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NINA M. PATANE, Esq. (SBN 157079)
ANDREA C., AVILA, Esq. (SBN 193982)
PATANE *GUMBERG, LLP
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Attorneys atLaw , FI LE D
4 Rossi Circle, Suite 231 ALAMEDA COUNTY
WY
Salinas, California 93907
Telephone: (831) 755-1461 FEB 25 2008
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Facsimile: (831) 755-1477 THES +
CLE FG SURERIQ RS
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Attorneys for Defendant By. as ,
CAIRE MEDICAL SYSTEMS, INC. Deputy
Dn
HN
SUPERIOR COURT OF THE STATE OF CALIFORNIA
Aa
IN AND FOR THE COUNTY OF ALAMEDA
o
UNLIMITED JURISDICTION
11
12 PUBLIC SERVICES MUTUAL ) CASE NO. 149743
INSURANCE COMPANY, )
13 7 ) DECLARATION OF ANDREA C.
Plaintiff, ) AVILA IN SUPPORT OF
14 y DEFENDANT’S MOTION FOR
. ) SUMMARY JUDGMENT OR,
15 APRIA HEALTHCARE, INC., CAIRE ) ALTERNATIVELY, SUMMARY
16 MEDICAL SYSTEMS, INC., DOES 1-15, ) ADJUDICATION
)
17 Defendants. ) Date: May 13, 2008
) Time: 9:00 a.m.
18 ) Dept.::301
) ,
19 a ; Reservation # R 793356
20 )
Trial Date: June 16, 2008
21
)
22
23 I,ANDREA C. AVILA declare as follows:
24 1. I am an attorney licensed to practice before all the courts of the State of California,
25 and a partner with the law firm of Patane - Gumberg, LLP, attorneys of record for defendant CAIRE
26 MEDICAL SYSTEMS, INC. in this action.
27 2. [make this declaration in support of Defendant’s Motion for Summary Judgment, or
28 alternatively, Summary Adjudication. .
-J-
Declaration of Andrea C. Avila inSupport of Defendant’s Motion for Summary Judgment or,Alternative, Summary
Adjudication
| ®
3, on hereto as Exhibit A is a true and correct copy of Alameda Fire
e
DY Department EMS Pre-Hospital Care Report, dated February 11, 2005.
4. Attached hereto as Exhibit B is a true and correct copy of Alameda Fire
WO
Department Fire Incident Report, dated February 11, 2005.
Ee
5. Attached hereto as Exhibit C is a true and correct certified copy of relevant portions
eH
of the Deposition of Michael Chong, dated November 28, 2007.
ND
6. Attached hereto as Exhibit D is a true and correct copy of Supplemental Response
SI
to Form Interrogatories, Set No. One, from Answering Party, Plaintiff, PUBLIC SERVICE
CO
MUTUAL INSURANCE COMPANY, to Asking Party, Defendant, APRIA HEALTHCARE,
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INC. |
CO
ele
7. Attached hereto as Exhibit E is a true and correct copy of a Letter from PUBLIC
KF
Sl
PO
SERVICE MUTUAL INSURANCE COMPANY, to Michael Chong, dated March 9, 2005.
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WH
8. Attached hereto as Exhibit F is a true and correct copy of Answers to Special _
FEF
FP
Interrogatories, Set No. One, from Answering Party, Plaintiff, PUBLIC SERVICE MUTUAL
SF
a
INSURANCE COMPANY ,to Asking Party, Defendant, APRIA HEALTHCARE, INC.
Nn
FS
9. Attached hereto as Exhibit G is a true and correct copy of Fire Cause Analysis
KF
A
Evidence Chain of Possession Form.
DBD
KF
10. Attached hereto as Exhibit H is a true and correct copy of Apria Healthcare Inc.’s
Oo
KF
Phone Record, dated February 20, 2007.
OD
NY
11. Attached hereto as Exhibit I is a true and correct copy of the Declaration of
KF
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Plaintiffs, PUBLIC SERVICE MUTUAL INSURANCE COMPANY’s, form complaint, filed
PO
PVP
August 31, 2006 |
WHO
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12. Attached hereto as Exhibit J is a true and correct copy of the Declaration of Nina
Ph
NY
M. Patane in support of Defendant’s Motion for Summary Judgment or Alternatively, Summary
WU
YH
Adjudication.
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13. Attached hereto as Exhibit K is a true and correct copy of Supplemental Answers to
NY
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Special Interrogatories, Set No. One, from Answering Party, Plaintiff, PUBLIC SERVICE
oo
no
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Declaration of Andrea C. Avila inSupport of Defendant’s Motion for Summary Judgment or,Alternative, Summary
Adjudication
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MUTUAL INSURANCE COMPANY, to Asking Party, Defendant, APRIA HEALTHCARE,
bot
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INC.
_ I declare under penalty of perjury under the laws of the State of California that the
WD
foregoing is true and correct to the best of my knowledge.
