Pamela Walker v. Suzanne Scopel and Justin Scopel ( 2015 )


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  •                                                                                ACCEPTED
    14-14-00411-CV
    FOURTEENTH COURT OF APPEALS
    HOUSTON, TEXAS
    6/10/2015 10:16:06 PM
    CHRISTOPHER PRINE
    CLERK
    NO. 14-14-00411-CV
    IN THE COURT OF APPEALS             FILED IN
    14th COURT OF APPEALS
    FOR THE FOURTEENTH DISTRICT OF TEXAS HOUSTON, TEXAS
    6/10/2015 10:16:06 PM
    CHRISTOPHER A. PRINE
    PAMELA WALKER,                          Clerk
    Appellant,
    v.
    SUZANNE SCOPEL AND JUSTIN SCOPEL,
    Appellees.
    On Appeal from Cause Number 12-DCV-200283
    From the 268th District Court of Fort Bend County, Texas
    BRIEF FOR APPELLANT
    ORAL ARGUMENT REQUESTED
    REGINALD E. MCKAMIE, SR.
    TBN. 13686750
    1210 Antoine Drive, Suite 100
    Houston, Texas 77055
    Phone: (713) 465-2889
    Fax: (713) 465-2894
    Counsel for Appellant
    i
    IDENTITY OF PARTIES AND COUNSEL
    PLAINTIFF/APPELLANT:                       Pamela Walker
    DEFENDANT/APPELLEE:                        Justin Scopel
    COUNSEL FOR PLAINTIFF/APPELLANT:           Reginald E. McKamie, Sr.
    Attorney at Law
    1210 Antoine, Suite 100
    Houston, Texas 77055
    COUNSEL FOR DEFENDANT/APPELLEE:            IRESON & WEIZEL, PLLC
    Lansford O. Ireson, Jr.
    9720 Cypresswood, Suite 310
    Houston, Texas 77070
    PRESIDING JUDGE AT TRIAL:                  Hon. Brady G.Elliott
    268th District Court
    Harris County, Texas
    1422 Eugene Heimann Cir.
    Richmond, Texas 77469
    ii
    TABLE OF CONTENTS
    IDENTITY OF THE PARTIES AND COUNSEL .................................................................. ii
    TABLE OF CONTENTS ................................................................................................ iii
    INDEX OF AUTHORITIES ............................................................................................ iv
    STATEMENT OF THE CASE ........................................................................................... 1
    ISSUES PRESENTED ..................................................................................................... 2
    STATEMENT OF FACTS ............................................................................................... 3
    SUMMARY OF THE ARGUMENT ................................................................................... 7
    ARGUMENT ................................................................................................................ 8
    A. The trial court erred in admitting photographs of extremely limited
    probative value that was substantially outweighed by the danger of
    unfair prejudice, confusing the issues, and misleading the jury .............. 8
    B. The jury was not at liberty to award no damages to Walker. The
    evidence that Walker suffered some amount of physical pain and mental
    anguish and physical impairment was undisputed .................................. 11
    PRAYER ................................................................................................................... 14
    CERTIFICATE OF SERVICE ........................................................................................ 15
    CERTIFICATE OF COMPLIANCE ................................................................................ 15
    APPENDIX ............................................................................................................... 16
    iii
    INDEX OF AUTHORITIES
    CASES
    Browning-Ferris, Inc. v. Reyna, 
    865 S.W.2d 925
    (Tex. 1993)................................. 9
    Burroughs Wellcome Co. v. Crye, 
    907 S.W.2d 497
    (Tex. 1995) ........................... 10
    Coates v. Whittington, 
    758 S.W.2d 749
    (Tex. 1988).............................................. 11
    Hicks v. Ricardo, 
    834 S.W.2d 587
    (Tex. App.—Houston [1st Dist.] 1992, no writ)..
