Supreme Court of Pennsylvania The information collected on this form is used solely for For Prothonotary Use Only: court administration purposes. supplement or replace the filing and service of pleadings or other papers as required by law or rules of court = ug P! This form does not [Commencement of Action Bx Complaint 1 weitot summons D petition Notice of Appeal S | Di transfer from Another Jurisdiction Gi Declaration of Taking E C [test Panatrs Name ead Detendan’s Name T | luis Cepeda and Zuleyka Rodriguez Geisinger Medical Center, et al. I Check here if you are a Seif-Represented (Pro Se) Litigant © | Name of Plaintift/Appellant’s Attomey: Matthew A, Casey, Esquire n-— Dollar Amount Requested: —_C_ within arbitration limits ‘Are money damages requested?: BJYes [No (Check onc i. ‘outside arbitration limits A Is thisa Class Action Suit? 1 Yes No lature of the Case: Place an “X” to the left of the ONE case category that most accurately describes your "~S”~”CRIMARY CASE. If you are making more than one type of claim, check the one that you consider most important. TORT (ao nor ince Mass Tor) [CONTRACT (éo noriniude Judgment) | [CIVIL APPEALS intentional Bayer Plainist ‘Administrative Agencies DD Malicious Prosecution Debt Collection: Credit Card [7 Board of Assessment [1 Motor Vehicle Debt Colleton: Other Board of Elections [Nuisance Dept of Transportation Gy remiss Liability SEs Zoning Board S | Di Product Liability (does not include Bi Statutory Appeal: Other By mortrd C Enpioymen Disp Slander/Libel/ Defamation serimination Tene | aie : (1 Employinent Dispute: Other T = Judicial Appeals = (MDI - Landlord/Tenant I — Dover: I MDI- Money Judgment © [Mass Torr Dotter: LD Asbestos care N | Tobacco Toxie Tort - DES Bae atone REAL PROPERTY MISCELLANEOUS Toxic Waste C1 Ejectment Gi Common Law/Stawory Arbitration B | Oot Eminent Domain/Condemnation Gi Declaratory Judement Gi Ground Rent Mandamus = = QD Landlord/Tenant Dispute 1 Non-Domestic Relations [Fy Morigage Foreclosure Restraining Order PROFESSIONAL LIABLITY 1 Partition 1 avo Warranto Dental DD Quiet Title O Replevin Dotter: Dotter: Cr Other Professionat: z PAR.CP. 205.5 22010ROSS FELLER CASEY, LLP By: MATTHEW A. CASEY, ESQUIRE (184443) JENNIFER L. RUSSELL, ESQUIRE (#78745) RYAN P. CHASE, ESQUIRE (#203224) DANIEL R. MCGRATH, ESQUIRE (#319386) One Liberty Place, 34" Floor 1650 Market Street Philadelphia, Pennsylvania 19103 (215) 574-2000 Attorneys for Plaintiffs LUIS DAVID CEPEDA and ZULEYKA RODRIGUEZ, Individually and as Parents and COURT OF COMMON PLEAS Co-Administrators of the Estate of ABEL LUZERNE COUNTY CEPEDA, a deceased minor 1192 State Route 940 Hazle Township, PA 18202 : NOs Plaintifts : v. GEISINGER MEDICAL CENTER 100 N. Academy Ave. Danville, PA 17822 JURY TRIAL DEMANDED and NOTICE TO PLEAD Nonice Apviso ‘Youu been sued in court, Ifyou wish wo delend apaist te claims et forth the flowing pages, you must take ato within {nventy 20) days ater this compat and noice are served Slerng a riuen appearance personaly ob corey and fing in Sting with the cout your Geknses or objections o fe claims St Fath Spas Yo ere ht you fat do th ce You By dhe court widhaat ure nie Tor any money cae he empha or for any her clam or rele requested bythe plat ‘Youtay lose money or property cr oder rights Important to You ‘YOU SHOULD TAKE THIS PAPER 10 YOUR LAWYER AT ONCE. IP YOU DO NOT HAVE A LAWYER. GO TO OR TELFPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE EAC PROVIDE YOU WITHINFORMATION ABOUT HIRING A IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAYBE ABLE TO PROVIDE. YOU WITH INFORMATION. ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO BLIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Lawyer Refer Service Lipemne ar Asrccaton Luzerne County Courthouse, Room 23 210 North River Stéet Witkes-Baye, PA T9T1 Sinaia eigen suena qt eens ore see Seas Sie ualseiaer eee Sedan Se eee ewes Bana aatee yee een ere ee raugateerecamatarimatnnan eee dieters ht Rina el te Seon creaceret eee Ernie cena bt LLEVE ESTA DEMANDA.A UN ABOGADO INMEDIATAMENTE, SI NO TIENE ABOGADO 0 SINO TENE: EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAVA EN PERSONA O LLAME POR TELEFONO.A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAIO PARA, {NERGUAR DONDE Se PUEDE CONSEOUIR ASISTENCIA ial ESTA OFICINA LO PUEDE PROPORCIONAR CON INFORMACION ACERCA DE EMPLEAR AUN ABOGADO, SI USTED NO PUEDE PROPORCIONAR PARA EMPLEAR UN ‘ABOGADO, ESTA OFICINA PUEDE SER CAPAZ DE. PROPORCIONARLO CON INFORMACION ACERCA DE LAS, AGENCIAS QUE PUEDEN OFRECER LOS SERVICOS EEGALES & PERSONAS ELEGIBLES BN UN HONORARIO REDUCIDO NINGUN HONORARIO. Lawyer Refer Service Luge Bar Association ‘Luzerne County Courtncuse, Room 23 “200 Nah River Steet. hikessBare, PA1S711 Snaseeni2GEISINGER HEALTH d/b/a GEISINGER HEALTH SYSTEM 100 N. Academy Ave. Danville, PA 17822 and GEISINGER CLINIC 2 100 .N. Academy Ave. Danville, PA 17822 and GEISINGER CLINIC a/k/a and/or d/b/a GEISINGER SOUTH WILKES-BARRE GYNECOLOGY/OBSTETRICS 25 Church Street Wilkes Barre, PA 18765 and GEISINGER CLINIC a/k/a and/or d/b/a GEISINGER FORTY FORT - MATERNAL FETAL MEDICINE 190 Welles Street, Suite 114 Forty Fort, PA 18704 Defendants CIVIL ACTION COMPLAINT MEDICAL PROFESSIONAL LIABILITY ACTION Plaintiffs, Luis David Cepeda and 2 aleyka Rodriguez, individually and as parents and Co- ‘Administrators of the Estate of Abel Cepeda, a deceased minor, by and through their undersigned attomeys, Ross Feller Casey, LLP, bring this medical malpractice and premises liability action on behalf of themselves and their deceased son, Abel Cepeda, against the above-named Defendants and demand compensatory and punitive damages in a sum in excess of the local arbitration limits, exclusive of interest, costs and damages for pre-judgment delay, upon the claims and causes of action set forth below. CASE SUMMARY Itis difficult to imagine a more damning set of facts giving rise to three infant deaths in six weeks time in a Level IV NICU than those that resulted in the death of Abel Cepeda, who died onin the NICU of Geisinger Medical September 30, 2019 after contracting a Pseudomonas infectio Center (GMC) in Danville. ‘As Geisinger now has publicly admitted, Abel was the eighth premature baby to be infected in its NICU between July and September 2019, while the hospital, its administration and staff deliberately concealed from its patients, including Abel’s parents, and the public that they had a crisis on their hands that had been allowed to persist while Geisinger did nothing to warn expectant parents or otherwise prevent their babies’ exposure to what they knew could be a deadly bacteria, By the time Abel Cepeda was delivered on September 24, 2019, Geisinger knew that the ‘NICU ofits flagship hospital, GMC, was dangerous, defective and contaminated with Pseudomonas Acruginosa based on a growing number of infected babies, two of whom already had died. Nevertheless, and in reckless disregard of the continued health and safety of its most vulnerable patient population ~ NICU babies — Geisinger made a conscious, deliberate decision not to close its NICU, mof to divert expectant mothers likely to deliver preterm, and nof to transfer premature infants delivered at less than 32 weeks, whom Geisinger knew to be at greatest risk for infection and potentially fatal complications due to their immature immune systems. As laid bare by their own public admissions and medical records in the case, Geisinger’s conduct was indefensible and their liability reckless and clear. Without question, Abel Cepeda’s exposure to Pseudomonas and resulting death would have been easily avoided with adherence to some of the most basic and fundamental standards of care by Geisinger, GMC and its NICU staff. Had Geisinger and its medical staff prioritized the health and safety of its most fragile patients over its reputation and financial interests, as the standard of care required, Abel Cepeda would not have suffered the catastrophic injuries he did and he would not have died.PARTIES AND JURISDICTIONAL FACTS 1, Plaintiffs Luis David Cepeda (“David”) and Zuleyka Rodriguez. (“Zuleyka”) are adult individuals, citizens and residents of the Commonwealth of Pennsylvania, residing at 1192 State Route 940 in Hazle Township, 2. Plaintiffs are the biological parents of Abel Cepeda, a deceased minor, 3. Plaintiffs were duly appointed Co-Administrators of the Estate of Abel Cepeda, deceased, by the Register of Wills for Luzerne County on October 15, 2019. See Letters of Administration attached as Exhibit A. 4, Plaintiffs file this Complaint in their capacity as Co-Administrators of the Estate of Abel Cepeda and individually, in their own right. 5, This action is brought against all Defendants under Pennsylvania’s Wrongful Death Act, 42 Pa. C.S.A. § 8301 and Survival Act § 8302 and 20 Pa. C.S.A. § 3371 6 Defendant Geisinger Medical Center (“GMC”) is a corporation or other legal entity organized and existing underand by virtue of the laws of the Commonwealth of Pennsylvania, which at all relevant times owned, maintained, operated and/or controlled a hospital with a Neonatal Intensive Care Unit (“NICU”) located at 100 North Academy Avenue in Danville, Pennsylvania, Atall relevant times, GMC was engaged in the provision of medical care and services to neonatal patients in its NICU, including Abel Cepeda, in particular. The claims asserted against this defendant for the professional negligence and recklessness of its actual, apparent and/or ostensible agents, servants and employees who participated in the medical care, treatment, management and clinical decision making for Abel Cepeda in September 2019 while he was an in-patient in GMC’s NICU, as more particularly described herein, and for claims sounding in premises liability. Theclaims against this defendant also include a direct claim for corporate negligence under Thompson v, Nason, $27 Pa. 330, 591 A.2d 703 (1991), and its progeny of case law, including Welsh v. Bulger, 698 A.2d 581 (Pa. 1997) and Whittington v, Woods, 768 A.2d 1144 (Pa, Super. 2001), Pursuant to Pa. R. Civ. P. 1042.3, a Certificate of Merit as to this defendant will be filed separately with the Court. 