money or other property to be delivered are specified in Attachment 19b(4). (Value of minor's entire estate, including the money or property to be delivered, must not exceed $5,000.) ()18 I be transferred to a custodian for the benefit of the minor under the California Uniform Transfers to Minors Act. The name and address of the proposed custodian and the money or other property to be transferred are specified in Attachment 19b(5). 6 1% of money be held on the conditions that the court determines to be in the best interest of the minor or adult person with a disability. The proposed conditions are specified on Attachment 19b(6). (Value must not exceed $20,000.) MLC1s of property other than money be held on the conditions that the court determines to be in the best interest of the minor or adult person with a disability. The proposed conditions and the property are specified in Attachment 19b(7). 8 1% be deposited with the county treasurer of the County of (name): The deposit is authorized under and subject to the conditions specified in Probate Code section 3611(h). © 1% be paid or transferred to the adult person with a disability. The money or other property is specified in Attachment 19b(9).MC-350EX [Rev. January 1, 2021] Page 6of 7 PETITION FOR EXPEDITED APPROVAL OF COMPROMISE OF CLAIM OR ACTION OR DISPOSITION OF PROCEEDS OF JUDGMENT FOR MINOR OR PERSON WITH A DISABILITY MC-350EXCASE NAME: CASE NUMBER: Mason v. Medina20.[_] Additional orders Petitioner requests the following additional orders (specify and explain): [] Continued on Attachment 20.21.[_] |, the claimant named in item 2, consent to the order or judgment requested in this petition. (Required if the claimant is an adult with a disability who has the capacity, under Probate Code section 812, to consent to the order or judgment and does not have a conservator of the estate. (See Prob. Code, § 3613.))Date: (TYPE OR PRINT NAME OF CLAIMANT) (SIGNATURE OF CLAIMANT)22, Petitioner recommends the proposed compromise, settlement, or disposition of judgment proceeds for the claimant to the court as being fair, reasonable, and in the best interest of the claimant. Petitioner requests that the court approve this compromise, settlement, or disposition and make any other orders that are just and reasonable.23. Number of pages attached: _Date: 3! ‘” Lq Sethn (L Bradleoy, (TYPE OR PRINT NANE) R =" e (SIGNATURE OF ATTORNEY)| declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.Date: Mar 4, 2024Virginia Mason ’ (TYPE OR PRINT NAME OF PETITIONER) (SIGNATURE OF PETITIONER)MC-350EX [Rev. January 1, 2021] Page 7 of 7 PETITION FOR EXPEDITED APPROVAL OF COMPROMISE OF CLAIM OR ACTION OR DISPOSITION OF PROCEEDS OF JUDGMENT FOR MINOR OR PERSON WITH A DISABILITYCourt Petition to review and signFinal Audit Report 2024-03-04 Created: 2024-03-04 By: Rebecca McDonnell (rebecca@capcitylaw.com) Status: Signed ' Transaction ID: CBJCHBCAABAAOJACIBNm-luQTBcPyoVuCvTNSdZe3HrX"Court Petition to review and sign" History™ Document created by Rebecca McDonnell (rebecca@capcitylaw.com) 2024-03-04 - 11:46:57 PM GMT- IP address: 76.158.185.55E3 Document emailed to gmason53@icloud.com for signature 2024-03-04 - 11:47:30 PM GMT) Email viewed by gmason53@icloud.com 2024-03-04 - 11:50:18 PM GMT- IP address: 172.225.89.37> Signer gmason53@icloud.com entered name at signing as virginia mason 2024-03-04 - 11:53:03 PM GMT- IP address: 99.57.74.107& Document e-signed by virginia mason (gmason53@icloud.com) Signature Date: 2024-03-04 - 11:53:05 PM GMT - Time Source: server- IP address: 99.57.74.107@ Agreement completed. 2024-03-04 - 11:53:05 PM GMT Adobe Acrobat Sign MC-025SHORT TITLE: SE NUMBER:— Mason v.. Medina ATTACHMENT (Number): __8 (This Attachment may be used with any Judicial Council form.) Enclosed, please find medical records(If the item that this Attachment concems is made under penalty of perjury, all statements in this Page ofAttachment are made under penalty of perjury.) (Add pag—es< _—ke ool Gaamia ATTACHMENT o coutinioca.v MC-025 [Rev. July 1, 2009] to Judicial Council Form UCDAVISAFTER VISIT SUMMARY HEALTHMatthias Mason MRN: 8278207 DoB: 8/19/2009 (3 1/18/2023 @ EMERGENCY - PAVILION 916-734-3790InstructionsThank you very much for visiting UC Davis Emergency Department today. It was a pleasure to take care of your child.You were seen in the emergency department for: being ran over by a vehiclePlease read the attached handouts if provided for more information.Recommendations:- Please follow up with your dentist in 1-2 days- Follow up with orthopaedic surgery in 1-2 weeks when scheduled for an appointment- Please do not remove splints until you follow up with orthopaedic surgery. Use crutches to help you walk.