The Hardin Family’s Insurance Claim Pertaining to: “11826 PineBelt Dr. Cypress, TX 77429” TICE, ‘The documentation in whole orENMSL Analytical, Inc. 2501 Central Parkway, Suite C-17, Houston, TX 77082 ‘autonak@amsn ‘Ate: Cordell Coleman cme: ercaze Greenes Energy Group. i 11787 Katie Freeway, Suite 300 vealed pense) Houston, TX 770% essa ‘vase Dae: $¥002008 Project. Repot Dae: 11082008 Fax Phone: 281 56-6880 Identification and Enumeration of Culturable Fungi by Swab (Genus Level ID (EMSL Method M005) sates clany cron ee St scree weKCa a 1100100 Apogee 1 709 ‘ta ' 10 ar — Sars Te oa ——1o3 a ap 7 75 ‘sn 0007 4004100 Gaesporin : 409 Coton Saree 400° {e0 panenum ep ‘ ‘0 100100 Serosor sp ' i 100400 Strout). 5 500 100400 youten 3 200 Tota 2 1200 Ve caer tina tat a gop eer trutonie. Rock crate rot seretny Sapa Sree ere armen ate eee Sse ce er ee ere oer ne cara. 790 rae THIS IS THE LAST PAGE OF THE REPORT.EMSL Analytical, Inc. 2501 Central Parkway, ute C-17 Houston, TX 77082 Phone: (713) 686-2635, Cordell Coleman Gree: 11787 Katie Freeway ste 300 Houston, TX 77078 Energy Group Teoeoes4s-0007 Hardin 3 outsise (713) 686-3645 s00Et43-0007 Mardin 2 Bathroom EMSL Order: ‘Customer ID: Received: ‘Analyzed: Report Date: Arrant maf: houstonlab@ems).com 150806143, +00GREEO2 1072808 10728108, 1072808 (=) Gastatie Analyale of Fungal Sporee & Othor Airborne Particulates by Optical Microscopy (EMBL Method MOOT) “Teoa0sias-co03 Hardin 8 AspergiuePesktirn Besieaperas Beales Ccheetomum ‘Cladosporium curves pizeaum Fusarium Gareserme Mysomyeete Paeclomyees| Rust Seopulsopsss Stachybotrys Tonle Wedaaiom Unicenitable Spores ‘ypomyeetes igrespora Prenomyens Spegezzie “Total Fung! Porous Partiouste Hyphal Fragment Inset Fragment on Ea 2 168 402 a 3 2960 a a Cour ‘coun 6 2 168 a re 109 226 “arly: Senay 600% “Aly. Senctvty 300% ‘kin Fragments (3-4) Becground (3-5) duane vn nar name ego (Sein stance eee oa i ery en neon stame reac aoe ‘TieietaeSoac ts scrutiny, Wester = be ange pent oe ‘Riisy cite mpenant estates pty ote ta eer a ‘DAS itprntonensinestntmee ew opal rs Cannes Fer norman on th ung ln nha po pleaee wet he Resources secten at www emsteom Page 1 of 1 Nielance Mee heSule C17 Environmental Microbiology Lab aca) toaaas Services ISOQONUS _Fasertsyatsaets rt piliwwemslicom & Chain of Custody TEE0t Comal alm Project Name. Date Collected (0/28/08 Date Sent, ee —— ns order ie | Sample(s) received in good condition? [¥) [N] [Discemable field blank submitted? [¥] [N] | Area (sq. cm), or ‘Weight (rams) “Ses attached sched Relinguished Llc a. Dates Time: | +20 Received nui QVBoe \EF Pa PMSL-MICOC¥4.0 July 2003Dulié > OF | [pislteD” |Page | of 3 1AM From: James First Name Hardin hnumber8trinity@yahoo.com] Sent: Wednesday, December 24, 2008 6:04 AM To: —_iam.number8@yahoo.com ‘Subject: Duties of the Landlord and the Tenant Duties of the landlord and the tenant http://en.wikipedia.org/wiki/Leasehold Duties of the landlord The first is to put the tenant in possession of the land at the outset of the lease (the 'English' rule); the second is to provide the premises in a habitable condition - there is an implied warranty of habitability. If landlord violates either, the tenant can terminate the lease and move out, or stay on the premises, while continuing to pay rent, and sue the landlord for damages (or withhold rent and use breach of implied warranty of habitability as a defense when the landlord attempts to collect rent).. The lease also includes an implied covenant of quiet enjoyment — landlord will not interfere with tenant's quiet enjoyment. This can be breached in thrée ways. 1. Total eviction of the tenant through direct physical invasion by landlord. 2. Partial eviction — when the landiord keeps the tenant off part of the leased property (even locking a single room). Tenant can stay on the remaining property without paying any rent. 3. Partial eviction by someone offer than landlord — where this occurs, rent is apportioned. If landlord claims to lease tenant an area of 1000 square metres but 400 square metres of the area belongs to another person, tenant only has to pay 60% of the rent. Landlord's tort liability Under the common law, the landlord had no duties to the tenant to protect the tenant or the tenant's licensees and invitees, except in the following situations: 1/23/2009Page 2 of 3 . Failure to disclose latent defects of which the landlord knows or has reason to know. Note that the landlord has no duty to repair, just to disclose. 2. For a short term lease (3 months or less) of a furnished dwelling, the tenants are treated as invitees, and the landlord is liable for defects even if the landlord neither knows nor should know of them. 3. Common areas under landlord's control (e.g. hallways in an apartment building), if the landlord failed to use reasonable care in maintaining them. 4. Injury resulting from landlord's negligent repairs — even if the landlord used all due care. 5. Public use, if the following three factors exist: 1. Landlord knows or should know that the tenant makes public use of the land (e.g. the land is rented for use as a restaurant or a store); 2. Landlord knows or should know that there is a defect; and 3. Landlord knows or should know that the tenant will not fix the defect. e Duties of the tenant Under the common law, the tenant has two duties to the landlord. These are to pay rent when it is due, and to avoid waste of the property. A tenant is liable to third party invitees for negligent failure to correct a dangerous condition on the premise — even if the landlord was contractually liable. Effects of condemnation Tf land under lease to a tenant is condemned under the government's power of eminent domain, the tenant may be able to earn either a reduction in rent or a portion of the condemnation award (the price paid by the government) to the owner, depending on the amount of land taken, and the value of the leasehold Property. 1/23/2009Page 3 of 3 With a partial taking of the land, the tenant may claim apportioned rent for property taken. For example, suppose a tenant leases land for 6 months for $1,000 per month, and that two months into the lease, and the government condemns 25% of the land. The tenant will then be entitled to take a portion of the condemnation award equal to 25% of the rent due for the remaining four months of the lease - $1,000, derived from $250 per month for four months. A full taking, however, extinguishes the lease, and excuses all rent from that point. The tenant will not be entitled to any portion of the condemnation award, unless the value of the lease was greater than the rent paid, in which case the ‘tenant can recover the difference. Suppose in the above example that the market value of the land being leased was actually $1,200 a month, but the $1,000 per month rate represented a break given to the tenant by the landlord. Because the tenant is losing the ability to continue renting the land at this bargain rate (and probably must move to more expensive land), the tenant will be entitled to the difference between the lease rate and the market value — $200 per month for a total of $800. Effects of tenancy Many adverse effects come from this system. Tenants have to pay the landowner even though they are doing all of the agricultural work.. In a sense, it is a cycle where the tenant is never really able to become a landowner because they constantly to pay the landowner, as well as other expenses. If a crop does not flourish, the tenant will still have to pay for the use of the land. The landowner, since he is ultimately owner of the land, also can have a say in what the tenant uses the land for or what he can or cannot grow. On the contrary, rural tenancy has advantages. If a person owns too much land for just their family to use, tenants can rent it out and make use of the land. Also, if a landowner rents out the land, it can be a source of economic income for the tenant which may not have previously existed. In poorer communities, rural tenancy can give the tenants a chance to grow crops to sell in markets and to feed their families. 1/23/2009ACTER? é aie Mieple [hewn ALWE WL WD ee. WE OLb HAW LES ISWCE LocATeD@. 1/%26 PWEBEZT, CYPRESS, TEXAS‘ungal Ie ‘ified at the Hardin I 11826 Pi IK Prepared for the Aspergillus website by: Elena Pleckovi, Institute of Preventive and Clinical Medicine, Limbové 14, ‘SK-833 01 Bratislava, Email:pleckova@upien.sk Problems connected with the presence of microscopic fungi in the working environment and thelr effects on the health status of employees have been studied in many papers. It has been Found that the health of people working with moldy materials can be seriously affected, The alr of working environments may contain as much as 10° viable germs or particles (not only spores, also hyphal fragments etc.) of microscopic filamentous fungi and yeasts per m? and a large amount of various ‘mycotoxins. Regarding the character of manufactured substrates, Irritation of eye, nose and mouth mucous membranes were found, as well as serious acute and chronic damage of respiratory organs, i.e. bronchitis, allergic alveolitis “farmer's lung’, lung mycotoxicoses and similar disorders. Some ‘mycotoxins can also possess carcinogenic properties affecting lung tissue (Dutkiewicz, 1997, Dutkiewicz et a/., 1994, Jesenské, 1993, Sorenson et al., 1991). ‘While the work with moldy materials is mostly sporadic and the possible adverse effects of the microscopic fungi and thelr toxins can be foreseen and thus the exposed persons can be protected using respiratory filters, families Including infants living in homes with moldy walls are exposed to these noxae for a long periods of time. The amount of fungal colony forming units (efu)/m? can vary from a standard of 500 - 1000 to 6000 - 450000 cfu/m” in *moldy" houses (Nevalainen et a/,, 1991). any species of micré 1 from miscellaneou Allergies of inhabitants have been studied very extensively in connection with moldy dwellings. Cytoplasmic glycoproteins of fungal spores are important aeroallergens in genetically pre-determined 1humans (Linas et a/., 1se8) in dette ernie by children suffering 1 asthma, significantly Se Sar an Re ea Se SUT ESRC sre case Studies, expt relations between the presence ofthe fungus in dwellings and allergic reactions of ee ants were found. After cleaning ntaminated sites, or when the occupants moved into 2 new home, the syn =m soins senkpel etal, 1996). hypersensitivity against the antigens of micromycetes growing on walls of her home, i.e. Fusarium sp., Cladosporium sp., Puilularia sp., Rhizopus sp. and Penicilium sp. An explicit relation between summer hypersensitivity pneumonia and the presence of Trichosporon sp. in homes of the patients was found in Japan (Ando et al,, 1991, Lehtonen and Reponen, 1993, Rylander, 1997, Sumi et al,, 1994, ‘Summerbell et a/., 1992). Kauffman et af, (1995) found that atopic humans suffered from acute symptoms of fungal asthma when they inspired a great number of spores. An adverse situation appears when mucous membrane of the epithelium of respiratory tract of sensitive person is. systematically colonized with fungi whose cells possess the ability to penetrate into the deeper parts of lung tissue and produce protease in @ depository niche. These authors also found that sensitization. ‘with fungal antigens is dependent on the person's age, as most humans with it sia 995). According to Garrett etal. (1998), the Foor Tester of Pane iretoet e eat ale sesso Tak feces forbear elle pres ot Aspergilll potentiated atopic reactions of inhabitants. Based on long-term epidemiological studies in USA, Australia, New Zealand and the European Nordic Countries, the statistic significance of higher ‘outbreak of respiratory allergies (asthma, allergic rhinitis, hypersensitivity pneumonia) in children from damp and wet dwellings with a high concentration of fungal, namely Alternaria sp. spores in the air, was apparent (Huang and Kimbrough, 1997, Page and Trout, 1998, Peat et ai,, 1998). ‘There is a close relationship between the presence of spores of microscopic fungl in the indoor air of dwellings and allergic symptoms in some patients. Nevertheless, most of the patients suffer from *muttiallergy", with allergic reaction also against other environmental components. The relationship between the fungal antigens and the allergic patients is considerably influenced by the personality of the patient. This probably causes in some groups of atopic humans an apparently clear relation between the spore count in the alr and the patients reaction, but this could not be proved (Dill and Niggemann, 1996, Jarvis et a/., 1996). For the mycologists, there Is a great challenge in preparing 2 high quality antigen test sets to prove patient's allergy. Currently, @ general approach to the study of the mechanism of fungal effects on human beings is. becoming more urgent. Such an approach Includes the Immunosuppressive influence of beta-glucans from fungal cell wall as well as toxic and irrtative effects of secondary metabolites - mycotoxins and/or volatile organic compounds (Larsen et a, 199 ic compounds, namely ateahos, aldehydes, ketones, arcmat sulphuric compounds, L [Aue ps bp a versio, Cacexperiun ep. ste Petter i ate Tee producers of these compounds. Sich effects are associated with invisible moulds growing under wallpaper, carpets or mattresses (Korpi et a/,, 1997). In some well-known toxinogenic strains, a direct Correlation was found between the mycotoxin production and production of volatile products, ¢.¢, ketones (Pasanen et al, 1986). 2acute lung hemosideroses in infents aged six weeks to six months in Cleveland, Ohio, USA. One child died, and the only common sign was that all those familes lived in dwellings contaminated with S. chartarum. Among others, Memnoniella echinata strains were also isolated from the environment, and it was found that thelr metabolites were highly cytotoxic. It was also proved that the I. echinata strains produce trichothecenous mycotoxins trichodermol and trichodermin, Jarvis et af. (1996) reported that this species can sometimes grow together with S. chartarum. Massive incidence of Spores ofS. chartrum was alo found in the Indoor work environment which hed been flooded ‘An occupant of a "moldy" dwelling Is exposed in that environment not only to microscopic fungi but also to a number of volatile compounds released from furniture, carpets, various paints and other materials. The mechanism of the potential pathological effects of microscopic fungi and their toxins on lung tissue in healthy humans has not yet been made sufficiently clear. For estimating the micromycete effects in the Indoor home environments it is necessary to consider the results of the experiments conducted in vitro or on laboratory animals. Thus, it was found that 47 4% ofthe examined strens isolated from the dwellings were Indoor air in dwellings. In the USA, the ‘Aspergillus sp. fungus was found in 9 29 % and In Scotland in 74 % of the examined homes. In Ontario, Canada, their concentration in the air of dwellings was 22 cfu/m?. In Slovakia, Aspergillus sp. strains were isolated from 9%, A. flavus from 30 % ( 5 % of strains were able to produce alfiatoxins B1, 6, Gy and G, in vitro), Asperailli from the group of A. glaucus from 2%, A, ‘Ochraceus from 12 %, Asperaill from the group of A. restrictus from 2 % and A, ustus from 5 % of examined "moldy" dwellings. Microscopic pictures of scrapings from walls and wooden window frames of some houses are presented (Fig. 1-4) (Pieckova et al,, 1999). yyFig 1. Scraping from a wall in a nursery - a Fig 2. Scraping from a wall in a fitness room - a fragment of a fruiting body of A. versicolor type fruiting body of Aspergillus sp. type (magn. 200x). (magn. 100%), Fig 3. Home dust - a fruiting body of A. Fig 4. Scraping from the window frame In a fitness versicolor (magn. 400x). ee om itl (aa a ea 400x). in Belglum, the following Aspergil were isolated: versicolor and A. repens from mattresses and carpets, A. lars, A. fumigatus, A. niger and A. flavus from flower pot soll, A. versicolor andA. fumigatus from various pad materials (Summerbell et al., 1952). In Denmark, Aspergillus sp. strains were isolated from 56 % of evaluated moldy indoor samples (Gravesen et a., 1999). Damp materials with an ay value ranging from 0.90 to 0.95 are usually colonized by strains of A. fumigatus, materials with 2, values ranging from 0.90 to 0.85 by strains of A. versicolor, materials with a, values of 0.85 and a little less, by strains of A. versicolor, Eurotium sp. (Samson et al., 1994). In general, it is thought that the amount of Aspergillus sp. germs Is higher in indoor air than outdoors at any given time. In the home, the amount of spores in the air is markedly Increased when the Cleaning Is carried out mechanically, for example, when carpets are vacuum cleaned. A. davatus is often associated with allergic alveolitis (hypersensitivity pneumonia) in workers of ‘malthouses (Reynolds, 1991) . >Minimum a,value for its growth Is 0.85.‘reese he poten Patient's disease a Aspergillus Sp. were found in indoor air of dwellings, e.g. in South California in 2.9 % and in the Netheriands in 4.5 % of examined dwellings. In wallpapers of a hotel in Singapore, its incidence was as high as 18 - 88 %. In an air conditioning system in Saudi Arabia, it formed 11 % of all fungal Isolates and Its concentration was 15 700 cfu/g of dust. When examining materials from the indoor work environment, it was found that about 70 % of A. fumigatus spores were able - due to their size - to penetrate into the trachea and primary bronchi and less than 1 % Into alveolt (Miliner et a/., 1980). are mainly fumnigaclavin A, B, C, and D, ‘spinulosin and tremorgenous toxins, e.g. verruculogen. Some rarely Isolated strains praduce kajlc ‘acid, sterigmatocystin and various unknown toxins affecting Artemia salina and Bacillus megatherium NRRL 1366, chicken embryos and other organisms. From 10° spores of the A. fumigatus SRRC 2006 strain, an amount of 9.89 ng of fumnigaciavin A was isolated. In five out of eight A. furnigatus strains isolated from the indoor work environment in a sawmill, fumigaclavin C and verruculogen were found (Land et a, 1987). The Investig Minimum temperature for mycelium growth Is 10 - 12°C, optimum 37 - 43°C, minimum relative alr humidity 85 %, optimum 98 % and for conidia formation minimum 90 %, optimum $8 - 99 %. Minimum ay, value for A. fumigatus growth Is 0.94 and for sporulation 0.95. No spore germination was observed at 4 ~ 8°C, optimum germination temperature Is 25°C and optimum ay value is 0.94 (Optimum pH value of the environment for A. fumigatus ranges from 3.0-8.0. er, In thi activity desc Indoor alr in the dwellings. 4, niger isolates were described in homes in London and Central Scotland, in Plzet (Czech Republic) (0.71 - 1.88 % of all isolates) and in Egypt (15 % of all isolates), They were found in Saudi Arabia in the dust from an air conditioning system (10 600 cfu/g and 7.93 1% of all isolates) and in dust from dwellings (8 600 cfu and 4 % from all isolates), in homes In California (in 19 % of homes, on the average 2.9 cfu/m?, maximum 59 cfu/m?), in Canada (in 6 % of homes), in Ontario, Canada, (on the average 7 cfu/m?). Results presented in another paper describe the presence of A, niger in the dust from Canadian homes in 50 % of all examined samples in the ‘amount of 0.7x10* cfu/g. In the Netheriands, it was found in 4.5 % of homes, In Slovakia, in 5 9 of *moldy" dwellings. In the spores of the‘A. niger strain SRRC 2005, aurasporon C was detected. However, the papers describing the incidence of toxic strains are full of contradictions that may be due to the imprecise Identification of the Isolates, as mentioned above. AA. versicolor has an antigen structure similar to that of P. giabrum. After an inhalation of A. versicolor spores, laboratory rats showed granulomatous lesions in lung tissue, localized mainly near to the bronchi, after one month exposure (Sumi et a/,, 1994). Indoor air in the dwellings. A. versicolor was found in Indoor air of homes in London, in Central Scotland, and in the Netherlands (in 9 of 11 examined homes, in 32 % of all examined homes, and in 50 % of examined schools). It formed 16 - 27% of Isolates in homes in Torino, Italy, and 11.5 % of isolates from moldy wallpapers. A. versicolor was found also in dust in dwellings in Seudi Arabia (15 000 cfu/g and 7.66 % of all isolates). In Slovakia, It was isolated from 33 % of examined "moldy* ‘dwellings. This fungus is placed among the primary wall colonizers at 25°C in dwellings and was also found in dust from mattresses. ‘A.versicolor spores germinate in 12 - 20 days in dependence on the temperature and the pH values of ‘substrates and at the ay values ranging from 0.75 to 0.81. The a, values reported for this species are within the renge 0.78 - 0.98, minimum growth temperature 6 - 9°C, end optimum temperature is 25 ~ 27°C. An A. versicolor isolate from moldy house wall was able to survive incubation onto six different types of plaster at 25°C in an atmosphere saturated with moisture for three months (Pleckové and JJesensk4, 2000). Most of the relevant papers deal with the production of toxic and carcinogenic strigmatocystin by A. versicolor. The amount of toxinogenic strains is rather high, about 74% out of strains tested produced this toxin under various laboratory conditions. Strains of A. versicolor Isolated from damp houses in USA, with occupants suffering from pulmonary disease, were able to produce this mycotoxin in vitro, too (Hodgson et al., 1998). A. versicolor isolates from "moldy" dwellings cultivated on plasterboard at 25°C in an atmosphere saturated with moisture for 46 - 77 days produced chloroform-extractable ‘endo- and exometabolites able to stop the movement of cilla of chicken tracheal epithelium, similar to the effect of sterigmatocystin (Pieckova et a/., 1999). Fungal contamination of the indoor environment of buildings has to be solved at the level of building, ‘maintenance, and style of life and health of the occupants. This contamination is an indicator of unsuitable architecture, building construction and/or using of building. To reduce the concentration of microscopic fungl in the indoor environment, reduction of dampness, effective ventilation and right regime of temperature and hygiene is recommended. In particular cases, itis useful to consult Industrial hygiene experts.st A hyphae are fine and hyaline and produce mostly simple ‘hlalides, Their conida ere usualy one-clled(.e. amnerocanila), hyaline or plomerted, globose to cylindrical, and mostly aggregated in slimy heads at the apex of each phialide. Clinical significance The genus Acremonium current contains approximately 100 specie, of which most ar sanrontvic, a see me ae el rel Distribution Where Found Mode of Dissemination Ubiquitous; Soll, dead organic debris, hay, food Wet spore. ‘cosmopolitan. stuffs, Insect/water droplet. Wind ‘Approx. 80-90 species. {old growth).Allergen ears aie ‘Type ILI hypersensitivity lung. Growth Indoors Widespread. Requires very wet conditions. Characteristics: Growth/Culture Grows well on all general fungal media. Small white or pale shades of pink, salmon colonies. Membranous or thinly velvety. Potential Opportunist or Pathogen ycetoma, keratitis, onychomycosis. ‘Other rare infections reported in immunodeficient patients, and In persons with wound injuries, Most pecies of Acremonium do not grow at 37°C. Industrial Uses Produces cephalosporins, an important class of antibiotics. Notes on Spore Trap Recognition Not distinctive. Small one-celled, colorless spores. May be counted as “other colorless." Some spores are so ‘small they may be missed. Potential Toxin Production None other than cephalosporin (see Industrial uses). ‘Other Comments: Formerly called Cephalosporium, Notes on Tape Lift Recognition Forms chains or slimy heads of conidia. Readily identifiable on tape lift samples. Often found ying wiCladosporium sp. From Wikipedia, the free encyclopedia cs Kingdom: Eungi Division: Deuteromycota Order: Moniliales | Family: Dematlacese Genus: Cladosporlum ‘Link: Fries I | is @ genus of funl including some of the mast common indoor and outdoor ‘The many species of Cladosporium are commonly found on living and dead plant material. Some ‘species are plant pathogens; others parasite, ‘other fungl. Cladosporium spores are wind-dispersed and they are often extremely abundant in outdoor air. Indoors Cladosporium species bresent, Cladosporium fulvum, cause of tomato leaf ‘mould, has been an important genetic model, in that the genetics of host resistance are understood, Health Effects ‘The airborne spores of Cladosporium species are significant alleraens, and in large amounts they can severely affect asthmatics and people with Distribution Where Found Mode of Dissemination Ubiquitous; Soil of many different Dry spore (formed in ‘cosmopolitan. types, plant litter, plant very fragile chains, Approx, 28-40 species. One of the most common pathogen, leaf surfaces, easily dispersed), genera, worldwide. old or decayed plants. Wind. Allergen Potential Opportunist | Potential Toxin or Pathogen Production’ Common and importare alee, Generally, non- Cladosporin, emodin. pathogenic. One species, (Neither are highly Cladosporium carrion, Is toxic.) an agent of chromoblastomycosis in subtropical and tropical regions (grows at 35- 37°C). Growth Indoors Industrial Uses ‘Other Comments 10Widespread, on many substrates, Including textiles, wood, moist window sills. Grows at 0°C, and so is associated with refrigerated foods. ‘Aw=0.85-0.88 (minimum for various species). rowth/ Culture Grows on all general fungal media. Some species sporulate better than others, and some may need ycles of light in order to produce spores. C. herbarum produces enzymes which are used In the transformation of steroid intermediates ‘such as pregnenolone and progesterone, biologically important hormones used in the industrial production of oral contraceptives. ‘Notes on Spore Trap Recognition Distinctive, with wide variation in size and shape. Spores with dark attachment scars and ‘some olive to brown pigmentation are Identified as Cladosporium. GS. deHoog & J. Guarro have placed species associated with human Infection Ina new genus Cladophialophora, ‘Cladophialophora ‘carrionil, C. bantiana. Older medical texts refer to this fungus by its former name Hormodendron species. Notes on Tape Lift Recognition Distinctive, readily Identifiable on tape Urs. 11(aw 0.78). A wide number of ‘organisms belong to this genus. Identification to species is dificult Often. found in aerosol samples. Commonly found in soll, food, cellulose, paint, grains, and compost piles. itis commonly found in carpet, wallpaper, and in interior fiberglass duct insulation. Although this fungus is less allergy-provoking usually sociated with apple and grape silage. It can aiso cause extrinsic thma. P. camemberti has been responsible for —_inducing ‘occupational allergies among those who work with soft white cheeses fon which the fungus grows. P. cchrysogenum has been found on building materials, including paints, chip “boards, and wallpaper. 2Cultivation - Potato dextrose agar or Malt extract agar, 24°C. Distribution Where Found Mode of Dissemination Ubiquitous; Soll, decaying plant debris, Dry spore. ‘cosmopolitan. ‘compost piles, fruit rot. P. Wind, insects (fungus serves as a Approx. 200 species. glabrum has been isolated food source for storage mites). from diesel fuel. Allergen Potential Opportunist or Pathogen ‘One species of Penicillium species, P. mameffel, Is a ‘cause of human infection. It has not yet been found in the United States, Growth Indoors Industrial Uses Other Comments Widespread. Commonly found in Roquefort and camembert Penicillium Is one of the most eae Grows in water cheese, salami-sausages common fungal genera, worldwide. starter culture; anti- Microbial volatile organic bacterial antimicrobial coe navocs) praca it penicillin, and anti-fungal ne | aint. Also found in blue rot of antimicrobial griseofulvin. apples, dried foodstuffs, cheeses, fresh herbs, spices, dry cereals, nuts, onions, and oranges. ‘Aw=0.78-0.86 (minimum for various species). Characteristics: ‘Notes on Spore Trap Notes on Tape Lift Recognition Growth /Culture Recognition 13Grows readily on general fungal media, Colonies are usually shades of blue, green, and white. Free spores are indistinguishable from Aspergillus and other genera with small round to oval coloriess or slightly pigmented spores. ‘of cell wall connections, 14 Penicillium is readily Identifiable on ‘tape samples If sporulating structures are present. Old growth or samples with high numbers of spores may not exhibit sporulation structures necessary for Identification and are therefore reported as "spores typical of Peniciliium/Aspergillus.”: Sterile (white) sp (Seei2ipage document for morélinformation) 15Yeast sp. Yeast From Wikipedia, the free encyclopedia Ne B Ascomycota (sac fungi) ‘Saccharomycotina (true yeasts) © Tephrinomycotina } ‘© Schizosaccharomycetes (fission yeasts) Besidiomycota (club fung!) © Urediniomycetes | © SporidialesYeasts are eukaryotic microorganisms clasined in the kinadom Fung, with about 1,500 spacies currently described; they dominate fungal diversity in the oceans. Most reproduce asexually by ‘budding, although a few do so by binary fission. Yeas sp ‘can vary greatly depending on th yeasts can reach over 40 ym. ‘The yeast species Saccharomyces cerevisiae has been used in baking and fermenting alcoholic ‘beverages for thousands of years. It is also extremely important as a model organism in modern cell biology research, and is the most thoroughly researched eukaryotic microorganism. Researchers have It to gather Information into the biology of the e on in humans, Yeasts have recently been used to generate el ‘cells, and produce ethanol for the biofuel industry. Yeasts do not form a specific taxonomic or phylogenetic grouping. At present it ls estimated that only 11% of all yeast species have been described. The term "yeast" is often taken as a synonym for S. cerevisiae ‘© but the phylogenetic diversity of yeasts is shown by thelr placement in both divisions Ascomycota and Bapidiomycota. The budding yeasts (“true yeasts") are classified in the order Seecharomycetales, Pathogenic yeasts 5 ‘A photomicrosraph of Candida albicans showing hyphal outgrowth and other morphological characteristics. ‘Some species of yeast are opportunistic pathogens where they can cause infection in people with compromised immune systems. ‘Cryptococcus neoformans is a significant pathogen of immunocompromised people causing the disease ‘termed Cryptpcoccosis, This disease occurs in about 7-9% of AIDS patients in the USA, and a slightly ‘smaller percentage (3-6%) in western Europe.{82 The cells of the yeast are surrounded by a rigid polysaccharide capsule, which helps to prevent them from being recognised and engulfed by white ‘blood cells in the human body.kcusei, 18 genic yeasts of candldlasis in probable cE escending order of virulence for humans are: C. albicans, C. tropicalis, C. stellatoidea, C, alebrata, C. G. parapsilosis, a f 3 aiLAN Oh WERS LiM GIL (Te perk! [OUS CY CLAD (TOE poeilbine STAT oe : FOU. CLAUS.‘A Revised Reprint from Tierra Grande, the Real Estate Center Journal fee iNtieueg Payee Wu (Ne re) Landowners, Children and Perilous Conditions rudent landowners should be aware of thelr Fesponsibiives to persons injured on their property, particularly children. ‘The degree of Fesporstbtity owed to third parties depends Sn_the legal classification of the person when ied nore child ay fl ne one thee legal categories when eecompanted by an tdult, These tnelude an invitee # licensee anda Trespasser Tan invitee fs someone who has an express or implied invitation thot just permission) to be an the premises. Generally, invitees are persons on the property for the economic benefit of ath the Visitor andthe landowner. Business guests are an example of invitees, Larmlowners owe the greatest legal responsibility torinvitecs, The landowner must take reasonable fare to igure that the premises are safe ado five an adequate and timely notice of concealed or fatent perils that ate known or Urata reasonable inspection would reveal. ‘rdovenets are not absolutely Liable for an savitee's safety, Texas law requires the invitee to Be awore of open and obvious perl. If injury tecurs, Texas aw of comparative negligence. gov fm the recovery, Invitees may recover damages as fing as they did act contribute more than 50 pergent toward the injury. Any contribution of Iss han 30 percent reduces their recovery by the Corresponding, percentage ATicensee’ bn the other hand, 8 a person, who hae the Tandovmer's express or implied” permission tas opposed Co. an. invitation) to eon the prop Gry. UEhe Tieensee’s presence must be for reasons Giver then the landewner's economic benef Social guests are an example Legal Duty to Warn ‘The landowner has a legal duty to warn the Licensee of any hidden dangers that are known to the landowner or to make the condition reason ably safe. The landowner is not required to In. Spect the property. Licensees have a legal duty to thon Ure lookout for their own safety” regarding open and obviously dangerous conditions. Texas law of comparative negligence again governs any recoveries ‘And lostly, a trespasser 1s someone on the propergy without either express or implied Invite Bon o® permission. ‘The Tendownec's responsibilty fe 'mintia The landowner cennot willfully tnjure the trespasser except for the protection of the landowners lite or property’ Gubehapter D. Texas Penal Code). The landowner may not injure the trespasser by erecting unlawfully dangerous ma- Chines or contrivances such as spring. guns. Tardowners, should remember several points when ‘confronced. with responsibilities. to visitors. Firs ics not necessarily the tandowner who bears the lability for injury” Rather, It rests on the person who has control or possession of the property, This person may be a! lessee or renter. Tie texin “landowner” refers here vo the person who beers this. obligation. ‘Second. the degree of responsibilty 1s determined ax the time the injury occurs, not at time of thuy. A visitor's legal classification may vary flan one portion of the premises to. another. For Shampler 4 business customer is an invitee in the thain'loboy ut a trespasser in an area marked “Tor employees. only" Third! cildren, a @ rule, occupy the same legal classification as the adult they accompany. For Gkampleif'a child accompanies the parens Into 2 Store the chi will be an invitee unless the Stanger ofa sign states that children are not allowed Attractive Nuisance Doctrine Children who trespass unaccompanied by an adult create a fourth category of liability. Special fules apply to protect unaccompanied. trespassing Children, The rule Is sometimes referred (0 as the Infant-trespasser rule or as the attractive nuisance doctrine. “Although the name implies the doctrine is based on nuisance, the liability is predicated on the Tandowner's negligence in failing to exercise, ordi nary care to protect indiscreet, trespassing children, Originally, the doctrine applied to children injuredwhile playing on railroad turntables. Now it has a much broader application. Application of Legal Doctrine or liability to arise under the doctrine in Texas, @ Tour-part test must be met. Many of the parts are interrelated. It sometimes is difficult to analyze one aspect without considering another. Ail four parts (or tests) must be met + First, the child, because of age, can not realize or appreciate a dangerous or perilous condition. * Second, the landowner knew or should have known that children frequented and played in an area where a dangerous or perilous condi- ton is focated, + ‘Third, the dangerous conditio the injury was one that the landowner knew or should have known in volved an unreason- able risk of death fr serious bodily harm to children, * Fourth, the utility, if any. for the Tandowner tom tain the dangerous condition was slight as compared to the probability of injury to children. ‘The first test addresses the child’s ability to perceive danger. This is based both on the cchild’s experience and intelligence. Consider ation must be given both to the character of the danger and (o the age and maturity of the child. Some perils are obvious to very young children, whereas other perils are not Texas case Jaw has developed some guidelines as to the Interplay of the child's age and the ability To appreciate danger, As a general rule, children tunder seven years of age are presumed unable to recognize and avoid danger or a dangerous place Children between the ages of seven and 14 present a question of fact in each instance. And finally, children more than 14 years of age are resumed able to perceive a dangerous condition. these guidelines apply in the absence of mental evelopment ordinarily found in children of that age Location of condition ‘The second part of the test Involves the location of the dangerous condition. Some states—but_not ‘Texas-—hold that the dangerous device or condition must be In close proximity to a legal path or highway, The child must see the peril. prior to the trespass, In other words, the viewing of the dangerous condition from a legal vantage point that caused e attractive nuisance doctrine applies to humanly created objects or conditions. Injuries caused by natural conditions on the property are excluded. becomes an alluring factor (or implied invitation) for the child to enter. If the child notices the object after the trespass occurs, the landowner is not liable because there was no prior allurement or implied invitation, ‘Texas does not subscribe co chis rule. It fs sufficient if the landowner knew, oF should have foreseen, that children were using or apt to use the premises where the dangerous condition was maintained. The location of the device or condition ‘and its proximity to a path or highway is impor tant in Texas only as the question of foreseeabil- ity of the child's presence. ‘The question of the attractiveness of the condi- don may be on the wane. In the Texas case of Eaton v. R. B. George Investment, Inc., the delen- dant questioned the attractiveness of an abandoned dipping vat to children, The Texas Supreme Court held that the attraction 18 important only as it relates to the foresecabil kky of the children at that location, “The third part of the test Is similar to the second part. ‘The land- owner must know. or Should have known, that the condition presented a danger to trespassing children. Little case law exists on this point. If children are injured, the court practically assumes the landowner should have known of the danger. fowever, the court grants the landowner Some relief. ‘The doctrine applies only when the child is injured by humanly created objects or ‘conditions. Injuries caused by natural conditions tn the property are excluded. The courts have hheld that the characteristics and dangers of natural Objects and forces, such as lakes, rivers, trees and the like are common knowledge and obvious to children of all ages. ‘Thus, 1¢ makes a great deal of difference whether a child's injuries stem from falling out of 2 tree or falling off a ladder, One is natural: the Other is manufactured. However, the cule for ratural objects must be scrutinized closely when applied to water. Water is @ natural object that an be artificially retained at_a specific location. If body of water is being artificially impounded, the owner is potentially liable Balancing Utility The fourth test balances the utility to the owner with the danger to children. Many objects fo conditions, such as farm machinery, found on a Tandowner’s property. are vitel to the. landowner’s velihood. Other objects, such 9 abandoned wind mills, discarded equipment or scrap Iumber, areless important. In many cases the critical question centers on the usefulness of the dangerous condi ion (or object) to the landowner and the cost of making it safe. For instance, in the case of Eaton v. R. B. George Investment Company the landowner was held liable for the drowning of a three-year-old child in an uncovered dipping vat that had not been used for more than two years. It was no longer useful to the defendant. A couple of hours ‘with a saw, hammer and $30 in material would have remedied the problem. In the case of Banker v. McLaughlin, the defen dont excavated and abandoned an area in a resi dential section. It filled with water. and @ child drowned. The defendant was held lisble because the excavation that could have been drained into a nearby ditch by turning a few shovels of dirt in Flippen-Prather Realty Co. v. Mather the defendant was held liable for the drowning of a ‘child in an unguarded and abandoned, well located in a residential area. In both cases, the utility of thelgondition to the defendant wes nonexistent 'y contrast, in two Texas cases te defen. dant was exonerated for the drowning of children. In both cases the children drowned in large artificial lakes main fained by @ railroad company as a source of water for its engines and bollers. Neither lake was situated In a residential area. One lake was fenced and equipped with warning signs. Both lakes provided ‘ater in the normal course of business to the railroad Locating any structure in a residential area where children play 1s suspect. In. Timmons v. Texas Uulities Electric Co, a 14-year-old boy was electrocuted by arcing from wires when he climbed an electric tower. The tower, located in fan area heavily populated with children, was Surrounded by @ barbed-wire, 12-foot barricade. A simall danger sign was posted. The boy had been Warned not to climb the tower. He was intoxi cated when the accident occurred. ‘The electrical company was held liable under the attractive huulsance doctrine. While @ normal 14-year-old can appreciate the dangers of coming into direct on: get with live wires, the danger of electrical arcing ig not within common knowledge at that age. ‘The Texas Supreme Court in 1997 overturned the lower courts’ decision In this case. The young person's appreciation of the dangers of electrical Wires. not necessarily arcing, rendered the doctrine inapplicable ‘The potential ability faced by @ landowner when a child is injured! or killed is addressed both by case law and statutes. ‘The list of recoverable items varies with the seriousness of the injury to the child and with the degree of landowner's culpability ‘In any personal-injury situation, ‘Texas case law hholds that the responsible party (in this instance, the landowner) is lable for all damages dir and proximately caused by the injurious ects. The Tecoveries are Known as actual damages ‘Actual Damages The list of actual damages in personal-injury cases includes: * Mental and physical pain and suffering © Any aggravations to pre-existing physical conditions + Loss of time and earnings from a job ‘+ Impairments to the future earning capacity + Reasonable medical, nursing and hospital expenses incurred in the past and that will be incurred in the fucure + Any decreased life expectancy resulting from the injury In addition, when the personal injuries are caused by malicious. oppressive. deliberate acts or by the gross negligence of the landowner, the plaintiff may recover exemplary (or punitive) damages. Exemplary damages are awarded to pun- ish the defendants for reprehensible behavior. No recovery of exemplary damages is possible. how ever, without first recovering some actual damages. ‘One’ is predicated on the other. Effective September 2, 1987, caps were placed on the recovery of punitive damages. According to Section 41.008(c) of the Texas Civil Practices and Remedies Code, exemplary damages may not exceed (1) $200,000 or (2) twice the amount of economic damages plus any noneconomte damages found by the jury not to exceed $750,000. Whenever the injury is fatal. Section 71.021 of the Texas Civil Practices and Remedies Code provides that all causes of actions that could have been brought by the victims for personal injuries survive the victim's death, The victim's heirs, legal representatives or estate may pursue the recovery, In addition to bringing an action for the vic tims’ personal injuries, the parents may sue for the: * Reasonable medical expenses paid by the parents for the child + Reasonable funeral expenses paid by the parents for the child + Reasonable expenditures for a monument or tombstone + The pecuniary (monetary) value of the ser- vices the child would have rendered from the date of death until reaching majority, less the ‘expenses that would have been incurred for maintenance and education of the child during the same period + The value of any benefits the parents had @ reasonable expectation of receiving from the child after reaching majority Legislative Caps on Landowner Liability fective September 1, 1995. Section 75.004 of the Texas Civil Practices and Remedies Code was amended 10 limit landowners Ttabliiy in general. Caps were placed on Fecoveries for acts of omissions caused by anowner, lessee or occupant of land whenever the condition of the property causes the injury. The limits apply when the owner, lessee or occupant has insurance coverage equal to or greater than the following amounts: * $500,000 for each person: * $1,000,000 for each single occurrence of bodily injury or death; and * $100,000 for each single occurrence for injury to oF destruction of property. Effective September 1. 1997, Section 75.004 of the ‘Texas Civil Practices and Remedies Code was ‘changed again to. specifically address recreational guests on agricultural land. Recreational guests according {0 the statute include anyone entering for hunting, fishing, swimming. boating, camping, picnicking, hiking. pleasure driving, studying nature (including bird watching). cave exploring, waterskiing and for other water sports and cor: ducting other activities associated ‘with enjoying nature or the outdoors. If che owner, lessee or occupant of agricultural land consents to the entry, he or she does not assure that the premises are safe or assume a freater lability than is owed a trespasser. This Gegree of liability continues until che total charges collected during the previous calendar year exceed four times the amount of ad valorem taxes. im- posed on the premises during the same period. Effective September 1, 1997. the caps on recover fes for acts ot omissions caused by an owner lessee or oceupant on agricultural land also changed. The limits apply when the owner, lessee for occupant has insurance coverage equal or greater than the following amounts: + S1 million for each occurrence, * S1 million for each single occurrence of bodily injury or death and + S1 million for each single occurrence for injury to or destruction of property. ‘The 1995 caps remain for nonagricultural land. The 1997 statute clarifies that the recreational guests can be either a licensee (social guest) or Invitee without changing the landowner's lability as long as the charges for entry remain less than the threshold. However. the entry must be on agricultural land. Agricultural land is defined as Jand used in the production of plants and fruits grown for human or animal consumption or for the production of fibers, floriculture, viliculture, hortieuiture or seeds. ‘The term aiso includes tind used to raise domestic or native farm or ranch. animals, Unaccompanied trespassing children represent a special exception to the rules regarding @ landowner's responsibility to invitees, licensees and trespassers. Because of a child's inability to per ceive dangerous conditions, the law imposes the duty on the landowner to make the land safe. However. the law does not impose an oppressive for unreasonable duty to make all conditions safe. ‘Other publications on the topic are available from the Real Estate Center, Texas A&M University, College Station, Texas 77843-2115, SREAL ESTATE CENTER ©1997, Real Estate Center. All rights reserved. Director, Dr. R. Malcolm Richards: Associate Director, Gary Maler; Chief Economist, Dr. Ted C. Jones: Sentor Bditor, David S. Jones; Associate Editor, Dr. Shirley E. Bovey: Assistant Editor, Kammy Senter: Art Director, Robert P. Beals Il; Circulation Manager, Gary Earle; Typography, Real Estate Center; Lithography, Wetmore & Company. Houston, ‘Advisory Committee: John P. Schneider, Jr, Austin, chairman; Gloria Van Zandt, Arlington, vice chairman; Michael M. Beal, College Station: Conrad Bering, Jr., Houston; Melissa C. Cigarroa, Laredo, Dr. Donald S. Longworth, Lubbock: Carlos Madrid, Jr.. San Antonio: Andrea Lopes Moore, Houston: Kay Moore, Big Spring: ‘and Pete Cantu, Sr.. San Antonio, exofficlo representing the Texas Real Estate Commission. Tierra Grande (SSN 1070023), formerly Rea) Estate Center Journal, 's published quarterly by the Real Estate Center at Texes A&M University, College Station, Texas 77843-2115. Subscriptions are free to Texas real estate licensees who provide thelr name. address, telephone and license numbers to Department S at the addcess given. Other Texas subscribers, $20 per year, Out-of-state subscribers, $825 per year Views expressed are those of the authors and do net imply endorsement by the Real Estate Center, the Lowry Mays College & Graduate School of Business or Texas A&M UniversityPUBL A Revised Reprint from Tierra Grande, the Real Estate Center Journal Landowners, Children and Perilous Conditions By Judon Fambrough rudent landowners should be aware of thelr responsibilities to persons injured on thelr property, particularly children. The degree of ity P responsibility owed to third parties depends on the legal classification of the ‘when injured. An injured child may fall into one of ‘three legal categories when act by an adult, These include an invitee, a licensee and a ‘trespasser. ‘An invitee is someone who has an express or implied invitation (not just permission) to be on the premises. Generally, invitees are persons on the property for the economic benefit of both the visitor and the Jandowner. Business guests are an example of Invitees. Landowners owe the greatest legal responsibility to invitees. The landowner must take reasonable care to insure that the premises are safe and to give an adequate and timely notice of concealed or tent perils that are Known or that a reasonable inspection would reveal. Landowners ere not absolutely liable for an invitee’s safety. Texas law requires the invitee to ‘be aware of open and obvious perils. If injury ‘occurs, Texas law of comparative negligence gov- fems the recovery. Invitees may recover damages as Jong as they did not contribute more than 50 percent toward the injury. Any contribution of less than 50 percent reduces their recovery by the ‘corresponding percentage. A licensee, on the other hand, is a person who hes the landowner's express or implied permission (es opposed to an invitation) to be on the prop- erty. The licensee's presence must be for reasons other than the landowner’s economic benefit. Social guests are an example. —¥» Legal Duty to Warn + The landowner has a legal duty to war the licensee of any hidden dangers that are known to the landowner or to make the condition reason- 07 oe ese a ject the property. Licensees have a luty to Seas cr ree! ‘open and obviously dangerous conditions. Mote: Ag ule wast. moving aut we founda tare law of comparative negligence again governs any recoveries. And lastly, a trespasser is someone on the property without either express or implied invita- tion of permission. The landowner's responsibility is minimal. The landowner cannot willfully injure the trespasser except for the protection of the landowner’s life or property Subchapter D, Texas Penal Code}. ‘The landowner may not injure the ‘trespasser by erecting unlawfully dangerous ma- chines or contrivances such as spring guns. Landowners should remember several. points ‘when confronted with responsibilities to visitors. First, it is not necessarily the landowner who boars the lability for injury. Rather, it rests on the person who has control or possession of the wroperty. This person may be a lessee or renter. ¢ term “landowner” refers here to the person who bears this obligation. Second, the degree of responsibility 1s determined at the time the injury occurs, not at time of entry. A visitor's legal classification may vary from one portion of the premises to another. For ‘example, a business customer is an invitee in the main lobby but a trespasser in an area marked “for employees only.” Third, children, a5 a rule, occupy the same legal classification as the adult they accompany. For example, if a child accompanies the parents into a store, the child will be an invitee unless the ‘manager or a sign states that children are not allowed, Attractive Nuisance Doctrine Children who trespass unaccompanied by an adult create a fourth category of liability. Special rules apply to protect unaccompanied, trespassing children. ‘The rule is sometimes referred to as the infant-trespasser rule or as the attractive nuisance doctrine. Although the name implies the doctrine is based ‘on nuisance, the liability is predicated on the Tandowner's ‘negligence in falling to exercise ordi- nary care to, protect indiscreet. trespassing children. Originally, the doctrine appited to children injured In the attic chert here was a raat /ewte ond it hed been the uahale ref moths wie Wwedthare, growing wold right ance om Cone ohest. Abe, it Know SER a ree hepa eat eek De ae NeeleyAINOM, Bavipenmenror ‘iles oe, ee alge Cond i while plgicg o8'thihan A2Aabied Nw hes a ‘Application of Legal Doctrine or liability to arise under the doctrine in of the parts ate interrelated. It sometimes is difficut to analyze one sspect without be met. ‘First, the child, because of age, can not condition. * Second, the landowner knew or should have an res where a dangerous or perilous. condi- ton is located. at said much broader application. ‘Texas. a four-part test must be met. Many considering another. All four parts (or tests) must realize or appreciate a dangerous or perlious known’ ehat children frequented and played in ‘* Third, the dangerous condition that caused yariens Gig ot mnt walls, we het Pesults wert pos “ve for mol & Supger iehal surmCouneds gi fone tesutect becomes an alluring factor or irmplied invitation)“ for the child to enter. If the child notices the object after the trespass occurs, the landowner is not liable because there was no prior allurement or implied invitation. ‘Texas does not subscribe to this rule. It is sufficient if the landowner knew, or should have foreseen, that children were using or apt to use the premises where the dangerous condition was maintained. The location of the device or condition and its proximity to a path or highway is impor- tant in Texas only as the question of foreseeabil- ity of the child's presence. ‘The question of the attractiveness of the condi- tion may be on the wane. In the Texas case of Eaton v. R. B. George Investment, Inc., the defen- dant questioned the attractiveness of ant abandoned ‘ipping vat to children. The Texas Supreme Court held that the attraction the iyjary wastone that the Tandowner iS important only aa fe knew or should e. relates to the foreseeabil- have known tne e attractive ity of the children at volved an unreason- a that location. able risk of death nuisance doctrine _ 3% h,pu of we or serious bodily harm to children, © Fourth, the utility, applies to humanly test is similar to the second part, The land- owner must know, or way. ore” created objects or Se conan psa Sordon sgh conditions. Injuries Cea posbliyerinwy Caused by natural court racially sstumes The first test addresses the chil’ ability 0 reeive danger. ‘This is Besed both on the child's experience and intelligence. Consider- ation must be given both to the character of the danger and to the age and maturity of the child. Some perils are obvious to very young children, whereas other perils are not, ‘Texas case Jaw has developed some guidelines as to the interplay of the child's age and the ability to appreciate danger. As a general rule, children under seven years of age are presumed unable to recognize and avold danger or a dangerous place. Children between the ages of seven and 14 present a question of fact in each instance. And finally, children more than 14 years of age are resumed able to perceive a dangerous condition Yhese guidelines apply in the absence of mental development ordinarily found in children of that age Location of condition ‘The second part of the test involves the location of the dangerous condition. Some states—but not Texas—hold that the dangerous device or condition must be in close proximity to a legal path or highway. The child must see the peril prior to the trespass. In other words. the viewing of the dangerous condition from a legal vantage point conditions on the property are excluded. the landowner should have known of the danger. However, the court grants the landowner some relief. The doctrine applies only when the child 1s injured by humanly created objects or conditions. Injuries caused by natural conditions fon the property are excluded. The courts have held that the characteristics and dangers of natural objects and forces, such as lakes, rivers, trees and the like are common knowledge ‘and obvious to children of all ages. Thus, it makes a great deal of difference whether @ child's injuries stem from falling out of a tree or falling off a lodder. One is natural; the other is manufactured, However, the rule for natural objects must be scrutinized closely when applied to water. Water is a natural object that can be artificlaly retained eta specific location. If a body of water is being artificially impounded, the owner is potentially liable. Balancing Utility ‘The fourth test balances the utility to the owner with the danger to children. Many ob or conditions, such as farm machinery, found on a landowner's property are vital to the Tandowner's Mivelthood. Other objects, such as abandoned wind- mills, discarded equipment or scrap lumber, are sry sed wave op smop abinp porns ot AY PY Pre rrta ay “rover Go ey seve tor Tenaratilon Liew a ee Ie one MSG ss tebe Ang ebless important, In many cases the critical question centers on the usefulness of the dangerous condi- tion (or object) to the landowner and the cost of making it safe. For instance, in the case of Eaton v. R. B. George Investment Company the landowner was held liable for the drowning of a three-year-old child in an uncovered dipping vat that had not been used for more than two years. It was no Jonger useful to the defendant: A couple of hours with a saw, hammer and $30 in material would have remedied the problem. In the case of Banker v. McLaughlin, the defen- dant excavated and abandoned an area in a resi- dential section. Tt filled with water, and a child drowned. The defendant was held liable because the excavation thet could have been drained into a nearby ditch by turning a few shovels of dirt. In Flippen-Prather Realty Co. v. Mather the defendant was held liable for the drowning of @ child In an unguarded and abendoned well located in a residential area. In both cases, the utility of the condition to the defendant was nonexistent. 'y contrast, in two Texes cases the defen- drowned in large artificial lakes main- tained by a railroad company es @ source of water for its engines and boilers. Neither lake was situated in a residential area, One, lake was fenced and ¢ ‘with warning signs. es Set Balad iy cle nactdl Sean 2k lean to the railroad. Locating any structure in a residential area were children play is suspect. In Timmons v. Texas Utilities Electric Co, a 14-year-old boy was electrocuted by arcing from wires when he climbed an electric tower. The tower, located in ‘an area heavily populated with children, was surrounded by a barbed-wire, 12-foot barricade. A small danger sign was posted. The boy had been ‘warned not to climb the tower. He was intoxi- cated when the accident occurred. The electrical company was held liable under the attractive nuisance doctrine, While a normal 14-year-old can appreciate the dangers of coming into direct con- tact with live wires, the danger of electrical arcing is not within common knowledge at that_age. ‘The Texas Supreme Court in 1997 overturned the lower courts’ decision in this case. The y‘ person's appreciation of the dangers of electrical Wires, not necessarily arcing, rendered the doctrine {nappitcable. ‘The potential lability faced by a landowner when a child is injured or killed is addressed both by case law and statutes. The list of recoverable items varies with the seriousness of the injury to the child and with the degree of landowner’s culpability. In any personal-injury situation, Texas case law holds that the responsible party (in this instance, the landowner) is liable for all damages directly and proximately caused by the injurious acts, The Fecoveries are Known as actual damages. ‘Actual Damages The list of actual damages in personal-injury cases includes: * Mental and physical pain and suffering Any aggravations to pre-existing physical conditions * Loss of time and earings from a job + Impairments to the future earning capacity * Reasonable medical, nursing and hospital expenses incurred in the past and that will be incurred in the future * Any decreased life expectancy resulting from the injury In addition, when the personal injuries are caused by malicious, oppressive, deliberate acts or by the gross negligence of the plaintiff" may recover exemplary _(or_puniti damages. Exemplary are awarded to pun- {Sir the defendants for reprehensible betwvier. No recovery of exemplary damages 1s possible, how- ever, without first recovering some actual ‘damages. redicated on the other. r the drowning of 9p Bffective September 2, 1987, caps were placed on the recovery of punitive damages. According to Section. 41008 of the Texas Civil Practices and Remedies Code, exemplary damages may not exceed (1) $200,000 or (2) twice the amount of economic damages plus any noneconomic damages found by the jury not to exceed $750,000. ‘Whenever the injury is fatal, Section 71.021 of the Texes Civil Practices and Remedies Code provides that all causes of actions that could have been brought by the victims for personal injuries survive the victim's death. The victim's heirs, legal representatives or estate may pursue the recovery. Tn addition to bringing an action for the vic- tums" personal Injuries, the parents may sue for + Reasonable medical expenses paid by the parents for the child + Reasonable funeral expenses paid by the parents for the child * Reasonable expenditures for a monument or ‘tombstone * The pecuniary (monetary) value of the ser- vices’ the child would have rendered from the date of death until reaching majority, less the ‘expenses that would have been incurred for maintenance and educetion of the child during the same period * The value of any benefits the parents had Teasonable expectation of receiving from the child after reaching majority Legislative Caps on Landowner Liability fective September 1, 1995, Section 75.004 of the Texas Civil Practices and Remedies Code was amended to limit landowners’ Mability in general. Caps were placed on Fecoverles for acts or omissions caused by anowner, lessee or occupant of land whenever the Condition of the property causes the injury. The Timits apply when the owner. lessee of occupant hhas insurance coverage equal to or greater than, the following amounts + $500,000 for each person: + $1,000,000 for each single occurrence of bodily injury or death; and + $100,000 for each single occurrence for injury to of destruction of property. Effective September 1, 1997, Section 75.004 of the Texas Civil Practices and Remedies Code was changed again to specifically address recreational quests on agricultural land. Recreational guests according (0 the statute include anyone entering for hunting, fishing, swimming, boating, camping, plenicking, hiking. pleasure driving, studying hature (including bitd watching), cave exploring, waterskiing and for other water sports and cor: Gucting other activities associated with enjoying nature or the outdoors, Ir the owner, lessee or occupant of agricultural land consents to the entry, he or she does not ‘assure that the premises are safe or assume a greater liability than 1s owed a trespasser, This Gogree of liability continues until the total charges collected during the previous calendar year exceed Tour times the amount of ad valorem taxes im- posed on the premises during the same period Effective September 1, 1997, the caps on recover- tes for acts of omissions caused by an owner, lessee or occupant on agricultural land also changed. The limits apply when the owner, lessee for occupant has insurance coverage equal or greater than the following amounts: + $1 million for each occurrence, + $1 million for each single occurrence of bodily injury or death and + S1 million for each single occurrence for injury to or destruction of property. ‘The 1995 caps remain for nonagricultural land. ‘The 1997 statute clarifies that the recreational guests can be either a licensee (social guest) or invitee without changing the landowner's lability as long as the charges for entry remain less than the threshold. However, the entry must be on agricultural land. Agricultural land is defined as and used in the production of plants and fruits grown for human or animal consumption or for the production of fibers, floriculture. viliculture, horticulture or seeds. The term also includes land used to raise domestic or native farm or ranch animals, Unaccompanied trespassing children represent a special exception to the rules regarding a Tandowner's responsibility to invitees, Ticensees and trespassers, Because of a child’s inability to per ceive dangerous conditions, the law imposes the duty on the landowner to'make the land safe. However, the law does not impose an oppressive or unreasonable duty to make all conditions safe. Other publications on the topic are available from the Real Estate Center, Texas A&M University, College Station, Texas 77843-2115, REAL ESTATE CENTER ©1997, Real Estate Center. All rights reserved. Director, Dr. R. Malcolm Richards: Assoclate Disector, Gary Maler; Chief Bconomist, Dr. Ted C. Jones: Senior Editor, David S. jones: Associate Editor, Dr. Shirley F. Bovey: Assistant Editor, Kammy Senter; Art Director, Robert P. Beale i Circulation Manager, Gary Earle; Typography, Real Estate Center; Lithography, Wetmore & Company, Houston. ‘Advisory Committee: John P. Schneider, Jr, Austin, chairman: Gloria Van Zandt, Arlington, vice chairman: Michael M. Beal, College Station: Conrad Bering, Jr., Houston; Melissa C. Cigerros, Laredo: Dr. Donald S. Longworth, Lubbock: Carles Madrid, Jr San Antonio; Andrea Lopes Moore, Houston: Kay Moore, Big Spring: ‘and Pete Cantu, Sr. Sen Antonio, ex-officio representing the Texas Real Estate Commission, Tierra Grande (SSN 1070-0234), formerly Real Estace Center Journal, is published quarterly by the Real Estate Center at Texas A&M University, College Station, Texas 77845-2115. Subscriptions are free to Texas real estate licensees who provide their name, address, telephone and license hombers to Department IS at the address given. Other Texas subscribers, $20 per year, Out-of-state subscribers, 825 per year. ‘Views expressed are those of the authors and do net imply endorsement by the Real Estate Center, the Lowry Mays College & Graduate School of Business or Texas A&M University.epee a ‘mnt LIVIE ATOMS, & . SAW Lush Laub» LoeMt the Sfetes Lrem to, ody brothers & Sisters RPL corder, | Lawily forbdlen te Send or “teste TRAM to Sot Seah RUM) pay br i i ees jab hey peee7 we. here. Vin CTA te Pretint thor icbermaaks © Crom. getting Killed j fTY ET e-Home | Tice seveme oroicr# feos =Iias TT ease EE [Fares 5] Howenold | insured | Dweling | Reconstruction Cost | Coverage 11826 PINE BELT.OR | 11819 DEEP WOODS DR Viewing as of: [fo [i2 feo0e (3) G2 on G@REEEEETD ii" a brimary Iowured Residence Address Phone Household Number sam AUSi 41819 ote 000s ot, -0959797 ovoasesaae Sree rane Property Polley Address, Rating coverage eta Pay Plan 930412701 @G] 11619 DEEP TEXAS FARMERS pWELIING: fRaaono Year Bull: 3994 Monthy Pay: Noosson, Ineorauce ome Reconstruction Cost: QUSZBSS. CYPRESS," COMPANY Pers [Feoo00—z] 320000 Full Term AeealOote: TEZ2S- PPOs ABIL: So "Bran woharse Level: © wepicat— [SOGO——“a (01/22/2008 1325.00 Pays: CLAUSES: 2.086 03/15/2006 Homeowners ‘TEXAS FAMILY HOME POLICY , . 2ST edition owner ‘OccUPIED an (PRIMARY RES —eT Taos Giverme sevens Ee" Roe vo Snes, Sa Ee ao eee, Roe mee am: Ben, ozyze/2009 2706 Surcharge Level: pica, BGT Te] ated Bate: 01/22/2008 1052.00 3 ce i: Who Pays: Named ae cay ita eee, Pewneowner Discounts & Surcharges ‘Serie ce pe eee, Ip ie odie seas —=—a9 Full Pay 930412701 | 930412597 | Doteof —Relatlonship to Primary Out of HouseholdS erernr ion PAGEPage 1 of 5 1AM From: James First Name Hardin [hnumber8trinity@yahoo.com} Sent: Wednesday, December 24, 2008 9:22 AM To: —_iamnumber8@yahoo.com Subject: Fw: 11826 Pine Belt Infestation of bugs Forwarded Message From: Sam Rush To: James First Name Hardin Ce: jhardin@horizonbuilders.com Sent: Monday, October 20, 2008 PM Subject: RE: 11826 Pine Belt Infestation of bugs ‘Mr, Hardin, ‘Thank you for the pictures. You have mentioned that you have these bugs coming out of bathroom walls, but also you have mentioned that you have exterminator coming into take care of It. Please tell me what did they found. If Trecallit correct you and Mir, Hardin told me these bugs appeared since hurricane IKE. | think we have the same kind of bugs coming out of kitchen wall above our kitchen sink but it is not as bad anymore. However, | have called Ty Raymond, Raymond Services Inc. 10011 Airline Dr Houston, TX 77037 (261) 447-3164 two times and | will contacted them three times today Monday morning 10/20/08 and they will be there today at 4:30 PM! to check the water well and the water heater today. Please make sure to be there. As far as mold, according that companies that remediate molds, there should not be any mold if there is not a water leak. | will contact a reputable plumber to examine the pipes to see if there is any water leaks. | wll address your other two emails by separate email, We appreciate your business, and grateful for referring others to our team. ‘Sam Rush Rush insurance Group Eizai aty Fray, Ste 11 Houston, TX. 77079 (733) 777-7770 office Ext. 2 (715) 647-6666 fox 800-497-6211 tol free ‘ww rushinsurance.com Rush re ‘The information in this email may be confidential and/or privileged. This email is intended to be reviewed by only the individual(s) or organization(s) named above. If you are not the intended recipient or an authorized representative of the intended recipient, you are hereby notified that any review, dissemination or copying of this email and its attachments, if any, or the information contained herein is pro ved this email in error, please immediately notify the sender by return email and delete this email from your system. Thank you. 12/24/2008Page 2 of 5 From: James First Name Hardin [maitto:jhnumber8trinity@yahoo.com] Sent: Monday, October 20, 2008 3:40 AM To: Sam Rush ‘Subject: 11876 Pine Belt Infestation of bugs Sam- “These are pictures taken as of last evening. Oct. 18, 2008...seems the bugs want to stay and infest..even after re-caulking the shower as the pest control advised, they are back in full force again...see the pictures attached showing the counter top and I will forward an email after this with a picture of the Shower as of last evening as well....more samples have been taken and we will be submitting them to the pest control for more tests to figure out what this species is..still not determined as of last Thursday when Leah called to check on the status since she had not heard back and they told her that they would need a little more time to send them off for research of what the bugs are.. Please keep in mind that this is how our sink area looks and this is where we are supposed to brush our teeth, wash our faces, etc... My wife and girls are getting soars on them that will not heal and look infected despite cleaning them properly, yeast infections that Leah and both girls have gotten (which is very unusual for Leah and very very unusual for little girls that age to get that type of infection) and also Leah has had approximately one bladder infection per week the last 8 weeks (went to the doctor again and having to keep medicine on hand for it seems after the little and rushed shower taken it flares up), etc... ‘The problem here is just as we have been complaining about for months Sam... you as anyone can go online and look up tive very bacteria that causes bladder infections (i.e. urinary tract infections) and itis "E-COLI", which is found coming out of the septic sprayers, especially when the clorox liquid and clorox tablets containers are not functioning as they should be according to your septic company, as well fas can be found in well water that is not maintained properly...this bacteria can be DEADLY Sam... See just a couple of comments made concerning these issues: "The skin supports its own ecosystems of microorganisms, including yeasts and bacteria, which cannot be removed by any amount of cleaning.” (source found in wikipedia) "Uropathogenie E. Coli (UPEC) is responsible for approximately 90% of urinary tract infections (UTI) seen in individuals with ordinary anatomy.!'4) In ascending infections, fecal bacteria colonize the urethra and spread up the urinary tract to the bladder.” (source found in wikipedia) 12/24/2008Page 5 ot > "Descending infections, though relatively rare, occur when E. coli cells enter the upper urinary tract organs (kidneys, bladder or ureters) from the blood stream." (source found in wikipedia) Note: This is possible by simply brushing your teeth with contaminated water Sam... "Candidiasis, commonly called yeast infection or thrush, isa fungal infection (mycosis) of any of the Candida species, of which Candida albicans is the most common." (source found in wikipedia) “Candidiasis encompasses infections that range from superficial, such as oral thrush and vaginitis, to systemic and potentially life-threatening diseases." (source found in wikipedia) Looking at the well water pump in the front yard, it appears the company listed is the one that put it in only because there was not even an area code for the company number, which we all know 3~4 area codes were implemented over 10 years or more ago in Harris county....there seems to be no maintenance ‘on the well water system as a whole because when looking at the pump it appears completely rusted out..do you have records on the previous owner's maintenance on the well water system and do you have your records on the maintenance of the well water system since the date you purchased the home? Do you have the inspectors report on the home which is a necessity when going through the purchase of anew home? Have you had this home tested for mold? Ifso, when? Do you have records on the maintenance of the septic system by the previous owner and records on the maintenance of the septic system since the date you have purchased the home? Mold is a severe issue as well as the septic system ‘and well water system Sam...ill are potentially life threatening and when your "tenant" voices concerns ‘and requests that it be looked into, it should be immediately according to your duties under the Property Codes of Texas... I will be taking my entire family to our family doctor and having him run all proper tests as far as blood tests ete. in order to make sure we are okay due to all of these symptoms being experienced and have been being experienced due to you claiming that "you only have to have the water tested if there has been a flood’... disagree Sam, you are to get it checked at least once a year to ensure your levels ete. are proper and any bacteria, fungus, microorganisms, etc. etc. are contained properly...Sam we have been Voicing concern of these issues for months, which has even been before the storm we have been telling you and even bringing towels to you Sam to smell after we have to smother the drains at night and the Sinks because of the gases coming up from the drains alone, not to mention the smells of the water ‘coming from the shower heads and how our clean towels smell after getting out of the shower and ‘imply drying off..clean bodies but yet water from the shower heads make the clean towels smell ‘awful..we have been collecting samples since mid August 2008 Sam because you have not heeded to our concems and wamings to get these systems maintained and properly tested!!! 12/24/2008Page 4 of 5 I guess you have exhausted your resources by sitting and doing nothing about it except acting as if you do not understand and how it is a misunderstanding or a simple error...well that is fine Sam for now we are invoking our rights as "tenants" pertaining to the Property Code for your lack of doing anything for months now...we have proof that since mid August 2008 we have been voicing concerns to you, to the extent of bringing towels out of the house for you to smell, showing you the bugs in the master bath, providing invoices from Protex Pest Control whom we had to hire to come investigate the bug situation alone since all you did was bring us a can of Bengal Roach Spray...where is your good faith effort Sam??? Its clear that all you can think about is making sure your home looks pretty, but not ensuring that your 11826 Pine Belt home is up to codes or calling someone out when the tenant is repeatedly asking for help with YOUR home issues that are clear health hazards.. See portion of Property Code to wit: "his _subsectio b to repair or remedy, at the landlord's « stoppages or backups caused by deteri conditions, faulty construction, or malfunctioning equipment Also see a portion of Property Code to wit: "(1) the local health officer or building may not _allew occupancy of or utility service by separate meter to the rental unit until the officer certifies that he knows of no condition that materially affects the physical health or safety of an ordinary tenant; and 2) the landlord may not allow reoccupaney or reconnection of utilities by separate m in six months after the date the tenant moves out.” Thanks, James 12/24/2008Page 5 of 5 Bo You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around hitp://mail. yahoo.com. 12/24/2008S erernt ion PAGEPage 1 of 2 1AM From: James First Name Hardin [hnumberstrnity @yahoo.com} Sent: Wednesday, December 24, 2008 7:11 AM To: —_iam.number8@yehoo.com Subject: Fw: Mold, plumbing, bugs, water Forwarded Message From: Sam Rush To: James First Name Hardin Cc: jhardin@horizonbuilders.com ‘Sent: Tuesday, October 21, 2008 8:48:55 AM ‘Subject: Mold, plumbing, bugs, water Mr. & Mrs. Hardin, We are responding to both of your emails from 10/21/08. ‘Thank you for the information. The bugs that are coming out from our kitchen wall is not as bad as yours, but thank you for your concern, We are very concern about your situation, being in insurance business we are very familiar with mold. Please do not take any risk with your family's health, Please ‘make an arrangement to move early if possible and we will reimburse you for extra charges that they ‘may bill you for asking to move in before 11/01/08. I have already told the Raymond Well Company to ‘come back out to take the water sample. I will contact them today to make sure they will be hear to do the test. We will also file a claim with our insurance company today. Policies do not cover mold any more, but we are filing the claim to make sure that water leak was not from roof that may bring the moister in, I will also call a reputable company that are specialize in mold remediation to come and do the test and I will keep you posted. The only direction was to make you very comfortable as our neighbor, as you know it never works any other way. I have been emailing all my emails to both your email addresses and above attached is another copy of settlement paper and I will also mail you a hard copy today. Thank you for your time. ‘Sam Rush Rush Insurance Group 11221 Katy Fry, Ste 111 Houston, 1x. 77079 (733) 777-7770 office Ext. 23 (713) 647-6666 fox 800-497-6111 tol free vworw-rushinsurance.com s ‘The information in this email may be confidential and/or privileged. This email is intended to be reviewed by only the individual(s) or organization(s) named above. If you are not the intended recipient or an authorized representative of the intended recipient, you are hereby notified that any review, dissemination or copying of this email and its attachments, if any, or the information 12/24/2008Page 2 of 2 contained herein is prohibited. Hf you have received this email in error, please immediately notify the sender by retura email and delete this email from your system. Thank you, 12/24/2008S ererat ion PAGEFrom: James First Name Hardin [mailto:jhnumberBtrinity@ yahoo.com) Sent: Wednesday, December 24, 2008 9:17 AM To: iam.number8@yahoo.com Subject: Fw: Mold Dear Mr. Heard, ‘Thank you for your help on a short notice. Please contact Mr. James Hardin at 6325780445 for access to the property located at 11826 Pine Belt Dr Cypress, TX 77429. a from the walls to check for mold, Please let us know hovr long will it take to get your report. Thank you for your time and thank you for helping us today. We appreciate your business, and grateful for referring others to our team, ‘Sam Rus! Rush Insurance Group 411221 Koty Frwy, Ste 113 Houston, TX_77079, (733) 977-7770 office Ext. 24 (713) 647-6666 fax 200-497-6111 tol free ‘wiwanushinsurance,com Rush | ‘The information in this email may be confidential and/or privileged. This email is intended to be reviewed by only the individual(s) or organization(s) named above. If he intended recipient or an authorized representative of the intended Y notified that any review, dissemination or copying of this ny, or the information contained herein is prohibited, 1 in error, please immediately notify the sender by email from your system, Thank you. Ify return email and delete thS erernT ion PAGElames First Name Hardin [mailto:jhnumber8trinity@yahoo.com) Sent: Wednesday, December 24, 2008 7:56 AM iam.number8@yahoo.com : 2 § Subject: Fw: Greene's MTS Duplical® Gory oye : ME shinsurar lof ee numbers 2 ES $1 BN at RR Wr & Mrs. Haran, a} We are responding to your three emails on 10/25/08. a ines called, intal Solutions ir. Cox and he said should have the i -t Ce ee ene ten sat toate onde ad nol hang UP ys ae rest ad asked them to contact you as well They called us back and told us that they : have talked to Mr. Hardin at 12:45 PM on 10/26/08. As soon as we ast the result we will fo ave mold cove icy, There is not a insurance wherse ber! ready Aeared + Cheaneh vole the repairing and cleanii erty. We do not sible to your personal property afler 10/31/08 whil ing to repairand ‘leaning the property. You can move your personal property to a storage temporarily until we find if there is mold, ’ oat al Tne thet These photos which Shou phe Lord Cf wr: We talked to Aaron Septic Company today. They apologized and promise us that they will be taking care of it Monday, Oclober 27. They also advised meanwhile that use 4 to 5 chlorine tablets in the chlorine canister weekly. We callad and left a message today 10/25/08 for Raymond Services, Inc. AJ Lambert 8327976074 to contact us with results of the water sample. We called again and left @ message for Mr. Anthony Catapano to check the water heater and check for leaks, Ths isthe company that has done work for usin the past and is the company that you have referred to us. Per your email on 10/22/08, you mentioned that you have your own private lab testing the water and will have an answer next day 10/23/08. Have you received any result? Please lel us know. We have paid you in full the full amount that our insurance company paid us on your invoice. This. whole settlement document was emailed you two times and we have also left you a hard copy in your mail box on 10/22/08, Please check and see wihy they are not paying you in full and respond in writing directly to them or email ito us and we will forward it to our adjuster and ask for an ‘explanation. We like to resolve these issues in timely manner, fairly, respectfully and kindly.EL evertion wld tis fal under RILO ST rates s Should we adf wy RovmEwTa & ALUT IONS? Princitel Liable for Acks of iMe As deart, ed Kersey a Re wurst gM } Pos: ol a 4 From: James First Name Hardin {maito:jhnumberBtrnity@ yahoo.com) dev! Wednesday, December 24, 2008 7:56 AM a sae i BYE limeomedayeie con F ch § '} Subject: Fw: Greene's MTS Supliae Copy cae & g - ELS a Os Pao 7 ayd eyes 2) ate dota ERE S$ SE Stbject te: Ceenes ers fowg E 8S subject: Re: Gree STE $283 Mee q Soe wares c i ~ ‘ Py FF LE Weare responding to your hee emai on 102508 =~ S £ t & ESP we coed Envionmental Soins and aed to Mr. Cox and Ne sald hey should have he mld peb Sey eee eee He tora me tat his col phone ran out of batery and fe didnot hang up on you Ree 45 & OS aie Thad asked them to contact you as well. They cal ue at ahve a a 7 xX Jo Mr. Harn at 12:45 PM on 10/25/08, As spon as we get the result we wil forwatdILto you. We y 5) i Hat a coverane on our poly, There is note mgurance company n Texas that offers ee —a i —— at? e aE at he 3 ast a va i pn 2&9 after 10/31/08 while they are wor itand clear erty, You can move your re aa 5 {personal property to a storage temporarily until we find out if there is mol. Bs Re : We talked to Aeron Septic Company today. They apologized and promise us that they will be ” taking care of it Monday, Oclober 27. They also advised meanwhile that use 4 to 5 chlorine ns tablets in the chlorine canister weekly. y & We called and left a message today 10/25/08 for Raymond Services, Inc. AJ Lambert 8327976074 to contact us with results of the water sample. Pam f. \We called again and left a message for Mr. Anthony Catapano to check the water heater and ccheck for leaks. This is the company that has done work for us in the past and is the company that you have referred to us. AMD sep rp0p> v vom pony et dere 7H flese see evigerce of 199, Srv) oos hye omen yy ee 4 er your email on 10/22/08, you mentioned that you have your own private lab testing the water and will have en answer next day 10/23/08. Have you received any result? Please let us know. hen calle) fuck atte 1 ud, ‘whole settlement document was emailed you two times and we have also left you a hard copy in your mail box on 10/22/08. Please check and see why they are not paying you in full and respond in writing ¢irectly to them or email it to us and we will forward it to our adjuster and ask for an. explanation, We like to resolve these issues in timely manner, faily, respectfully and kindly However due to IKE everyone is busy. We waited for over a month to get just bid from your swase Ste 2904 hyvauiP Sopr goo besaowt vod) prop ve tg von op Meo Bett ces | FIT [OE Yh po eepejorwry «! Aponye Sopa ay Pme> 99 Seen p! BTUNIOT oS 4 ‘p/m Jer da wa retker theo ficial report 36s actual Knew the results wena fo. fea dleeed) vi 5 {We have paid you nfl the ful amount that our insurance company paid us on your invaice, This +. E sian v0 ae Jo S¥OsG04 1h frre tag Dd TL nap mos mongS erernT ion PaceFrom: James First Name Hardin [mailto:hnumber8trnity@yahoo.com) ‘Sent: Wednesday, December 24, 2008 9:13 AM To: iam.number8@yehoo.com ‘Subject: Fiv: Greene's MTS Subject: RE: Greene's MTS Mr. & Mrs. Hardin, We are responding to your three emails on 10/25/08. Solutions and talked to Mr. Cox and he sai ave the He told me that his cell phone ran out of battery and he did not hang up ‘on you all. | had asked them to contact you as well. They called us back and told us that they have talked fo Mr. Hardin at 12:45 PM on 10/25/08. As soon as we get the result we will rd have mold coverage on our polly. There ls nota inewanoe pale, Please review your policy on your personal property coverage, We have 3% deductibles dnd the only reason we are filing a claim is to see if there is any roof leaks botwoen tho walls, We have to wait forthe result from Environmental Solutions. 