7. Defendant Geisinger Health d/b/a Geisinger Health System (“GHS”) isa corporation and fully-integrated health care system with a principal place of business and office address of 100 N. Academy Avenue in Danville, Pennsylvania, At all relevant times, GHS owned, maintained, operated and/or controlled a network of health care facilities and ambulatory medical practices and employed various physicians, residents, physician assistants, nurses, nurse practitioners, technicians and other professional staff to provide medical care and services to patients at Geisinger-affiliated hospitals, clinics and out-patient medical offices, including GMC, Geisinger Clinic, Geisinger South Wilkes-Barre Gynecology/Obstetrics and Geisinger Forty Fort-Maternal Fetal Medicine, and to Zuleyka and Abel Cepeda in particular, The claims asserted against GHS are for its own negligence and recklessness and for the professional negligence and recklessness of its actual, apparent and ostensible agents, servants and employees who participated in and/or were responsible for the medical care, treatment and management of Zuleyka and Abel Cepeda as described herein, and whose acts and failures to act increased the risk of harm to them and were substantial factors in causing Abel Cepeda’s catastrophic injuries and death. 8. Upon information and belief, defendant GHS is neither a “licensed professional” as defined by Pa. R. Civ. P. 1042.1, nor a “health care provider” as defined by the M-CARE Act and, therefore, a Certificate of Merit is not required as to this defendant. Nevertheless, and in anabundance of caution, a Certificate of Merit as to this defendant will be filed separately with the Court 9. Defendant Geisinger Clinic (“GC”) is a corporation or other legal entity organized and existing under and by virtue of the laws of the Commonwealth of Pennsylvania, which at all relevant times owned, maintained, operated and/or controlled a multi-specialty group medical practice with a principal place of business and office address of 100 N. Academy Avenue in Danville, Pennsylvania, Atall relevant times, GC employed various physicians, residents, physician assistants, nurses, nurse practitioners, technicians and other professional staff to provide medical care, treatment and services to patients at Geisinger-affiliated hospitals, clinics and out-patient medical offices, including GMC, Geisinger South Wilkes-Barre Gynecology/Obsietrics. and Geisinger Forty Fort-Maternal Fetal Medicine, At all relevant times, GC was engaged in the provision of medical care and services to obstetrical and neonatal patients, including Zuleyka and Abel Cepeda in particular. ‘The claims asserted against this defendant are for the professional negligence and recklessness ofits actual, apparent and/or ostensible agents, servants and employees who participated in the medical care, treatment, management and clinical decision making for Zuleyka and Abel Cepeda as described herein. Pursuant to Pa. R. Civ. P. 1042.3, a Certificate of Merit as to this defendant will be filed separately with the Court. 10. Defendant Geisinger Clinic a/k/a and/or d/b/a Geisinger South Wilkes-Barre Gynecology/Obstetrics (“GS WB”) is a corporation or other legal entity organized and existing under and by virtue of the laws of the Commonwealth of Pennsylvania, which at all relevant times owned, maintained, operated and/or controlled a multi-specialty group medical practice with a principal place of business and office address of 25 Church Street in Wilkes-Barre, Pennsylvania, At allrelevant times, GSWB employed various physicians, residents, physician assistants, nurses, nurse practitioners, technicians and other professional staff'o provide medical care, treatment and services to high-risk obstetrical patients, including Zuleyka Rodriguez in particular, The claims asserted against this defendant are for the professional negligence and recklessness of its actual, apparent and/or ostensible agents, servants and employees who participated in the medical care, treatment, management and clinical decision making for Zuleyka and her then-unborn baby, Abel Cepeda, as described herein. Pursuant to Pa. R. Civ. P. 1042.3, a Certificate of Merit as to this defendant will be filed separately with the Court, 11, Defendant Geisinger Clinic a/k/a and/or d/b/a Geisinger Forty Fort-Maternal Fetal Medicine (*GEF-MFM”) is a corporation or other legal entity organized and existing under and by virtue of the laws of the Commonwealth of Pennsylvania, which at all relevant times owned, maintained, operated and/or controlled a multi-specialty group medical practice with a principal place of business and office address of 190 Welles Street, Suite 114 in Forty Fort, Pennsylvania, At all relevant times, GFF-MFM employed various physicians, residents, physician assistants, nurses, nurse practitioners, technicians and other professional staff to provide medical care, treatment and services to high-risk obstetrical patients, including Zuleyka Rodriguez in particular, The claims asserted against this defendant are for the professional negligence and recklessness of its actual, apparent and/or ostensible agents, servants and employees who participated in the medical care, treatment, management and clinical decision making for Zuleyka and her then-unborn baby, Abel Cepeda, as described herein. Pursuant to Pa. R. Civ. P. 1042.3, a Certificate of Merit as to this defendant will be filed separately with the Court, 12. Defendants GMC, GHS, GC, GS ‘WB and GFF-MEM are at times collectivelyreferred to throughout this Complaint as “Defendants,” “Geisinger” and/or “the Geisinger Defendants.” Reference to “the Geisinger Defendants” or “Defendants” may include any one, more than one, or all of these individually named Defendants. 13, Atall relevant times, GMC owed non-delegable legal duties directly to the plaintiff-parents and to Abel Cepeda pursuant to Thompson v, Nason, 591 A.2d 703 (Pa. 1991), and its progeny, including Welsh v, Bulger, 698 A.2d 581 (Pa. 1997) and Whittington v. Woods, 768 A.24 1144 (Pa. Super, 2001), ‘These duties consisted of: (1) a duty to use reasonable care in the maintenance of safe and adequate facilities and equipment; (2) a duty to select and retain only call persons who practice medicine within its walls as to ans; (3) a duty to overs competent phy: patient care; and (4) a duty to formulate, adopt and enforce adequate rules and policies to ensure quality care for patients. 14, Atal relevant times, ahealth care provider-patient relationship existed between Abel Cepeda and Zuleyka Rodriguez and all Defendants. 15, All Defendants are vicariously liable to Plaintiffs for the injuries and other damages they suffered as a result of the negligent and reckless acts or omissions of persons or entities whose conduct was under their supervision, control or right of control, and which conduct increased the risk of harm to Abel Cepeda, and did in fact cause Abel Cepeda’s catastrophic injuries and death as described herein and in the medical records, which are incorporated by reference. 16. Atal relevant times, all Defendants were engaged in the practice of medicine, pursuing their respective specialties and/or health care duties, and were obligated to use the professional skill, knowledge and care which they possessed, and to pursue their professions in accordance with reasonably safe and accepted standards of medical care in general, and in theirspecialties in particular, as well as all applicable institutional standards of care, in their treatment of Zuleyka and Abel Cepeda. 17, Atall relevant times, all Defendants had actual or constructive knowledge of the medical and professional care and treatment provided to Zuleyka and Abel Cepeda. 18. The catastrophic injuries and death of Abel Cepeda and the damages and other losses suffered by the Plaintiff-parents Luis David Cepeda and Zuleyka Rodriguez were the direct result of the negligence and recklessness of Defendants, their agents, servants and/or employees, and were due in no manner whatsoever to any act or failure to act on the part of the Plaintiffs. 19, The amount in controversy exceeds the prevailing local arbitration limits. 20. Venue for this action is properly laid in Luzeme County as to all Defendants as all of the medical care provided to Zuleyka and her then unborn baby, Abel Cepeda, by GSWB, GFF- MPM and their medical staff, which is at issue in this case, was rendered in Luzerne County. See Pa. R. Civ. P, 1006, 2179(a). FACTS 21. Zuleyka was admitted to GMC on September 18, 2019, while pregnant with Abel 22, For several weeks leading up to Zuleyka’s admission to GMC, the Geisinger Defendants were aware of the existence of a Pseudomonas outbreak in the NICU that had resulted in an escalating number of infected infants, some of whom had been rendered critically ill and, as of the date of her admission, two of whom had died. 23, Atall relevant times, leading up to and during Zuleyka’s admission to GMC, the Geisinger Defendants knew that Zuleyka was going to deliver prematurely and that her baby would be less than 32 weeks gestation at birth and require extended NICU care.24, Despite that knowledge, and in reckless disregard for the continued health and safety of her then-unborn baby, Defendants made a conscious, deliberate decision to instruct Zuleyka to go to GMC, and to admit her for the specific purpose of delivering her preterm baby and admitting him to the NICU in the midst of a lethal Pseudomonas outbreak 25, From September 18, 2019 through September 24, 2019, Geisinger negligently and recklessly kept Zuleyka at GMC, knowing all along that her preterm delivery was certain and would require admission of her newborn baby to its infected NICU that already had caused several babies to become ill and two of them to die. 26. Iman ongoing and reckless deviation from the standard of care, at no point did Geisinger attempt to transfer Zuleyka to one of several other hospitals in the region that were capable of managing the care of a premature baby safely and without the increased risk of exposure to the deadly infection known to be lurking in GMC’s NICU at the time. 27. On September 24, 2019, Abel Cepeda was born prematurely at 26.2 weeks and admitted to the NICU. 28, During his first days of life, Abel remained stable and his parents were led to believe that he was doing well. 29. Zuleyka was discharged home from GMC on September 27, 2019. 