    ............................................................................................................................. 11
    Insurance Co. of North Am. v. Myers, 
    411 S.W.2d 710
    (Tex.1966).. .................... 10
    Lopez v. Carrillo, 
    940 S.W.2d 232
    (Tex. App. — San Antonio 1997). ................... 9
    Lowery v. Berry, 
    269 S.W.2d 795
    (Tex. 1954)....................................................... 11
    RULES
    Tex. R. Evid. 403 ...................................................................................................... 8
    iv
    STATEMENT OF THE CASE
    On August 19, 2012, Pamela Walker (“Walker”) filed suit against Justin
    Scopel and Suzanne Scopel for damages she sustained in a car accident that
    occurred on January 5, 2012. (CR 6-10).
    On March 25, 2014, Walker non-suited all of her claims against Suzanne
    Scopel as well as her claims for medical expenses (RR 2:5), lost wages (RR 2:5),
    and punitive damages (RR 2:10) against Justin Scopel. Justin Scopel (“Scopel”)
    stipulated to causing the accident. (RR 2:5).
    Both parties announced ready for trial and proceeded only on the issue of
    damages for past and future physical pain and mental anguish and past a future
    physical impairment. On March 27, 2014, the jury awarded zero damages on each
    of Walker’s claims. (CR 73).
    The district court entered judgment that Walker take nothing on May 2,
    2014. (CR 78). On May 27, 2014, Walker filed her notice of appeal. (CR 82).
    1
    ISSUES PRESENTED
    1.   Did the court err by admitting photographs whose probative value was
    substantially outweighed by the danger of unfair prejudice, confusing the
    issues, and misleading the jury over the Plaintiff’s objection?
    2.   Was the jury free to award zero damages when liability was stipulated and
    there was undisputed evidence of damages caused by the collision?
    2
    STATEMENT OF FACTS
    On January 5, 2012, Justin Scopel (“Scopel”) failed to control his speed and
    collided with the rear of Pamela Walker’s (“Walker”) vehicle. It is undisputed that
    Scopel caused the collison. (RR 2:5, 3:5). Walker’s neck whipped forward and her
    back popped on impact. (RR 3:100). She called 911 and asked that an ambulance
    be dispatched because her neck and back were hurt in the collision. (RR 3:100).
    The ambulance arrived and then transported her to the hospital. (RR 3:15, 100).
    At the hospital, Walker underwent a CAT scan             (RR 3:101) and was
    diagnosed with lumbar strain and cervical strain due to the collision. (P. Ex. 1).
    Walker was involved in another motor vehicle accident approximately seven
    months earlier, in June 2011. (RR 3:104). In that accident, she suffered a bruise on
    her hand. (RR 3:105). She experienced some short-term back and neck pain from
    that accident and sought a referral for physical therapy. (D. Ex. 2). However, the
    pain resolved, she had no lingering neck or back problems (RR 3:105), and she
    never sought treatment. (RR 3:123).
    In contrast, after the collision with Scopel that is the subject of this case,
    Walker experienced “intense pain” that she had not experienced prior. (RR 3:113).
    She was no longer able to work in her garden (RR 3:91) as she had before the
    accident. (RR 3:87). She was unable to do her daughter’s hair. (RR 3:92). She
    was no longer able to sit through her son’s basketball games, and thus stopped
    3
    attending. (RR 3:92). She stopped cooking, no longer slept through the night, and
    was no longer able to take regular trips with her husband, all of which she had
    done prior to the collision. (RR 3:86, 91, 93).
    After the collision, Walker went to see her primary-care physician, who
    referred her to physical therapy. (RR 3:107).       She saw a physical therapist
    approximately 13 times. (RR 3:107). At trial, Renee Blalock (“Blalock”), the
    therapist who conducted the majority of Walker’s sessions, testified. (RR 3:67-85).
    Blalock testified about her assessment of Walker.
    Objectively, there were found to be deficits in her following the
    flexibility and her balance and her ability to perform what we call a
    functional squat. There were deficits in the mobility of her lumbar
    spine, which is her low back spine. There were -- there was weakness
    found in her lower extremity muscles as well as in her spinal and core
    musculature. There was also tenderness upon palpation, which means
    upon feeling the muscles there was pain and tenderness and her range
    of motion in her low back was limited with pain, as well. And that's
    the objective part of it.
    (RR 3:70). Blalock also testified unequivocally that, based on her experience and
    training, Walker was not faking her injuries, as well as how she reached that
    conclusion. (RR 3:77-79).