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Dated: February21, 2008 PATANE* cumBa /LLP
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Declaration of Andrea C. Avila in Support of Defendant’s Motion for Summary Judgment or,Alternative, Summary
Adjudication
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7005-08818
Med Rec#:
2791 1 Toomay Technologies Inc
-Call Daté:02/14/2005 EMS PREHOSPITAL CARE REPORT Agency:Cityof Alameda
CALL INFORMATION:
Dispatch: 2005-0008818 MEDICAL Reason Aid Requested:RespiratoryDistress
Unit 2794 Level:Minor | (4 Medical (1 Trauma [_]Critical
Trauma
PatientNo: 1 of 1 CallType: Scene (_]DryRun (J Cardiac [_] AMA
ChiefComplaint SOB -
Type ofPatient: Shortness ofBreath First
Care GivenBy: ALAMEDA FIRE DEPARTMENT
i PATIENT INFORMATION TIME
Name (LFM): Cood, Ivan Sex: M Received: 8:53 Initial
Patient
Contact:8:58
Address: 2257 Pacific
Ave E Weight Kg:88 UnitDispatched: 8:53 TransportUnitLeft
Scene: 9:04
City,
State,Zip: Alameda, CA 94501 Age: 73Years Enroute: 8:55 JU Anived Destination:
9:09
Phone: 510-769-7001 DOB: 03/01/1931 ArtivedatScene: 8:57 dstHospital
Report: 9:41
Soc Sec No: 517-26-2581 Time ofBirth:
00:00 TransportUnitArsival:
8:57 Available:9:30
SCENE INFORMATION INITIAL PHYSICAL EXAM
Incident
meaelekeral 2257 Pacific
Ave E, Alameda 94501 SkinColor __ SkinTemp SkinMoisture Cap Refill
Dispos ; vibe ONIN ik y: si) /i\ PeNomar| Toycwam f= eA 2 | <2 Seconds
SpecialScene cong eae [P | [RIS D L- Pupils:Size- R PERL L- Pupils:
Reactivity-R :
CallSource:
Communications: ALCO 800 Mhz Radio Eye Opening VerbalResponse MotorResponse
Map Zone Type: Metropolitan(>500/ inish}(0)(0) [2 /s\[R2 ~ : : —
Destination
Decision: Patient/Family
soon Spontaneous Oriented Obeys Verbal
PoliceAgency: None GCS# 15
NotTransported:C1 PROVIDER INFORMATION BodySystemWNL ABN NC |Comment
Déstination:Alameda'Hospita” SUVA lFicadiesce?Ow O singed hair a
ae
TransportPre Ge
NotRopo
as AFD j
Nek
h Flan
@ ee
0. OL yen y i [\
:
Transport Unit:ah bdqmen \\ / \\
Transport Mode: sanewy ce a @O redness toback /-=\
CallDispdsltion: \ttansper uniktg ED elvis HO-O \l UO UL \Wee
TransportCode To Scene: To Hopital Extremities@ O O
PrimaryMedic ‘etomparied Patient in
Ambulances. a
Lungs ; 7 Clear& Equal,Good Tidal
Volume: O
Lk R_ Direction oe Location — a Sound — TidalVolume =” Gomment Oo
WIL] Expiratory Upper hee yy 1D Diente
OM Expiratory Upper pt minished
Agency Specific NPP Form Provided?:Split nee? Yes |
Mechanism ofInjury: Ve SafetyEquipUsed:
TriageComment: , + Trauma Score: 15 CRAMS Score:
_ Trauma Tuage !
_ General
Assessment _| Main:RESPIRATORY/SOB Sub: Bronchospasm -COPD -Comment:
. exacerbation
Treatment
Priorto Arrival
| None Comment:
Current Medication 02
~ CurrentAllergy
MedicalHistory | | Asthma/Emphysema Comment:
, PatientNarrative
73 yiomale c/oSOB forthelast10min. ft cameonwhen hisapartmentcaughton fire.
Ptstatedthathe tured hiswallheateroffandthen turnedif back
on, it started
afire.Ptstatedhe was Inside
theroom for3-4 minwiththesmoke, and Isnow havingtroublebreathing.No CP,no sputum,5-6 word
sentences,decreased exercisetolerance.
Pthas some wheezes bilaterally.
Ptgiven02 viaNRB, and startedtofeelbetter.Ptwas thengivena
breathingtreatmentand hisbreathing
startedtoease up. Pt's
hairwas singed,andhe had some redness totheback. No othertraumanoted. Ptcare
transferred
to ER staff.
Procedures
Time Procedure
Name : Detail _ Attendant
Name
Dispatch
Code 3 . i Originating Agency
Code 4 : Page1 of 3
0010
@
2005-0008818
Med Rood 27514 a
_ Toomay a Technologies ' Inc
Call Daté:02/14/2005 EMS PREHOSPITAL CARE REPORT Agency: City
of Alameda
9:00:00 Medications Administered Medications:Albuterol! Dose:5mg Route: Hand Held Nebulizer Cody Moxley PARAMEDIC
PtResponse: Medication notlisted:
PtResp Text:
9:00:00 Medications Administered Medications:atrovent Dose:.5mg Route: Hand Held Nebulizer Cody Moxley PARAMEDIC
Pt Response: Medication notlisted:
PtResp Text:
9:00:00 Oxygen Device:Non-Rebreather Mask WiRes LPM: 10 Cody Moxley PARAMEDIC
PtResponse:
Pt Resp Text:
9:00:00 Vitals B/P Systolic:
160 B/PDiastolic:90 PulseRate:88 Cody Moxley PARAMEDIC
PtResponse: Pulse Location:Radial PulseCharacter:Regular Resp Rate:26
Pt Resp Text: : RespirationsCharacter:Labored %O2 SAT: 92
EGG Character:SinusRhythm
EGG Detail:
Ectopy Frequency: Ectopy Focus: Ectopy Region:
ALAMEDA FIRE DEPARTMENT
| FieldSave i improved Cc
1200
Maintained O UnableTo
PARK
Determine [_]Admit
ST. C] Transfer {_]FieldDeath [7]Expired |
Primary:Cody Moxley PARAMEDIG R134 CAN NA] [= [D)/\. (C/AING ain} taf
Me
Crew 1:Joshiwa Sanders PARAMEDIC P1841 MD/Approve Signature:
= PANEIDERTERA ne:
~ Crew2:
Crew 3: ReceivingHosp Staff:
ics,
WAIN E TAIN
COPY
Dispatch
Code 3 Originating
Agency
Code 4 . Paga2 of 3
0011
to. : @
2005-0008818
Med Rec #:
2791 1
Toomay Technologies Inc
CallDate: 02/11/2005 EMS PREHOSPITAL CARE REPORT Agency: City
of Alameda
BILLING DATA , ° |
Dispatch: 2005-0008818
Unit: 2791
PatientNo: 1 of 1
Guarantor / Next ofKin
Name: Ivan Cood Soc. Sec.No.: 517-26-2581 Phone: (510)769-7001
Address: 2257PacificAve E Relation: Insured: ¥i Employment
City,State,
Zip: Alameda,CA 94501- Bill
To: Insurance Different:[_} Related:[]
| Health Insurance |
Comm. Co. Name: Kaiser Policy: 00832473 Medicare: 0
Group: 0 Patient{D: 0 MediCal/Medicaid: 0
|Auto/2nd Health Insurance|
neo ALAMEDA FARES DEPARTMENT
Name: povt>
| Employer
Company: ml 23(0)(0) phone jA(\ © 26 fc S |Fo Pt,Occupation:
Address:
City,State,
Zip: , O -
Mileage |
ath
SIMU
GA PM c=
Sta
LULAA5
ya CEN
LA Or
GA50
Alls oc U
On Departure: 0 On Time Available’ 0
On Scene PO On’ Nf |pote rrival:y
0
On Destinationfpnak\o \ imN ain Fret ‘i age:| 1
[ Patient/Call \ ;
NY
PatientType: Privaté-InSurance Primary Reason: elles |
i REATH
\\LE=3 .