30. Unbeknownst to his parents, for every day that Abel spent in GMC’s contaminated NICU, he was particularly vulnerable and at-risk for infection due to his immature immune system which rendered him defenseless against the Pseudomonas bacteria that was infecting other babies at GMC. 31. Inagross departure from the standard of care, Defendants negligently and recklesslywithheld from Abel’s parents the fact that an exceedingly high number of premature infants recently had become infected and sickened, and in two cases died, from the same type of Pseudomonas infection contracted in the very NICU where their premature baby lie. 32. Ato time during Abel’s first five days of life did anyone from the newborn team inform David or Zuleyka about the deadly hazard of the recent Pseudomonas cluster/outbreak in the NICU, or about any precautions that were being taken to safeguard their son, 33, Instead, and in an ongoing deviation from the standard of care, Abel’s parents were falsely reassured that Abel was in safe hands and being properly cared for in the NICU whea, in fact, the opposite was true, 34, Not surprisingly, and as a direct result of the negligence and recklessness of Defendants, within just a week of his delivery, Abel became infected with Pseudomonas while admitted to the NICU at GMC. 35. Nevertheless, and in a continuing departure from the standard of care, it would be another week before Abel’s parents would learn the truth about what caused their son to take a tum. for the worse and suddenly become ill 36. On September 30, 2019, Zuleyka and David were asleep at home in Hazle Township when they were awakened in the middle of the night by the first in a series of phone calls from the NICU staff at GMC. 37. During the call, a NICU nurse told Zuleyka and David that Abel had become very sick and required an increase in supplemental oxygen. 38. Given the deterioration in Abel’s condition, David and Zuleyka were advised to come to GMC. 1039. Shortly after that, as they were preparing to leave for Danville, they received another call from the NICU and were told that their son had arrested and had to be resuscitated. 40. While en route to the hospital, David and Zuleyka received another call and spoke with the neonatologist who advised them that Abel had Coded more than once, required aggressive resuscitation and that the NICU team would try to keep their son alive until they got there. 41. David and Zuleyka rushed to the NICU as quickly as they could; when they arrived, they were given the devastating news that Abel had died minutes earlier. 42. Abel Cepeda was pronounced dead at 2:40 am on September 30, 2019, when he was just five days old. 43. On September 30, 2019, David and Zuleyka were informed by neonatologist Dr. Edward Everett that there was some concern that Abel may have had an infection for which he was started on antibiotics; they were not told, however, what type of infection was suspected or why. 44, Ase jenced by the horrific circumstances leading up to his death, and as a direct result of Defendants’ negligence and recklessness, there isno question that Abel endured tremendous conscious physical pain, suffering, anxiety and distress before he died. 45. Asif losing their infant son wasn’t heartbreaking enough, due to Defendants’ negligence and recklessness, David and Zuleyka were deprived of the opportunity to be at his bedside and to comfort him before he died. 46. Upon information and belief, and unbeknownst to the Plaintiffs, Defendants began treating Abel with antibiotics because they knew that they had placed Abel at a constant, heightened risk of contracting a Pseudomonas infection every day that he remained in GMC's contaminated NICU. i47. Forsix agonizing days following Abel’s death, Defendants failed to disclose to David and Zuleyka that their son’s clinical deterioration and death likely was due to the same bacteria that had infected several other babies in the NICU before him, even though Defendants knew or should have known that Abel was the third death in two months resulting from the same Pseudomonas cluster/outbreak that continued to contaminate the NICU while Geisinger did nothing to warn or protect patients, or to eradicate it. 48. Finally, on October 6, 2019, Zuleyka and David received another call from Dr. Everett, this time to inform them that Abel had, in fact, died from a Pseudomonas infection. 49, Dr. Everett also told Zuleyka and David that two other babies in GMC’s NICU recently had died from the same Pseudomonas infection, and that Geisinger “may be releasing a statement” about the cluster/outbreak of Pseudomonas-related deaths. 50. What Abel’s parents were nof told is that Geisinger planned to hold a press conference the next day (October 7, 2019), in which three of Geisinger’s highest-ranking medical staff and administration would speak on-camera — and take questions from the press ~ to describe the circumstances surrounding Abel’s death and the other victims of this senseless and preventable institutional tragedy. 51. Geisinger also failed to inform Zuleyka and David that the October 7, 2019 press conference was just the first step in a well-planned media campaign designed to protect and bolster Geisinger’s reputation, public image and financial interests in the aftermath of the Pseudomonas crisis. 52. Much to the surprise of Abel’s mourning parents, Geisinger held an on-camera press conference at GMC on the afternoon of October 7, 2019 in which their son’s death was discussed. 1253. Front and center in this October 7, 2019 press conference were Dr. Frank Maffei, Chair of GMC’s Department of Pediatrics, Dr. Mark Shelly, GMC Infectious Disease specialist, and Dr. Rosemary Leeming, GMC’s Chief Medical Officer (CMO). 54, During that October 7, 2019 press conference, these Geisinger officials publicly confirmed and admitted, while being videotaped, the following staggering facts: (a) (b) © @ © starting as far back as early July 2019, at least eight infants had been sickened by Pseudomonas bacteria while in the GMC NICU, three of whom died from Pseudomonas infections; the first Pseudomonas-related death ocourred in early August, with two more deaths occurring in September; all eight cases of Pseudomonas infections involved babies born at or around 26 or 27 weeks of gestation; the infection cluster/outbreak was specifically confined to the GMC NICU; and as of October 7, 2019, Geisinger still had not identified, let alone eradicated, the source and/or cause of the Pseudomonas cluster/outbreak wreaking havoc on premature babies in its NICU. 55. Perhaps the most disturbing revelation of this press conference was that Geisinger admitted that they recognized a “/rend” of infections dating as far back as (at least) early August, vet it made a conscious, deliberate decision to conceal the problem for two months while continuing to admit premature infants (like Abel, in late September) to the NICU. 56. The following exchange from the October 7, 2019 press conference makes painfully clear that Geisinger knew of the Pseudomonas hazard long before Zuleyka was even transferred to GMC to deliver her baby: Reporter: When did you notice this? When did it start? 1BDr. Maffei: So - so when infections happen, there are acceptable sort of rates of infections. And if we see one infection with a certain organism and we can say that — well, that’s within the context of what we would call a standard type of rate for that infection. We look at it and we follow it. If we see a second one, then we start thinking about a trend. And I’ll defer to Dr. Shelly, but I think for certain in_early August, we had an infection that we said, gosh, this seemed unusual, and perhaps we needed to look back [to the first identified Pseudomonas infection in July]. 57. __ Inthat same answer, Dr. Maffei emphasized that Geisinger knew in early August 2019 that Pseudomonas infections were causing premature babies to get “very sick” in its NICU: [W]hen a bacteria enters the body and has a—certainly a bloodstream infection, then we know that that is pathogenic, that that child is likely to be very sick. The first one of those happened in early August. 58, During that same October 7, 2019 press conference, Dr. Maffei also admitted that Pseudomonas exposure is known to be particularly dangerous for premature babies who are immunocompromised and who often require invasive treatments, 59. Following the October 7, 2019 press conference, Geisinger continued its public relations offensive — releasing statements to the press, granting television interviews, and pushing a favorable and misleading story from another patient whose care pre-dated the Pseudomonas crisis, ~ all in hopes of safeguarding its own public image and financial interests at the expense of the families who needlessly lost their newborn babies and were kept in the dark far too long 60. On October 8, 2019, Dr. Leeming (@MC’s CMO), spoke on camera with a reporter from WNEP-TV’s Newswatch 16, the Seranton-based ABC affiliate which broadcasts throughout ‘Northeastern and Central Pennsylvania. 61. During that October 8, 2019 interview, which appeared on the 5 p.m. television 14broadcast and also in an online print version, Dr. Leeming corroborated Dr. Mattei’ prior admission that Geisinger knew of the pattern of Pseudomonas infections in early August. 62, The transcript of Dr. Leeming’s on-air interview provides in part Reporter: “Dr. Rosemary Leeming is Geisinger’s Chief Medical Officer. She says that an infant in the NICU was sick with Pseudomonas in carly July, and in early August, another infant died from the infection.” Dr. Leeming: “When we looked back [in August], we realized that it was a similar organism to the child a month before.” 63. Incredibly, in that same October 8, 2019 interview, Dr. Leeming argued that Geisinger had somehow been proactive in notifying the public of the crisis, stating, “Once we realized this was an unusual number of infections, we felt it was important to let the public know.”" 64, This October 8, 2019 claim by Dr. Leeming directly contradicted Geisinger’s own statements made 24 hours earlier during the October 7 press conference. 65. According to Dr. Maffei’s videotaped admission during the October 7, 2019 press conference (quoted above), Geisinger actually knew in early August about a “trend” of Pseudomonas infections that “seemed unusual” to Geisinger officials 66. Contrary to Dr. Leeming’s claim to WNEP-TV, Geisinger did nof inform anyone, much less “the public,” about the Pseudomonas cluster/outbreak until October 7, 2019. 67. Simply put, Geisinger inexcusably, consciously and recklessly concealed a known hazard from the public for at least two months after they recognized an “unusual” rate 1 “Infant Deaths in Geisinger NICU Remain a Mystery.” Newswatch 16, WNEP (posted 4:58 p.m., October 8, 2019) print version available at https://wnep.com/2019/1 0/08/infant-deaths-in-geisinger-nicu-remain-a-mystery/ (last accessed October 16, 2019). 15of confirmed Pseudomonas infections in its NICU. 68. In two additional media statements, Geisinger further admitted that Pseudomonas bacteria is “dangerous” because it “can cause significant illness” when it comes in contact with vulnerable individuals, especially premature babies. 