i

NO. 14-14-00411-CV

 

IN THE COURT OF APPEALS

FOR THE FOURTEENTH DISTRICT OF TEXAS

PAMELA WALKER,

Appellant,

v.

SUZANNE SCOPEL AND JUSTIN SCOPEL,

Appellees.

On Appeal from Cause Number 12-DCV-200283

From the 268th District Court of Fort Bend County, Texas

BRIEF FOR APPELLANT

ORAL ARGUMENT REQUESTED

REGINALD E. MCKAMIE, SR.

TBN. 13686750

1210 Antoine Drive, Suite 100

Houston, Texas 77055

Phone: (713) 465-2889

Fax: (713) 465-2894

Counsel for Appellant

ACCEPTED

14-14-00411-CV

FOURTEENTH COURT OF APPEALS

HOUSTON, TEXAS

6/10/2015 10:16:06 PM

CHRISTOPHER PRINE

CLERK

 FILED IN 14th COURT OF APPEALS HOUSTON, TEXAS 6/10/2015 10:16:06 PM CHRISTOPHER A. PRINE Clerk
ii

IDENTITY OF PARTIES AND COUNSEL

PLAINTIFF/APPELLANT: Pamela Walker

DEFENDANT/APPELLEE: Justin Scopel

COUNSEL FOR PLAINTIFF/APPELLANT: Reginald E. McKamie, Sr.

Attorney at Law

 1210 Antoine, Suite 100

Houston, Texas 77055

COUNSEL FOR DEFENDANT/APPELLEE: IRESON & WEIZEL, PLLC

Lansford O. Ireson, Jr.

 9720 Cypresswood, Suite 310

 Houston, Texas 77070

PRESIDING JUDGE AT TRIAL: Hon. Brady G.Elliott

 268th District Court 

Harris County, Texas

1422 Eugene Heimann Cir.

Richmond, Texas 77469
iii

TABLE OF CONTENTS

IDENTITY OF THE PARTIES AND COUNSEL .................................................................. ii

TABLE OF CONTENTS ................................................................................................iii

INDEX OF AUTHORITIES ............................................................................................ iv

STATEMENT OF THE CASE........................................................................................... 1

ISSUES PRESENTED..................................................................................................... 2

STATEMENT OF FACTS ............................................................................................... 3

SUMMARY OF THE ARGUMENT................................................................................... 7

ARGUMENT ................................................................................................................ 8

A. The trial court erred in admitting photographs of extremely limited 

probative value that was substantially outweighed by the danger of 

unfair prejudice, confusing the issues, and misleading the jury .............. 8

B. The jury was not at liberty to award no damages to Walker. The 

evidence that Walker suffered some amount of physical pain and mental 

anguish and physical impairment was undisputed.................................. 11

PRAYER ................................................................................................................... 14

CERTIFICATE OF SERVICE ........................................................................................ 15

CERTIFICATE OF COMPLIANCE ................................................................................ 15

APPENDIX ............................................................................................................... 16
iv

INDEX OF AUTHORITIES

CASES

Browning-Ferris, Inc. v. Reyna, 865 S.W.2d 925 (Tex. 1993)................................. 9

Burroughs Wellcome Co. v. Crye, 907 S.W.2d 497 (Tex. 1995) ........................... 10

Coates v. Whittington, 758 S.W.2d 749 (Tex. 1988).............................................. 11

Hicks v. Ricardo, 834 S.W.2d 587 (Tex. App.—Houston [1st Dist.] 1992, no writ)..

............................................................................................................................. 11

Insurance Co. of North Am. v. Myers, 411 S.W.2d 710 (Tex.1966).. .................... 10

Lopez v. Carrillo, 940 S.W.2d 232 (Tex. App. — San Antonio 1997). ................... 9

Lowery v. Berry, 269 S.W.2d 795 (Tex. 1954)....................................................... 11

RULES

Tex. R. Evid. 403...................................................................................................... 8
1

STATEMENT OF THE CASE

On August 19, 2012, Pamela Walker (“Walker”) filed suit against Justin 

Scopel and Suzanne Scopel for damages she sustained in a car accident that 

occurred on January 5, 2012. (CR 6-10).