    Walker stopped physical therapy when her primary doctor referred her to a
    spine specialist, who in turn recommended that she see a chiropractor or an
    acupuncturist for her pain. (RR 3:107). She did see an acupuncturist and also
    began seeing Dr. Roberto Solis (“Dr. Solis”), a chiropractor. (RR 3:108).
    4
    Dr. Solis testified as both a fact witness and an expert witness at trial. (RR
    3:19). He had reviewed Walker’s MRI (P. Ex. 3) and testified that it showed bone
    spurring and a bulging disc, among other things. (RR 3:23). He further testified
    that while most of the findings on Walker’s MRI could be attributed to
    degeneration or simple aging, in his expert opinion, the bulging disc was a result of
    trauma. (RR 3:25). This injury is consistent with the head whip one experiences in
    a rear-end collision. (RR 3:26). Furthermore, even if the bulging disc had existed
    prior to the collision with Scopel, that collision would have caused increased
    trauma to it. (RR 3:26).
    Dr. Solis testified about over 30 visits with Walker. (RR 3:20-51). He
    testified that she was obviously in pain from the collision (RR 3:29), and that
    treatment would ease the pain, but it would return several hours later. (RR 3:32).
    Dr. Solis testified that at each of the visits, he conducted “a palpatory
    assessment, basically just feeling for muscle tightness, muscle spasms, joints that
    may not be moving the way that they're supposed to.” (RR 3:51). Each time he
    conducted this assessment, he detected “very consistent pain, inflammation, a
    tightness and tenderness in the upper neck and the back.” (RR 3:52).
    At trial, Scopel rested behind Walker, calling no witnesses. (RR 3:133).
    Scopel’s evidence consisted of just three exhibits, including photographs of
    Walker’s vehicle admitted over her objection. (D. Ex. 1).
    5
    Scopel also presented an email showing that Walker had previously sought a
    referral for physical therapy (RR 3:122, D. Ex. 2) and a portion of her medical
    records showing that she had experienced some arm pain prior to the accident, but
    that the accident had exacerbated it. (RR 3:129, D. Ex. 3).
    6
    SUMMARY OF THE ARGUMENT
    The trial court erred by admitting three photographs offered by Scopel. The
    photographs were of extremely limited probative value to the amount of physical
    pain, mental anguish, and physical impairment suffered by Walker, which were the
    only questions before the jury. What little, if any, probative value the photographs
    did have was substantially outweighed by the danger of unfair prejudice, confusing
    the issues, and misleading the jury.
    The jury awarded Walker no damages after speculating that because the
    photographs showed minimal damage to Walker’s vehicle, the collision must have
    been low-impact. The jury further speculated that Walker could not have been
    injured in the purportedly low-impact collision.
    The jury was not at liberty to award Walker no damages when the evidence
    was undisputed that the collision caused Walker some amount of damages for
    physical pain and mental anguish and physical impairment.
    7
    ARGUMENT
    A.      The trial court erred in admitting photographs of extremely limited
    probative value that was substantially outweighed by the danger of
    unfair prejudice, confusing the issues, and misleading the jury.
    Walker moved to exclude three photographs (D. Ex. 1) of her vehicle taken
    by Scopel after the collision. (RR 2:11). The court denied her motion and admitted
    the photographs into evidence. (RR 2:12). The photographs were published to the
    jury during Scopel’s testimony. (RR 3:15). Scopel’s counsel implied through his
    questioning, and later argued that because her vehicle was not badly damaged, she
    could not have been hurt. (RR 3:16, 4:20).
    The probative value of the photographs was limited, at best. While they
    clearly would have been relevant to any property damage claim, there was no
    claim for property damage at issue in the trial. (CR 73). The photographs also
    would have been probative of the issue of causation, but causation had been
    stipulated. (RR 2:5).
    The photographs were simply of extremely limited, if any, probative value to
    Walker’s physical pain, mental anguish, or physical impairment, which were the
    only questions before the jury. What little probative value they might have had
    was clearly substantially outweighed by the danger of unfair prejudice, confusing
    the issues, and misleading the jury and they should have been excluded under Tex.