LocationType: Patient
Address . Second Reason:
AccidentType: Non Auto Accident ThirdReason:
CallNumber: 0 Fourth Reason:
Re
[ BillingNarrative [ nenvara
| Release of Info Signature:
| herebyauthorize
any holder
of medicalorotherinformation-aboutme.toO
4 ) to_mylinsurance
carrier_or
tothesocial
security
administration
orits
intermediaries
orcarriers
any information
needed forthis
ora related
claim. | permit
a copy
ofthisauthorization
to beused inplaceoftheoriginal
and requestpayment ofmedicalinsurancebenefits
tomedical
transportation
services.
L. FieldSave = |__Improved | Maintained —_|_| UnableTo Determine |_|Admit |_|Transfer Lf FieldDeath — {|_|
Expired |
Primary:Cody Moxley PARAMEDIC P18424 Base Hospital
MD:
Crew 1: Joshiwa Sanders PARAMEDIC P19150 MD/Approve Signature:[Y][i]
cee *. ReceivingHosp Staff:
Crew 4: MICN/RN: Gene
Signature: PCR Id302258937 Start Time
2/11/2005
9:33:07
AM End Time
2/11/2005
9:20:09
AM Done vi
Dispatch
Code 3 Originating Agency
Code 4 Pago3 of 3
0012
2005-0008818
Med Rec#:
2791 4 Toomay Technologies Inc
-CallDaté: 02/11/2005 ; ' EMS PREHOSPITAL CARE REPORT Agency:City ofAlameda
CALL INFORMATION:
Dispatch: 2005-00083818 MEDICAL Reason Aid Requested:RespiratoryDistress
Unit 2791 Level:Minor ¥] Medical (] Trauma [_] Critical
Trauma
PatientNo: 1 of 4 CallType: Scene [] DryRun [|]Cardiac [] AMA
ChiefComplaint: SOB .
Type ofPatient: Shortness ofBreath First
Care GivenBy: ALAMEDA FIRE DEPARTMENT
os PATIENT INFORMATION TIMB
Name (LFM): Cood, Ivan Sex:M Received:8:53 Initia]
PatientContact:8:58
Address: 2257 PacificAve E Weight Kg:83 UnitDispatched:8:53 TransportUnitLeftScene: 9:04
City,
State,Zip: Alameda, CA 94501 Age:73 Years Enroute:8:55 TU Anived Destination:
9:09
Phone: 510-769-7001 DOB; 03/01/1931 ArrivedatScene: 8:57 istHospital
Report: 9:74
Soc Sec No: 517-26-2581 Time ofBirth:
00:06 TransportUnitArrival:
8:57 Available:9:30
SCENE INFORMATION INITIAL PHYSICAL EXAM ;
Incident
— oo PacificAve E,Alameda 94504 SkinColor _ SkinTemp SkinMoisture Cap Refill
Conde Lota WTI] at D 5 TesNamar\ Tey Snaim (ile pa = [<2Seconds
SpecialScene Congitih L- Pupils:Size- R PERL L- Pupils:Reactivity-
R
Calllevel | :
Communications: Aco 800 Mhz Radio Eye Opening VerbalResponse MotorResponse —
Map Zone Type: Metropolitan(>500/: iis} (0) [2 [s\{R2 - : ; —
Destination
Decision: PatientiFamilyRequest eee Oriented Obeys Verbal
PoliceAgency: None 7 15
NotTransported:C1 PROVIDER INFORMATION BodySystemWNL ABN NC | Comment
Déstination:Alameda‘Hospital’7 SUE Hen sow Owe Singéd hair” “7 4
Base Hospital:Not Reported Neck COMO)
Firstin
Hem hepring Wheezes Bilateraly!