On March 25, 2014, Walker non-suited all of her claims against Suzanne 

Scopel as well as her claims for medical expenses (RR 2:5), lost wages (RR 2:5), 

and punitive damages (RR 2:10) against Justin Scopel. Justin Scopel (“Scopel”) 

stipulated to causing the accident. (RR 2:5). 

Both parties announced ready for trial and proceeded only on the issue of 

damages for past and future physical pain and mental anguish and past a future 

physical impairment. On March 27, 2014, the jury awarded zero damages on each 

of Walker’s claims. (CR 73).

The district court entered judgment that Walker take nothing on May 2, 

2014. (CR 78). On May 27, 2014, Walker filed her notice of appeal. (CR 82).
2

ISSUES PRESENTED

1. Did the court err by admitting photographs whose probative value was 

substantially outweighed by the danger of unfair prejudice, confusing the 

issues, and misleading the jury over the Plaintiff’s objection?

2. Was the jury free to award zero damages when liability was stipulated and 

there was undisputed evidence of damages caused by the collision?
3

STATEMENT OF FACTS

On January 5, 2012, Justin Scopel (“Scopel”) failed to control his speed and 

collided with the rear of Pamela Walker’s (“Walker”) vehicle. It is undisputed that 

Scopel caused the collison. (RR 2:5, 3:5). Walker’s neck whipped forward and her 

back popped on impact. (RR 3:100). She called 911 and asked that an ambulance 

be dispatched because her neck and back were hurt in the collision. (RR 3:100). 

The ambulance arrived and then transported her to the hospital. (RR 3:15, 100).

At the hospital, Walker underwent a CAT scan (RR 3:101) and was 

diagnosed with lumbar strain and cervical strain due to the collision. (P. Ex. 1).

Walker was involved in another motor vehicle accident approximately seven 

months earlier, in June 2011. (RR 3:104). In that accident, she suffered a bruise on 

her hand. (RR 3:105). She experienced some short-term back and neck pain from 

that accident and sought a referral for physical therapy. (D. Ex. 2). However, the 

pain resolved, she had no lingering neck or back problems (RR 3:105), and she 

never sought treatment. (RR 3:123).

In contrast, after the collision with Scopel that is the subject of this case, 

Walker experienced “intense pain” that she had not experienced prior. (RR 3:113). 

She was no longer able to work in her garden (RR 3:91) as she had before the 

accident. (RR 3:87). She was unable to do her daughter’s hair. (RR 3:92). She 

was no longer able to sit through her son’s basketball games, and thus stopped 
4

attending. (RR 3:92). She stopped cooking, no longer slept through the night, and 

was no longer able to take regular trips with her husband, all of which she had 

done prior to the collision. (RR 3:86, 91, 93).

After the collision, Walker went to see her primary-care physician, who 

referred her to physical therapy. (RR 3:107). She saw a physical therapist 

approximately 13 times. (RR 3:107). At trial, Renee Blalock (“Blalock”), the 

therapist who conducted the majority of Walker’s sessions, testified. (RR 3:67-85).

Blalock testified about her assessment of Walker.

Objectively, there were found to be deficits in her following the 

flexibility and her balance and her ability to perform what we call a

functional squat. There were deficits in the mobility of her lumbar 

spine, which is her low back spine. There were -- there was weakness 

found in her lower extremity muscles as well as in her spinal and core 

musculature. There was also tenderness upon palpation, which means

upon feeling the muscles there was pain and tenderness and her range 

of motion in her low back was limited with pain, as well. And that's 

the objective part of it.

(RR 3:70). Blalock also testified unequivocally that, based on her experience and 

training, Walker was not faking her injuries, as well as how she reached that 

conclusion. (RR 3:77-79).

Walker stopped physical therapy when her primary doctor referred her to a 

spine specialist, who in turn recommended that she see a chiropractor or an 

acupuncturist for her pain. (RR 3:107). She did see an acupuncturist and also 

began seeing Dr. Roberto Solis (“Dr. Solis”), a chiropractor. (RR 3:108).
5

Dr. Solis testified as both a fact witness and an expert witness at trial. (RR 

3:19). He had reviewed Walker’s MRI (P. Ex. 3) and testified that it showed bone 

spurring and a bulging disc, among other things. (RR 3:23). He further testified 

that while most of the findings on Walker’s MRI could be attributed to 

degeneration or simple aging, in his expert opinion, the bulging disc was a result of 

trauma. (RR 3:25). This injury is consistent with the head whip one experiences in 

a rear-end collision. (RR 3:26). Furthermore, even if the bulging disc had existed 

prior to the collision with Scopel, that collision would have caused increased 

trauma to it. (RR 3:26).