    R. Evid. 403.
    8
    Scopel introduced the photograph in order to invite the jury to speculate that
    because the damage to Walker’s vehicle was relatively minor, the collision must
    have been low-impact. The jury was then invited to draw the further speculative
    conclusion that because the collision was purportedly low-impact, Walker must be
    faking her injuries. (CR 4:20).
    This is simply conjecture, not evidence. “Some suspicion linked to other
    suspicion produces only more suspicion, which is not the same as . . . evidence.”
    Browning-Ferris, Inc. v. Reyna, 
    865 S.W.2d 925
    , 927 (Tex. 1993). Clearly the
    danger for unfair prejudice, confusing the issues, and misleading the jury was
    great.
    Furthermore, the probative value of the photographs to claims before the
    jury was so minimal as to border on irrelevance. However, even if it could meet
    that minimal standard, the probative value was so slight that the great danger for
    unfair prejudice, confusing the issues, and misleading the jury substantially
    outweighed it.
    Proving causation between negligence and injury requires expert testimony.
    Lopez v. Carrillo, 
    940 S.W.2d 232
    , 234 (Tex. App. — San Antonio 1997).
    9
    To constitute evidence of causation, an expert opinion must rest in
    reasonable medical probability. Insurance Co. of North Am. v. Myers,
    
    411 S.W.2d 710
    , 713 (Tex.1966). This rule applies whether the
    opinion is expressed in testimony or in a medical record, as the need
    to avoid opinions based on speculation and conjecture is identical in
    both situations.
    Burroughs Wellcome Co. v. Crye, 
    907 S.W.2d 497
    , 500 (Tex. 1995).
    Scopel’s opinion (RR 3:16) and his counsel’s opinion (RR 4:20) that the
    photographs are evidence that the collision did not cause any damages for physical
    pain, mental anguish, and physical impairment to Walker simply cannot meet this
    standard.
    Walker proved causation between Scopel’s negligence and her injuries
    through Dr. Solis’ expert testimony. (RR 3:17-53). Scopel failed to negate
    Walker’s proof either through his own expert or through his cross-examination of
    Dr. Solis. The photographs simply lacked any meaningful probative value in an
    area that is the domain of expert testimony.
    Clearly the jury was confused and misled by the photographs. It is the only
    way to explain their decision to award no damages whatsoever despite the
    overwhelming evidence that the collision did indeed cause at least some amount of
    physical pain, mental anguish, and physical impairment to Walker.
    10
    B.      The jury was not at liberty to award no damages to Walker. The
    evidence that Walker suffered some amount of physical pain and
    mental anguish and physical impairment was undisputed.
    A jury is not at liberty to award zero damages when the evidence is
    undisputed that a plaintiff suffered injury. See Lowery v. Berry, 
    269 S.W.2d 795
    ,
    796–97 (Tex. 1954). If any of the jury’s damages findings is against the great
    weight and preponderance of the evidence, the proper remedy is to reverse the
    verdict and remand the case for a new trial. Hicks v. Ricardo, 
    834 S.W.2d 587
    , 590
    (Tex. App.—Houston [1st Dist.] 1992, no writ).
    The only evidence presented by Scopel, other than the improperly admitted
    photographs, was an email and a portion of Walker’s medical records showing that
    she had experience some pain prior to the collision. (D. Ex. 2, D. Ex. 3). As any
    first year law student can tell you, it is well settled that a tortfeasor takes the
    plaintiff as he finds her. See Coates v. Whittington, 
    758 S.W.2d 749
    , 752 (Tex.
    1988) (a.k.a. the "eggshell skull rule"). None of Scopel’s evidence, including the
    photographs, dispute Walker’s ample evidence that she suffered some amount of
    damages as a result of the collision.
    Whether or not Walker had experienced pain at some point in her life prior
    to the collision does not absolve Scopel of responsibility for the damages he
    caused. Even if Walker had some actual pre-existing condition, which Scopel’s
    11
    meager evidence does not show, he is still responsible for her damages to the
    degree that his negligence aggravated the condition.