| | /\ |
TransportPrd dere 7 Vom
‘AFD A
iiamen \\ / \\
ode: we A ) ce ae! @ OC vk
[Feahesstobath is j=~s \
i ior \transpet UniktgER alvis' ) 4 a @)a \ | L | |[/ \\ es
TransportCode To Scene: a Hospital: . |Extemities @ O O
PrimaryMedic Accompanied Patient in
Ambulance: wm
Lungs . . ; Clear &Equal,Good Tidal
Volume: a
i R_ Direction oo Location — ~ Sound TidalVolume ~ “ "Comment
Expiratory Upper Tree) TD Dimi ished’
Ovi Expiratory Upper Dimintshed
_ Agency Specific NPP Form Provided?:Kes/ | pe nee? Yes |_|
Mechanism of Injury: eae, SafetyEquipUsed:
TriageComment: ; , Trauma Score:15 CRAMS Score:
_ Trauma Triage ,
_ General
Assessment —_—|Main:RESPIRATORY/SOB Sub: Bronchospasm - COPD © -Comment:
. exacerbation
‘Treatment
Priorto Arrival
| None Comment:
Current
Medication | 02
~~CurrentAllergy
MedicalHistory ~-'| Asthma/Emphysema Comment:
j , Narrative
Patient : } |
73 ylomale c/oSOB forthelast10min. It cameonwhen hisapartmentcaughton fire.Ptstatedthathetumed hiswallheateroffand thenturnedit back
on,it started
afire.Ptstatedhe was Inside
the room for
3-4 minwiththe smoke,and Jsnow having trouble
breathing.Ne CP, nosputum, 5-6word
sentences,decreased exercisetolerance.
Pthas some wheezes bilaterally.
Ptgiven02 viaNRB, and startedfofeelbetter.
Piwas thengivena
breathingfreatmentand hisbreathing
startedtoease up. Ptshairwas singed,and hehad some redness totheback. No othertrauma noted.Ptcare
transferred
toER staff.
Procedures
Time { Procedure
Name . Detail _ Attendant
Name
Dispatch
Code 3 . Originating
AgencyCode4 . Page1 of 3
0010
"8
2005-0008818 27911
ved Rood | Toomay Technologies Inc
CallDate: 02/41/2005 ' EMS PREHOSPITAL CARE REPORT Agency: City
of Alameda
9:00:00 Medications Administered Medications:Albuterol Dose: 5mg Route: Hand Held Nebulizer Cody Moxley PARAMEDIC
Pt Response: Medication notlisted:
Pt Resp Text:
9:00:00 MedicationsAdministered Medications:atrovent Dose:.5mg Route: Hand Held Nebulizer Cody Moxley PARAMEDIC
Pt Response: Medication notlisted:
PtResp Text:
9:00:00 Oxygen Device:Non-Rebreather Mask WiRes LPM: 10 Cody Moxley PARAMEDIC
Pt Response:
PtResp Text:
9:00:00 Vitals B/P Systolic:
160 B/PDiastolic:90 PulseRate: 88 Cody Moxley PARAMEDIC
Pt Response: Pulse Location:Radial PulseCharacter:Regular Resp Rate:26
Pt Resp Text: RespirationsCharacter:Labored %O2 SAT: 92
ECG Gharacter:SinusRhythm
ECG Detail:
Ectopy Frequency: EctopyFocus: Ectopy Region:
ALAMEDA FIRE DEPARTMENT
| CL Field
Save i improved Cc
1800
Maintained [_]UnableTo
PARK
Determine [_]Admit
ST, L] Transfer [_]FieldDeath C Expired |
Primary:Cody Moxley PARAM PANTPERLA II [e [D)/\. (C/AINGzain tafMy
Crew 1: Joshiwa Sanders PARAMED! MD/Approve Sonatas
Crew 2:
Crew 3: ReceivingHosp Staff:
Crew4: um be anh r)
signa (> i \ I |POR Idlh. apr \ theanit |be anri Billable Done [I
7)
ee BY
Dispatch
Code 3 Originating
Agency
Coda 4 . Page2 of
3
C011
2005-0008818
Med Rec#:
2791 1
Toomay Technologies Inc
CallDate: 02/11/2005 EMS PREHOSPITAL CARE REPORT —_Ageney: CityofAlameda
~~ ——_ BILLING DATA
Dispatch: 2005-00088138
Unit: 2791
PatientNo: 1 of 1
Guarantor / Next of Kin
Name: !van Cood Soc. Sec.No.: 517-26-2581 Phone: (510)769-7001
Address: 2257 PacificAveE Relation: Insured: Vi Employment
City,State,
Zip: Alameda,CA 94501- Bill
To: Insurance Different:(_} Related:[]
[| HealthInsurance —|
Comm. Co.Name: Kaiser Policy: 00832473 Medicare: 0
Group: 0 ; PatientiD: 0 MediCal/Medicaid: 0
|Auto/2nd Health Insurance|
|
senean ost
Employer
/ANIEDA Mikes DEPARTMENT
eepany: 5] B00) phame//ai\} 220°C Sale Pt. Occupation:
City,State,Zip:, 0 -
Wiicese J NCSI DNS CON DASOT
On Departure: 0 On Time Available: 0
On Scene© Ar ival
Arrivals0 i On' Transport por
U rrival:7 :
0
On DestinationfifiatNe» (/— IN | | \ | \\ | Hy rota
eo é:}1
Patient/Call \_ } \]
——
WwW
PatientType! Privaté
Insurance Primary Reason: alles
/ REATH
LES
Location Type: Patient
Address Second Reason:
Accident Type: Non AutoAccident ‘Third
Reason:
CallNumber: 0 rourth Reason:
[Billing Narrative | anvar A
| Release of Info | Signature:
{ hereby
authorizeanyholderof°
medicalor other ut
information-abo ne.toO}
re td .mylinsurance
carrier.or
to thesocial
»securityadministration
orits
intermediaries
orcarriers
any information
needed for
thisora related
claim.| permit
a copy
of this
authorization
tobe used inplaceoftheoriginal
and requestpaymentof medicalinsurance
benefitstomedical
transportation
services.
