Claim Schmitz, LynnIN THE IOWA DISTRICT COURT FOR DUBUQUE .COUNTY
Plaintiffls) Name:
Address:
LYl~%~ SCPL~_~ITZ
1595 Curtis Street )
Dubuque, IA 52003 )
DOB** )
Case No.
EIN/PIN*
Pialnt~ff(?l~Nam~%
Address:
EIN/PIN*
Defendant(s) Name:
Address:
DOB**
vso
CITY OF DUBUQUE
c/o CITY HALL
50 W. i3th Street, Dubuque, IA 52001
EIN/PIN*
Defendant(s) Name:
Address:
DOB**
EIN/PIN* DOB**
SMALL CLAIMS
ORIGINAL NOTICE
(Action for Money Judgment)
If you require the
assistance of auxiliary
ai~s or services to
p~rticipate in ~ourt
because of a disability,
immediately call your
distric= ADA coordinator
at (563]589-4448. (If
you are hearing impaired
call Relay ~owa TTY at
1-800-735-2942.
TO THE ABOVE NAMED DEFENDANT(S),
YOU ARE HEREBy NOTIFIED that the Plaintiff(~ demand(s) from you the amount of
$ 5.000.00 based on ia%juries I sustained when i tripped on s defeotive
public sidewalk on August ~,~0~59~%~idewalk was on the south si~e of
Asbury P~)ad, near 1905 and 1909 Asbury.
UNLESS YOU APpE~%Rby cgmple~kng and filing the attache, ~
the Clerk of th~ District Co ~ .~ AND ANSWER FOP~M w~th
Iowa 52001-706~, ~i%hin o0 ~..~t_,_~?_q~_e C~unty~Co~rthouse, 7~0 Central Avenue, Dubuque,
~ ~= ~zu~r servlce, oz this ORIGINAL NOTICE upon you, judgment
shall be rendered against you upon Plaintiff s claim together with interest and c~sts.
IF YOU DENY T~ ~LAIMANDAPpFa%R by filing the attached APPEAI~NCEANDANSWER FORM within
20 days after service of this original notice upon you, you will then receive
notification from the Clerk of District Court's office of the place and time for hearing.
Reynolds & Kenline, PoO. Box 239, Dubuque, IA
IN THE IOWA DISTRICT COURT FOR DUBUQUE COUNTY
Plaintiff(s) Name:
EIN/PIN*
SM~'r!'r · CI.~IMS
APPEARANCE AND ANSWER
Plaintiff(s) Name:
EIN/PIN*
vs.
Defendant(s) Name: "" )
Address: )
)
EIN/PIN* DOB** )
OF DEFENDANT
Case ,,o. Olin SCSCO
Defendant(s) Name: )
Address: )
)
EIN/PIN* DOB** )
I HEREBY ENteR MY APPEARANCE and DEN~ / Al)HIT the claim of the Plaintiff(s).
Signature(s) of Defendant(s) or Defendant's(s') Attorney
Attorney's Addres~
The Court's address is:
Clerk of District Court
Small Claims Division
Dubuque County Courthouse
720 Central Avenue
Dubuque, Iowa 52001-7063
* EIN = tiAIPLOYt~ IDENTIFICATION NUMBER (To be furnished, on Ibis APPEARANCE AND ANSWER FO~. by paffi~ who ~ bus~sses
or other enlities.)
Corporation Cotmsel
Suite 330, Harbor View Place
300 Main Street
Dubuque, Iowa 52001-6944
(563) 58~4113 office
(563) 583-1040 fax
balesq~mwci.net
March 3, 2003
Chadwyn D. Cox
REYNOLDS & KENLINE, LLP.
Suite 222 Fischer Building
PO Box 239
Dubuque, IA 52004-0239
RE:
Injury Claim of Lynn Schmitz
Date of Loss: August 27, 2002
Location: Public Sidewalk at 1905-1909 Asbury Road
Dear Mr. Cox:
If you wish to file a claim against the City of Dubuque on behalf of Lynn Schmitz, we
would request that you fill out the enclosed claim form and mail it to the City Clerk's Office
at the following address:
Ms. Jeanne Schneider, City Clerk
City Hall - City Clerk's Office
50 West 13th Street
Dubuque, IA 52001
Once the claim has been stamped in by the City Clerk, it will be forwarded to the Legal
Department for investigation. Enclosed is an addressed envelope for your convenience.
Also for your information, you can obtain a City of Dubuque claim form by visiting the City
Of Dubuque's website @ www city. ofdubuqueor9 and sign ng onto Legal Services.
Very sincerely,
Tracey Stecklein
Legal Department
Enclosure
cc: Jeanne Schneider, City Clerk
LAW OFFICES OF
REYNOLDS & KENLINE, L.L.P.
DAVID L. CLEMENS
WILLIAM ,1. MAIl?RS
CHADWYN D. COX*
MARK J. SULLIVAN
JEFFREY L. WALTERS
JENNIFER A. CLEMENS-CONrLON
JOHN T. NEIVLMERS
TODD N. KLAPATAUSKAS**
KlM C. RODDICK**
Of Counsel
LEO A, McCARTHY
SUITE 222 FISCHER BUILDING
P.O. BOX 239
DUBUQUE, IOWA 52004-0239
TELEPHONE: (563) 556-8000
FAX: (563) 556-8009
E-Mail:rkenline@mwci.net
*ALSO LICENSED IN MINNESOTA
**ALSO LICENSED IN ILLINOIS
Februaw 25,2003
Ms. Jeannie G. Schneider
City Clerk
City Hall
50 West 13th Street
Dubuque, IA 52001
RE:
Injury Claim of Lynn Schmitz
Date of Loss: August 27, 2002
Location: Public Sidewalk at 1905-1909 Asbury
Dear Ms. Schneider:
We represent Ms. Schmitz who lives at 1595 Curtis Street, Dubuque, Iowa
52003. Ms. Schmitz was injured when her foot was caught by a defective sidewalk. My
purpose in writing is to set forth the details of her claim to determine whether we might
be able to resolve this without need for litigation. It is my intention to provide all
pertinent details of Ms. Schmitz' claim, together with supporting documentation. Ifthere
is more information that you desire, please let me know and I will see if I can provide it.
Thank you.
CDC/clm
Enclosures
cc: Lynn Schmitz
Very truly yours,
S:\WP\CHARLENE~LE~-ERS\022503-cdc.wpd
INJURY CLAIM OF LYNN SCHMITZ
I. BACKGROUND.
Lynn A. Schmitz, age 47, resides at 1595 Curtis, Dubuque, Iowa, w/th her husband Steve.
She is employed full-time at Stone Hill Care Center. At the time of her injury on August 27,
2002, she had no pre-existing medical problems with her right arm.
II. FACTS RE INCIDENT.
As a regular walker, it was common for Lynn to spend leisure time walking in the City.
On this particular evenh~g Lynn was walking with her friend, Paula Lange. At approximately
5:30 p.m. the two of them were walking in an easterly direction on the south side of Asbury Road
in front of the houses marked 1905 and 1909 Asbury. The weather was clear and dry. Lyrm was
wearing tennis shoes and wasn't carrying anything. As she walked along her right foot suddenly
caught on the protruding edge of an elevated sidewalk section. This sidewalk section was part of
the public sidewalk running along the south side of Asbury Road (near Rosedale). A photo
showing the portion she tripped on is supplied herewith. When her foot caught Lynn stumbled
forward and fell on the sidewalk mostly on her right arm. She skinner her right knee, and her
right arm hurt immediately. She went home and put ice on it. She attempted to work the next
day, but when the pain in her arm continued to worsen, she went to Finley Hospital.
III. INJURIES AND TREATMENT
At Finley she was x-rayed, splinted, and referred to an orthopaedist. See Finley records
supplied. In follow-up care at Westside Orthopaedics she was diagnosed with two right elbow
fractures, splinted, and given a work release. See Westside Orthopedic records supplied. At a
follow-up appointment on September 9, 2002 she was instructed to start weaning herself from
the splint, and released from work for two (2) more weeks. At a follow-up visit on September
23, 2002 she was allowed to return to work with a 10 pound lifting restriction on her right arm.
At a follow-up appointment on October 8, 2002 her work restriction was lifted.
IV. DAMAGES
A. Medical (see bills supplied)
Total
Westside Orthopaedics ...................... $ 473.10
Finley Hospital ............................ $ 300.00
Radiology ................................ $ 29.00
$ 802.00
B. Lost earnings (see documentation supplied)
19 days ~ 8 hours ~ $9.34 an hour ......... $1,420.00
C. Injury, Pain and Suffering ....................... $ 4,000.00
TOTAL
$ 6,222.00
PHOTOGRAPH
FINI FY
HOSPITAL
RECORDS
WESTSID
ORTHOPAEDICS
RECORDS
MEDICAL
BILLS
WAG LOSS
DOCUMENTATION
ASSISIVILLAGE
ADULT CENTER
CARECENTER
3485 Windsor Avenue
Dubuque, Iowa
52001-1312
(563) 557-7180
Fax: (563) 584-9282
November 19, 2002
Chadwyn D. Cox
Reynolds & Kenline, L.L.P.
Suite 222 Fischer Building
P.O. Box 239
Dubuque, Iowa 52004-0239
Re: Lynn Schmitz
Lynn Schmitz missed the following dates of employment due to the injury to her arm:
August 28, 29, and 31
September 1, 2, 3, 4, 5, 9, 10, 11, 12, 14, 15, 16, 17, 18, 19, and 23.
The above dates of work were scheduled to be 8-hour shifts at an hourly rate of $9.34.
If you have any further questions, feel free to contact me at (563) 557-0849 ext. 133.
SLncerely, ,.
Cris Kirsch
Human Resources Director
Stonehill Franciscan Services celebrates daily the dignity of older adults.