    In his expert testimony, Dr. Solis conceded that he could not say for certain
    that Walker did not have a torn disc prior to the collision with Scopel. However,
    he stated unequivocally, “every single accident you have will cause increased
    trauma to those particular areas. It basically is like pouring more fuel on the fire.”
    (RR 3:26-27). This simple fact is not disputed or called into question in any way
    anywhere in the record. With causation of the collision conceded, this evidence
    alone renders the jury’s award of no damages as against the great weight and
    preponderance of the evidence.
    The jury awarded Walker no damages for past or future physical pain and
    mental anguish despite undisputed evidence that she had suffered physical pain and
    mental anguish as a result of Scopel’s negligence.
    Dr. Solis testified that Walker was obviously in pain. (RR 3:29). He also
    conducted “several orthopedic tests that were positive for inflamed joints, pain in
    the neck, and the low back.” (RR 3:21). On each of the more than 30 times he saw
    her, he conducted a palpatory assessment. Each and every time, he found “very
    consistent pain, inflammation, a tightness and tenderness in the upper neck and the
    back.” (RR 3:52).
    12
    Blalock testified that she objectively found “pain and tenderness and
    [Walker’s] range of motion in her low back was limited with pain, as well.” (RR
    3:70). She further testified that she was trained to detect people faking pain (RR
    3:77), how she detects it (RR 3:78-79), and that Walker was not faking her pain.
    (RR 3: 77-79).
    Gregory Walker testified that when he first saw Walker after the collision, “I
    found my wife was in pain, discomfort.” (RR 3:90). He also testified about having
    to massage his wife’s back to relieve the pain from back spasms. (RR 3:90-91).
    Walker herself testified to the “intense pain” she experienced after the
    collision that she had never experienced prior. (RR 3:113). She also testified that
    while she had experienced slight numbness prior to the collision, she had not
    experienced the type of intense pain she had afterwards. (RR 3:133).
    As to future physical pain and mental anguish, Walker testified that even at
    the time of trial, she had to wear patches to control the pain and spasms. (R 3:133).
    The fact that the pain persisted more than two years after the collision makes it a
    near certainty that it would continue after the trial and that she would experience at
    least some amount of physical pain and mental anguish in the future.
    The jury also awarded Walker no damages for past or future physical
    impairment despite undisputed evidence that she had suffered physical impairment
    as a result of the collision.
    13
    In addition to seeing bone spurring and disc bulging in Walker’s MRI (RR
    3:23), Dr. Solis detected inflamed joints (RR 3:21), general inflammation, and
    tightness and tenderness when he examined Walker after the collision. (RR 3:52).
    Blalock also testified to Walker’s physical impairment. After the collision,
    Walker objectively had flexibility deficits, mobility deficits, and muscle weakness
    in her spinal and core musculature. (RR 3:70). She also had difficulty tolerating
    exercises and “required frequent position changes due to difficulty tolerating one
    position for longer than five minutes.” (RR 3:70-71).
    Gregory Walker provided ample evidence of Walker’s physical impairment.
    He testified that prior to the collision, Walker gardened. (RR 3:87). After the
    collision, Walker was no longer able to garden. (RR 3:91). He testified that prior
    to the collision, he and Walker took regular trips (RR 3:86). After the collision,
    she was unable to sit for the period of time required to travel on a regular basis.
    (RR 3:91).
    He testified that Walker did not feel physically up to doing her daughter’s
    hair after the collision (RR 3:92) and that she was no longer able to attend her
    son’s basketball games. (RR 3:92, 95). Furthermore, she stopped cooking and
    stopped sleeping through the night as a result of the physical impairment she
    suffered as a result of the collision. (RR 3:93).
    14
    Gregory Walker also provided some evidence of future physical impairment.
    He testified that his wife has gotten better, but she still needed to stretch more and
    was still trying to regain a sense of normalcy. (RR 3:95).
    Walker’s own testimony was that she had experienced no lingering neck or
    back problems from her previous collision. (RR 3:105). She testified that she
    could no longer drive or ride in a car for more than an hour under normal
    circumstances after the collision. (RR 3:111). She testified that she could no
    longer engage in regular sexual activity with her husband (RR 3:114), which he
    corroborated. (RR 3:91).
    She also testified that she had spasms while testifying at the trial itself (RR
    3:133), making it a near certainty that the impairment would continue in the future.
    None of the evidence that Walker sustained damages in the collision was
    disputed in any way. All of Scopel’s evidence, including the photographs (D. Ex.
    1), the email (D. Ex.2), and the excerpt of Walker’s medical records (D. Ex. 3), go
    to the degree to which she suffered damage, not whether she suffered damage.
    The evidence is thus undisputed that Walker suffered some damages as a result of
    the collision and the jury was not at liberty to award zero damages.
    15
    PRAYER
    For the foregoing reasons, Appellant respectfully requests this honorable
    court to reverse the judgment, grant a new trial, and remand this case to the district
    court.
    Respectfully submitted,
    Law Offices of Reginald E.
    McKamie, Sr., P.C.
    /s/ Reginald E. McKamie, Sr_____
    REGINALD E. MCKAMIE, SR.
    TBN: 13686750
    1210 Antoine, Suite 100
    Houston Texas 77055
    (713) 465-2889
    (713) 465-2894 fax
    Attorney for Appellant:
    PAMELA WALKER
    16
    CERTIFICATE OF SERVICE
    I certify that a copy of this instrument has been served upon opposing
    counsel.
    /s/ Reginald E. McKamie, Sr_____
    REGINALD E. MCKAMIE, SR.
    CERTIFICATE OF COMPLIANCE
    This document complies with the typeface requirements of Tex. R. App. P.
    9.4(e) because it has been prepared in a conventional typeface no smaller than 14-
    point for text and 12-point for footnotes. This document also complies with the
    word-count limitations of Tex. R. App. P. 9.4(i) because it contains 3,422 words.
    /s/ Reginald E. McKamie, Sr____
    REGINALD E. MCKAMIE, SR.
    17
    APPENDIX
    18
    Texas Rules of Evidence
    Rule 403.
    Excluding Relevant Evidence for Prejudice, Confusion, or Other Reasons
    The court may exclude relevant evidence if its probative value is
    substantially outweighed by a danger of one or more of the following: unfair
    prejudice, confusing the issues, misleading the jury, undue delay, or
    needlessly presenting cumulative evidence.
    08S         i;        I
    J.IBIHX3      l
    S,J.NVON3:130
    £0::JS
    Walker, Pamela D (MR # 07282551)                                                                              Encounter Date: 06/28/2011
    Author                   Note Status             Last Update User                            Last Update DatefTime
    Cherice M Conley-Harvey, Signed                  Cherice M Conley-                           6/30/2011 9:50 AM
    MD                                               Harvey, MD
    Telephone Encounter
    From: WALKER. PAMELA 0
    To: Cherice M Conley-Harvey, MD
    Sent: Tue Jun 2 8, 2011 9:47 AM
    Subject: Physical Therapy
    Good Morning,
    I wa$ in a hiVrun car accident last week and in need of a physical therapist. Would you please schedule me
    with one? I injured my left hand however; my neck and back are beginning to hurt. Thanks!
    Please reply_ lo this message by electronic messaging.
    -     •     '" •n ""'"n"'"' ee I '   n .._.:_ .. _ ... t... •• r _ T - - - r n d Tr. A C l - · C l ,   I,, ..,   .::.A n   A AA
    KELSEY SEYBOLD CLI N IC - ivIEDICAL                                                                                                               [5442558-04] 90
    16                             Clinic   LAKES AT 610                              WALKER.PAMELA D
    8900 LAKES AT 610                         MRN: 07282551
    HOUSTON, TX 77054-2525                    DOB: 12114/1966, Sex: F
    KSC COMPLETE CHART                        Enc. Date:04/03/12
    Patient Information (continued)
    Meds Comments as of 2127/2012
    2127/2012 Pt. Stopped reflux med. One week ago. Takes Nutrilite multi-vii.
    Ordered Medications
    Disp            Refills       Start            End
    Pregabalin (LYRICA) 25 MG OR CAPS                       60 each         0             4/3/2012         5/4/2012
    (Discontinued)
    Sig: 1 po hs for one week, then bid
    All Results
    No results found
    Vitals - Last Recorded
    Ht                                 Wt                                                 BMI        LMP
    5'   r {1.702 m)                   140 lb (63.504 kg)                                 21.93      03/1212012
    kg/m2
    Vitals History Recorded
    Progress Notes
    Keosha Albert Cma I Certified Medical Assistant I 4/3/2012 9: 11 AM Signed
    Referral? Self referral
    Chief complairit:
    Chief Complaitit
    Patient           with
    • Back Pain
    Pain: 2110
    A) Chief complaint or Subjective:
    Where is your pain?: left arm pain for approx. 4-5 years, left arm tingling and numbness, leg tingling
    and numbness - emg 2010 neg for peripheral neuropathy. emg 2011 of left upper limb was normal. Reports
    aching and tingling/numbness in left arm is worse following an mva in early 2012.
    When did this problem start? 3 month(s); sx also present prior for approx. 4 years, no inciting
    event 4 years ago
    How did this pain start? gradually 4 years ago
    Any inciting event?: yes - nothing in particular but cites an mva 3 mo ago making left arm
    symptoms worse
    Is the pain improving, worsening, or stable over time?: worsening left shoulder and neck/lower
    back improving           .
    Have you had this pain before? - reports no initially, but later states she's had left arm tingling
    and numbness for several years.
    DEFENDANT'S
    Typical pain severity: 2/10
    Printed on 5/31/2013 6:41 AM                                            I       EXHIBIT                      Page 35 of 80
    lJ             3
    KELSEY SEYBOLD CLINIC - MEDICAL                                                                                   [5442558-04] 36
    WALKER,PAMELA D
    9' Kelsey-Seybold Clinic                                                      MRN: 07282551
    HOUSTON, TX 77054-2525               DOB: 12/14/1966, Sex: F
    KSC COMPLETE CHART                   Enc. Date:04/03112
    Patient Information (continued)
    Progress Notes (continued)
    Pain severity during flare-ups: 4/10
    How often do you get a flare up? Several times a week and Factors that cause a flare up:
    prolonged sitting/lifting and bending
    What is the duration of your pain? M1nutues/hours/daily
    Describe your pain: Burning arm/shoulder, Dull, Pins/Needles back, Numbness arms and
    shoulder
    What activity increases your pain? Sitting, Bending, Lifting, Driving
    What have you tried for this pain? Rest, Heat. Physical Therapy, Medications - (ibuprofen).
    exercise
    Prior experience with neurontin: Caused suicidal ideation; SSRI, sx did not improve
    Do you have any .. Weakness yes .. left arm and hand and Numbness yes - left arm and hand
    What position/activities improve the pain?: None in particular
    Which doctors have you seen for this problem? Physical Therapist and Neurologist
    What diagnostic tests have you had for this pain? MRI Scan: Results: and CT Scan: Results:
    Blood Thinners:
    Allergies
    Allergen                                                    Reactions
    • Azithromycin
    Felt like her throat was closing up.
    • Codeine                                                 Rash
    • Nitrofurantoin                                          Hives
    Current Outpatient PrescrfpUons
    Medication                                    Sig                                 Dispense        Refill
    • Ergocalciferol 50000 UNIT OR Take 1 capsule by mouth once a                    4capsule        1
    CAPS                         week
    • Ibuprofen 600 MG OR TABS     Take 600 mg by mouth every 6
    hours as needed
    • IRONOR                       Take by mouth                                               •
    • OMEPRAZOLE 40 MG OR CPDR TAKE 1 CAPSULE BY MOUTH                               30 capsule ·    0
    EVERY MORNING 1/2 HOUR
    PRIOR TO BREAKFAST
    • Venlafaxine HCI (EFFEXOR XR) Take 1 capsule by moulh daily                     30capsule       2
    37.5 MG OR CP24
    Printed on 5/31/2013 6:41 AM                                                                              Page 36of80
    KELSEY SEYBOLD CLINIC - lvfEDICAL                                                                                [5442558-04] 37