| | FieldSave = |___
Improved | Maintained |_|Unable To Determine |_|Admit |_|Transfer | _|Field
Death | | Expired
Primary: Cody Moxley PARAMEDIC P18424 Base Hospital
MD:
Crew 1: Joshiwa Sanders PARAMEDIG P19150 MD/Approve Signature:LY][NI
Crew 2:
Crew 3: ivi
ReceivingHosp Staff:
Preview
é eo mecca NINA M. PATANE, Esq. (SBN 157079) ANDREA C., AVILA, Esq. (SBN 193982) PATANE *GUMBERG, LLP i) Attorneys atLaw , FI LE D 4 Rossi Circle, Suite 231 ALAMEDA COUNTY WY Salinas, California 93907 Telephone: (831) 755-1461 FEB 25 2008 He Facsimile: (831) 755-1477 THES + CLE FG SURERIQ RS AeA Attorneys for Defendant By. as , CAIRE MEDICAL SYSTEMS, INC. Deputy Dn HN SUPERIOR COURT OF THE STATE OF CALIFORNIA Aa IN AND FOR THE COUNTY OF ALAMEDA o UNLIMITED JURISDICTION 11 12 PUBLIC SERVICES MUTUAL ) CASE NO. 149743 INSURANCE COMPANY, ) 13 7 ) DECLARATION OF ANDREA C. Plaintiff, ) AVILA IN SUPPORT OF 14 y DEFENDANT’S MOTION FOR . ) SUMMARY JUDGMENT OR, 15 APRIA HEALTHCARE, INC., CAIRE ) ALTERNATIVELY, SUMMARY 16 MEDICAL SYSTEMS, INC., DOES 1-15, ) ADJUDICATION ) 17 Defendants. ) Date: May 13, 2008 ) Time: 9:00 a.m. 18 ) Dept.::301 ) , 19 a ; Reservation # R 793356 20 ) Trial Date: June 16, 2008 21 ) 22 23 I,ANDREA C. AVILA declare as follows: 24 1. I am an attorney licensed to practice before all the courts of the State of California, 25 and a partner with the law firm of Patane - Gumberg, LLP, attorneys of record for defendant CAIRE 26 MEDICAL SYSTEMS, INC. in this action. 27 2. [make this declaration in support of Defendant’s Motion for Summary Judgment, or 28 alternatively, Summary Adjudication. . -J- Declaration of Andrea C. Avila inSupport of Defendant’s Motion for Summary Judgment or,Alternative, Summary Adjudication | ® 3, on hereto as Exhibit A is a true and correct copy of Alameda Fire e DY Department EMS Pre-Hospital Care Report, dated February 11, 2005. 4. Attached hereto as Exhibit B is a true and correct copy of Alameda Fire WO Department Fire Incident Report, dated February 11, 2005. Ee 5. Attached hereto as Exhibit C is a true and correct certified copy of relevant portions eH of the Deposition of Michael Chong, dated November 28, 2007. ND 6. Attached hereto as Exhibit D is a true and correct copy of Supplemental Response SI to Form Interrogatories, Set No. One, from Answering Party, Plaintiff, PUBLIC SERVICE CO MUTUAL INSURANCE COMPANY, to Asking Party, Defendant, APRIA HEALTHCARE, oO INC. | CO ele 7. Attached hereto as Exhibit E is a true and correct copy of a Letter from PUBLIC KF Sl PO SERVICE MUTUAL INSURANCE COMPANY, to Michael Chong, dated March 9, 2005. Ee WH 8. Attached hereto as Exhibit F is a true and correct copy of Answers to Special _ FEF FP Interrogatories, Set No. One, from Answering Party, Plaintiff, PUBLIC SERVICE MUTUAL SF a INSURANCE COMPANY ,to Asking Party, Defendant, APRIA HEALTHCARE, INC. Nn FS 9. Attached hereto as Exhibit G is a true and correct copy of Fire Cause Analysis KF A Evidence Chain of Possession Form. DBD KF 10. Attached hereto as Exhibit H is a true and correct copy of Apria Healthcare Inc.’s Oo KF Phone Record, dated February 20, 2007. OD NY 11. Attached hereto as Exhibit I is a true and correct copy of the Declaration of KF NY Plaintiffs, PUBLIC SERVICE MUTUAL INSURANCE COMPANY’s, form complaint, filed PO PVP August 31, 2006 | WHO YH 12. Attached hereto as Exhibit J is a true and correct copy of the Declaration of Nina Ph NY M. Patane in support of Defendant’s Motion for Summary Judgment or Alternatively, Summary WU YH Adjudication. DW VY 13. Attached hereto as Exhibit K is a true and correct copy of Supplemental Answers to NY NYO Special Interrogatories, Set No. One, from Answering Party, Plaintiff, PUBLIC SERVICE oo no -2— Declaration of Andrea C. Avila inSupport of Defendant’s Motion for Summary Judgment or,Alternative, Summary Adjudication ¢ MUTUAL INSURANCE COMPANY, to Asking Party, Defendant, APRIA HEALTHCARE, bot WN INC. _ I declare under penalty of perjury under the laws of the State of California that the WD foregoing is true and correct to the best of my knowledge. FP nH Dated: February21, 2008 PATANE* cumBa /LLP NID oOo By: v ea ‘AVILA Atto. r Plaintiff o CAIRE MEDICAL SYSTEMS, INC. CO Se KF Pe PO FeO WO Bh PF Fe A | NH Fe DTD Fe WB KF BO KF ODO NO FF WN PO NY HO NY FP