- Take over-the-counter Children’s Tylenol as needed for pain or fever. You can give Tylenol every 4-6 hours. Make sure tofollow bottle label instructions for dose recommendations. You can also supplement this with Children's Ibuprofen (i.e.Advil, Motrin) every 6 hours as needed. If the fever remains high, you can alternate giving the Tylenol and Ibuprofen every3 hours each (so that each medication is still given every 6 hours individually).Reasons to return to hospital:Return to the nearest Emergency Department immediately if you develop worsening pain, inability to walk, any otheracute concern.For any pérceived medical emergency, call 911 or go to the emergency room. Read the attached information 1. Arm Fracture (English) 2. Effusion: Joint: General Info (English) O ORTHOPEDIC-PEDS REFERRAL @ Multiple visits requested (expires 1/18/2024)a Schedule an appointment with Satya N Mantripragada, MD as soon as possible for a visit in 2 days (around 1/21/2023) Why: For ED follow u Specialty: PEDIATRIC Contact: 650 HOWE AVENUE SUITE 100 Sacramento CA 95825 916-924-9337@ Follow up with ORTHO ACC in 1 week (around 1/26/2023) Why: For ED follow up in 1-2 weeks Contact: 4860 Y Street Suite 1700 Sacramento California 95817 916-734-2700Matthias Mason (MRN: 8278207) « Printed at 1/19/2023 1:05 AM Page 10of 10 EpicInstructions (continued)Today's VisitYou were seen by Daniel O Hernandez, MDReason for Visit*933:Blunt/Critical Trauma Level IlDiagnoses« Effusion of right knee» Closed nondisplaced fracture of styloid process of right ulna, initial encounter+ Tooth avulsion, initial encounter& Lab Tests Completed Basic Metabolic Panel CBC No Differential performed 2 times CBC with Differential Hepatic Function Panel Lipase POC GLUCOSE ONCE Type and Screen Urinalysis-Complete@ Imaging Tests ANKLE 3+ VIEWS, LEFT CT ABDOMEN + PELVIS WITH CONTRAST CT C-SPINE WITHOUT CONTRAST CT CHEST W CONTRAST CT HEAD WITHOUT CONTRAST CT L-SPINE (2D RECONS L-SPINE FROM ABD/PELVIS) CT SINUS / FACIAL WITHOUT CONTRAST CT T-SPINE (2D RECONS T-SPINE FROM CHEST) DX CHEST 1 VIEW FEMUR, LEFT FINGER, LEFT FINGER, RIGHT HAND 3+ VIEWS, LEFT HUMERUS, LEFT KNEE 4+ VIEWS, LEFT KNEE 4+ VIEWS, RIGHT PELVIS 1 OR 2 VIEWS WRIST 3+ VIEWS, LEFT WRIST 3+ VIEWS, RIGHT(3] Done Today HEMOBANK ACTIVATIONMatthias Mason (MRN: 8278207) = Printed at 1/19/2023 1:05 AM Page 2 0of 10 EpicToday's Visit (continued)@ Medications Given Acetaminophen (OFIRMEV) Stopped at 11:20 PM Clindamycin in D5W IV Syringe Stopped at 8:10 PM Diph,Pertus(Acel), Tetanus Vaccine Booster-Tdap (BOOSTRIX) Last given at 447 PM Electrolyte Solution A (PLASMA-LYTE A) Stopped at 7:37 PM lohexol (OMNIPAQUE) 350 mg/mL Injection 500 mL Last given at 4:36 PM® Immunizations Given Tdap (ADACEL, BOOSTRIX) Blood Pressure - Temperature Pulse E%%) Respiration 133/47 - 98.2°F o1 17 Oxygen Saturation 99%What's NextYou currently have no upcoming appointments scheduled.Your Medication ListYou have not been prescribed any medications.Matthias Mason (MRN: 8278207) « Printed at 1/19/2023 1:05 AM Page 3 of 10 Epic Attached Information Arm Fracture (English)Broken Arm: Care InstructionsYour Care InstructionsFractures can range from a small, hairline crack, to a bone or bones broken into two or more pieces. Your treatmentdepends on how bad the break is.Your doctor may have put your arm in a splint or cast to allow it to heal or to keep it stable until you see another doctor. Itmay take weeks or months for your arm to heal. You can help your arm heal with some care at home.You heal best when you take good care of yourself. Eat a variety of healthy foods, and don't smoke.You may have had a sedative to help you relax. You may be unsteady after having sedation. It can take a few hours for themedicine's effects to wear off. Common side effects of sedation include nausea, vomiting, and feeling sleepy or tired.The doctor has checked you carefully, but problems can develop later. If you notice any problems or new symptoms, getmedical treatment right away.Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call yourdoctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.How can you care for yourself at home? « If the doctor gave you a sedative: = For 24 hours, don't do anything that requires attention to detail, such as going to work, making important decisions, or signing any legal documents. It takes time for the medicine's effects to completely wear off. = For your safety, do not drive or operate any machinery that could be dangerous. Wait until the medicine wears off and you can think clearly and react easily. * Putice or a cold pack on your arm for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake). Put a thin cloth between the ice and your cast or splint. Keep the cast or splint dry. * Follow the cast care instructions your doctor gives you. If you have a splint, do not take it off unless your doctor tells _ youto. + Be safe with medicines. Take pain medicines exactly as directed. = |f the doctor gave you a prescription medicine for pain, take it as prescribed. = If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine. * Prop up your arm on pillows when you sit or lie down in the first few days after the injury. Keep the arm higher than the level of your heart. This will help reduce swelling. * Follow instructions for exercises to keep your arm strong. * Wiggle your fingers and wrist often to reduce swelling and stiffness.When should you call for help?@ Call 911 anytime you think you may need emergency care. For example, call if: * You are very sleepy and you have trouble waking up. Call your doctor now or seek immediate medical care if: * You have new or worse nausea or vomiting.Matthias Mason (MRN: 8278207) « Printed at 1/19/2023 1:05 AM Page 4 of 10 Epic * You have new or worse pain. * Your hand or fingers are cool or pale or change color. ¢+ Your cast or splint feels too tight. * You have tingling, weakness, or numbness in your hand or fingers. Watch closely for changes in your health, and be sure to contact your doctor if: * You do not get better as expected. * You have problems with your cast or splint.Where can you learn more?Go to https://www.healthwise.net/patientEdEnter Y909 in the search box to learn more about "Broken Arm: Care Instructions.”Current as of: March 9, 2022 Content Version: 13.3© 2006-2022 Healthwise, Incorporated.Care instructions adapted under license by your healthcare professional. If you have questions about a medical conditionor this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability foryour use of this information.Matthias Mason (MRN: 8278207) - Printed at 1/19/2023 1:05 AM Page 5 of 10 Epic Attached Information Effusion: Joint: General Info (English)Learning About Joint EffusionWhat is it? Healthy joint Joint effusion ” Sy - N s fil’ .'.g;'Fluid is normally found in joints such as knees, hips, and elbows. When too much fluid builds up around a joint in yourbody, it's called joint effusion. When you have this problem, your joint may look swollen.What causes it?Many things can cause fluid buildup in a joint. It may be caused by a condition like osteoarthritis, rheumatoid arthritis, orgout. It may also happen because of an infection. Or it can happen because of an injury, like a twisting fall.What are the symptoms?You might feel pain when you try to straighten a joint where you have fluid buildup. Your joint may be stiff or swollen.How is it diagnosed?Your doctor will do a physical exam. You may need an X-ray. You may need other imaging tests, like an MRI or a CT scan.Your doctor may remove some fluid from your joint to learn more. This is called aspiration. It's done by using a needle todrain fluid from your joint.How is it treated?Your doctor may suggest rest, ice, and raising the joint (elevation) to help with pain and swelling. The fluid might bedrained from the area. Your doctor may suggest using nonprescription anti-inflammatory drugs (NSAIDs) or getting asteroid shot. Or you may need surgery to repair damage.Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call yourdoctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.Current as of: December 20, 2021 Content Version: 13.3© 2006-2022 Healthwise, Incorporated.Care instructions adapted under license by your healthcare professional. If you have questions about a medical conditionor this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability foryour use of this information.Matthias Mason (MRN: 8278207) « Printed at 1/19/2023 1:05 AM Page 6 of 10 EpicUC Davis Health System Express CareFor any additional follow up needs, a UC Davis provider is available to all discharged patients through ExpressCaretelehealt 

Related Contentin Sacramento County