69. The reality is, after Abel became the third baby in just two months to die in GMC’s NICU from the same Pseudomonas infection, Geisinger had no choice but to inform the public about the Pseudomonas crisis that had been allowed to infect its most vulnerable patient population over the last three months ~ especially given its reporting requirements under state and federal law. 70. On October 7, 2019, Geisinger finally began diverting mothers likely to deliver prematurely before 32 weeks gestation, and infants born at less than 32 weeks gestation, to other regional hospitals with appropriate NICU facilities and infection control policies. 71. Pursuant to the standard of care and proper institutional infection prevention and control policies and procedures, Geisinger’ s diversion policy, announced on October 7, 2019, could have, and absolutely should have, been triggered months earlier. 72. Instead, Geisinger negligently and recklessly decided to continue to fill its NICU beds with premature infants known to be at an extraordinarily increased risk of imminent, catastrophic injury and death due to the Pseudomonas cluster/outbreak. 73. Based on their own public statements, many of which were uttered on-camera, ? “Pennsylvania hospital searching for answers after three infant deaths,” Joe Sylvester and John Finnerty, The (Sunbury, PA) Daily Item, October 8, 2019. Available at https://www.tribdem.com/news/pennsylvania-hospital-searching-for-answers-after-three-infant-d eaths/article_bb0b45b1-180d-Sbec-acdd-f1£277500a2c-html (last accessed October 16, 2019). > “Geisinger Medical Center NICU Update.” Available at htips://www.geisinger.org/sites/nicu-update (last accessed October 16, 2019). 16Geisinger officials knew for months that their NICU was extremely dangerous ~ particularly for premature babies under 32 weeks gestation, like Abel — yet they made a conscious, deliberate decision not to warn its healthcare customers or otherwise mitigate the catastrophic risks to which they knowingly exposed their most vulnerable patients. 74, Atall relevant times, Geisinger knew of the catastrophic risks to premature babies lurking in its contaminated NICU. Nonetheless, Geisinger consciously and wantonly disregarded those risks by continuing to refer expectant mothers like Zuleyka to GMC for preterm delivery, and to admit premature infants like Abel to its contaminated NICU. 75. Abel's progressive illness, pain, suffering and eventual death were the direct result of Geisinger’s flagrant refusal to take even the most basic steps required by the standard of care to protect the health and safety of its premature patients. 76. The tragedy of Abel's death is only compounded by the fact that he never should have been in GMC’s NICU in the first place. 77. As Geisinger now has publicly admitted, around the time that the first baby became infected in GMC’s NICU in July 2019, Zuleyka was in her second trimester of pregnancy with Abel, whose estimated due date was December 29, 2019. 78. Zuleyka’s pregnancy was being co-managed by the obstetrical staff at Geisinger South Wilkes-Barre in Luzerne County and the maternal fetal medicine specialists at Geisinger MFM in Forty Fort, Luzerne County. 79. Zuleyka’s obstetrical history was significant for a previous preterm delivery secondary to chronic hypertension and preeclampsia, requiring a c-section at 31 weeks. 80. Inher next pregnancy, her blood pressures were well-controlled with 7medication and she had a scheduled c-section at term, at 38-39 weeks. 81. Based on this history, Zuleyka’s pregnancy with Abel was deemed high-risk and required vigilant supervision and management to prevent her from developing superimposed preeclampsia and other maternal and fetal complications that would put her at even greater risk for preterm delivery, 82. Between July and September 2019, Zuleyka was managed by Arianne Schott, PA-C and obstetrician Evan McClennen, DO; she was seen twice by maternal fetal medicine, including Fereshteh Boozarjomehri, MD, Lisa DeDomenico, CRNP, Mohamed Satti, MD and Awathif Mackeen, MD 83. Inaddition to Zuleyka’s history of chronic hypertension, she had class 1 obesity with a BMI of 32. 84. During her first trimester, her blood pressure was well-controlled with low-dose oral anti-hypertensives and she was started on aspirin to reduce her risk of preeclampsia. 85. However, by her second trimester, in or around mid-July, she reported to her providers that her blood pressures were becoming persistently elevated in the 150s/100s-1 10s. 86. Inexplicably, and in a clear violation of the accepted standard of care, Defendants failed to properly adjust her blood pressure medication and allowed her BPs to remain out of control and significantly elevated for another six weeks. 87. Inan ongoing deviation from the standard of care, Zuleyka’s obstetrical team failed to increase her BP medication, failed to consult with maternal fetal medicine and told her she did not need to return to the office for another month. 88, AtZuleyka’snext visit on August 14, 2019, she remained severely hypertensive with 18a BP of 152/110 and increasingly abnormal labs. 89. The next day, Zuleyka reported that her blood pressure had peaked at 174/108, 90. A prescription for a second anti-hypertensive was phoned in to her pharmacy, but she was instructed not to start taking it until she was seen in the office the following week. 91. By the time she finally was seen by maternal fetal medicine in late August, Zuleyka’s blood pressures were chronically elevated and she had worsening headaches and proteinurea, which were worrisome for preeclampsia and increased her risk of preterm delivery. 92. Nevertheless, and in ongoing deviation from the standard of care, Zuleyka’s BP ‘medication still was not increased for another week, allowing her condition to progress. 93. By the time her anti-hypertensives were adjusted to a level sufficient to bring her blood pressures back down to within normal range, the die had been cast. 94. When she returned for her next maternal fetal me ine consult on September 18, 2019, Zuleyka immediately was assessed as having chronic hypertension with superimposed preeclampsia with severe features. 95. Based on these findings, Dr. Satti and Dr. Mackeen instructed Zuleyka to go to GMC to be admitted for steroid administration and NICU consultation in anticipation of a preterm delivery. 96. Dr. Mackeen contacted the in-house MFM at GMC, Dr. Neubert, and the covering OB on Labor and Delivery, Dr. Adigun, both of whom agreed with the plan and arranged for Zuleyka’s admission. 97. Zuleyka was admitted to GMC that evening and remained pregnant for six more days. 1998. She received a full course of betamethasone for fetal lung maturity and neuroprotection and was treated with intravenous anti-hypertensives to control her BPs. 99. Aspredieted, Abel was delivered prematurely by repeat c-section on September 24, 2019. 100. He was 26.2 weeks at the time and at-risk for a number of complications as a direct result of Defendants’ mismanagement of his mother’s prenatal care and his resulting preterm birth 101. What Abel’s parents did not know ~ and Geisinger did its best to conceal ~ was that Abel's risk of infection was exponentially increased due to an outbreak of Pseudomonas that already had infected a number of babies in GMC’s NICU since July, and caused two of them to die. 102. From the outset of Zuleyka’s pregnancy, Geisinger and its obstetrical team. knew, understood and appreciated that, based on her history of chronic hypertension, preeclampsia and previous preterm birth, she was at-risk for a repeat preterm delivery in her current pregnancy with Abel and required close supervision and follow-up care to prevent that from happening, 103. Defendants also knew that Zuleyka’s risk of preterm delivery was directly related to the severity of her hypertension and that if her blood pressures were not adequately controlled throughout the pregnancy, her risk of a premature delivery and other complications would be substantially increased. 104, Nevertheless, and in the face of those risks, Defendants failed to properly manage Zuleyka’s prenatal care with the level of urgeney it required, leading to chronic, uncontrolled hypertension, preeclampsia and other complications that increased the risk that she would go on to deliver Abel prematurely, exactly as occurred. 105. Had Zuleyka’s prenatal care been managed properly and in compliance with 20the standard of care, Abel would not have been delivered as early as he was, he would not have ended up in GMC’s NICU when he did, he would not have become infected, and he would not have died. 106. By September 18, 2019, Dr. Mackeen and her colleagues knew or should have known that GMC was operating an extraordinarily dangerous, defective and infected NICU. 107, Clearly, when Zuleyka was instructed to go to GMC, Dr. Mackeen and her colleagues knew, understood and appreciated that Abel was going to be delivered prematurely and that he was going to require admission to the NICU for an extended period of time. 108. In compliance with the standard of care, Geisinger was obligated to make its obstetrical and maternal fetal medicine staff aware that GMC was not able to accept any patients expected to deliver preterm, and in particular those whose infants would be less than 32 weeks gestation, which put them in the highest risk group for a potentially catastrophic and fatal outcome secondary to Pseudomonas infection. 109. Based on the number of patients who had been infected already, GMC’s NICU. should have been closed and patients like Zuleyka diverted to other hospitals for delivery and NICU admission for their infants. 110, Instead, and in a reckless violation of the standard of care, Geisinger made a conscious, deliberate decision to keep GMC’s NICU open and to continue to accept patients like Zuleyka and Abel, whom they knew to be the most vulnerable, notwithstanding the risks. 111, Had Geisinger and its medical staff prioritized the continued health and safety of its most fragile patients over profits, as the standard of care required, Abel would not have been delivered at GMC, and would not have ended up in its NICU, become infected and died. 21112, Abel’s exposure to Pseudomonas and resulting death would have been easily avoided with adherence to some of the most basic and fundamental standards of neonatal and institutional care by Geisinger and its obstetrical and NICU staff. 