NY UA WHO NWN WH aI NYO non ao -3- Declaration of Andrea C. Avila in Support of Defendant’s Motion for Summary Judgment or,Alternative, Summary Adjudication @ - 4 “ - : - . © 7005-08818 Med Rec#: 2791 1 Toomay Technologies Inc -Call Daté:02/14/2005 EMS PREHOSPITAL CARE REPORT Agency:Cityof Alameda CALL INFORMATION: Dispatch: 2005-0008818 MEDICAL Reason Aid Requested:RespiratoryDistress Unit 2794 Level:Minor | (4 Medical (1 Trauma [_]Critical Trauma PatientNo: 1 of 1 CallType: Scene (_]DryRun (J Cardiac [_] AMA ChiefComplaint SOB - Type ofPatient: Shortness ofBreath First Care GivenBy: ALAMEDA FIRE DEPARTMENT i PATIENT INFORMATION TIME Name (LFM): Cood, Ivan Sex: M Received: 8:53 Initial Patient Contact:8:58 Address: 2257 Pacific Ave E Weight Kg:88 UnitDispatched: 8:53 TransportUnitLeft Scene: 9:04 City, State,Zip: Alameda, CA 94501 Age: 73Years Enroute: 8:55 JU Anived Destination: 9:09 Phone: 510-769-7001 DOB: 03/01/1931 ArtivedatScene: 8:57 dstHospital Report: 9:41 Soc Sec No: 517-26-2581 Time ofBirth: 00:00 TransportUnitArsival: 8:57 Available:9:30 SCENE INFORMATION INITIAL PHYSICAL EXAM Incident meaelekeral 2257 Pacific Ave E, Alameda 94501 SkinColor __ SkinTemp SkinMoisture Cap Refill Dispos ; vibe ONIN ik y: si) /i\ PeNomar| Toycwam f= eA 2 | <2 Seconds SpecialScene cong eae [P | [RIS D L- Pupils:Size- R PERL L- Pupils: Reactivity-R : CallSource: Communications: ALCO 800 Mhz Radio Eye Opening VerbalResponse MotorResponse Map Zone Type: Metropolitan(>500/ inish}(0)(0) [2 /s\[R2 ~ : : — Destination Decision: Patient/Family soon Spontaneous Oriented Obeys Verbal PoliceAgency: None GCS# 15 NotTransported:C1 PROVIDER INFORMATION BodySystemWNL ABN NC |Comment Déstination:Alameda'Hospita” SUVA lFicadiesce?Ow O singed hair a ae TransportPre Ge NotRopo as AFD j Nek h Flan @ ee 0. OL yen y i [\ : Transport Unit:ah bdqmen \\ / \\ Transport Mode: sanewy ce a @O redness toback /-=\ CallDispdsltion: \ttansper uniktg ED elvis HO-O \l UO UL \Wee TransportCode To Scene: To Hopital Extremities@ O O PrimaryMedic ‘etomparied Patient in Ambulances. a Lungs ; 7 Clear& Equal,Good Tidal Volume: O Lk R_ Direction oe Location — a Sound — TidalVolume =” Gomment Oo WIL] Expiratory Upper hee yy 1D Diente OM Expiratory Upper pt minished Agency Specific NPP Form Provided?:Split nee? Yes | Mechanism ofInjury: Ve SafetyEquipUsed: TriageComment: , + Trauma Score: 15 CRAMS Score: _ Trauma Tuage ! _ General Assessment _| Main:RESPIRATORY/SOB Sub: Bronchospasm -COPD -Comment: . exacerbation Treatment Priorto Arrival | None Comment: Current Medication 02 ~ CurrentAllergy MedicalHistory | | Asthma/Emphysema Comment: , PatientNarrative 73 yiomale c/oSOB forthelast10min. ft cameonwhen hisapartmentcaughton fire. Ptstatedthathe tured hiswallheateroffandthen turnedif back on, it started afire.Ptstatedhe was Inside theroom for3-4 minwiththesmoke, and Isnow havingtroublebreathing.No CP,no sputum,5-6 word sentences,decreased exercisetolerance. Pthas some wheezes bilaterally. Ptgiven02 viaNRB, and startedtofeelbetter.Ptwas thengivena breathingtreatmentand hisbreathing startedtoease up. Pt's hairwas singed,andhe had some redness totheback. No othertraumanoted. Ptcare transferred to ER staff. Procedures Time Procedure Name : Detail _ Attendant Name Dispatch Code 3 . i Originating Agency Code 4 : Page1 of 3 0010 @ 2005-0008818 Med Rood 27514 a _ Toomay a Technologies ' Inc Call Daté:02/14/2005 EMS PREHOSPITAL CARE REPORT Agency: City of Alameda 9:00:00 Medications Administered Medications:Albuterol! Dose:5mg Route: Hand Held Nebulizer Cody Moxley PARAMEDIC PtResponse: Medication notlisted: PtResp Text: 9:00:00 Medications Administered Medications:atrovent Dose:.5mg Route: Hand Held Nebulizer Cody Moxley PARAMEDIC Pt Response: Medication notlisted: PtResp Text: 9:00:00 Oxygen Device:Non-Rebreather Mask WiRes LPM: 10 Cody Moxley PARAMEDIC PtResponse: Pt Resp Text: 9:00:00 Vitals B/P Systolic: 160 B/PDiastolic:90 PulseRate:88 Cody Moxley PARAMEDIC PtResponse: Pulse Location:Radial PulseCharacter:Regular Resp Rate:26 Pt Resp Text: : RespirationsCharacter:Labored %O2 SAT: 92 EGG Character:SinusRhythm EGG Detail: Ectopy Frequency: Ectopy Focus: Ectopy Region: ALAMEDA FIRE DEPARTMENT | FieldSave i improved Cc 1200 Maintained O UnableTo PARK Determine [_]Admit ST. C] Transfer {_]FieldDeath [7]Expired | Primary:Cody Moxley PARAMEDIG R134 CAN NA] [= [D)/\. (C/AING ain} taf Me Crew 1:Joshiwa Sanders PARAMEDIC P1841 MD/Approve Signature: = PANEIDERTERA ne: ~ Crew2: Crew 3: ReceivingHosp Staff: ics, WAIN E TAIN COPY Dispatch Code 3 Originating Agency Code 4 . Paga2 of 3 0011 to. : @ 2005-0008818 Med Rec #: 2791 1 Toomay Technologies Inc CallDate: 02/11/2005 EMS PREHOSPITAL CARE REPORT Agency: City of Alameda BILLING DATA , ° | Dispatch: 2005-0008818 Unit: 2791 PatientNo: 1 of 1 Guarantor / Next ofKin Name: Ivan Cood Soc. Sec.No.: 517-26-2581 Phone: (510)769-7001 Address: 2257PacificAve E Relation: Insured: ¥i Employment City,State, Zip: Alameda,CA 94501- Bill To: Insurance Different:[_} Related:[] | Health Insurance | Comm. Co. Name: Kaiser Policy: 00832473 Medicare: 0 Group: 0 Patient{D: 0 MediCal/Medicaid: 0 |Auto/2nd Health Insurance| neo ALAMEDA FARES DEPARTMENT Name: povt> | Employer Company: ml 23(0)(0) phone jA(\ © 26 fc S |Fo Pt,Occupation: Address: City,State, Zip: , O - Mileage | ath SIMU GA PM c= Sta LULAA5 ya CEN LA Or GA50 Alls oc U On Departure: 0 On Time Available’ 0 On Scene PO On’ Nf |pote rrival:y 0 On Destinationfpnak\o \ imN ain Fret ‘i age:| 1 [ Patient/Call \ ; NY PatientType: Privaté-InSurance Primary Reason: elles | i REATH \\LE=3 . LocationType: Patient Address . Second Reason: AccidentType: Non Auto Accident ThirdReason: CallNumber: 0 Fourth Reason: Re [ BillingNarrative [ nenvara | Release of Info Signature: | herebyauthorize any holder of medicalorotherinformation-aboutme.toO 4 ) to_mylinsurance carrier_or tothesocial security administration orits intermediaries orcarriers any information needed forthis ora related claim. | permit a copy ofthisauthorization to beused inplaceoftheoriginal and requestpayment ofmedicalinsurancebenefits tomedical transportation services. L. FieldSave = |__Improved | Maintained —_|_| UnableTo Determine |_|Admit |_|Transfer Lf FieldDeath — {|_| Expired | Primary:Cody Moxley PARAMEDIC P18424 Base Hospital MD: Crew 1: Joshiwa Sanders PARAMEDIC P19150 MD/Approve Signature:[Y][i] cee *. ReceivingHosp Staff: Crew 4: MICN/RN: Gene Signature: PCR Id302258937 Start Time 2/11/2005 9:33:07 AM End Time 2/11/2005 9:20:09 AM Done vi Dispatch Code 3 Originating Agency Code 4 Pago3 of 3 0012 2005-0008818 Med Rec#: 2791 4 Toomay Technologies Inc -CallDaté: 02/11/2005 ; ' EMS PREHOSPITAL CARE REPORT Agency:City ofAlameda CALL INFORMATION: Dispatch: 2005-00083818 MEDICAL Reason Aid Requested:RespiratoryDistress Unit 2791 Level:Minor ¥] Medical (] Trauma [_] Critical Trauma PatientNo: 1 of 4 CallType: Scene [] DryRun [|]Cardiac [] AMA ChiefComplaint: SOB . Type ofPatient: Shortness ofBreath First Care GivenBy: ALAMEDA FIRE DEPARTMENT os PATIENT INFORMATION TIMB Name (LFM): Cood, Ivan Sex:M Received:8:53 Initia] PatientContact:8:58 Address: 2257 PacificAve E Weight Kg:83 UnitDispatched:8:53 TransportUnitLeftScene: 9:04 City, State,Zip: Alameda, CA 94501 Age:73 Years Enroute:8:55 TU Anived Destination: 9:09 Phone: 510-769-7001 DOB; 03/01/1931 ArrivedatScene: 8:57 istHospital Report: 9:74 Soc Sec No: 517-26-2581 Time ofBirth: 00:06 TransportUnitArrival: 8:57 Available:9:30 SCENE INFORMATION INITIAL PHYSICAL EXAM ; Incident — oo PacificAve E,Alameda 94504 SkinColor _ SkinTemp SkinMoisture Cap Refill Conde Lota WTI] at D 5 TesNamar\ Tey Snaim (ile pa = [<2Seconds SpecialScene Congitih L- Pupils:Size- R PERL L- Pupils:Reactivity- R Calllevel | : Communications: Aco 800 Mhz Radio Eye Opening VerbalResponse MotorResponse — Map Zone Type: Metropolitan(>500/: iis} (0) [2 [s\{R2 - : ; — Destination Decision: PatientiFamilyRequest eee Oriented Obeys Verbal PoliceAgency: None 7 15 NotTransported:C1 PROVIDER INFORMATION BodySystemWNL ABN NC | Comment Déstination:Alameda‘Hospital’7 SUE Hen sow Owe Singéd hair” “7 4 Base Hospital:Not Reported Neck COMO) Firstin Hem hepring Wheezes Bilateraly! | | /\ | TransportPrd dere 7 Vom ‘AFD A iiamen \\ / \\ ode: we A ) ce ae! @ OC vk [Feahesstobath is j=~s \ i ior \transpet UniktgER alvis' ) 4 a @)a \ | L | |[/ \\ es TransportCode To Scene: a Hospital: . |Extemities @ O O PrimaryMedic Accompanied Patient in Ambulance: wm Lungs . . ; Clear &Equal,Good Tidal Volume: a i R_ Direction oo Location — ~ Sound TidalVolume ~ “ "Comment