Dr. Solis testified about over 30 visits with Walker. (RR 3:20-51). He 

testified that she was obviously in pain from the collision (RR 3:29), and that 

treatment would ease the pain, but it would return several hours later. (RR 3:32).

Dr. Solis testified that at each of the visits, he conducted “a palpatory

assessment, basically just feeling for muscle tightness, muscle spasms, joints that 

may not be moving the way that they're supposed to.” (RR 3:51). Each time he 

conducted this assessment, he detected “very consistent pain, inflammation, a 

tightness and tenderness in the upper neck and the back.” (RR 3:52).

At trial, Scopel rested behind Walker, calling no witnesses. (RR 3:133). 

Scopel’s evidence consisted of just three exhibits, including photographs of 

Walker’s vehicle admitted over her objection. (D. Ex. 1). 
6

Scopel also presented an email showing that Walker had previously sought a 

referral for physical therapy (RR 3:122, D. Ex. 2) and a portion of her medical 

records showing that she had experienced some arm pain prior to the accident, but 

that the accident had exacerbated it. (RR 3:129, D. Ex. 3).
7

SUMMARY OF THE ARGUMENT

The trial court erred by admitting three photographs offered by Scopel. The 

photographs were of extremely limited probative value to the amount of physical 

pain, mental anguish, and physical impairment suffered by Walker, which were the 

only questions before the jury. What little, if any, probative value the photographs 

did have was substantially outweighed by the danger of unfair prejudice, confusing 

the issues, and misleading the jury. 

The jury awarded Walker no damages after speculating that because the 

photographs showed minimal damage to Walker’s vehicle, the collision must have 

been low-impact. The jury further speculated that Walker could not have been 

injured in the purportedly low-impact collision.

The jury was not at liberty to award Walker no damages when the evidence 

was undisputed that the collision caused Walker some amount of damages for 

physical pain and mental anguish and physical impairment.
8

ARGUMENT

A. The trial court erred in admitting photographs of extremely limited 

probative value that was substantially outweighed by the danger of 

unfair prejudice, confusing the issues, and misleading the jury.

Walker moved to exclude three photographs (D. Ex. 1) of her vehicle taken 

by Scopel after the collision. (RR 2:11). The court denied her motion and admitted 

the photographs into evidence. (RR 2:12). The photographs were published to the 

jury during Scopel’s testimony. (RR 3:15). Scopel’s counsel implied through his 

questioning, and later argued that because her vehicle was not badly damaged, she 

could not have been hurt. (RR 3:16, 4:20).

The probative value of the photographs was limited, at best. While they 

clearly would have been relevant to any property damage claim, there was no 

claim for property damage at issue in the trial. (CR 73). The photographs also 

would have been probative of the issue of causation, but causation had been 

stipulated. (RR 2:5).

The photographs were simply of extremely limited, if any, probative value to 

Walker’s physical pain, mental anguish, or physical impairment, which were the 

only questions before the jury. What little probative value they might have had 

was clearly substantially outweighed by the danger of unfair prejudice, confusing 

the issues, and misleading the jury and they should have been excluded under Tex. 

R. Evid. 403.
9

Scopel introduced the photograph in order to invite the jury to speculate that 

because the damage to Walker’s vehicle was relatively minor, the collision must 

have been low-impact. The jury was then invited to draw the further speculative 

conclusion that because the collision was purportedly low-impact, Walker must be 

faking her injuries. (CR 4:20).

 This is simply conjecture, not evidence. “Some suspicion linked to other 

suspicion produces only more suspicion, which is not the same as . . . evidence.” 

Browning-Ferris, Inc. v. Reyna, 865 S.W.2d 925, 927 (Tex. 1993). Clearly the 

danger for unfair prejudice, confusing the issues, and misleading the jury was 

great.

Furthermore, the probative value of the photographs to claims before the 

jury was so minimal as to border on irrelevance. However, even if it could meet 

that minimal standard, the probative value was so slight that the great danger for 

unfair prejudice, confusing the issues, and misleading the jury substantially 

outweighed it.

Proving causation between negligence and injury requires expert testimony. 