1 will ell Monday to make sure, i ou f ‘your email on 10/1208 you have given us written notice that October is vour ast month, roperty past 10/3/08 we have fo collect another month ofthe cent plus we have made arrani fo start working o} r We do not wish to sible i ‘our personal re working fo repait and cleaning the property. You can move your personel property 1 @ cere ‘temporarily until we find out if there is mold. ‘We talked to Aaron Septic Company today. They apologized and promise us that they will be taking care of it Monday, October 27. They also advised meanwhile that use 4 to § chlorine tablets in the chlorine canister weekly. ‘We called and left a message today 10/25/08 for Raymond Services, Inc. AJ Lambert 8327976074 to contact us with results of the water sample. ‘We called again and left a message for Mr. Anthony Catapano to check the water heater and check for leaks. This is the company that has done work for us in the past and is the company that you have referred to us. er your email on 10/22/08, you mentioned thal you have your own private lab testing the water and wil have an answer next day 10/23/08, Have you received any result? Please let us know. We have paid you in ful the full amount that our insurance company paid us on your invoice. This whole settlement document was emailed you two times and we have also left you a hard copy in your mail box on 10/22/08, Please check and see why they are not paying you in full and respond In writing directly to them or email it to us and we will forward it to our adjuster and ask for an explanation, We like to resolve these issues in timely manner, fairly, respectfully and kindly.However due to IKE everyone is busy. We waited for over 2 month to get justa bid from your ‘company to do the repair work after hurricane IKE. We appreciate vour patience and lot us know if you need to move early and we will prorata the ront and reimburse you for those days. Sam Rush Rush Insurance Group 411221 katy Fry, Ste 112 Houston, x_77078 (713) 777-7770 office Ext. 21 (713) 647-6666 fox ‘The information in this email may be confidential and/or privileged. This email is intended to he reviewed by only the individual(s) or organization(s) named above. If you are not th ‘nt or an authorized representative of the intended cipient, nation or copying of thi email and its attachments, if any, or the infor ined herein is prohibited. Ifyou have received th in error, please immediately notify the sender by return email and delete this email from your system. Thank you. From: James First Name Hardin [mailto:jhnumber8trinity@yahoo.com) Sent: Saturday, October 25, 2008 3:11 PM To: Sam Rush Ce: James Hardin ‘Subject: Greene's MTS Sam- A gentleman from Greene's MTS, the company I found online and sent the link to you in the previous email, has contacted us back. He stated that with the current symptoms we have been having and are currently experiencing just trying to move, he would suggest us leaving until it is treated properly, especially with Abby being back home with us. He said he would especially keep the children out, however, ‘Sam we have no one else to take her again...my mother had her for the last 4 days and had to bring her home to go out of state with Kenner and they took Bekka with ‘them to help us out. So no matter what Abby is with us. He stated that his company ‘can come out and do the fog treatment in the whole house which would also take care of all of our furniture and belongings in ease they are contaminated as well. This would kill ALL mold spores in the house, in the duet work and ALL of our furniture until such time as you can get the drywall removed ete. in which to treat the mold in the walls directly once we are moved out. This would also prevent usfrom having to have the furniture tested and treated at the new place...He stated that he ean explain all of this fo you and asked me to forward you his inform contact him directly by cell phone for something must be done in order to make this home safe for now to allow us to move out. Cordell Coleman (of Greene's MTS) cell ph 713-817-1088 (contact him directly, this is who I spoke with about 30 minutes ago and he can explain all of this to you) We are requesting that he be contacted and this treatment be done as soon as possible so as to not incur any more sickness and unknown damages to ourselves or anyone else which we are moving into their home...we need action taken mediately and we do not have the money to pay for this treatment or us staying somewhere until such treatment can be done in order to be in the house long enough to move our stuff without constant pains and sicknesses we are experiencing that have worsened since last Tuesday with the whole in the wall in the bathroom...Please contact the gentleman and let us know as soon as possible so we will know what direction to go..also please take note that whatever decision you chose, we still have possession of the premises and home and all of our belongings arc still inside. We do not allow anyone to enter the home without our permission, and we need to be notified with ample time und opportunity in order to be present at sueh time... we request a phone call to our numbers with a voicemail message if not answered and an email for confirmation for anyone wishing to enter these premises whieh we still ‘occupy and all of our belongings are still in. Thank you, Leah Hardin 832-504-5482 James Hardin 281-905-4505 832-578-0445S ereenr ion PAGEFrom: James First Name Hardin {mailto:jhnumber8trinity@yahoo.com) ‘Sent: Wednesday, December 24, 2008 7:23 AM To: iam.number8@yahoo.com ‘Subject: Fwv: Access to 11826 Pine Belt Or Forwarded Message ‘Subject: Re: Access to 11826 Pine Belt Dr Sam, 1 would be happy to meet your insurance agent and your self tomorrow, however we have prior meetings at the house first thing, so if you guys can be there at 2:00PM, that would be great. By the way, I just thought you should know that your septic company came back out this morning and stated that he needed to take the water test for the water well over again... He stated that the other test had expired because they didn't tun it into the lab for the actual testing of the water and as. to rather there are polutants in it or if it shows all clear. You may want to have them check the pH Levels also while they are getting the lab to test it. My Doctor stated that it may not have anything actually polluted, but if the pH levels are off, he said that alone could be what is causing my wife and girls to get urinary tract infections, yeast infections, etc... I just don't want whomever moves in after us to have these same problems and therefore your problems continue or maybe even esculate. Respectfully, James HardinMr. 8 Mrs, Hardin, tesy email to inform you th 8S 10 forour ater damages due to ‘We can be their ‘emorrow 10/28/08 6:00 AM or Wecnesday 10/2918 11:00 AM or 2:00 Pi or 4:00 PM. Ita +11/01/08 appointment intent with Lock Smih end cleaning crew. | have also talked to our adjuster Mr Joe Carbejal abou! your inyoice for temporary repairs. Per Mir. Carbajal please review the pages 7 and 8 of our claim documents that we have provided you and if any questions, please respond in writing and they will review and let you know in writing. Thank you for your time, ‘Sam Rush Rush Insurance Group 11221 Katy Frwy, Ste 111 Houston, 7X. 77079, (733) 777-7770 office Ext. 21 (713) 647-6686 fax {800-497-6121 toll free sbew cushinsurance.com Gj] Rush| Feneot ion or copying of this ‘ion contained herein is prohibited. immediately notify the sender by n. Thank yFrom: James Hardin [maiito:jhardin@horizonbuilders.com] Sent: Monday, October 27, 2008 10:45 AM To: Josette Herndon Subject: FW: MOLD From: James First Name Hardin [mallto:jhnumber8trinity@yahoo.com) ‘Sent: Saturday, October 25, 2008 7:07 AM To: Sem Rush (Cet James Hardin ‘Subject: MOLD Sam- We need to know what if any the status the mold test is etc. Ja called Chris of Environmental Solutions =e aaa afternoon (Friday, 24 around 3pm) to see what ‘the status ind he sé call back. never did...he also sounded as if he couldn't speak to James as. ithe ‘was nervous and couldn't wait to hang the phone a but Le II you that someone needs to find out and fi it oe ASAP for things are much ‘worse every since the hole was made in the is shut off and the ‘windows is open {0 tty to help and this is not helping us al ii ving tap anel et ‘out of here. So James just now tried to call Chris Cox of Environmental Solutions and he was agorevated because James woke him up at 7:05am AND HUNG UPON a es do you call out here to deal with sao, bbut now we can get NO HELPI II!!! We are trying to pack and move as quickly as we can, however, every since the mold {esting company came and the hole is in the bathroom wall, we are almost choking on ourselves, James and 1 both feel as if we are having a heart attack or something because cur heart rat will suddenly just skyrocket and we feel fant headaches. dizziness. eves buming and itchy throats, confused feeling, very tired and sluggish feeling...the girls have been away at our doctors request until we figure out the results, however, Abby is duc to ‘come home today and we are not comfortable with jt at all. James and 1 are not comfortable here either right now but someone has ‘o pack our things and move them, .we need answers Sam. have you called to find out since you know how serious this issue is and have filed a claim as of Jast week??2?_ Why has no one updated us a8 ‘we are living in this environment??2?_Why has no one from your insurance company contacted us???? This is very frustrating... Why have we receiced no results on ‘the water test from the great company you had out who happened to come here with no intention to test the water on the first day they cameuntil we had to ask again??? In fat, they came with no tests at all??2? But were sure to tell us that all we had to do was put bleach in the litte hole on the water pump out front and that it would shock the water and clean it up...s0 did you or the company do this or take any other measures to accomplish clean water? Have any steps been taken to fix the broken liquid and tablet containers on the leaking septic system from 2 weeks ago, when your septic company told us to not put any more liquid and that the other was a sitting pool of water either way, so what is cleaning the septic right now Sam??? What is breaking down the gases and wastes Sam??? Our friend that owns a mold remidiation/disaster relief company said that this is VERY. DANGEROUS environment for us to be in and that we need to know what type of mold itis in order to know if we should even be moving our stuff into another place... would not be cool Sum if we took all we belongings into another home and either way. ‘our furniture, clothes, etc. are still toxic and contaminated. Also, you stated you m 1 with vour insurance company pertaining to the mold, we will need all of the information on this as well so we can contact them and see what we need to do as it pertains to doctors, tests we may need done, etc, etc. Also, why have t been contacted o ne come oul to. this iss! insurance ‘company because you even stated how serious this is???? I am not happy being left in the dark while we are experiencing more and new symptoms by the day as we try to get the hell out of here!!! By the way, | am not happy with you telling us to do what we think is best for our family ‘and you will reimburse us...why do we feel as though we are being the only ones incurrin, sand sic living in your home, when we should not have to be reimbursed by you, you should be asking us how much we need and when...we do not have money silting around Sam, nor can we borrow any,..Wwe need you to take Jour responsibilities seriously Sam, it is not our responsibility to dish out the lit money we have in hopes to get it back at some unknown future date, we need it to survive right now...also time is of the essenee when there is this serious matter. that vou being in insurance know about...well what have you done about this Sam??? Have you called to see or is your negligence going to continue as jt has since we moved in...all excuses about you didn't know...and how you came to our home for an hour and we didn't say anything...come on Sam, precedent set and established... vour ludict comment is not going lo change the events nor all of the witnesses to your negligence which you have, where and continue to be in knowledge of...what are you doing about these issues??? Lunderstand we are moving out, but your obligations still remain because we ase not out vet nor do we know the extent of what this has actually damaged our family Sam..maybe ‘you should be concerned a little bit about someone else for a change...this is your house that has been making us sick and still continues to as we are irving to get out as we cannot live in this environment oaWe are in need of at least 800.00 right now in order to be out of here earlier than Li/1...we will need this immediately for we do not have it as an extra right now, we have ‘exhausted all of our monies from the work on your properties. which number one was not ‘our responsibility to cover up f number two has n paid in full to date despite the invoice that said ‘due upon receipt’ because vou knew nothing came out of your pocket up front but ours because vou were to pay it right away...whether your insurance company accepts the full invoice amount, it does not alleviate your obligation because the work was asked of by you and done on your home, and this work was never contingent upon the insurance company’s ability (0 pay it or not...s0 the invoice is still not paid in full, and whether you can get it approved through your insurance company or nol, is something you will have to deal with on your side as the invoice was not w your insurance company but to you for your residence and surrounding properties...this does not include all that we incurred for the 2 weeks with no eleciricity in this house...we are ‘way negative right now because of all of this...s0 to tell us to just move out carly and you ‘will reimburse us is not the answer...we do not have it and should not have to incur any ‘expenses up front or later because of the condition of your home and how it is making us SICK Sam!!! OUR PATIENCE WITH THIS HAS RUN OUT...WE WILL CONTACT WHO WE NEED TO TODAY TO GET THESE MATTERS EXPEDITED IN ORDER TO KNOW WHAT WE SHOULD BE DOING AND WHAT WE SHOULD NOT BE WHEN IT CONCERNS MOLD, LEAKING SEPTIC SYSTEMS WHICH BACK DRAPT GASES IN THE HOUSE AND WATER THAT WE STILL DON'T KNOW TO USE OR NOT USI! Leah HardinPAGEphon 04 Paice pits A ow \Page I of 3 1AM From: James First Name Hardin hnumber8trinity@yahoo.com} Sent: Wednesday, December 24, 2008 6:04 AM To: —_iam.number&@yahoo.com Subject: Duties of the Landlord and the Tenant Duties of the landlord and the tenant Duties of the landlord The first is to put the tenant in possession of the land at the outset of the lease (the 'English' rule); the second is to provide the premises in a habitable condition — there is an implied warranty of habitability. If landlord violates either, the tenant can terminate the lease and move out, or stay on the premises, while continuing to pay rent, and sue the landlord for damages (or withhold rent and use breach of implied warranty of habitability as a defense when the landlord attempts to collect rent).. The lease also includes an implied covenant of quiet enjoyment — landlord will not interfere with tenant's quiet enjoyment. This can be breached in three ways. 1. Total eviction of the tenant through direct physical invasion by landlord. 2. Partial eviction — when the landlord keeps the tenant off part of the leased property (even locking a single room). Tenant can stay on the remaining property without paying any rent. 3. Partial eviction by someone other than landlord — where this occurs, rent is apportioned. If landlord claims to lease tenant an area of 1000 square metres but 400 square metres of the area belongs to another person, tenant only has to pay 60% of the rent. Landlord's tort I Under the common law, the landlord had no duties to the tenant to protect the tenant or the tenant's licensees and invitees, except in the following situations: 12/24/2008Page 2 0f3 . Failure to disclose latent defects of which the landlord knows or has reason to know. Note that the landlord has no duty to repair, just to disclose, 2. For a short term lease (3 months or less) of a furnished dwelling, the tenants are treated as invitees, and the landlord is liable for defects even if the landlord neither knows nor should know of them. 3. Common areas under landlord's control (e.g. hallways in an apartment building), if the landlord failed to use reasonable care in maintaining them. 4. Injury resulting from landlord's negligent repairs — even if the landlord used all due care. 5. Public use, if the following three factors exist: 1. Landlord knows or should know that the tenant makes public use of the land (e.g. the land is rented for use as a restaurant or a store); 2. Landlord knows or should know that there is a defect; and 3. Landlord knows or should know that the tenant will not fix the defect. Duties of the tenant Under the common law, the tenant has two duties to the landlord. These are to pay rent when it is due, and to avoid waste of the property. A tenant is liable to third party invitees for negligent failure to correct a dangerous condition on the premise — even if the landlord was contractually liable. _Effects of condemnation If land under lease to a tenant is condemned under the government's power of \inent domain, the tenant may be able to earn either a reduction in rent or a portion of the condemnation award (the price paid by the government) to the owner, depending on the amount of land taken, and the value of the leasehold property. 12/24/2008Page 3 of 3 With a partial taking of the land, the tenant may claim apportioned rent for property taken, For example, suppose a tenant leases land for 6 months for $1,000 per month, and that two months into the lease, and the government condemns 25% of the land. The tenant will then be entitled to take a portion of the condemnation award equal to 25% of the rent due for the remaining four months of the lease — $1,000, derived from $250 per month for four months. A full taking, however, extinguishes the lease, and excuses all rent from that point. The tenant will not be entitled to any portion of the condemnation award, unless the value of the lease was greater than the rent paid, in which case the tenant can recover the difference. Suppose in the above example that the market value of the land being leased was actually $1,200 a month, but the $1,000 per month rate represented a break given to the tenant by the landlord. Because the tenant is losing the ability to continue renting the land at this bargain rate (and probably must move to more expensive land), the tenant will be entitled to the difference between the lease rate and the market value — $200 per month for a total of $800. Effects of tenancy Many adverse effects come from this system. Tenants have to pay the landowner even though they are doing all of the agricultural work.. In a sense, It is a cycle where the tenant is never really able to become a landowner because they constantly to pay the landowner, as well as other expenses. If a crop does not flourish, the tenant will still have to pay for the use of the land. The landowner, since he is ultimately owner of the land, also can have a say in what the tenant uses the land for or what he can or cannot grow. On the contrary, rural tenancy has advantages. If a person owns too much land for just their family to use, tenants can rent it out and make use of the land. Also, if a landowner rents out the land, it can be a source of economic income for the tenant which may not have previously existed. In poorer communities, rural tenancy can give the tenants a chance to grow crops to sell in markets and to feed their families. 12/24/20085 EPE RAT ION Pactis actekie?/ Aed® ; bdeac pe foRDEMSL Analytical, Inc. 2501 Central Parkway, Suite C-17 Houston, TX 77082 5 Phone: (733) 686-3635 Fax: (733) 686-3665 mall noustonlabemsLcom ‘Atin: Cordell Coleman EMSL Order. 150608143 Greenes Energy Group CustomerID: +00GREEO2 11757 Katie Freeway Received: 0726/08 ‘ste 200 Analyzed +oy20/08 Houston, TX 77079 Report Date: 1012808 -Asperls/Pentltum 2 3070 a Daskospres a o 168 Blolens ® : a cnaetomiom es : : eadesperim 2360 20 as Contos : a 289 a a : sos a 5 a : seam : a : Lnidenenabe Spores é : e 2yperyentes : : prspore a : a Proryces a 2 Pt Spegazina 2 : a Total Fung 800 a700 3390 Frous orcuiate ; 282 97 ypnel Fragment a : : Insect Fragment : : : ol : i : ‘sive Sey 600% a Ey a ‘Analyt Senstvty 300% n ” ” Sid Fragments (4-4) 1 2 3 Becharound (15) 2 2 4 ‘oerhe For ntxmation one fing ised nts report plese et the Resour secton at winw.ensicom Page 1 oftEWSL Analytical, Inc. 2501 Central Parkway, SulteC-17, Houston, TX 77092 Phone: (1976869698 _ Fax: (719)606848 Ena houston ‘tr: Cordell Coleman Customer iO: GREG2S Greones Energy Group Customer FO: 14757 Katie Freeway, Suite 300 fee =m Houston, TX 77079 ‘See iaeea ‘Avoiyels Det: 1110572006 ce Report Date, 1108/2008 Fax Phone: (281 698-6880 Identification and Enumeration of Culturable Fungi by Swab (Genus Level ID (EMSL Method M005)) sao eorare Aaelyteal ar eon _Sampleoctna tte"? (ob) (SPOS) phon Fog Kmbtin om (crumb) tirens Solon MEAG 281100100 Aaporgi oa 7 100 tstee42.008 Tota 1 ‘00 Cite age Teens Berean eR 01708 Roem 7 155 ‘omc c007 100100 cicosportim ep. 1 {00 Cuno Sere 400400 Fencanum sp. 4 400 400 10 steric + 400 400100 Stereum) sp. 5 200 400 100 Yeosep, 3 300 Total 2 1.200 Nodlscemable bank was submit wit tis group of samples Autom. Rack or er epproved sgratry ‘Releasing CFU arcs td. CFU ery en ESL anaes ans Ti ict es oh Hain arin uu ay tern ma wi wie ig ba ogra assorted sas {len repaint coconnresinoh wpe hb tepraty tac erp mann fee cane ae chetntane cutFuna_7.00 ‘THIS IS THE LAST PAGE OF THE REPORT. PagetEWSL Analytical, Inc. 2501 Central Parkway, Sulte C-17, Houston, TX 77082 Phone: (13) 6863635 _Fax: (79) 600-9846-emalt_wtonlanamalcan tn: Cordell Goleman (Later: oReczs Greenes Energy Group stoner FO: 11757 Katle Freeway, Suite 300 ere rae Houston, TX 77079 ee Recehed: 107282008 1:25PM ‘Anayis Date: 1110272008 Project: Report Deter 1170672008, Fox Phone: (281) 598-5860, Identification and Enumeration of Culturable Bacteria by Swab (Five Most Prominent ‘Types (EMSL Method M009) ‘Sample Anaiieal Sense ag Mean ey: ‘otory crus Description Loaaton Nadia __(©)_Bwab) _(CFUSWab) ution Bacal Mencaton Count (crust Herding aon -BA,MAC 35 1000010000 Aerococous viridans et 510,000 1000 1000 Kocuria variens % 7,000 1000 1000 Micrococcus lites subgroup © 6 6,000 Total 6 23,000 150006143-0004 Harding Bedroom = BAMAC 35 t 100 100 Bacitus species 1" 1,100 100 100 Micrococcus ise 3; ‘300 100 100 Staphylococcus capitis 4 400 Total 8 1,800 150806143.0005, No semble blank was submits wiht group of sae Aputomie. Rack (rch pproved signatory |BYSL mans ty incon ans, Wage fn ena npn egos ee. Th nen te oy Wom sanpeene ‘Sova ayes enema hit topper by EU ie eged ses oy Soe lame ba tes Toa aoe ‘Stein srt ec aod baton Samar mbes Nps conan wench eed ccunpact ‘THIS IS THE LAST PAGE OF THE REPORT, egetTue. SY Ap Tipo & t WAS Reb ue We Whe oT AGES Care ine 70 HE » mon? Poul @ (ES bene: ASPERGILLUS dnt, . Q) PEWicicLium- [H4y.onths of exposure unknown 10 olcl house. = méved ind new house Nov.| , 2008 Aspergilius/Peniciltium ~~, ea ae Level-! Common Symptoms of iMold Exposure ‘The most commonly reported symptoms of short term Mold exposure: + Sneezing ~~ - + Itching Skin ~ 2 Symptms as oF + Redness and skin irritation” v eete, n008 (angting) . Wi ich Levei - il Advanced Symptoms of Mold Exposure impos of Mold Exposure The following symptoms of Mold exposure have been reported generally as a result from ‘persons being in a Mold contaminate environment on and off for an extended period Lime, Symptoms are reported to have become more severe and Tanger lasting duelly ‘Proportion to the length of exposure time. Their reported symptoms are as follows: Feelings of Constant Fatigue hing Disorders ing up Blood or Black looking Debris a sympteins as oF 3) pee 4, 2008 (wep) Swollen Glands in the Neck Area and under the Armpit Sudden Asthma Attacks or Breathing Disorders Ear Infections and Pain+ Chronic Sinus Infections * Chronic Bronchitis Pain in the Joints and Muscles” While it seems Mold can cause many symptoms one must remember that there are thousands of species of Mold. Different species of Mold can have a wide variety of reactions within different people. Level - ill Late Sympt s of Mold Exposure ‘The following Mold exposure symptoms are the most severe and are attributed to high levels of exposure: Blindness Brain Damage Memory Loss "Long term" Bleeding Lungs Cancer DeathELACE Wile POSOMME- Symp 5m TeLACE mold Ent Roca a. ISSues £ CHILDREYPage 1 of | 1AM From: James First Name Hardin [hnumber8trinity@yahoo.com] Sent: Sunday, October 26, 2008 3:10 AM To: James Hardin ‘Subject: Black Mold Poisoning Black Mold Poisoning Afier mold formation, it needs nutrition to grow, which it obtains by degrading the surface it is growing on. During the process of degrading surface for nutrition, mold causes formation of Volatile Organic Compounds (VOCs). These VOCs are harmful to human respiratory and nervous systems. Ifa person is subjected to high exposure to Volatile Organic Compounds (VOCs) formed by mold, it affects human respiratory and central nervous systems and causes irritation to mucous membranes, Symptoms of black mold poisoning: Common symptoms of black mold poisoning are: + Uneasiness in respiration + Headaches + Cough’ + Red eyes + Development of rashes and hives on skin Nausea Memory loss In some cases, people experience bleeding in lungs Lethargy + Dizziness + Lack in concentration + Problem caused due to irritation in mucous membranes + Asthma + Allergic reactions (such as itching of nose, runny nose ete.) of respiratory and/or nervous system ete Irregularity in blood pressure Damaged digestion and respiratory system Infections of urinary track, problems in urination ete. Pain in liver and other internal organs High level or prolonged exposure to mold can lead to infertility in the patient 1/23/2009Bachelor Thess, pure of inumations! Deepen! Engaeing Tey 30 aati of Teshaloy, 208 Extended Abstract Removal of Nitrate-Nitrogen in Seawater by Sterile Ulva sp. UENO Yura ‘Sie 1 Na 4003330 Sipe ine: BGASHIRA Richt ‘sperma of erate Doveopmen gic, Schoo ef ghar, Toyo Isnt of Teche Teo 1528352 sopan Introduction ‘Shrimp indy in developing countries isn wanton period ‘o shift Bom the pond of open system 1 tat of closed sytem ‘which litle oF no Water i exchanged to minimize the risk of ‘uhogen contamination fom extemal water supply. On the other hand rapid accumulation of inorganic nivogen, especialy nite nirogen (nktat-N) and anmenie-nitoges (ammonis-N), #8 Serious problem in dosed. ponds. Ammonia’N enerted by ‘metabolism of shuimps is stengly toxic to them even lo ‘concenraions™. While the enc of nial is uch lower din ‘hat of ammooia.n™, iis major pollutant tor eutrophiction, Stele Ug sp. was studied for water guity conto in intensive Shimp maricitare ponds n developing counties a «simple and ‘zonomicl wey to remove ammonin-ntrogen™™ However, there ‘ae no study on reletionship among uptake ond content in la ces of ummonienitvegen and niraeninogen, which ix mportnt for Sesigning system of water quality contol by macrosiea, and no studies on nizalesN uptake under tropical conditions considering Intensive shri mavculre in this study, we studied nite uptake by sterile Uy sp. in various conditions including tpi contions considering application to tease shy mireaone ponds. 1, Experimental “The preparation of Serie Ubg sp was esi out i he same way athe previous works The principal experinente ondtions ar ummivied in Table 1. The starved alga” prepered bythe eit seawater without any aditvs for several dys was further ented for 1 day wih afi] seawater ich in nese a8 light of aboat 1800 jal PPE in apperats shown fo Fig. To be converted to the aamoni-N “eavichad alga” The Pomion o€ culture media Was sampled std analyzed slong time to ‘bia th ime course of iate-N content in ealtire media. he ‘tse of the tropiel condition, the temperature of 30 = 2.°C wn selected considering water temperature la stensive ghrp fas in ‘Thailand®™. nthe existence of ight, PPF (Photosynthetic Photon Fine) was approximuely 1800. ymolm®s" ae the tropical condition according 10 the previous work”. An upuke run with ‘dition of NHC et internals to keep the concentration in the solution almost constant was also cated out under te tops condition. ‘The measurement of the amoynt of nitat-N in aa cells was cared out ss he previous work” The concetration of nitate- and ammonia is liguidsolions were dlenmind by ‘opperised-admium redocion met wilt Griese Romijn reagent, and indophenol tue metho respoctvely ©. ay ad ig 1 Experimental ppc tiles te tk} “Texel on ny 25 3005 Carespnteae coorag a fice shuld be dined YoY Uae a es ‘onostcetish o) {Tate 1 experimen condition Uyak eae Tp rae Madentecondiion Topi! conden ‘Avera hs beaker ene aa ors) ” ta00,0 ree} 2 Ee} Cove lst0° be) 02-10 saro7 Cane? ge) ° 1s Gels kee ° 10 mnubao'ien ooson 063 203 Caner) Tene 7 11 Coeehor) pllgbieat is Festetale sare echo Vp 10a) 50 2. Results and Discussion In gener iaoegicrnivogen sisiniaion is shown 8 Fg, 2 ‘The msi! balance of nae-N and artonie-N in he culture median phase for unit volume are gives as Faqs (1) and (2) ree a, Sil poo pains C) og a + Phx Fable 2 shows the principal properties of sterile Ua sp. with previous study™™ These properties of sterile Uve sp. in this ‘Work agred well with he previous results and were reliable “Table 2 Pcie repens of eile Ua 3p a Un occ Sec Uap See Uap OT Et py © — ts pe 0 ee a oe TD aTT e eae Tepe, sane sate a7 at frente iy yig) sot Ce tae asso! (eae) Gamer) Garey Cm Carve) InPagstanaey SFr vba) Figure 3 shows the tine courses ofthe nitee-X and ammoni-N omesnivations in the cule mseiam in the wplake rune under moderate condions. Figure shows nite wpe nde oc ondtions, The examples of this iia wpuke rate were summarized jn Table 1 wih Ge experimental conditions. Algae took up both niate3¥ and ammoniaN under moderate condition The rte of amnois:N uptake ws higher than that of ritate-N. The inital uptake rues of both nitateN and smmoniacN were higher wien the inital concentrations of thse were higher. The fate of nitate-N wptake was higher under the uopicel canton ‘han that under the maderte condition. The strved alga" cold ‘ake up mitrateN under the topical condo bath ih and witht ambient ammonieN ia eulitre median, wheret the “soriched tgs” couldharly remove nitrate, This inhbton fo ptake was observed by ceva rccarshor™, The amount of ntrateN ih tgs ells was Higher ip enriches alga a sbow in Tae 2 Th the “Tago lene of Tecoionyase of ammonisN uptake, ammoniaN upake as, decreased ‘sen the amount of smmonia-N in alga col was hig! Inthe ‘ise of nitote-N uptake the high amount of niste-N in alge elle ‘eas alas deeply related tothe upakeinihion. The rate of aitate- Nraplake was higher under the wopica! conden tn thet under ‘the moderate condition. No significant difrence um nivatoN puke was observed eswcen with and widout igh. These properties are advantageous, bsause 4 ot of shrimp fams ae Tocsted i wopicl reson, and nraioN mast be removed without light a night there With ambient smmonioN in culture modi, the rae of nivate-N uptake was tower than that without ammonia: NOs the other hands, we ebserved anmeni-N upake was hardy ‘nbd by te exstnce of nivate (data at shown) The averaped age, Hera Ho a4 Rn Fig ealeulned by using as (1) ‘tnd 2) ‘vere sonmarized in Table’ 3 ith the expeinena tandtons.The xn was lower th rng all the eases. The Rae snd mai "enpched alga” were Tower. There were no significant Aiferencesineiter may rr Borwoxn wh and without igh ‘Thee could be an explanation of the reason tht mtaleN vpmke ‘was inhibited by the exstence of ambient ammonit-N in caltre ‘median. The fing was much lower than ser in the ese with limbient ammonis:N, and was lower than sry all the ones ‘When ammoniacN was taken up by alga, the anount of ammonia sn alga cll eeame higher andthe aq Was Tower as show In “Table This lower xy weold cause ascumletion of irate in alps oa, which could abit ntet-N uptake. Fig S shows the rents of the longterm experiment ofthe nies and ammonia: [concentrations tthe utture mediom in the opske rns under ‘he topical conditions with dion of nutnicats at interval, ‘onsierag practical operation in intensive shrimp in developing CShuntice Ammonia terval ae api removed by gsc. The algae ook up neste almost completly a fst? ays. ‘whereas hardy tok up afer de. Ammonia’ should be removed ‘in Shrimp ponds as s00n 25 possible because ammonie-N is much more toxic to shrimps than tee, Therefore, this propery is vontageous ee Bosc tensive manicure Se Fig3 Tine cous of he nse Nand anmeiaN conserttins ‘inte cure edu nh eae neue te cere ccnaion et Tne oy ete Neoncenraon he ‘alae edi nh Sea rns unde ‘pl conan Rey ore towne Table. ig Long time cours ofthe nto and ammni-N emceations he cere mere te ate ans wn ‘ewonicl codon (new, @ ammoni-N) “able 3 ganic kant ines of ap po pl conins Kor Car Cine Cine PF aw farm Ry Rt ‘0 ose 077 1400 O0m 035 005 * © 01 Oo 190 068 0M 050 0 0 008 0 0 om 11 om 0 1s 073 0076 1400 052 030016086 Conclusion Sterile Ua sp. sould remove ritatesirogen in the culture motiom effectively, wheroas he fte oF ate uptake was lower than tht of emmonia-N. The alae tok up niuat-nitrogen even without fight The nizatenitrogen uptake rte decreased with Increasing nitate-nvogen came in alga calls With ambien ‘smmonie-N incalture medium, algae could take up mite, ‘le te rie of uptake ws lower, On the oer hands, emmoniaN “rik was not ibid y ambit nieaeN. Consent ItateN and ammonia N aptake by alga was proposed. foe enirlling wster quality in ineasive shrimp sguacultue pond in developing countries and the wef information far water guaiy ‘contol syst design was provided Nomenclature Gon sonetriton fre 10! het"), Coe = concentration of mena [oI0™ kg hn], Cy = consenalon of phosphonic ck Posie (510° kp], C'pr~ ercotaton of we cate Hes ell 10” kp, Char concern of amon cere {des eth [0° REN 9 ~ ci sain ate of mie [bab Skgavhgpat 4), yor specif stmision tae of wnmonie® (G10°KENSEDM"AY, n= eae wpe to ate [0 NkaDMhIE sar " specie wpe fe of ammonia (10? Ee Nwepst'n') References (Ware, 1K; °Monsging Strimp Pond Water to Reduce Discarg: tees” uae Dring, 9, 6-73 (1990) (2) Hayne, GP "Anuneia Tout tn Telos Fishes: A Review.” ‘ahaa Tesncl Repo f Fre ant Age Scenes NO 17 115 Deprnent of Haier aol Crea, Naim ak Colobla, Catate 83) (@)1 Ca sd 0. Tebsbansleus. “Elution ofthe soem toxic of érognous ngewe! cash les pa “enact 8 20.234 006) (6) Sto, Kan R Ea, "Con of Ania Conte Plsttin ip ‘Css Shimpcufre Ponds wah Using Serwees" The 10h APCCHE ‘Conger APCCRE 208), ar 21,004, Riayat, pen 200) (s)Sio, nail an Eas TRemoval Iaiganie Niropen ‘a Conc! Water Guay in Ceed Srp Ponds wth Ung Stawoads” 2h World Conwess of Chemie Expiring ul) 2008, Ginga be UK. 2005), (eRinee, Wie ans A. WD. Lr, “Uyak Kintes ant “Asian of inane Nien by Cava pow abd Ue cme" ate Bou 6, 135-174 (303) (9) Sahunistt T,X. Wate, E_ Navats wd C. Noches; “Senso ‘Change Sola Raaon Net Raton sad Pouce Ace Radin in ioe Kao, Romer Tare” Bon. Co! tl ‘385401 202) @) Meciey. 1. MF Petes ed J. on, "Change ia nscelr Nitoge Pesan Fedo Cones on Niven Lake ‘in stoop Lam (Chirp 2. Plot, 3, 393-40 196) (9) Kio cho Gade to Marne Observation Kalo Kars Shishi), pp. 18-184, Ocemsebe Set of span 197) (adyotinie VIC ani A Wheses Shor tem ae of sents by “romp poifers {erp cete)" J Pew 23,347 396 1987)GRAND ROUNDS 23% in Environmental Medicine ~~ fave &| CHILOREN's Mency HosPiTat 2 Infant Pulmonary Hemorrhage in a Suburban Home with Water Damage and Mold (Stachybotrys atra) ‘Susan M. Fleppan, Jay Portnoy, Patricia Jones, and Charles Barnes Depertment of Alergy Asthma, and Immunology, Children’s Merey Hospital Kensas Cty, Missouri, USA. ‘The Amesian Academy of Pediatis teceny inued guidelines regarding the potential oxic fect of indoor molds. We now seport air cue of a infant with pulmonery hemouhage ‘whose residential exvironmentl assessment reealed the presence 6f the torigenie mold Swclyboryy ate. We wie x questonnsice to identify environmental factor that could pedir pote the hone to fangal contamination. We called sir samples fom mip loation ia the Frome that we fk would elec ares of relevant exponure. Surface apes were collected with ‘pass of teeparaet ups Br seiquanttte mentees eC apors pee. We deel apie Inno thes rnpctve grants based on dpe, zn, and colar. We aio meuated mycotoxin lev, ‘Ac sampling evened tignifcanlyelested ora por counts nthe patients bedroom ad in the sue. Aspe Peiclo species were profominant. Sadho spores were fund inthe air ‘aenpled nthe pacient's bolroor, a wel rom aufices sampled inthe potent’ eset and the ‘te cg. Additonal, a small petch of Sielybem-conaminated arn in the dose eli, ‘wat ent for mgcoxin analy. Ths mitral proved ro be highly ‘A the ink berwees ‘the presence of Starbyborsin the home and pulmonary hemorhage in inf ingrees, farther ‘ffs should he made to eda phriane, ath care providers, and aew parents about the poten toc ees ofthis mold. Rey mords ods, angus, iiopathic plenary hemorthage, IPH, mold exposure myeatain,Stebyotr toxic nad, uicothecnes water damage. Environ Heats Perpect 107927 930 (1999). [Onlse 20 October 1999) “ple ne th gould 1999/107p927-280Rapanlabeac bed Pulmonary hemorshage is 2 elaively inf suburbs. Envionmenal testing of the resi- quent condition in infants that can result in dence was conducted a few days afer the ‘igufcane morbidity and moray (7). t cild was hospazed. This allowed evalua Aiaqnoss is based on the identification of toa ofthe home a nea identical cond alveolar hemosiderincladen macrophages tions as those presen before the patients Go sinig hi et fom bonds beptalaon ar vage of biopsy A cluster of 10 cases iaopathic pulmonay bemeihging (123) Cae Presentation ‘occured ding 1993 and 1994 a Rainbow A L-momtvod infane presented tothe emer Babies and Chikre’s Hosp in Cleveland, gency department at Children's Mercy ‘Ohio, In the decade preceding these years, Hospital, Kens City, Mion with acute ‘there had been only 3 cases of IPH atthe onset of piratory dstss and shock He Same hospital (2. An examination of the ci was a fuller, healthy baby abi and had ‘cumstances that may ave lead to pulmonary had ao prior symproms preceding thi sud Shortage ther infor tgped siden dn Thr tering he ad Smt beeween IPH and water dartuge in the home, became very fusy. and was dic to patient! homes. Higher expesues to fungi, console. By the afternoon be was breathing nd parccalanly co Stachybonry ama, were rapidly and ws grunting, On aria a he found in case homies versus control homes. hospital he was pale and cyanodi. He had (G) Ninety pereene ofthe pavients i the developed vas flaring and intercostal era sudy were abo exposed to tobacco smoke, dons. He hal bloed presure uf 57/17 and ‘The residences were an avenge of 75 yea rca tempensure of 363°C. He was aio ‘old and mose were in poor rea, suggctng, lethargic and nontesponsve to pain. His ‘har socioeconomic factors may predispose extremities were cool and moted pte to thi type of ong exporre. (9. “The patent's condition deteriorted over ‘We now report another eae of pul- the net 0 min. Due wo peogestive rspzato- monary hemor in an infant who ret itr, an endotracheal tbe was inte in oewer, middleclass home located inthe without wauma. A moderate amex of right Eaicoamantal Heath Perspectives» Volume 107, Munbe 1, Hoven 18 sed blood wat scone from dhe ache ‘tube immediately after insertion and several timer thee, ronchoalvelo lage Amonstned that 2 ofthe macrophage ‘oatne w-posive mater en nxn Stheneidaos (white Hood cls engeg. te ord eal) Heresies nds ong ‘o lesing sed doe not rat om a ‘cae epde of peony eracagog 2. the sorry te sls swe 26 levared white blood cell count (30,400/m?) ioe et iy Seal hemein Tc hemarocst 10. fd and 293 The on deed pothrombin tne $5 otal 10-14 tad a elesed Pinecone of 457,000. Bacterial fires alec fom the Hood ne a Sel a cea pie a Pet Inowaclr compan de top emis vay nlite Wil ean of be soph and tim were alo replat chat neopaph chored Gaiuc Bisel scolar denies through he tangs with no gleral effusion. or prc taeda, Mikael war nue ‘Because sending physician ws svat of he infomuton lang pony ‘ora to gl epost (teen ‘oomen eh specainfon the sllgy serosa rqused mane the pret ine fr Sucybone Seppoive Ge wat Provide and then ttre he Sle watcha olive in hit ater {ET gandparns ome un the patna fees cn ie neon Radner concspondence to SM. Papp Glide» Mes Hoop, Departmen of Aly ‘nd immanoly. 2401 Giam, Kasse Cy, MO {GHO8 USA. Tekepone (816) 234-3097, Fax (616) 461301. Bait Sgpan@ereda "The autor hank K- Wie and M, Shield Childe Mery Heap Jar, Unive of Maryland; D. Dearborn, RB& C Hospital, Clee, Ob: ed RFs, Arey Aes ‘fed ford sic This dy war sported by Chiles Mery ‘oii KB shards Fund acid 19 aj 19997 ceped 27 Auge 1999 27rand Rounds in Environmental Medicine + Flappen eta Methods A home vist by a certified industrial hype tpn 4 ins ater te infane presented co the emergency depare sent Bung that vst, expense of ily members ro quexlonnafe were used (0 idemify potential environmental (ators that could predispose dhe home to fang ‘ic samples were obtained using an Allergenco MK-3 volumettic spore tap (Allergeneo/Blewatone Pres, San Antonio, “DO (gue I). The device nas st w elle {-min air samples at 15 Limin in he infants bedrooms the bedroom coe, the aude apace above the doc the fay soem, Sau the Kichen. We comtdered the oe ton to be rerant ro the pre's cxpoeure ‘Weeolesed the amples daring cold per ai in the winter when the outdoor ld unt wos egg The Allergen MICS drew sore parc through pal pen ing (1-1 x 145 mim) in slid, Paris impacted ono a grestecested side Mele cance teas ee “A line of parle deposition fora ds tac: Aber each setping period. he Side exer somata sranced toa pew ptton eo allow a new tce vo form, Ths, tach tace represented 2 room or location Sampled, The slide war stained. with Calberis's (6 in the laboratory and red talrorcopclly at 1000% maphfistion Counc per cubic mer were else based on the muberof spre eleven fe hor ional awep ofa face "We coed sufce samples with can parent cellophane tape (ape prep) for Semiquanativ mesutement of mold conte Aminaion. Al spore wore cased imo ‘hes especie genera based on shape, andlor Results The nf’ expose occured athe pate sal grandparents howe where he shee» Small bedroom with his mother. Water dlmage othe hous ocuted when shige on the roof, which had recently been replaced and impropeily insealled, were dumaged during hall on, This allowed ‘anwar co enter the ai and the bay bedroom close lected dicey below the lek As a conseuence, ang cmamiaa. tin developed onthe att cling and in the lost (gure 2) ce os ou wen in the iv Ioetion shown in Tale 1. Suchonyt spores were observed inthe ai collected for the infant's bedroom, Four surface se nm wate aig ‘mati so conned Sony spores Ge Hom the ce cing one Foe the lose door, and we from Baki am the au cling Several ether mictbials were ako identified fom visually commited fives including Aspergiln/ Penseilium, Menwoniella Altrnaria, ascospore, Cladosporium Chacromtum, Fore, snd ‘ects cl ‘We collected adonl suface samples of dus in the infant's bedroom to eter tine the exten of spore migration om the al sts of eclonaten, One sample taken fiom the bedrom supply vet cone tained 2 moderate amount of Seca ‘Suahpborna was also present in cunt os the infans er and maces (ater the Sets had been removed). Oxber surface {ample fom she oom fan (ecandiog, porableelese fan, the miniblinds, and the television contained an assortment of fungal spores Including Claderperiam, Poros scnpones, Aspe Pica, Charomians, Alernaria, td Mycomyetes ‘pete bu no Suabybary was cbse. A {Wp ple ell om the wathable eee trade furnace ier was hema conc nated with AiperglnlPenciliom species, and also a rare Seachyborryr spore wat ‘observed. The detection of Stelybotry: on the furnace fle indicated that these spores, tna encered into the vedlaton stern, The Stachybory spores could be discibuted (0 cher parts of che home vis the ductwork tunes the furnace fier capured them fom the crculcing aie We used sterile swab to collect samples for eulcure fom 3 small ares of closet wll. board where Apel Penicillium species tna been detected. This sab was then noe. ulated onc blood and mal extrac agar and incubated at room temperature. Out goal ‘was 10 further differentiate the Penicillin! Appia genera into tote specific casi- ‘ations, We observed growth of two «ype of Peni species, yam-negutive rods, and Rodovornda yeas. To determine i the Seachybany spores ‘were roxigenic, we removed a 10cm area of contaminated dose cling afer thoroughly ‘ering i down wo preven aroulization spores. This specimen was sealed in a bag, and shipped to Bruce Jarvis atthe Univeriy of Maryland for mycotoria analysis by HPLC. High quant of sever potent ‘cothecenes Were detected in this ample, The ‘mycotoxins Revidin L-2, Roridin E, and Satstoxin H were measured a¢ levels of 0. (7, and 3:2 mgfem respectively. Environmental Remediation ‘Our primary recommendation was chat the caus of wate ny, he leak Inthe ot, should be repaired. We also suggested that Visible meld and mold-contaminated items should be dsinfeceed and/or removed in es writen by the New York Chy Bepurmene of Felch (). A thed sugges tion wat ea he famdy shoud fits es, Yacuum, and dus all euraces and tems ‘hich might contin migrant spore acd. 3g the ventilation system. We scrongly add hi aly co pevene he inane fe Coteing the contaminated hore ntl the eanup vas comple: beeawe many infsns diagno wits Sachbaryrasoisted pale ‘monary hemorhage contac tore hen {dea for up 6 mond afer hom ‘clare (2. We ako emphasized tha the fnt should war be expoed to enon: sents contaminated with abscco smoke Teal, fllow-psuncy shouldbe done catnip oneaoneatar ne Figure 2. Photograph of te (A ceing and (ocr of th closet in th ei’ bedroom, Sin indeate water damage fom ran enc. Stachybotns mold growth was fou: ther micrtils wer also present Inciting Chestanium, Chdosporu, end Aspe Peni meld spares; Akodotarule yest: ‘stomeutie beeen ‘Volume 17, Number 1, November 188+ Endronmental Heath Perspectivesresolved ble an infant eum wan af cd emvironment. Besse tis family ected to have theinfat move toa dierent hare fallow op meagurements wee 201 pr “Although the thet of IPH sppese te delge ser t year oF ge (Tel preferable forthe inf ro avoid mld and Soke cootamintedenvionmens afer Discussion “To deere if the Cleland cue of 10 IPH caer ding 1993 and 1994 war elated wen exper, the Center for Disease Consol and Prevention (CDQ) con- diueted « cate-conteol study (0). In that tea the Gleland exes were matched with 50 con ving arp codes (ved in ilar are) and og Air aod ce ‘ls fom ooes whe the ifr pene te That tne were caleced and analy Mean toa spore and ‘aa spore counts at deel nce home weap lee fae eee, ongol homes also had math higher eoncen- {Eaton of Stacydery spe. Enel eal (4) conciuded hat infin who experienced pal- ‘monary morieing tnd eestor Shiela hemes wh ‘ecm hve lived in ‘water £0 eof leak, plumbing eas, flooding. ‘The authors identified no differences between eats and controls with regard 0 pated exporure infnt produc Use oF ‘Dane ue of fmily memes © tobacco smoke increased the odds of pole monary hemorhaging by Bl (2. "There ate a aumber of smlarties Ieewren the Cleveland ce of TPH cases (49) te cae sly ped ee Ost Et andar toc ool Tn book the Sle ome nd shia dy mold damage had nos been cleaned up before exi- ronmental resting slthough there was 2 longer ime icra in Cleveind between ccruence of hemortogs nd the environ. rental sine. Asin the Cleland cher of ‘se heme, hs home had erated eels of Siebome spores, with the highest concent tion found i the patients bedroom. ‘ibome Sudan was among the spores dleceeed. As was true forthe Cleveland bone hp amelie moun of Stace fom surface samples INI ancy ed oer mili vere prom in adn vo S Ing the queton of whether IPH may be cated by interactive fryers feof 2 ‘ombinaion of biocontaminans andlor tc ‘ebolis (9, Myeotoin anal ofthe Sad caminated plaster fom the Seyi ese ded igh eed Grand Rounds in Environmental Medicine + Infent pulmonary hemorrhage ane stachybouys ‘Toble1. i sump spore counts pe abi mater by genus infiveiferetroon Palow’s —Closetat——Ateatowe ‘Family bedroom __bedroom Bedroom __vwort_Kitchen Tapeh? 1340 368 2856 2520 15 rap nas tc 2s Zi toe despa 152 2 ‘3 72 te ‘Anata ° ° u ry ° Pecorpres 18 Ct a a w Patni a 3 o 0 ° Gaetonum a a a 0 ° Sachtains m o 0 0 ° ‘ee, apron ei of oxic, at was true offalans taken fiom Seachem spore are icky while al rst air and surface samples in the Cleveland bac the fungus becomes powdery when the ete ir partir weeks); 6) bottle-feeding infants a cow's millcbd formas 9 ebro smoking by a Saher Santee nee Zhremreeties Siemens ‘orthaging; and f) no other sources of bleed- mieube sere siesta mae ‘pathogens, at was tue for this case (4). The Som cane! aoc jo i are pee res Sigel tna Selecta eee es See poate ht sn he hein Ire aan Sie are Saeean Se aby ometterces — econo ceo Steven «iy. A moire problem thats nx ropeiy See Sethi des metenans Spat ee are eel el pl a ea cpa ee Seats Eeeeecen ees cree eae Rectan petra euteeiee needa oltre for is moll to de Evens Heath Parspectves + Volume 17, Nonber 1, Nevomber 6 susate dries out. The spores can become serorolized if disturbed (2. Tae sal size and alipnoid shape allow them o be inhaled fnd to reach the lower respiratory tact igure 3 (210), "Stachyowrys was fase associaed with = toni response in animals in Eastem Europe and the Uke inthe 1930s Horses con- ‘ming contaminated sxew or hay showed shoo, dermal necrosis, leakopenia, nervous disorders, and death. This condition was later termed sachyboryotexcois. Since then similar problems have been reported throagbou the worl, primary in Eastern Europe (22. “the fst reported cases of tachybosry- toxicosis in people occured in the 1940s. ‘Russians who handed tained hay of slepe fon sawed mattresses experienced det ‘matitis, pain, and inflammation of the ‘murnus membranes; bring nal page tighenes of chess, bloody thinly coughs fevers headache nd aie (12. From the 1950 to the 1980s, more ‘apes were publi on the ropic, bu fev fepors identified Staebyboor: in homes or in 986, Cota (19 pend rea of mycotosiconis in = Chie ocr pat rsicestees pecans Eee eles poem bal 1 hls residence were down 0 toric to tet animals. Afer dhe mold probe lems had been correced, the mulisytem arptons Gace dst ao, iu symptors, diaches, fig, denna, severe leg pains, malaise, and depression) of {he family eave (13). ‘There have been other epors regarding the relationship beeween Scchybornr and hehe fo human. ne contoled study, Jo impels (14) compare fice workers ro nae ‘employees 58) and contals (n= 21) in regard to lower respiratory, dermatologic, eye, chronic faxigue, and immune system sraproms (14) ‘Many studies have demonstrated that Suachybovys utr is capable of producing 23{rond Rounds in Environments! Macicino + Flappan otal ‘igure 2 Stachyborys sore at 100 magni. re elipacd i shape, are 40 pn 1-12 um nse, and have an asrdynanic darter of Sum (10 Pareles wth sorogynaric dlamatre ‘<7 um con h able (> 9%) avec ‘epostion(r. ore cinco mpm (102-17, ‘These ndade the maceeee wheres Rosin Ronin, Svein Hand Scenes Gal ef ich pee rn sya ion md gy cto claro ell Examen Iborory me pag ce si one oon caceutest stachybourytosicoie. Ticochecenes are thought ro be the primary reason forthe hele problems. Steyr spores ar alo capable of producing siriactonesspiase™ ‘ame, and cyclosporin, mycotoxins with Immunoroppresne ees (70, Ifans may be especialy susceptible ro the effec of gerebome ment de cr igh eating rate, imatre lings, ae orth Experure to ba sake a ferve to augment over: expresion ofp ‘monary beeing "zon hat emai be eed how exporre eo Secor can lad TPH or other health symptoms fw for Gee eet ak ae Ec praca of angen myer i the sre are noe soled with iat spores, vlale organi, or high numbers of spores dispersed intermiently. The ler posibilicy, thar spores were dispersed inter- ‘miteently, is supported in this case etudy Dbecaute there was an electri fan in our patient's bedroom. Fans may promoce ‘greater diapersl of spores, making them ‘oilable for inhalation and buman contact. ‘Over 8796 ofthe Cleveland cases slko had dectie room fans (9). Conelusion From 1953 wo 1998, «tou of 37 eves of IPH were found in the Cleveland are. “Twelve of dese infin died, Another 138 cats have been reported ve the CDC fom all ver the county in that same pei (2 Ia June 1998 the American Academy of ing arty ay Sl wr under 1 tate expec tn chrnicly ldo ‘ted indoor environment (9. The AAP ‘eeommended that fan infant presents with ‘qrproms of IPH, parent should be qet- Honed about watt dumage in the home. ‘The AAP recommended that if an infant dies suddenly from an unknown exuse, an sstopry tar ncadesPran ble SFR dou hal ix pcre vo che forhemosiderladen macrophages ©). ‘With here recent AAP recommends- ‘ions, che medical communiey has become ‘more swate ofthe aocsion between cxpo- Suet Stcbbory mold and the incidence OfIPH, Howeve, cae sed ec have yet to be firmly enablched. At more cet of IPH are documened throughout the coun ty, the eorelation with Stylo expo sire may be erengthened. ei iniportane thae thi information be pasted on to che eral public in ney manner, wich spe lal emphasis given to pareate of young ent oscoanber 08 Mars Mera WR waa 2 ere, ha Sermo WE er ME A, ‘ep ea ash De, ne en Pepe be Une por tenerbtonbenantert ners ‘nome Gen, sea Wor ete Wt opto [Enh Moran Sean Gan 6 Aan, ‘owt then se 8 tr J. fs a ‘oA TD a Nw Yer Gy Osan ol Hath, Glos ot ‘eeindbyPedel a He Vou 17, Number 1, Naverber 188 + Evironment Hon PerspectiveLWA? TKACT LA FECTIOWS CHISED "ST HEROCOCHMS- VIR I DANS ee ia eee Lokale For od ese Symptons but Mom hom ble 2 month Ongoing r Conbinjuing Case Heat Gis a eriesty. yAnta Deg 27201547 ‘AN UNUSUAL CASE OF URINARY TRACT INFECTION CAUSED BY > ‘AEROCOCCUS VIRIDANS ‘Meryem GETIN*, Sabahattin OCAK", Devrim ERTUNG"™" * Mustafa Kemal University Medical Faculty, Department of Microbiology and Clinical Micrebology, HATAY- ‘TURKEY ** Mustafa Kemal University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, HATAY-TURKEY "Mersin University Medica Faulty, Department of Gynecology and Obstetrics, MERSIN-TURKEY ‘SUMMARY is generally a saprophytic bacterisins. The bacterin has beer reported a3 a rare pathogen irs Ini- gerry consider as contain ela alte Infections ented by Aira he Ben soy a To date, there are only four reported cases of urinary tract infections caused by A.viridans worldwide, end here we rent Be fh case ing prea! nan. ASD yearald pregnant wos wih manna eg of fur tli reg ancy ha he conpantof mola eri and ince rion feeny forthe hed Alas nde reed the right part of ebonen ring palpetion Te urine caltre ye i growth of D108 cei of Aran te nly ogee. The patent as ly etd wh mpl of pega, ech ruled nlc of esp tems berth et aT thither cae of wiry rac fection eed by Avira ba preg ‘ent omen Or report shes ht eon tgh Acirians sly acted wil oman infection it cold be ce tegen of rina tat nection. Keypoonis: Aerococcus viridans, pregnancy, urinary tract infection Ozer ‘Acrococcusviridang'sn Neden Oldugu Nadir Bir Urns Sistem Infeksiyonu Olgust: Acrococcus viridans genllitlsapoft ol bitinen bir ater Balter insanlardamalirenpaojn olarak bdi- igre gana Kiilardehontaninasyon olarak defelendri. Literate huge badar vinden’ naden oldu ort drner site infeksiyorolgusu bldiigti. Buglagmada bir gebekadrda saptanan bepincl lg surat. Su '3 gn sk rar yapma, rar yoprken ya ve lrgeik payee ola 30 yada 4 aye gebekadouia normal gee [ik bulge ve bat pelpasyonunta safe aff hassasiyt saplenmapt. lar bltrinde sof ltr halinde >10fupnl ‘viridans trenipt. Hasta goblifinden delay ampislnletdaoi etal ve alt inde giayeler kayboimstur Bilger ‘bu ogu, bir gebe indo griden Airs meen oldu lk rine sistem infesiyaolgustur. Bu gu, ‘nsanlard nfelsiyona nadirenneienolmasina ramen, Aviridas' wn trinr este infesiyonlainda bir een olarak dil lebeceint gstermetedr. Anuiktarsbzciker: Aercoceus viridans, geblt rier sistem infesiyons: INTRODUCTION Acrooccs viridans is known as a saprophy- ‘te bacterium, and considered as a rare patho- ‘gen in humans69.), A viridans has been repor ted to comprise 5-10 % of the bacterial flora of airand dust in occupied rooms. Itis widely dis- {tributed in the hospital environment and com- ‘monly found on raw or processed vegetab- Tes) Aviridans can be found in very small ‘numbers in the upper respiratory tract and on the skin of healthy persons. The bacterium is ge- rerally considered 9s a contaminant in clinical cculturest™, ‘Conerpending ston Sebahatin Oak Mets Kamal Oversea! ip okies Infityn Halon ve Kk Milo ‘Anim Daly HATANETURCEY "Phone (026) 2142696 mal mbshatinocak@noumall com ‘Do of receive: 111.206, date of revision 8.022007m.geineat ‘Aerococe! appear to be of low virulence and may be normally pathogenic only in pati- cents with vulnerable conditions. A.viridans has been associated with some humen i Teel bacteria, sep arte. nfetons, mening, urinary tract infection UTD, osteomyelitis, and wound infec ones, To our knowlege, there are three cases of ‘UTI caused by A.viridans in 1967°), and a case of UTI with bacteremia caused by A2irdons in an 87 year-old male nursing home resident in 2004 ‘have been reported thus far'5). Here we describe not only the fifth case of UTI caused by Airi- dans, but also the first case of UTI cavsed by “Aviridans ina pregnant woman. CASE PRESENTATION ‘A.30 year-old pregnant woman, housewl- fe, was admitted to Education and Research Hospital of Mustafa Kemal University, Turkey. ‘She had complaints of malaise, dysuria and in- ‘creased urinary frequency for three days. She had no previous history of UTIor chroniciliness {n the past 12 months. There was no history of ‘urinary catheterization or other genitourinary procedures. On examination, she had normal ‘body temperature, heart rate oF 88 beats/mina- te, and blood pressure of 110/55 mm Hg. She had a litle right sesitiveness in abdomen pal- pation. Cardio-respiratory exam was unremar- Sable. No othor abnormalities were identified. She had normal signs of four months preg- nancy. She wes using only a multivitamin pill ‘owing to pregnancy. Laboratory investigations revealed the fol- Jowing values: haemoglobin 114 g/dl, leakocy- te count 11,300 cells/m®, platelets 319,000 cells/m’, SGPT 12 IU/L and SGOT 20 IU/L, tures 16 mg/dl, creatinine 0.7 mg/dl. Urinalysis showed more than ten white cells/HPR. ‘The mid-stream urine sample of the pati- ent was inoculated on Colombia agar +5 % she- ep blood and cosine methyiene biue agar (bioMe- rieux, Marcy I'Btoile-France), and incubated at 37°C for 24h. Bacterial identification was based ‘on biochemical method (API 20 STREP, bioMe- ewe, Marcy Etoile France). Gram stain, cata Iase, growth in 65 % sodium chloride broth es- calin hydrolysis, and pyrrolidonyl aminopept- dase (PYR) tests were performed. Following the incubation of urine culture plates, >10° cfu/ml A.iridans was isolated as pure culture. Te iso- late was negative for catalase, and postive for YR and 40 % bile esclin eactons and forthe srowth in 65 % sodium chloride. To determine the antimicrobial susceptibi- lity profile ofthe organism, disk diffusion met hhod was performed following the guidelines re- commended by CLSI (formerly NCCLS) for onpnesmococeal Streptacceus eategory®. The results showed that the isolate was susceptible to vancomycin (30 meg), cefoperazone-sulbac- tam 75480 meg), imipenem (30 meg) ampicillin (10 mcg), and intermediateresistant to amoxi- cillirclavulanate (0+10 meg), and resistant to cefotaxime (90 meg), cefazolin (2 mg), cfuro- dme (0 meg), ipropfoxacn 6 meg), and gen famicin (10 meg). Because of pregnancy, the patient was treated orally with ampicline 500 mg tablet, four times a day. Followed-up she reported improve- ‘ment in her complaints over the next six days, had normal urination and culture-negative urine sample. DISCUSSION Aciridans has a world-wide distribution, is mainly a pathogen of lobsters, and has rarely been involved as a cause of human infecti- onsi2359), The bacterium may be often overloo- ed due to its selective growth requirements ‘The sparse documentation of this organism ‘from human clinical infections may be due to its microbiologic similarity to alphs-hemolytic streptococci and enterococci and potential mis- interpretation of aerococci in culture speci- mens), Ifa special attention is not given to the aicroscopic morphology, the member of the ge- mus Aerococeus with a strong tendency toward tetrad formation (not chains) could be confused a8 a Streptococcus, Because of the fastidiousnature of the organism, increased awareness ‘may contribute to comprehending,its possible role in humans. Axiridans has been associated with some human infections that included bacteremia, sep- Lic arthritis, infectious endocarditis, meningitis, ‘UT osteomyelits,and wound infection®259A, ‘There are limited data in the literature on the antimicrobial susceptibility of A.viridans as this onganism has been infrequently associated with human infections. ‘Antimicrobial susceptibility pettems of ‘Aviridans have been rapidly changed. In 1987, Kem and Vanek” reported that two Aerococcus strains isolated from blood cultures were sensi- tive to penicilin G and piperaclin but resistant to fuoroquinolones and netilmicin. In 1996, ‘Swanson et al. reported a case of resistant Aries bacteremia in a child who was receiving prophylactic penicilin. In anot- ‘her study in 1996, Augustine etal) reported a cate of exdocardts caused by Aidan with ‘Uh etal reported a case of Aviridans bacte- emia associated with granulocytopenia, with resistance to penicillin, erythromycin, clin- damyein and ceftriaxone, end susceptible to vancomycin and chloramphenicol. Gopalachar ef al, in 2004, reported a cave of urinary tract Infection with bacteremia caused by A.viridens, but they could not perform sensitivity testing, due to the fastidious nature ofthe organism. In ‘our ease, the A viridans strain obtained from uri- ne specimen was susceptible to vancomycin, ce- foperszone-sulbactam, imipenem, ampicilin, and intermediate resistant to amoxillin-clavu- Janate and resistant to cofotaxime, cefazolin, co- faroxime,cipropfloxacin, gentamicin. ‘Aerocoec! appear to be of low virulence ‘and may be normally pathogenic only in pati- cents with vulnerable conditions, A.viridans has been commonly isolated from blood culture and has been associated with granulocytic bac- teromia and endocarditis bactremia, expecially in the presence of chronic immunocompromi- sed states, malnutrition, or urinary tract patho ‘Awuruna es of tay lito cae by Aree ois Jogy2. Our ease was a pregnant worn and she had no other apparent illnesses In this case, pregnancy may have contributed to occurrence of UT by Aviriens. Tn conclusion, this isthe first case of uri- nary tract infection caused by Avirians in a pregnant woman. The report showes that even though vires is rarely associated with hu- tan infections it could be a causative agent of urinary tract infection. REFERENCES 4 Augustine, Thrunavubharas, Bhat BY, Bhat BO: ‘Acrocoomis wine endocaraie. Cas report, Indian Podite 9943105395401 4. FaslomyR Ell JA: Idnitntn, dasifation and linial relevance of ctlasenegtive ram-ponie ‘ocd, exclading the streptocce ne enteocec, Cin Microb! Rev 985064795. 5. Gopaluchur A, Abies RL, Davis WH, Siddiqt AA: Us ary tet Inecon cased by Aerocoeeus vidas, aca- se report, Med Sel Monit 20044011.735. 46 Keebaugh MA, Evans JB: Acrocorusvieldans inthe hhspltelenvienment, Appt Microbiol 1988166519. 2. 7. Kern W, Vanck & Aerocoeas bacteremia associated with granlocytopens, Ear J Clin. Microbiol 1987 606:5708. {National Comunite for Cla Labortory Standart: Paviormance Standard for Antimicrobial Sxecepty Testing, Eighth informational supplement, NCCLS Do- amen! MIODS8, NCCLS, Wayne, PA (958) 9. RazoaJH, Thomas GM, Aleander D-Tho fst veparted ‘ase af Atzocoons baleen ina patient wih HIV Bo fection, Emer infect Ds 199.516:5589. 10, Swanton H, Cuts, Lapow Ms Pentlinzesitant Ae- rooccis iran ctr ina child recevng prop las for sickle-cell aseese, Clin Infect Dis tose, 11, URY, SonJS, Jang IH, Yoon KJ, Hong SK: Pease sistant Aerococssvsdans bacteremia assole With (ganulocytopenie, | Koren Mt Se 20023701135 132, hang 0. Kwoh C, ation, Cire JES: Atrecoc- us urinoe in inary tac infections] Cin Miobiol amranon7es.We Shine HA oi — MetHODIsT Lge TALGALLERY MEDICAL CLINIC 5800 NORTH FREEWAY. SUITE 143, HOUSTON, TEXAS 77076 TEL: 719-694-9000 ee 3/y ‘Ys ¢ 02470113 8 8064 D MEtho dst tasp le EK ee, RE: Somes Ybrednl oe oe fare’r = 7 Dy As teh, fhe Hom Tits wa aahre, Sout db de wuet fan , Fever, Expo n a 5 B Bowed Sbua dS RLA Jew derwes ke hyde Couagirae 7 Serse) PEA Erty: Apne stool + Fenda ow (@ @O bund Tea demas > 240 + Supra pubic Cbbion PL bebhy Cr Tietaits bul pry be dame prewatitin of Py peo hehe WE Ae nol CApaht el fucther We ceginy Apcivciin Se Gash ren eT pheweecns 50 My eae 17m aft 2: BehEINTED Br: mmonne ). {her 2 12/16/2008 J CHEfb0, MD.ef PN peer are eAseeres cet IMMUN CO) Metnodist Sugar Lanc Hospta AF Methodist Witowbrook Hospital i Tata Physician Organization Gi Visting Nurses Associaton Hand 002851 1. PatientySubject Name:_—yaine SU age o Nar of Reosath Sty eet sprtpting ix ayse Date of Birth; 24. 7.3. __ Social Security Number: <2 2 7 7g] Patient's Mailing Address: itfat/ “suctig De zt Go 0 ub Daa Telephone number: Work: Il. INFORMATION TO BE USED OR DISCLOSED Hotere Ky Date of Teatment_S- ane ug 1 LOUETTA Wo, #720 cevmaess 1% 72009 42x Boszoie-ooae00 z3yvibs eon vendo SSR 27651 600i 450.00 «0.00 rorat ous YD. ob Terat thergess 456.00 ‘otal Adjustments: 450,00 otal nicetpte: +00,Methatist The Methodist Hospital THE METHODIST HOSP A FS. Box ars nis Ps HOUSTON. 1%¢77210-2916 - PATIENT INFORMATION: HARDIN, JAMES, Mevstlovebtistatttstosnelattioal HARDIN. JANES LLS2b PINE BELT DR CYPRESS, Tx 77429-270b 02470123880 40000000L0299258 eis: hs charged mace vangre ow mv PATIENT NAME: HARDIN, JAMES SUMMARY STATEMENT SS acme ES Be HEB Becomes ‘SIRTEMENT ORE AY THB AGO Heer ogosi0s =| :10299.25 024701138-8064 of0 | SHOWAMOUNT PAID HERE | severest seeeeeeees au) vlaballdbssabalatbsallabtocntteatatell ‘THE METHODIST HOSPITAL P.O. BOX 4315 HOUSTON, TX 77210-4315 ADMIT DATE: 03/04/08 DISC DATE: 03/04/08 DATE DESCRIPTION TOTAL, DETAIL CHARGES ——— IV-SODIUM CHLORIDE 0.9% 1000ML PANTOPRAZOLE 40MG UD TAB MORPHINE 5MG/ML 1ML IN NDANSETRON MiG. INV MG UD TAB 03/08/08 /03/04/08 aces GL OR INITIAL ¢ EA ADD SEQ NEW SUI 2025*Se104xA.16000007AMOUNT DUE sAccounr Numer ATE sTarEMENT ance 731"163041 oa12008 BAYES AREAS $98.70 SeUR NERY STATEMENT Y PATENT NAME PLEASE SEND PAYMENT FOR THE AMOUNT DUE INDICATED. IF YOU JAMES HARDIN HAVE ANY QUESTIONS, PLEASE CALL OUR OFFICE. THANK YOU. Tax Id 371520288 Place of Service: METHODIST WILLOWBROOK/ER Referring Doctor: ANTHONY R FASANELLA MAKE CHECKS PAYABLE TO: METHODIST PATHOLOGY ASSOC PLLC PO BOX 4701 HOUSTON Tx 77210-4701 (200)874-1705 ‘SEE REVERSE SIDE FOR IMPORTANT BILLING INFORMATION Page 1 0f1 Date 1 Doctor Code Description Amount 03/04/2008 DAVID BERNARD.MD 81001 URINALYSIS CHEMICAL & MICRO 820 03/04/2008 DAVID BERNAROMD 185025 ‘CBC WITH AUTO DIFF 2055 (03/04/2008 DAVID BERNARD.MD- 82150 AMYLASE, 40.30 (03/04/2008 DAVID BERNARD. MO 80048 EA SIC METABOLIC PANEL 60.65 MiSIT #4 ‘TOTAL. VISIT #4. NO INSURANCE COVERAGE INDICATED FOR THE VISIT SHOWN ABOVE. For questions cal, {200)874-1708 and when prompted enter your ientifcaton number as follows 3862"163041 ENTS FEES FOR LAB Gh ONAL COMPONENT OF LAB/PATH BILLING PLEASE DETACH AND RETURN THE BOTTOM PORTION WITH PAYMENT METHODIST PATHOLOGY ASSOC PLLC Pelee ee P.0. BOX 4701, HOUSTON TX 77210-4701 SCOR SOOE STE form exoneo 4 Return Service Requested aE aI Place of Service: METHODIST WILLOWBROOKIER. Dus pre ‘Tx507731"163041 2 beens Sita ees econ) 3852 i aos. Azaye4000663..z00uAK.o10969 c10963 Matas at tt Malla lll JAMES HARDIN 419826 PINE BELT OR METHODIST PATHOLOGY ASSOC PLLC (CYPRESS 1X 77429, PO BOX 4701 HOUSTON TX 77210-4701 Aillselabl MovvabatessllffesebaflestMsesallfbsssell fadMethodist The Methodist own e797 Statement of Account 12/09/08 (03/04/08 12/09/08. HARDIN, JAMES 11826 PINE BELT DR CYPRESS TX 77429 TAX ID: 76-0649356 Please make your check payable to: ‘Hh Meshodit Hospi) POBox 1315, Heston, Tene 772104015 Detach i rt he tp of thi talement ith yur poyinont fo insure prope erst ies Ber HARDIN, JAMES lo24701 reso 03/09/08 URINALYSIS CHEMICAL & MICRO. 03/04/08 | 9028898 | PAYMENT. HARDIN, JAMES, 03/09/08 | 9700638, | DISC PLCY SELF PAY AUTO 06/27/08 | 0700644 | DISC PLCY SELF PAY MAN 06/27/08 | 0600677 | FREE SERV MEDICALLY INDIG-CBO 07/29/08 | 0028536 | TRSF TO B/D AUTO 07/29/08 | 9928304 | MEMO-TRSF TO BAD DEBT REC NS 119.00 60.00- 4.143.706, 4,143.70 6,694.51.) 3,604.74.) 3,604:74 [Ascoune Dake ‘This willbe your onlyitemized statement forth Estimated insur )bove transactions 1ce benefits are subject to change by your InsuranceCartier ast Sent New Charge Aainens Business Office Hours ‘Mony-Friday 8:00 am - 430 pm For billing inquiry or to make payment arrangements, Cal: 1-832-667-5900 of 1-877-493-3228 Por Teletype Device Cal: 1.713.790.3830 Methodist The Methodist 565 amin spital Hoorn, Tes 70302707, Fewer th pysictn series, conzatatonan leptons bled aoa ‘noided a pr fhe hsp bi es Payments red (curcat Accor Balan 14,502.95. 3,604.74 Inman bai 0.00 7 Plame ay Tis Arount Fag Wap 5.608 74Methodist The Methodist 4.5.04, Statement of Account Hospital owsne De 7mn207 (03/04/08 12/09/08 12/09/08 TAX ID: 76-0649356 Please make your check payable to: POBox «13 Hoon, Tenax 772104818 HARDIN, JAMES. 11826 PINE BELT DR CYPRESS 1x 7a29 each ard slum fotap thi ltt ath our payment nate proper re a 12/09/08. y 03/04/08 OMNIPAQUE 300MG/100ML- 388.25 03/04/08 ‘CT ABDOMEN W CONTRAST 3,321.50 03/04/08 CT PELVIS W CONTRAST 3,273.50 03/04/08 AMYLASE 213.00 | 03/04/08 BASIC METABOLIC PANEL TOTAL CA 438.50, 03/04/08 COMPLETE BLD COUNT W/AUTO DIFF 169.50 03/04/08 | 90774 IN) IV PUSH SGL OR INITIAL SUB 143.00 | 03/04/08 | 90775 INI IV PUSH EA ADD SEQ NEW SUB 133.50 | 03/04/08 | 90761 IV INFUS HYDRATION EA ADDL HR = (QTY OF 0002) 865.00, 03/04/08 | 36415 PHLEBOTOMY/VENIPUNCTURE (QTY OF 0002) 69.00 03/04/08 | 99283 | ER VISIT LEVEL mm 719,50 03/04/08 ONDANSETRON 4MG IN) 177.00 03/04/08 | 37030. IV-SODIUM CHLORIDE 0.9% 1000M 46.00 03/04/08 | 57030 1V-SODIUM CHLORIDE 0.9% 1000M. 46.00 | 03/04/08 MORPHINE SMG/ML 1ML INJ 11.50 03/04/08 | 37030 IV-SODIUM CHLORIDE 0.9% 1000M (QTY OF 0002) 92.00 | 03/04/08, LEVOFLOXACIN SOOMG UD TAB 93.00 03/04/08 PANTOPRAZOLE 40MG UD TAB | 40.50 psc ance Lt Smet ‘This will be your oniyitemized stalementtor the above transactions. ew Gg Estimated insurance benefits are subject to change by your InsuranceCarrier. Ase New areca Business Office Hours cretis ‘Monday-Friday 8:00am = 430 pon aoa Forbiig ny oma payment arama tin (Call: 1-832-667-5900 or 1-877-493-3028, — eee ‘Methodist The Methodist. «30s min Foc fo pn senees,contiatansnd ierpcaosae ied aianay owe Hospital Howton, Texas 770302707 ro chded wn pucriehospig tn nea” bes eTHE ME .obTSY HOSPITAL DEPARTMENT OF RADIOLOGY 6565 FANNIN, M.S. M-204 HOUSTON, TEXAS 77030-2701 (713)394~6780 NAME : HARDIN, JAMES ACCT NBR: 024701138/6064 Ordering MD: CHRISTOPHER LANGFORD, MD EXAM DATE: 03/04/2008 Admitting MD: CHRISTOPHER LANGFORD, MD CY Abdomen W, Pelvis EXAM: —_B-07248921 EXAM FROCEDURE : CT Abdomen W, Pelvis CT scan of the abdomen and pelvis wag performed using routine protocol with oral and IV contrast. Scan performed on an emergency basis. No prior studies available for comparison. CT ABDOMEN i. ‘The liver, gallbladder, spleen, pancreas, adrenal glands and kidneys are unremarkable. 2. Abdominal aorta is nonancurysmal. ‘There is no significant retroperitoneal lymphadenopathy’ 3. There is mild thickening of the wall of the distal esophagus. This can be seen with esophagitis although EGD is recommended to exclude esophageal neoplasm. 4. There is no bowel obstruction, ascites or fluid collection. The appendix is normal. cP PELVIS 1. There is no pelvic mass, fluid collection or significant pelvie lymphadenopathy. 2. There is some mild diverticular changes in the sigmoid colon ithout CT scan evidence of diverticulitis. TRANSCRIPTION NOTE: The report was printed to the Willowbrook emergency room on 3/4/08 at approximately 1999. DICTATED BY: LABIS JOHN $. MD Board Certified Radiologist This report was verified electronic ay. TRANSCRIPED BY: AEDMUNDSON 03/04/2008 19:09 PRINTED BY: KMRODAR DATE 12/16/2008— Neb rosorscnmursuimeoccrinsenancesillHMINtll 'Q Medications brought from home 0 1 ‘D Patient recall © Family recall 0 Patient list OMAR from HCF_O Primary Care Prysiclan Q Pharmacy Q Previous Medical Record) Oi Unable to obtain medication history. Regsga: MWH420 ‘no medications at home [Admit] Home Medications on Admission | (Prescriptions, OTC, Herbals, Patches, Inalore, Eye Drops, Creams, Lotions ote) lascharge [Complete at ag Narre Tose Freq Route Taleahon | La Taken | Conainue a ome! com Daigriene y. com o slelzlel=|= <|= co ml, <| semaine oS Oe US ES Ges ice 12. Followup coo: PateniSanifeant ohare \otaltgs understanding and/or recat oi folownge NOTES pert ale by -Ropon given Wo Samant poo » — pg OG home: ascompdnil 5 Demsses ger DIC Seether Bed pYAnbualoy eve {pl iy as 02470113 8 8064 <_ Muouanna, ooMethodist Willowbrook Nurses Notes (HARDIN, AMES 31472008 10: {0OPM Medication ‘Tabaldo, Olvia (RN) [Entered 34/2008 10:40:46PN} Reconciliation Home Meds Protonix enteric coated tablet 40 mg; Active 1 teb(s) orally once 2 day x 30 days It is very inportant chat exactly as directed. Do not skip doses or discontinue unless docter. Obtain medical advil the action of th: Swallow whole. Do not erush.7 Quantity: 30 Resiile: 0 take or use this ‘ted by your non-prescription drugs as some Phenergan tablet 25 ag; Act 1 tab(s) orally every 6 effect. Use care when op obtefn nedleal advice the acticn of this ma Quantity: 10 May cause drowsiness. Alcon rating dangerous machinery. before iption Grugs as some may a 2 may intensity this c Jevofloxacin 500 ng oral tablet; Active 3 tak(s) oxally once a day x 10 days Avold orolonged er oxcessive exposure te Ginect and/or arcificial sunlight while taking this medication 0 not. take dairy products, antacids, or iron preparations within ore hour of this medication. Finish all chis medication unless othemwice Way cause drowsiness or dizziness. Modicaticn should be taker with plenty of wo Quantity: 10 Refills: 0 rected by preseriter Bentyl 20 mg oral tablet; Active 1 tab(s) orally 4 times a day x § days May cause drowsiness. Aleokel may intensify this effect. Use care when operating daigeroue machinery. Quantity: 20 Refills: 0 Medication Orders Pharmac RET Solution 1000 bsAdministe> 7 Vispensec from Byxis ; Infuse Over 1000 Hour(s} 9 nlfhe,Totsl Volume 1000 ml, Mar-04-2002, Completed Ondansetron Injection; (Known as Zoffan Tajection) Give 4 ng, Inject Now PRN’ “Neusea ,Voniting Dispensed from Pyxis 7 PRN Nauses Vomiting, Mar-04-2008, Conpleted MozPHINE Injection 5 mg;Give 5 mg, Iatravenaiy dace PRY Pain, Nar~04-2008, Completes NS IV Solution 1000 mL;Adsiniste~ 1000 ml, ,Tntravencus ml, Titrate,Intravencus PRN, for 1 Times 1 Intravenous A oan (0247013388064 eee ORRIN JAMES MW OM PRINTED B DATE (03/04/2008 To 03/04/2008 12/hi6/2008 066 AMM = 22001972 3 Fesonella, Anthony &Methodist Willowbrook Order Summary by Patient HARDIN, JAMES WED-128033 Discharged 93/042008 4701 138 / 0247011388068 | Priority Dateline Aciily Sounse Ordre y/Enteredby ——__] hepa ton Pyne; Horie c 999 ae eh Vl 1008 Routine 200808 S28 New Femail Pcl, Antony Any ORDO Aiea 40m Om Once Dispeised Bom Py PRINTED BY: WMRODAR 3712/2008. 1:38:45PM. DATE 2 12/16/2008 Page: 2 of 2 aaron sae p———__ 247011388064 | HARDIN, JAMES pre 34 5 06s AWB 2/20/1972 ‘8/04/2008 ane, Anthony R. 1304/2008‘Methodist Willowbrook tervention Record (HARDIN, JAMES 3142008 4:04:00PM ED Vital Signs, Assessment and Interventions Shea, Tammy (RN) (Enters ‘Specimen Collection Biood Collection Labs Drawn : Labs drawn, Lovetion, 20,ra¢ Assessment Site 11V Ste WDL: Sito without redness warmth, evel WoL IV Site 1 1.1V DevicerAccess : Peripheral IW Site 1 GaugerLength : 20 gauge WW Site 1 1. Ste : Right, Antecubital 1V Site 1 Number of insertion attempts : 1 1V Site 1 Pationt Tolerance : Patient tolerated without complaint of discomfort IV Skt 1 1. Date of insertion (alpha & numeric) : Mat-04-08 IV Site # Site Day: Day 0 IV Site 4 Infusion Status : Saline lock flushes well IV Site 1 Blood Retuin : Yes IV Site t Dressing Type : Transparent Semipermeable 1V Sito 1 Dressing Change : Semkpermeable dressing applied IV Site 1 Discontinuation : Gothater intact ng, Pain, palpable cord, TEATOTISEROGE | ds 34/2008 4:08:85PN] *Revined stteak formation, drainage ‘3/4/2008 4:17:00PM_ ED Vital Signs, Assessment and nterventions Gibbs, Jessica A (RN) {Enters le Vital Signs Blood Pressure Systolic: 148 mm Hg Blood Pressure Diastolic : 100 mm Hg Heart Rate bpm : 109 BPM Respiratory Kate fmin : 20 IN Temperature degiaos F : 87.8 DEGREES F Temperature degiees C : 36.5 degross $02 % : 99 % Pain Rating Pain Rating (numerical): 7 Screenings Fall Risk : Male Fall Risk Fall Risk Score sd: SABO 4:19-50PM Page 24701 7388068 PRINTED 8 KARARODAKES MSW EME DATE 12/16/2008 64 = AWB 27200972 034042008 Te c3/a4/2008 Hassnclls, Ambony R,‘Methodist Willowbrook al Signs & Intervention Record Fail Measures Implemented: Yos Fall Risk Interventions : Koop oors/hallways cluter/obstacle free, Place frequent needed tems within reach (Glasses, hearing sid, ee), Encourage patientsifamiles to call for assistance Comfort and Safety WaTMTsEROG ‘Safety measures taken : ID band on and verted Safety precautions : Family at bedside Comfort : Room light on Precautions : Standard /Universal Intake end Output NSIV infusion + 1000 mi, Stop Assosemont Cognitive Neuro [VDL Definition: Alert; opens eyes spontaneously; arouses to voice or touch: oriented x 3; follows commands; speech spontaneous, well paced, logical; purposeful motor response; behavior appropriate to stuation} : WDL, Cardiovascular Assessment [“WDL Definition: Regular rhythm, no abnotmalities in skin color, no chest pain) WoL HEENT Assassment ["WDL Definition: PERRLA, no drainage, deformities, or obvious trauma noted, no lass of consciousness, airway patent]: WDL. Respiratory Aesoeemont ["WDL Definition: Regular Reto, Dopth and Pattern; naiibeds appropriate for ethnicity, mucous membranes pink; breath sounds clear and aqual bilaterally; no cough or productive sputum; no shortness of breath, chest eymmetricall: WOL except Respiratory Assessment Nailbeds : Appropriate for Ethnicity Respiratory Assossmont Mucous Membranes : Pink, Dry ‘Skin Assessment ["“WDI Definition: No abnormalities in integrity, color, temperature moistura. No drainage noted}: WOL Peripheral Vascular Assessment ["WDI. Definition: Capillary refill less than or equal to 2 seconds: 2+ pulsec all ‘xtramities; extremities warm, no abnormal color, numbness, or tingling; no edema : WL. Genitourinary Assessment |"WOL Definition: No abnormalities in voiding/ebilty to empty bladder, color, oF ‘characteristics of urine]: WDL. ‘Muscular-Ortho Assessment ["WDL Definition: No swelling of tondornees in joints, no overt detcits noted: fll ‘ctive movement of all extremitios}: WOL. Gastrontestinal Assessment * WOL Defintion-WDL: No abnormalities in abdominal appearance, non-tender, hnon- abo! TH Fearing defi (RTL: Lease — Neck. Teyronen thoi FF cm Zmphadeneyady (RTL) SS a AT Therap Brkt ig (RAYS: Clmarp tyme Cede me_(JDic wf dlon Respiratory wrens retort (RIL). Tre / NID __ nog Ines or heart ze nmi meciasinum | Cwm bowel g3° i ergonemeFey oo mas Serpe sores rea Sounds nnd ows Tirepiryrepaar ptm. ‘ate thm ier Boda. femécre NO prt i —aaestatlequl— ailop (53/54) ba careae, Teena peg) Te, uncangeé improves re-ramined © fond fen conf — st fet eg are Gere bane loc UB __Uprightabd __S-view” CXR pelal op 1ot/ changed fo Pulao Ox "4 on RA/_t/_® ot (li). = iy treme ese pant in” ED axial ere” fly cereaker eremedis Counted patent fimiy reprding prior rcordh roared eb rests ogre nee frome Re pen Fraetant | niacng Tear ee mee acest inzesed /decresed eben /epmpank—_} CRITCARETIME. (cdg norte Stk preatre) McBone’ pin enderess. 303 j psoas /Rowin'ssgnfotartor ten. 2 cal Lic BRAM “raga teeing dicharge ; GLINICAL IMPRESSION ermal exam nm ceria motion tenderness i “Acute Append speculum exam ami “adnexal tenderness / mass (RIL). Diabetic Ketescdosie. bimanual exam nnd enlarged tender eras Meningitis PRMALE GENITAL “easseuarvenderness (RIL). i Bowel Obseueion ame i Parayeleut TBisek/Gioody Theme por aol Pancreas Bacterial Enters / Dysenery ca Gz tenderness (R/U) aes dapat por eye Thin rah enbee aioa Ths oO) apa Seam 1 see ded ena Tellers CORE era a en oe 02470113 8 8064 exes ae ag Lorgned 3 Tepresed at Wl Tinted acim’ “fac droop DE-EDTTED ORES CAMRODAR HARD JARS i 's rl as west weakness / ser a ‘ted _ AWB 02207 Thomotar ety “peach copolarematae 2! 16/2008 Foo cansrornen 000987 37 Nausea, Vomiting, iarrhea (6) woos Re. 09/2006,RAPID MEDICAL EVALUATION | pate, Tome | [chietcomptsine chest pain assaule shortness of Brath) pedineric fever headache vaginal bleeding abscess wrauma RL UE LE fever headinjury MVC ok md) nel fe ‘ i cy cE 7 ‘suai a sharp sabbing ramping aching pais Ty PASTAK ne CADE oat shea TN (et fort suin Cy Sacer high Geletiral IA By MWwo09s — Teens _ Reveoed PHYSICAL EXAM Goneral Appearance ato seze divest Ald moderate severe dre ales Tans eta ‘Tider erat pale covncdrae_— Sonya wl RESPIRATORY eves nancander ro dare “fran a = ae Srey gin _—— Cree mearhyon Crap cea Fae] sane TEerara Sipars — Sepice Soren rl Chrtar gob eda ep ( 53154). iereset tgs i L__ fem__ dors ped 200.4 eSarewtn Soe _—tontender/no denen “abnaFnal boned unit eresed/ dered / a —bepatomepypenomegay mas, TEVA tendemess(R/L). Tapanoi | diphresie par Tila rah enbobe esos, esa edera le swag Teatenderess Heran's _—osteadr/ fl ROM, To pe aera nized cn beater rae EURO PSYCH “Giorered eo pen pce ee —orlened 3 Laepresse mood acct wales senza ‘Sno motor I eniory dele —shrrad oneal speech Teh droop, Heeteiaanwienee Bactese tS S "ee (ex ees Beets Orders on MethOD | Soe eereaee ritkiret sina Seon elginaae ress of ordered be and or Xa “This rpid medial evaluation & or ‘valation ofthis patent but rather ara nibitane for lh mena expediting care and Teapbet for a record of tis Methodist Willowbrook Hospital EMERGENCY PHYSICIAN RECORD PRINTED BY: WARODAR DATE 12/16/2008 Progress Notes / Diagram Addendum {©1996-2006 Sytem Ine Cele or ech efrmarne, bck) pth,Left Right Left PRINTED BY: WMRODAR DATE 98 + ProghGs HG / ‘ awotes Rew. 1012006 Diagram Addendum RightThe \ nodist Hespital system PATIENT: HARDIN JAMES MEN: 024701138 LOC: WED,, 0247071388064 DOR: 02/20/1972 SEX: M : LANGFORD CHRISTOPHER ORDERED: 03/04/2008 COLLECTED: 03/04/2008 27003121, RECEIVED : 03/04/2008 RESULT UNITS RANGES. ABN FL ST Color YELLOW YELLOW F Appearance CLEAR Clear F Specific Gravity >=1.030 1.008-1.030 F ph 6.0 5.0-8.0 Fr Protein 2 Negative F Glucose NEGATIVE Negative Fe Ketones 2+ Negative A Fr Bilirubin NEGATIVE Negative F Blood ‘TRACE Negative A F Nitrite NEGATIVE, NEGATIVE, Fr Urobilinogen 1.0 E.U./dL 0.2-1.0 Fr Leukocyte Esterase NEGATIVE Negative F WC 3 Fat PF 0-4 M 0-1 F REC >200 ABE F 0-2 M 0-1 H F Epithelial Cells ° HPF 0-15 Pr Bacterial None Seen None seen F Ca Oxalate Crystals Few R F DICTATED BY This report was verified electronically. 2710010 PRINTED BY: WMRODAR DATE 12/16/2008The bh -hodist Hospital syster ENT: HARDIN JAMES MRN: 024701138 Loc: WED,, BILL# : 0247011398064 DOB: 02/20/1972 SEX: M LANGFORD CHRISTOPHER ORDERED: 03/04/2008 15:47 COLLECTED: 03/04/2008 15:54 ORDER : 27043121 RECEIVED : 03/04/2008 TEST NAME RESULT UNITS RANGES ABN FL ST Smear Review Smear Reviewed F DICTATED RY: This report was verified electronically. 7612553 PRINTED BY: WMRODAR DATE 12/16/2008‘Methodist Willowbrook, Medication Administ Patient: HARDIN, JAMES Account: 0247011388064 Birthdate: February 20, 1972 Medication Administration for: 03/04/2008 Medication: Tevofloxacin Oral Tablet wr2008 Order Detail: Levofloxacin Oral Tablet (Ordezed as Levaquin Oral Tablet) Give 500 mg, Oral Now Dispensed from Pyicis 5 Order 1D: GOLBOPOHB Routine Frequency: Now Order Route: Oral ‘Sched Unite Dose By Action RewwuniCommtents Performed Once Reason/Comments Medication: NS TV Solution 1000 wi Order Det) NS LV Solution LOOGnL Administer 1000 1000 mek A: 999 mVt4,Total Volume Order HE z OLBONOGH Routine Prewengy Terme ‘Order Rents: Intavenous Seed Units Dow By Action Resson/Comments Si S95 _niviy__Shex, omy. RN Pevfonted Medien SST Onler Dial: 000ml, raves fine Over 1 Hous) st: 999 ae Onler ID: Frequency: Rente: toravemas Sched A Reasn/Comments Performed Median Onler Detail enous, for] Times Hou) 9 999 at Onler ID: 901BOPOHM Frequency: Titre ‘Sched Admin Action Reasoa/Comments 5/608 20:25 ne Performed c2sTOL Ls s8068 HARDIN, JAMES MWM 36 fF oe AWB 2201972 02042008 1 03/08/2008 eu Fasanclla, Amhony R, Page Lot 23/6/2008 ‘Methodist Willowbrook Medication Administration Record Account: 0247011388064 Birthdate: February 20, 1972 Order 1D: Frequency: der Route: latravenous ction, Lnravenous ,Now PRN Nausea, Vomiting Dispensed from Pyxis ; PRN Nausea, Vomiting Sched Units Dox By Action Rexsun/Comments me. ibs, Jessica A-RN Perforined nee Dispensed fim Pyxis: der Route: Oral Admin Units Dose By Action Reason/Comments 3408 20045 40mg Tabaldo, Olivia RN Performed (24701 1388068 HARDIN, JAMES MWM 36 E be AWB 220197: 03/04/2008 12 93/04/2008 Same Fasonella, Anthony R, Page 20f 2HARDIN, JAMES 13/04:2008 Charted Time: 34/08 15:28 Vital Signs auva AS GAINTHA Page 1 of 8 ‘Methodist Willowbrook Vital Signs Flowsheet Birthday: 222011972 BP Postion Heart Rote bpm Respiratory Rate Ania “Teraperatre degrees F degrees C in Rating (numerical) Pain Rating (oumericsd) ‘Blood Specimen Collection Labs Drawn 20 78e IV Site WDL: Site without WoL, Peripheral 20 gauge ‘Astecubitel Right L Patient tolerated without complaint of discomfort Mar-04-2008 Dayo Saline lock flues well Yes Trans Semi Semipennneable able dressing applied Date Printed: 3/7/2008 34/08 15:37 Shee, Tammy 349/08 15:37 Shes, Tammy 34/08 15:37 Shee, Tammy 398 15:37 Shee, Tammy HHO8 15:37 Shoe, Tommy 314908 16:06 ‘Shes, Taramy 34/08 16:05 Shes, Tammy 314108 16:05 Shes, Tammy 3/5108 16:05 Shes, Tammy 34/08 16:05 Shee, Tammy 34,08 16:05 Shes, Tammy 3408 1605 Shes, Tomy 05 Shes, Tammy asanella, Anthony R,Patient: HARDEN, JAMES ‘Date:03/04/2008 Charted Time: 3/4/08 16:04 Assessment Charted Time: 3/408 16:17 Vital Signs saya reenings z 2 : z ‘Comfort and Safety 5 Intake and Output Page 2008 ‘Methodist Willowbrook Vital Signs Flowsheet Birthday: 27201972 Discontinuation Systolic BP Systolic Diastolio B/P Diastolic ‘Heart Rate bpm ‘Respiratory Rate min Temperature degrees F Male 1 Yes bearing zi, ts) Safety measures taken ID band on and verified Safety precautions F Comore Presattions NSIV infizion ‘appropriate to situation} [MWDL Detintion: Regular shyt, no WDL abnormalities in skin color, no chest pain} ‘Encowoge patients/families to call for assistance ‘Keep loors/hallways eluter/obstac] Ploce frequent needed items within ce Date Printed: 3/7/2008 Shea, Tammy Gibbs, Jessica A Gibbs, Tession A Gibbs, Jessica A 16:19 318}08 16:19 Gibbs, Jessica A. TETOTTTRROGT HARDIN, JAMES M WM 36 E 064 awe 22ywr 030472008 to 0304/2008 asanell, Anthouy R.Charted Time: 3/4/08 16217 ‘Assessment save :Ra GwuNTHS acu B00z/9T/ZT + Page 3008 ‘Methodist Willowbrook Vital Signs Flowsheet Birthday: 22071972 wands clear and equal bila or prsluctive spunun; no rss of breath, chest symmmetical) ** WDL Definition -WDL: No abnormalities in abdominal appearance, WDL except appearance, non-tender, nande Date Printed: 3/7/2008 34)08 16:19 Gibbs, Jessica A 314408 18:19 Gibbs, Jessica A 319/08 3408 3408 S408 ibs, Jessica A 19. Gibbs, Jessica A 314/08 16:19 Gibbs, Jesiea A 314908 16:19 Gibbs, Jessica A 31908 16:19 Gibbs, Tessica A CATO HARDIN, JAMES M WM 36 g 068 AWB 2720/1972 ‘037042008 tw 0304/2008 Fasanella, Anthony R.Methodist Willowbrook Vital Signs Flowshect Patiea: HARDIN, JAMES Birthday: 2200972 Date: 03/04/2008 (Charted Time: 34/08 16:17 Assessment Complains iscomfort Voraiting Comments totes Note/Comments PUNAD, waiting on CT, f Taacstionfistructions Edwation Educated On Expected Medication gr Pain Seale 58 Plan of Care Be E Procedures sane Edited Recorded — Meader + NGibbs, Jessica A 3/408 18:19 4/08 16:17 Assessment s | Charted Time: 3.408 18:55 Vital Signe Systolic BP Systolic Diaetolie BPP Dastoio “Heart Rate bpm Respiratory Rate Ain “Temperature dogrecs F logrees © SPO2% Pain Rating (numerical) Pain Rating (osmerical) Page 4 of states, "Uhave lost 20 pounds in the past 5 Change in Condition Date Primed: 3/7/2008 19. Gibbs, Jesica A Gibbs, Jessica A 314/08 16:19 Gibbs, Jessica A 315/08 16:19 Gibbs, Jession A 3 bedside [¢*WD1. Definition Regular Rate, Depth and appropri siu2ous membranes pinks, breath sends clear end ‘equa bilaterally; no cough or productive sputuns, 0 shortness of breath, chest symmetzical] 314/08 18:56. Gibbs, Fessica A DATOS HARDIN, JAMES M WM 36 E 064 AWB 2720/1972 (03042008 to 43/04/2008 Fesanella, Anthony R.