Expiratory Upper Tree) TD Dimi ished’ Ovi Expiratory Upper Dimintshed _ Agency Specific NPP Form Provided?:Kes/ | pe nee? Yes |_| Mechanism of Injury: eae, SafetyEquipUsed: TriageComment: ; , Trauma Score:15 CRAMS Score: _ Trauma Triage , _ General Assessment —_—|Main:RESPIRATORY/SOB Sub: Bronchospasm - COPD © -Comment: . exacerbation ‘Treatment Priorto Arrival | None Comment: Current Medication | 02 ~~CurrentAllergy MedicalHistory ~-'| Asthma/Emphysema Comment: j , Narrative Patient : } | 73 ylomale c/oSOB forthelast10min. It cameonwhen hisapartmentcaughton fire.Ptstatedthathetumed hiswallheateroffand thenturnedit back on,it started afire.Ptstatedhe was Inside the room for 3-4 minwiththe smoke,and Jsnow having trouble breathing.Ne CP, nosputum, 5-6word sentences,decreased exercisetolerance. Pthas some wheezes bilaterally. Ptgiven02 viaNRB, and startedfofeelbetter. Piwas thengivena breathingfreatmentand hisbreathing startedtoease up. Ptshairwas singed,and hehad some redness totheback. No othertrauma noted.Ptcare transferred toER staff. Procedures Time { Procedure Name . Detail _ Attendant Name Dispatch Code 3 . Originating AgencyCode4 . Page1 of 3 0010 "8 2005-0008818 27911 ved Rood | Toomay Technologies Inc CallDate: 02/41/2005 ' EMS PREHOSPITAL CARE REPORT Agency: City of Alameda 9:00:00 Medications Administered Medications:Albuterol Dose: 5mg Route: Hand Held Nebulizer Cody Moxley PARAMEDIC Pt Response: Medication notlisted: Pt Resp Text: 9:00:00 MedicationsAdministered Medications:atrovent Dose:.5mg Route: Hand Held Nebulizer Cody Moxley PARAMEDIC Pt Response: Medication notlisted: PtResp Text: 9:00:00 Oxygen Device:Non-Rebreather Mask WiRes LPM: 10 Cody Moxley PARAMEDIC Pt Response: PtResp Text: 9:00:00 Vitals B/P Systolic: 160 B/PDiastolic:90 PulseRate: 88 Cody Moxley PARAMEDIC Pt Response: Pulse Location:Radial PulseCharacter:Regular Resp Rate:26 Pt Resp Text: RespirationsCharacter:Labored %O2 SAT: 92 ECG Gharacter:SinusRhythm ECG Detail: Ectopy Frequency: EctopyFocus: Ectopy Region: ALAMEDA FIRE DEPARTMENT | CL Field Save i improved Cc 1800 Maintained [_]UnableTo PARK Determine [_]Admit ST, L] Transfer [_]FieldDeath C Expired | Primary:Cody Moxley PARAM PANTPERLA II [e [D)/\. (C/AINGzain tafMy Crew 1: Joshiwa Sanders PARAMED! MD/Approve Sonatas Crew 2: Crew 3: ReceivingHosp Staff: Crew4: um be anh r) signa (> i \ I |POR Idlh. apr \ theanit |be anri Billable Done [I 7) ee BY Dispatch Code 3 Originating Agency Coda 4 . Page2 of 3 C011 2005-0008818 Med Rec#: 2791 1 Toomay Technologies Inc CallDate: 02/11/2005 EMS PREHOSPITAL CARE REPORT —_Ageney: CityofAlameda ~~ ——_ BILLING DATA Dispatch: 2005-00088138 Unit: 2791 PatientNo: 1 of 1 Guarantor / Next of Kin Name: !van Cood Soc. Sec.No.: 517-26-2581 Phone: (510)769-7001 Address: 2257 PacificAveE Relation: Insured: Vi Employment City,State, Zip: Alameda,CA 94501- Bill To: Insurance Different:(_} Related:[] [| HealthInsurance —| Comm. Co.Name: Kaiser Policy: 00832473 Medicare: 0 Group: 0 ; PatientiD: 0 MediCal/Medicaid: 0 |Auto/2nd Health Insurance| | senean ost Employer /ANIEDA Mikes DEPARTMENT eepany: 5] B00) phame//ai\} 220°C Sale Pt. Occupation: City,State,Zip:, 0 - Wiicese J NCSI DNS CON DASOT On Departure: 0 On Time Available: 0 On Scene© Ar ival Arrivals0 i On' Transport por U rrival:7 : 0 On DestinationfifiatNe» (/— IN | | \ | \\ | Hy rota eo é:}1 Patient/Call \_ } \] —— WwW PatientType! Privaté Insurance Primary Reason: alles / REATH LES Location Type: Patient Address Second Reason: Accident Type: Non AutoAccident ‘Third Reason: CallNumber: 0 rourth Reason: [Billing Narrative | anvar A | Release of Info | Signature: { hereby authorizeanyholderof° medicalor other ut information-abo ne.toO} re td .mylinsurance carrier.or to thesocial »securityadministration orits intermediaries orcarriers any information needed for thisora related claim.| permit a copy of this authorization tobe used inplaceoftheoriginal and requestpaymentof medicalinsurance benefitstomedical transportation services. | | FieldSave = |___ Improved | Maintained |_|Unable To Determine |_|Admit |_|Transfer | _|Field Death | | Expired Primary: Cody Moxley PARAMEDIC P18424 Base Hospital MD: Crew 1: Joshiwa Sanders PARAMEDIG P19150 MD/Approve Signature:LY][NI Crew 2: Crew 3: ivi ReceivingHosp Staff: