Claim by Eugene SandTHE CITY OF
DUB U E MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
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To: Mayor Roy D. Buol and
Members of the City Council
DATE: March 11, 2011
RE:
Claimant Date of Claim
Eugene Sand 03/10/11
Claim Against the City of Dubuque by Eugene Sand
This is a claim in which claimant alleges that he
Central Avenue, fracturing his left arm.
This claim has been referred to Public Entity Risk
Communities Assurance Pool.
Date of Loss
cc: Michael C. Van Milligen, City Manager
John Klostermann, Street & Sewer Maintenance Supervisor
Eugene Sand
Nature of Claim
01/22/11 Personal Injury
slipped and fell on an icy curb at 1516
Services of Iowa, the agent for the Iowa
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001 -6944
TELEPHONE (563) 583 -4113 / FAx (563) 583 -1040 / EMAIL tsteckle @cityofdubuque.org
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
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This written report constitutes your claim against the City of Dubuque, Iowa. You should
complete this form in full and attach any additional information that supports your claim.
The claim must be filed with the City Clerk at City Hall, 50 West 13th St., Dubuque, IA
52001. It will then be referred to the appropriate department for investigation and to the City
Attorney's Office. Once that investigation is completed, a report and recommendation will be
submitted to the City Council. You will be provided with a copy of that report and
recommendation.
The final decision on all claims is made by the City Council. No employee of the City of
Dubuque has the authority to make any representation to you as to whether your claim will or
will not be paid.
1. Name of Claimant:
Eugene K. Sand
2. Address:
2460 Pennsylvania Avenue, Dubuque, Iowa 52001
3. Telephone Number:
563 -583 -7583
4. Date of Incident:
January 22, 2010
5. Time of Incident:
10:30 A.M.
6. Location of Incident (Be specific):
In front of 1516 Central Avenue, Dubuque, Iowa 52001.
7. Describe the accident or occurrence that caused injury or damage. (Give full details upon
which you base your claim. If a City employee was involved, give the employee's name.)
See attached Description.
8. What were weather conditions like?
It had rained the night before and the deteriorated adjacent curbing was ice covered.
See attached photo taken 1 -23 -10 for deteriorated condition of curbing.
9. Give name and address of any witnesses:
None known.
10. Did police investigate? (If so, give names of officers.)
No.
11. Was anyone injured? (If so, give names, addresses, and extent of injuries.)
Yes, Eugene K. Sand.
12. Was any damage done to property? (If so, describe property and the extent of damages.
Attach estimates of damages or describe basis for ascertaining extent of damage.)
No.
13. What other damages do you claim, if any?
See attached Description.
14. Have you been compensated for any part or all of your claim by any insurance company?
(If so, give name and address of insurance company and amount paid.)
Yes, Medicare and Medical Associates HMO paid all of my medical bills.
15. What amount do you claim from the City of Dubuque?
See attached Description.
16. Why do you claim the City of Dubuque is responsible?
Failure to maintain curbing, which has broken and deteriorated; failure to keep curbing
free from accumulations of ice and snow; failure to close off curbing until it was repaired or
replaced and safe for pedestrians.
17. Have you made any claim against anyone else for damages as a result of this incident? (If
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yes, give name and address.)
No.
18. If the answer to Question 17 is yes, have you received any payment from that source, and if
so, in what amount?
N/A
Dated this 7th day of March, 2011
FUERSTE, CAREW,
JUERGENS & SUDMEIER, P.C.
By:
Stephen J. Juei t., AT0004125
200 Security Building
151 West 8th Street
Dubuque, Iowa 52001
Phone: (563) 556 -4011
Fax: (563) 556 -7134
Email: sjuergensafuerstelaw.com
ATTORNEYS FOR EUGENE K. SAND
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DESCRIPTION
I exited my barber shop at 1516 Central Avenue to cross the street to visit Bill
Winders at Dubuque Labor Leader at 1527 Central Avenue. As I stepped off the curb,
I slipped on the ice on the curb and my left heel caught in the deteriorated curbing.
See attached photo of curbing. I fell to my left and landed on my left side in the
street. I broke my left humerus. A gentleman who did not identify himself helped me
get up. I drove myself to Finley Hospital and was examined by Dr. Theodore Gifford
and x -rays were taken. I was told I had a closed fracture of my left humerus. My left
arm was placed in a sling and I was discharged to see an orthopedic surgeon.
I saw Dr. Judson Ott at Medical Associates the following Monday, January 25,
2010. Dr. Ott x -rayed my arm and gave me a different sling and a prescription for
Lortab/Hydrocodone, which I filled at Hy -Vee, 2395 N.W. Arterial, Dubuque, Iowa
52002. I refilled it once more later at Hy -Vee. I wore the sling for approximately
eight (8) weeks. Dr. Ott sent me to physical therapy at Mercy Medical Center twice
per week for approximately six (6) weeks.
I had several return visits to Dr. Ott. Dr. Ott kept me off work for
approximately three (3) months.
My barber shop sales receipts for the first calendar quarter of 2010 were
$897.34, and $2,593.00 for the second quarter of 2010. Based on my sales receipts
for the first quarter of 2009 ($5,135) and my receipts for the second quarter of 2009
($5,036), I believe I lost $6,680.66 in income as a result of my injury.
I have incurred the following medical bills, all of which were paid by
Medicare:
Finley Hospital
Med. Assoc.
Mercy Hospital
Billed
$325.00
$1,332.00
$4,234.00
Medicare Medical
Approved (Paid) Associates HMO
(Paid)
$53.20 $68.61
$468.60 $0.00
$1,072.80 $265.58
My left bicep has atrophied. I have weakness in my upper left arm. If I sleep
on it, it causes me pain and wakes me up at night.
During the first three (3) months I had no use of my left arm. I could not:
- Work
- Drive
-Tub bath or shower
-Ride stationary bike
A friend, Maggie Becker, was my care giver. Otherwise, I would have had to go to a
local nursing home for rehab and care.
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