113. With prompt and proper handling of this matter by the Geisinger Defendants, in all of the ways described throughout this Complaint, there is no question that Abel Cepeda would not have been infected with Pseudomonas, suffered from progressive hypoxia and died under the terrible circumstances that he did, 114, Defendants undertook and/or assumed a duty to the Plaintiff-parents and to Abel to provide Zuleyka and Abel with timely and appropriate medical care and management, to take appropriate measures to ensure their ongoing health, well-being and safety, and to avoid the risk of additional harm and injury to them, 115. Defendants treated Zuleyka and Abel Cepeda without the appropriate knowledge, skill, raining, care and advice. 116. The carelessness, negligence and recklessness of Defendants and each of them, jointly and severally, as described herein, substantially increased the risk of harm to Zuleyka and Abel Cepeda, and did, in fact, cause Abel to suffer a myriad of catastrophic injuries, most significantly a devastating infection and death, all of which were avoidable with timely and appropriate care. 117. Asadirectresult of the negligence and recklessness of Defendants and each of them, jointly and severally, as described herein, Abel Cepeda did not receive appropriate care in accordance with the standard of care as it existed both before and following his delivery at GMC and through the time of his death on September 30, 2019. 22118. Asadirect result of the negligence and recklessness of Defendants and each of them, jointly and severally, as described herein, Abel Cepeda needlessly suffered catastrophic and permanently disabling injuries and a hastened death. 119. Asa direct and proximate result of the negligence and recklessness of Defendants as set forth herein, Abel Cepeda was exposed to an increased risk of harm and was caused to suffer the injuries described above, as well as those set forth herein: Ce ne t infection; respiratory distress; asphyxia; respiratory failure; air hunger; shock; cardiopulmonary arrest; hypoxia; physical pain and suffering: mental anguish; extreme anxiety; severe emotional distress; disfigurement and disability; embarrassment and humiliation; past and future loss of enjoyment of life and life’s pleasures; past and future inability to participate in and/or perform activities of daily living, occupations and avocations; past and future loss of earings and earning capacity; medical expenses for medications, hospitalizations, medical and surgical care, testing, equipment and other care required to treat, alleviate, minimize and/or otherwise treat his conditions between delivery and death; such other injuries documented in the medical records of those physicians and other health care professionals who treated Abel Cepeda between September 24, 2019 and September 30, 2019; and a hastened and horrific death. 120. As adirect and proximate result of the negligence of Defendants, as set forth herein, the Plaintiff-parents have suffered and will continue to suffer substantial economic and non- economic injuries, damages and losses, including but not limited to past medical and other expenses 23relating to the treatment of their son’s injuries and death; depression, anxiety and severe emotional distress; physical manifestations of severe emotional distress; and such other injuries and damages as described more fully herein. COUNTI Plaintiffs v. Defendants Geisinger Medical Center, Geisinger Health d/b/a Geisinger Health System and Geisinger Clinic 121, The preceding paragraphs are incorporated by reference as if set forth fully herein. 122. Thenegligence and recklessness of Defendants Geisinger Medical Center, Geisinger Health and Geisinger Clinic consisted of all or some of the following: a. Negligently and recklessly failing to conform to the accepted standard of care in the proper evaluation, diagnosis, management, treatment and infection- prevention and control of Abel Cepeda before and during Abel’s time in the GMC NICU, as described herein; b, In conscious disregard of the safety and well-being of its neonatal patients like Abel Cepeda, Defendants negligently and recklessly concealed from the Plaintiffs and the public the fact that premature babies continued to get sick and die from the same Pseudomonas infection in the same NICU ~ and that Geisinger still had not identified a source or cause of the infection, let alone taken steps to eradicate its cause; ¢. _ Inconscious disregard of the safety and well-being of its neonatal patients like Abel Cepeda, Defendants negligently and recklessly referred and admitted Plaintiff-mother Zuleyka Rodriguez to Defendant Geisinger Medical Center on September 18, 2019, knowing that she would deliver a preterm infant requiring NICU care and thus knowingly, consciously and recklessly exposed Abel to an unconscionable risk of a deadly Pseudomonas Aeruginosa infection; 4, In conscious disregard of the safety and well-being of its neonatal patients like Abel Cepeda, Defendants negligently and recklessly exposed Abel to their highly contaminated NICU, causing him to needlessly suffer and die; ©. Negligently and recklessly allowed neonatal patients like Abel Cepeda to be admitted to Defendants’ NICU despite knowing — up to and including the highest level of Geisinger leadership — that their NICU was contaminated with Pseudomonas Aeruginosa and that at least two neonatal patients had already died and several other neonatal patients were already sickened from the same bacteria in the same NICU; f, _ Negligently and recklessly failing to warn expectant parents or to otherwise 24prevent their babies’ exposure to what Defendants knew could be a deadly bacteria; Negligently and recklessly failing to close Defendants’ NICU to eradicate and/or contain the Pseudomonas Aeruginosa cluster/outbreak that was known by Defendants to exist; Negligently and recklessly allowing new neonatal patients, including premature infants like Abel Cepeda, to be exposed to Defendants’ NICU despite their actual knowledge of the extreme risk of harm associated therewith; ‘Negligently and recklessly failing to inform the public, appropriate agencies, and/or expectant parents whose babies may require NICU care that Defendants’ NICU was contaminated with a Pseudomonas Aeruginos cluster/outbreak; Negligently and recklessly failing to follow proper and adequate infection prevention and/or control policies and procedures to prevent any exposure, spread, clusters and/or outbreaks of Pseudomonas Aeruginosa in GMC’s. Negligently and recklessly failing to prevent a cluster/outbreak of Pseudomonas Acruginosa in GMC’s NICU, and allowing the same to worsen; Negligently and recklessly allowing Defendants’ NICU staff and/or visitors to infect neonatal patients by failing to follow proper and adequate infection prevention and/or control policies and procedures; In conscious disregard of the safety and well-being of its neonatal patients like Abel Cepeda, Defendants negligently and recklessly failed to transfer Plaintiff-mother Zuleyka Rodriguez from GMC to another regional hospital with appropriate NICU capabilities and infection control policies from September 18, 2019 through and including September 24, 2019, despite knowing that she was going to deliver a preterm infant requiring NICU care and thus knowingly, consciously and recklessly exposing Abel to an unconscionable risk of a deadly Pseudomonas Aeruginosa infection; ‘Negligently and recklessly failing to adequately clean, sterilize, or otherwise disinfect the equipment, items and materials in or around GMC’s NICU; Negligently and recklessly failing to properly and timely recognize the signs and symptoms of new and worsening cases of Pseudomonas infection; Negligently and recklessly failing to follow, formulate, adopt and/or enforce adequate rules, procedures and policies to prevent neonatal patients like Abel Cepeda from suffering the harm specified herein; Negligently and recklessly failing to properly investigate, manage and timely treat Abel who was known to be at an extreme and constant risk of 25bb. ce. dd. ee. ff developing a life-threatening Pseudomonas infection; Negligently and recklessly failing to formulate an appropriate and timely differential diagnosis for Abel’s signs, symptoms and clinical findings, including those concerning fora life-threatening infection due to Defendants’ actions and inactions; Negligently and recklessly failing to appropriately and timely investigate the cause and/or source of the worsening Pseudomonas crisis, including well before and during Abel’s admission to GMC’s NICU; Negligently and recklessly failing to recognize and appreciate Abel’s signs, symptoms and clinical findings on exam as being concerning for and/or consistent with a life-threatening infection; Negligently and recklessly failing to fully, timely and/or properly notify the appropriate governmental agencies, including the Pennsylvania Department of Health and the Centers for Disease Control and Prevention, of the ongoing and worsening Pseudomonas outbreak/cluster; Negligently and recklessly transmitting Pseudomonas from staff to patients; Negligently and recklessly transmitting Pseudomonas from patient to patient; Negligently and recklessly transmitting Pseudomonas from contaminated water sources to patients; Negligently and recklessly transmitting Pseudomonas from contaminated equipment to patients; ‘Negligently and recklessly transmitting Pseudomonas from contaminated surfaces to patients; Negligently and recklessly transmitting Pseudomonas from contaminated milk and/or formula and/or nutrition delivery systems and/or bottle warmers to patients; Negligently and recklessly failing to timely sample and/or test any and all potential water/fluid sources, equipment and/or surfaces in the NICU in order to timely identify the source of the Pseudomonas cluster/outbreak; Negligently and recklessly failing to screen infants in the NICU and/or those being transferred into the NICU in a timely manner given the known Pseudomonas cluster/outbreak; Negligently and recklessly failing to wash hands and/or use sterile gloves, linens, clothing or other equipment when coming into contact with infants and/or materials that would come into contact with infants in the NICU; Negligently and recklessly failing to treat Abel’s infection with appropriate interventions, including appropriate broad-based antibiotics covering both gram negative and gram positive organisms, given his signs, symptoms and laboratory results and given the pre-existing knowledge that there was a Pseudomonas cluster/outbreak in Defendants’ NICU; Negligently and recklessly failing to inform other Geisinger and non- Geisinger healthcare providers and outside entities, including Zuleyka’s treating obstetrical and MFM physicians who also were employed by 26Defendants, of the known Pseudomonas cluster/outbreak and/or the true extent of the crisis; gg. Negligently and recklessly concealing the known Pseudomonas cluster/outbreak in Defendants’ NICU in order to protect Defendants’ reputation and promote Defendants’ financial interests at the expense of the safety of vulnerable preterm infants; bh. Negligently and recklessly failing to alert infection control supervisors of the Pseudomonas cluster/outbreak in a timely manner, ii, Negligently and recklessly failing to update, implement, and amend infection prevention and/or control policies applicable to Defendants’ NICU given the known and ongoing Pseudomonas cluster/outbreak; jj. Negligently and recklessly failing to act ina timely manner to prevent further infection of preterm infants with Pseudomonas in Defendants’ NICU; kk. Negligently and recklessly failing to respond in a timely manner despite a known deadly Pseudomonas cluster/outbreak in Defendants’ NICU; and L ‘Negligently and recklessly continuing to admit preterm neonatal patients to Defendants’ NICU after infants first were sickened by the deadly Pseudomonas cluster/outbreak existing in the NICU. 123. The foregoing negligence and recklessness of Defendants increased the risk of harm to Abel Cepeda. 124, Asa direct and proximate result of the negligent and reckless acts and omissions of Defendants, as described herein, Abel Cepeda was infected with Pseudomonas Acruginosa, experienced tremendous conscious, physical pain and suffering and died. 125, As a direct and proximate result of the negligence and recklessness of Defendants, as described herein, Abel Cepeda suffered catastrophic injuries and a hastened death, WHEREFORE, Plaintiffs demand judgment in their favor and against Defendants, individually, jointly and severally, and an award of compensatory and punitive damages in an amount in excess of Fifty Thousand Dollars ($50,000.00), and above the prevailing arbitration limits, exclusive of prejudgment interest, post-judgment interest and costs. 27COUNT It Plaintiffs v. Defendant Geisinger Medical Center 126. The preceding paragraphs are incorporated by reference as if set forth fully herein. 127. Inaddition to the derivative and vicarious liability of Geisinger Medical Center for the negligent and reckless acts and omissions of its agents, servants and/or employees, as set forth in the preceding Count, GMC further owed direct and non-delegable duties to the Plaintiff-parents and to their son, Abel Cepeda, under the tenets set forth in Thompson v. Nason, 527 Pa. 330, 591 ‘A.2d 703 (1991), and its progeny, including Welsh v. Bulger, 698 A.2d 581 (Pa. 1997) and Whittington v, Woods, 768 A.2d 1144 (Pa, Super. 2001). 128. Defendant GMC’s duties included: (1) a duty to use reasonable care in the maintenance of safe and adequate facilities and equipment; (2) a duty to select and retain only ‘competent physicians; (3) a duty to oversee all persons who practice medicine within its walls as to patient care; and (4) a duty to formulate, adopt and enforce adequate rules and policies to ensure quality care for patients. 129. Defendant GMC had a duty to its patients, and to Abel Cepeda, in particular, to exercise reasonable care in the appointment and reappointment of the physicians, fellows, residents, physician assistants, nurses, nurse practitioners and ancillary staff. 130, Defendants GMC had @ duty to its patients, and to Abel Cepeda, in particular, to provide reasonable and competent medical care and services and to avoid negligent and reckless conduct that would increase the risk of harm to Abel Cepeda. 131. The corporate negligence of defendant GMC, arising out of the care and treatment provided to Abel Cepeda, consisted of one or more of the following: a, Failing to havea proper infection prevention and/or control policy, procedure 28and/or plan in place for GMC’s NICU in 2019; Failing to have proper policies and procedures to warn the public and/or expectant parents of premature babies of a cluster/outbreak of a bacterial infection in GMC’s NICU in 2019; Failing to hire/retain competent physicians, nurses and ancillary staff who were properly trained with respect to the measures to be undertaken to prevent exposing additional neonatal patients to Defendants’ NICU, when it was known and/or suspected to be contaminated with Pseudomonas Aeruginosa in at least as early as July 2019; Failing to have physicians and staff appropriate in number, training and/or experience in infection prevention and control applicable to the NICU in 2019; Failing to ensure that Abel Cepeda received appropriate attention from fully and properly trained and experienced physicians and nursing staff trained in proper and adequate policies and procedures for infection prevention and control in the NICU in 2019; Failing to select and retain physicians, nurses and other medical staff competent in recognizing and responding to neonatal risk of infection in the NICU in 2019; Failing to select and retain physicians, nurses and other medical staff competent in the care of preterm newborns suspected of having bacterial infection; Failing to select and retain physicians, nurses and other medical staff competent in the prevention and/or control of infections in the NICU in 2019; Failing to select and retain physicians, nurses and other medical staff competent in the recognition and treatment of patients with bacterial infection; Failing to select and retain physicians, nurses and other medical staff competent and adequately trained in the prevention of a cluster/outbreak of Pseudomonas Aeruginosa in the NICU in 2019; Failing to select and retain physicians, nurses and other medical staff competent in the assessment of neonatal patients at risk for infection; Failing to select and retain neonatology and infectious disease physicians, nurses and other medical staff competent in the assessment and treatment of newborn patients at increased risk for infection Failing to oversee all persons who practice medicine within its walls as to patient care to ensure that the resident physician and/or nursing staff involved inthe evaluation, treatment and diagnosis of Abel Cepeda, were appropriately and adequately supervised by the attending physician staff; Failing to oversee all persons who practice medicine within its walls as to patient care to ensure that the physician staff was properly trained in the 29ability to recognize, document, communicate and act upon fin: delivery infection in the NICU; Failing to oversee all persons who practice medicine within its walls as to patient care to ensure that the physician staff was properly trained in the ability to recognize, document, communicate and act upon a cluster/outbreak of Pseudomonas Aeruginosa in GMC’s NICU in 2019; Failing to formulate, adopt and/or enforce appropriate rules, guidelines, policies, procedures or protocols with respect to the management of patients such as Abel Cepeda, including, but not limited to policies and procedures regarding: gs of post- i infection control; ii, infection prevention; iii, infection protocols; iv. NICU infection protocols, v. notification of the medical staff of an infection cluster/outbreak; vi, closure of the NICU in the setting of an infection cluster/outbreak; vii, closure of the labor and delivery department to at-risk patients in the setting of an infection cluster/outbreak in the NICU: viii. notification of the medical staff regarding the inability to accept new patients in the setting of an infection cluster/outbreak; ix. diversion of patients to other hospitals in the setting of an infection cluster/outbreak in the NICU; x. handwashing for all entrants to the NICU; hygiene protocols; washing and sterilizing of materials expected to be in contact with patients in the NICU: xiii, prevention of Pseudomonas infections; xiv. determination of patients requiring additional post-delivery evaluation and risk assessment by physicians and/or infectious disease consultants in the NICU; xv, determination of patients requiring additional post-delivery evaluation and risk assessment by physicians, including but not limited to neonatology and pediatric infectious disease specialists in the NICU; xvi, determination of patients in the NICU requiring coordination of a treatment plan and management among sub-specialty services for infection; xvii. determination of patients in the NICU requiring coordination of a treatment plan and management among sub-specialty services, including but not limited to neonatology and pediatric infectious diseases; xviii, determination of appropriate patients for infectious diseases consultations; determination of patients requiring transfer for pediatric infectious 30diseases evaluation and/or intervention; xx. _post-delivery risk assessment for infection; and xxi, strict adherence to infection control policies and procedures. 132, Defendant GMC knew or should have known that it did not have adequate written policies or procedures as described above. 133. Defendant GMC knew or should have known that its medical and nursing staffeither ‘were not familiar with or failed to follow the hospital’s written policies and procedures with respect to the matters described above, to the extent that such policies and procedures did exist. 134, Defendant GMC knew or should have known that it failed to provide its physician and nursing staff with adequate and proper training, skill or knowledge with respect to the appropriate, necessary, sufficient and/or timely evaluation, management and formulation of a coordinated plan to prevent infection and/or clusters of infections in its NICU for neonatal patients. 135. Defendant GMC knew or should have known that it failed to provide its physician, nursing staffand ancillary staff with adequate and proper trai ing, skill orknowledge with respect 0 the appropriate, necessary, sufficient and/or timely evaluation, management and formulation of a coordinated plan of care to prevent, contain and/or abate infections of neonatal patients in the NICU. 136. Asaresult of the negligent and reckless acts and omissions of Defendant GMC, Abel Cepeda became infected with Pseudomonas Aeruginosa and then was deprived of necessary, appropriate, sufficient and/or timely evaluation, treatment and management of his condition. 137. The negligent and reckless acts and omissions of Defendant GMC, as described above, increased the risk of harm and were a substantial contributing factor in causing the injuries 31and death of Abel Cepeda. 138. Asa direct and proximate result of the negligence and recklessness of Defendant GMC, Abel Cepeda was exposed to an increased risk of harm and caused to suffer catastrophic injuries leading to his hastened death, as described above. WHEREFORE, Plaintiffs demand judgment in their favor and against Defendants, individually, jointly and severally, and an award of compensatory and punitive damages in an amount in excess of Fifty Thousand Dollars ($50,000.00), and above the prevailing arbitration limits, exclusive of prejudgment interest, post-judgment interest and costs COUNT Il Plaintiffs v. Defendants Geisinger Clinic, Geisinger South Wilkes-Barre Gynecology/Obstetrics, Geisinger Forty Fort - Maternal Fetal Medicine, Geisinger Medical Center and Geisinger Health d/b/a Geisinger Health System 139. The preceding paragraphs are incorporated by reference as if set forth fully herein. 140, The negligence and recklessness of Defendants Geisinger Clinic, Geisinger South Wilkes-Barre, Geisinger Forty Fort-Maternal Fetal Medicine, Geisinger Medical Center and Geisinger Health d/b/a Geisinger Health System conceming the prenatal care and management provided to Zuleyka Rodriguez. and Abel Cepeda in utero consisted of all or some of the following a, failing to conform to the accepted standard of care in the timely and proper evaluation, diagnosis, treatment and management of Zuleyka Rodriguez's prenatal care, as described herein; b. failing to formulate and execute an appropriate plan of care in view of Zuleyka’s obstetrical history, risk factors and clinical presentation; c. failing to perform a proper, complete and thorough clinical exam; failing to timely and properly assess the progress of Zuleyka’s pregnancy: e. failing to timely and properly assess and re-assess fetal well-being throughout Zuleyka’s pregnancy; £. failing to order and perform timely and appropriate antenatal testing; g. failing to order and perform timely and appropriate lab studies; h. failing to timely and properly prescribe and manage Zuleyka’s medications during pregnane} 32poeB aa. bb. failing to timely and properly monitor, manage and treat Zuleyka’s chronic hypertension during pregnancy; failing to timely evaluate and re-evaluate the patient in the setting of chronic, uncontrolled hypertension; failing to timely and properly respond to clinically significant changes in Zuleyka’s condition during pregnancy; failing to be properly suspicious for preeclampsia during Zuleyka’s pregnancy; failing to timely and properly manage Zuleyka’s risk of preeclampsia; failing to timely and properly diagnose and treat Zuleyka’s preeclampsia; failing to manage Zuleyka’s pregnancy with the level of urgency it required; {ailing to timely consult with appropriate specialists, including maternal fetal medicine; failing to timely and properly coordinate care with other members of the prenatal team; failing to timely and properly communicate clinically significant information to other members of the prenatal team; failing to timely respond to clinically significant information provided by other members of the prenatal team; failing to properly document the medical record with clinically significant information relating to the patient’s pregnancy and clinical condition; failing to timely and properly review the medical record; failing to properly supervise and instruct the CRNP and PA staff involved in Zuleyka’s prenatal care; failing to properly advise Zuleyka of the risks of delivering her baby at GMC and having him admitted to the NICU given the increased risk of infection; failing to refer Zuleyka to a hospital other than GMC for further management of her pregnancy, including her expected preterm delivery, and NICU admission for her baby; negligently and recklessly instructing Zuleyka to go GMC, knowing that she was expected to deliver preterm and that her baby would require extended NICU care due to his prematurity; negligently and recklessly accepting Zuleyka for admission to GMC, knowing that she was expected to deliver preterm and that her baby would require extended NICU care due to his prematurity; failing to be familiar with and to follow hospital and/or office policies and procedures relating to matters described herein, which were intended to promote patient safety and protect patients like Zuleyka and Abel Cepeda; and failing to enforce hospital and/or office policies and procedures relating to the ‘matters described herein, which were intended to promote patient safety and 33protect patients like Zuleyka and Abel Cepeda. 141, Atal relevant times, Defendants GC, GSWB, GFF-MFM, GMC and/or GHS engaged PA Schott, Dr. McClennen, Dr. Boozarjomehri, CRNP DeDomenico, Dr. Satti, Dr. Macken, Dr. Adigun, Dr. Neubert and those other medical providers who were responsible for Zuleyka’s and Abel Cepeda’s care, as described herein, as their actual, apparent and ostensible agents, servants and employees to provide medical care and treatment to Zuleyka and her then- unborn baby, Abel Cepeda, while acting within the course and scope of their agency and/or employment with one or more of these Defendants. 142. Defendants GC, GSWB, GFF-MFM, GMC and/or GHS are derivatively liable for the negligent and reckless acts and omissions of PA Schott, Dr. McClennen, Dr. Boozarjomehri, CRNP DeDomenico, Dr. Satti, Dr. Mackeen, Dr. Adigun, Dr. Neubert and those other individuals under principles of respondeat superior, master-servant, vicarious liability, agency and/or right of control. 143. Defendants, individually and by and through their agents, servants and employees, acted and failed to act in conscious disregard of, and with a deliberate, reckless indifference to, the continued health, safety and well-being of Zuleyka and Abel Cepeda as described throughout this Complaint. 144, Atall relevant times, Defendants were aware of the negligent and reckless acts and omissions of their agents, servants and employees and allowed that conduct to occur, despite the risk of catastrophic and fatal injuries to its neonatal patients, including Abel Cepeda. 145. The negligence and recklessness of Defendants, acting by and through their agents, servants and employees, increased the risk of harm to Abel Cepeda and were substantial factors in causing his catastrophic injuries and hastened death, as described herein. 34WHEREFORE, Plaintiffs demand judgment in their favor and against Defendants, individually, jointly and -verally, and an award of compensatory and punitive damages in an amount in excess of Fifty Thousand Dollars ($50,000.00), and above the prevailing arbitration limits, exclusive of prejudgment interest, post-judgment interest and costs. COUNT IV Plaintiffs v. Defendants Geisinger Medical Center and Geisinger Health d/b/a Geisinger Health System 146. The preceding paragraphs are incorporated by reference as if set forth fully herein. 147. Atal times relevant hereto, the Plaintiff-parents and Abel Cepeda were invitees lawfully present at GMC and, in particular, its NICU. 148. Atal times relevant hereto, the Defendants, despite having actual or constructive knowledge of a dangerous and hazardous condition existing within GMC’s NICU that they owned, managed, maintained and/or controlled, failed to take any action to remedy or mitigate the dangerous and hazardous condition, thereby causing Abel’s injuries and death, 149. At all relevant times hereto, the defective, unreasonably dangerous and hazardous condition of GMC’ s NICU had been present and existed for months prior to Abel’s illness and death; moreover, this condition was known and/or should have been known to the Defendants, who failed to wam or notify Plaintiffs of such dangerous and unsafe conditions. 150. Defendants” actions and inactions despite actual and/or constructive knowledge of the dangerous condition of GMC’s NICU were wanton, deliberate, willful and done with a reckless indifference and disregard to the interest, safety and well-being of Plaintiffs and other invitees. 35151, Plaintifis specifically allege that some or all of the Defendants herein had actual and/or constructive knowledge and/or notice that GMC’s NICU was defective and that it posed serious and extreme risks of harm to the health and safety of Abel and other invitees, and failed to act to correct that condition, thus rendering Defendants liable for damages to the Plaintifis 152. The dangerous condition of the property was foreseeable to those Defendants herein who had legal responsibility for GMC’s NICU, and the parcel or parcels of land involved, and, accordingly, said Defendants, jointly and severally, bear legal responsibility for the consequential harm to the Plaintiffs, which includes physical and non-physical injuries as well as all economic and non-economic damages recoverable under Pennsylvania law. 153, Atal times relevant and material to this action, Defendants acted by and through their duly authorized agents, servants and employees, who themselves were acting within the course and scope of their employment and/or agency with one or more of the Defendants. 154, Plaintiffs’ injuries resulted solely from the negligence and recklessness of Defendants and their agents, servants and employees, and were due in no manner whatsoever to any act or failure to act on the part of the Plaintiffs. 155. The Defendants herein, jointly and severally, due to their ownership and/or possession and/or control of the relevant parcel or parcels of land/property on which the GMC NICU exists, had legal responsibility to correct known defects and/or dangerous conditions that were pertinent to all invitees’ ability to safely use and/or enjoy the GMC NICU, which conditions were foreseeable. 156. Abel Cepeda’s injuries and death, and the damages arising therefrom, were caused solely by the negligence, carelessness and recklessness of Defendants, jointly and severally, acting 36by and through their separate and respective agents, servants and employees in each of the following respects permitting and allowing premature infants like Abel Cepeda to be exposed to the GMC NICU which Defendants knew to be contaminated with an extremely dangerous and deadly Pseudomonas bacteria; allowing and permitting the dangerous and/or defective condition of the NICU to exist and persist throughout the relevant time period; allowing and permitting the NICU to exist and persist in a state of a clear hazard to the public; creating a defect or unreasonably dangerous condition in the NICU; creating a dangerous and/or defective condition and/or conditions in the NICU; failing to maintain the NICU in a safe and proper condition free of deadly infectious diseases; failing to maintain the NICU and allowing the dangerous and/or defective condition and/or conditions of the same to exist and persist; failing to warn and/or notify Plaintiffs of the existence of the dangerous and/or defective condition and/or conditions of the NICU; failing to regularly and adequately inspect the NICU so as to insure it was in a proper and safe condition; failing to regularly and adequately clean the NICU so as to insure it was ina proper and safe condition; failing to warn and/or notify Plaintiffs of the degree of dangerousness of the NICU; failing to remedy or mitigate the dangerous and/or defective condition and/or conditions of the NICU; failing to remedy or mitigate the hazards of the NICU; failing to properly supervise, maintain and/or control the NICU; failing to implement necessary safety precautions under the circumstances and abate the hazards posed by the deadly Pseudomonas cluster/outbreak in the NICU; failing to follow and/or enforce necessary safety precautions under the circumstances; failing to discover or take proper steps and/or measures to discover the existence of a dangerous and/or hazardous condition under the circumstances; concealing the existence of the dangerous and/or defective condition and/or conditions of the NICU from Plaintifis and other invitees; consciously and recklessly concealing the degree of dangerousness of the NICU from the Plaintifis and other invitees; and 37t. __ failing to exercise that degree of care required of them to Plaintiff, lawfully on the premises. 157. Asa direct and proximate result of the negligence and recklessness of Defendants, jointly and severally, Abel Cepeda was infected with Pseudomonas, leading to his catastrophic injuries and a hastened death, as described herein. WHEREFORE, Plaintiffs demand judgment in their favor and against Defendants, individually, jointly and severally, and an award of compensatory and punitive damages in an amountin excess of Fifty Thousand Dollars ($50,000.00), and above the prevailing arbitration limits, exclusive of prejudgment interest, post-judgment interest and costs, COUNT V. Plaintiffs v. Al! Defendants 158. The preceding paragraphs are incorporated by reference as if set forth fully herein. 159. Plaintiff-parents, Luis David Cepeda and Zuleyka Rodriguez, were present and witnessed and experienced first-hand the negligence and recklessness of Defendants as described herein, 160. Plaintiff-parents, Luis David Cepeda and Zuleyka Rodriguez, also were present and witnessed first-hand their son’s clinical deterioration leading to his hastened death, which were the direct result of the negligence and recklessness of all Defendants, as described herein. 161. Asaresult ofthe negligence and recklessness ofall Defendants, jointly and severally, and actually observing the resultant injuries suffered by their son, Abel Cepeda, the plaintifi-mother, Zuleyka Rodriguez, and the plaintifi-father, Luis David Cepeda, have suffered mental anguish and severe emotional distress directly related to their observations of their son’s pain, suffering and demise under the doctrine of Sinn v. Burd, 404 A.2d 672 (Pa. 1979) and Love v. Cramer, 606 A.24 381175 (Pa. Super. 1992). 162. Plaintiffs Luis David Cepeda and Zuleyka Rodriguez were present for and contemporaneously witnessed the negligent and reckless acts and omissions of Defendants, as described herein, that resulted in the catastrophic injuries and death of their son, Abel Cepeda, as described herein, and witnessed their son's physical injuries, ongoing treatment and subsequent death. 163. As arresult of Defendants’ negligence and recklessness, the Plaintiffs Luis David Cepeda and Zuleyka Rodriguez have in the past experienced, continue to experience, and will in the future continue to experience, numerous physical manifestations of their severe emotional distress including but not limited to nightmares, stomach upset, headaches, sleeplessness, impaired concentration, anxiety and depression. WHEREFORE, Plaintiffs demand judgment in their favor and against all Defendants, individually, jointly and severally, and an award of compensatory and punitive damages in an amount in excess of Fifty Thousand Dollars ($50,000.00), and above the prevailing arbitration limits, exclusive of prejudgment interest, post-judgment interest and costs. FIRST CAUSE OF ACTION - WRONGFUL DEATH ACT Plaintiffs v. All Defendants 164, The preceding paragraphs are incorporated by reference as if set forth fully herein. 165, Plaintiffs Luis David Cepeda and Zuleyka Rodriguez, as Co-Administrators of the Estate of Abel Cepeda, deceased, bring this Wrongful Death Action on behalf of the Estate, under and by virtue of the Wrongful Death Act, 42 Pa.C.S.A. §8301, the applicable Rules of Civil Procedure and decisional law interpreting this Act. 39166. Under the Wrongful Death Act, Abel Cepeda, deceased, left surviving him ashis sole heirs-at-law his mother and father, the Plaintiff-parents, Luis David Cepeda and Zuleyka Rodriguez. 167. Asa result of the negligent and reckless acts and omissions of the Defendants, as described herein, Plaintiffs’ decedent, Abel Cepeda, suffered catastrophic, permanent and fatal injuries and death resulting in the entitlement to damages by his parents under the Wrongfial Death Act, 168. Plaintiffs Luis David Cepeda and Zuleyka Rodriguez, as Co-Administrators of the Estate of Abel Cepeda, deceased, claim the full measure of damages recoverable under and by virtue of the Wrongful Death Act and the decisional law interpreting the Act. 169, Plaintiffs Luis David Cepeda and Zuleyka Rodriguez, as Co-Administrators of the Estate of Abel Cepeda, deceased, claim damages for the pecuniary losses suffered by reason of the death of Abel Cepeda, including, but not limited to, damages for all medical expenses, funeral and burial expenses, and the costs of estate administration necessitated by reason of the injuries which caused their son’s death. 170, Plaintiffs Luis David Cepeda and Zuleyka Rodriguez, as Co-Administrators of the Estate of Abel Cepeda, deceased, claim damages for the loss of earnings, maintenance, support, comfort, care, society and/or other losses recognized under the Wrongful Death Act, which they would have received from their son had he not died. 171. Plaintiffs Luis David Cepeda and Zuleyka Rodriguez, as Co-Administrators of the Estate of Abel Cepeda, deceased, claim damages for the monetary support that the decedent would have been expected to provide to the Wrongful Death beneficiaries during his lifetime had he not died, 40172, Plaintiffs Luis David Cepeda and Zuleyka Rodriguez, as Co-Administrators of the Estate of Abel Cepeda, deceased, claim the loss of the pecuniary value of the services which the decedent could have been expected to provide to the Wrongful Death beneficiaries during his lifetime had his death not occurred. This is not a claim for filial consortium. WHEREFORE, Plaintiffs demand judgment in their favor and against all Defendants, individually, jointly and severally, and an award of compensatory and punitive damages in an amount in excess of Fifty Thousand Dollars ($50,000.00), and above the prevailing arbitration limits, exclusive of prejudgment interest, post-judgment interest and costs, SECOND CAUSE OF ACTION - SURVIVAL ACT Plaintiffs v. AN Defendants 173. The preceding paragraphs are incorporated by reference as if set forth fully herein, 174, Plaintiffs Luis David Cepeda and Zuleyka Rodriguez, as Co-Administrators of the Estate of Abel Cepeda, deceased, bring this Survival Action on behalf of the Estate, under and by virtue of the Survival Act, 42 Pa.C.S.A. §8302, the applicable Rules of Civil Procedure and decisional law interpreting this Act. 175. Asa result of the negligent and reckless acts and omissions of the Defendants, as described herein, Plaintiffs’ decedent, Abel Cepeda, suffered catastrophic, permanent and fatal injuries and death resulting in the entitlement to damages by the Estate of Abel Cepeda, deceased, under the Survival Act. 176. Plaintiffs Luis David Cepeda and Zuleyka Rodriguez, as Co-Administrators of the Estate of Abel Cepeda, deceased, seek to recover the full measure of damages recoverable under and by virtue of the Survival Act and the decisional law interpreting the Act, 41177. On behalf of the decedent’s Estate, the Plaintiff-parents claim damages for all economic losses to the decedent's Estate, including, but not limited to, the decedent’s total estimated future earning capacity, less his personal maintenance costs 178. On behalf of the decedent's Estate, Plaintiffs claim damages for the decedent’s physical discomfort, pain and suffering, loss of enjoyment of life and life’s pleasures, and all other damages and losses recoverable under the Survival Act and the decisional law interpreting the Act. WHEREFORE, Plaintiffs demand judgment in their favor and against all Defendants, individually, jointly and severally, and an award of compensatory and punitive damages in an amount in excess of Fifty Thousand Dollars ($50,000.00), and above the prevailing arbitration limits, exclusive of prejudgment interest, post-judgment interest and costs, Respectfully submitted, ROSS FELLER CASEY, LLP Vy ete BY: MATTHEW A. CASEY, ESQUIRE JENNIFER L. RUSSELL, ESQUIRE RYAN P. CHASE, ESQUIRE DANIEL R. MCGRATH, ESQUIRE Attorneys for Plaintiffs Dated: October 17, 2019 42“ EXHIBIT A”VERIFICATION Plaintiffs, Luis David Cepeda and Zuleyka Rodriguez, hereby verify that the within Ci ‘Action Complaint is based on first-hand information and on information furnished to their counsel and obtained by counsel in the course of this lawsuit. The language of the document is that of counsel and not of the affiants. To the extent that the contents of the document are based on information furnished to counsel and obtained by counsel during the course of this lawsuit, the affiants have relied upon counsel in taking this verification. All statements are founded upon ies of 18 Pa.C.S.§4904 relating to reasonable belief. This verification is made subject to the pens unswom falsification to authorities. Rodriguez,CERTIFICATE OF COMPLIANCE I, hereby certify that this filing complies with the provisions of the Public Access Policy of the Unified Judicial System of Pennsylvania: Case records of the Appellate and Trial Courts that require filing confidential information and documents differently than non-confidential information and documents. ROSS FELLER CASEY, LLP BY: /s/ Matthew A. Casey MATTHEW A. CASEY, ESQUIRE Attorney for Plaintiffs