Lopez v. Carrillo, 940 S.W.2d 232, 234 (Tex. App. — San Antonio 1997). 
10

To constitute evidence of causation, an expert opinion must rest in 

reasonable medical probability. Insurance Co. of North Am. v. Myers, 

411 S.W.2d 710, 713 (Tex.1966). This rule applies whether the 

opinion is expressed in testimony or in a medical record, as the need 

to avoid opinions based on speculation and conjecture is identical in 

both situations. 

Burroughs Wellcome Co. v. Crye, 907 S.W.2d 497, 500 (Tex. 1995). 

Scopel’s opinion (RR 3:16) and his counsel’s opinion (RR 4:20) that the 

photographs are evidence that the collision did not cause any damages for physical 

pain, mental anguish, and physical impairment to Walker simply cannot meet this 

standard.

Walker proved causation between Scopel’s negligence and her injuries 

through Dr. Solis’ expert testimony. (RR 3:17-53). Scopel failed to negate 

Walker’s proof either through his own expert or through his cross-examination of 

Dr. Solis. The photographs simply lacked any meaningful probative value in an 

area that is the domain of expert testimony.

Clearly the jury was confused and misled by the photographs. It is the only 

way to explain their decision to award no damages whatsoever despite the 

overwhelming evidence that the collision did indeed cause at least some amount of 

physical pain, mental anguish, and physical impairment to Walker.
11

B. The jury was not at liberty to award no damages to Walker. The 

evidence that Walker suffered some amount of physical pain and

mental anguish and physical impairment was undisputed.

A jury is not at liberty to award zero damages when the evidence is 

undisputed that a plaintiff suffered injury. See Lowery v. Berry, 269 S.W.2d 795, 

796–97 (Tex. 1954). If any of the jury’s damages findings is against the great 

weight and preponderance of the evidence, the proper remedy is to reverse the 

verdict and remand the case for a new trial. Hicks v. Ricardo, 834 S.W.2d 587, 590 

(Tex. App.—Houston [1st Dist.] 1992, no writ).

The only evidence presented by Scopel, other than the improperly admitted 

photographs, was an email and a portion of Walker’s medical records showing that 

she had experience some pain prior to the collision. (D. Ex. 2, D. Ex. 3). As any 

first year law student can tell you, it is well settled that a tortfeasor takes the 

plaintiff as he finds her. See Coates v. Whittington, 758 S.W.2d 749, 752 (Tex.

1988) (a.k.a. the "eggshell skull rule"). None of Scopel’s evidence, including the 

photographs, dispute Walker’s ample evidence that she suffered some amount of 

damages as a result of the collision.

Whether or not Walker had experienced pain at some point in her life prior 

to the collision does not absolve Scopel of responsibility for the damages he 

caused. Even if Walker had some actual pre-existing condition, which Scopel’s 
12

meager evidence does not show, he is still responsible for her damages to the 

degree that his negligence aggravated the condition.

In his expert testimony, Dr. Solis conceded that he could not say for certain 

that Walker did not have a torn disc prior to the collision with Scopel. However, 

he stated unequivocally, “every single accident you have will cause increased 

trauma to those particular areas. It basically is like pouring more fuel on the fire.” 

(RR 3:26-27). This simple fact is not disputed or called into question in any way 

anywhere in the record. With causation of the collision conceded, this evidence 

alone renders the jury’s award of no damages as against the great weight and 

preponderance of the evidence.

The jury awarded Walker no damages for past or future physical pain and 

mental anguish despite undisputed evidence that she had suffered physical pain and 

mental anguish as a result of Scopel’s negligence.

Dr. Solis testified that Walker was obviously in pain. (RR 3:29). He also 

conducted “several orthopedic tests that were positive for inflamed joints, pain in 

the neck, and the low back.” (RR 3:21). On each of the more than 30 times he saw 

her, he conducted a palpatory assessment. Each and every time, he found “very 

consistent pain, inflammation, a tightness and tenderness in the upper neck and the 

back.” (RR 3:52).
13

Blalock testified that she objectively found “pain and tenderness and 

[Walker’s] range of motion in her low back was limited with pain, as well.” (RR 

3:70). She further testified that she was trained to detect people faking pain (RR 

3:77), how she detects it (RR 3:78-79), and that Walker was not faking her pain. 

(RR 3: 77-79).

Gregory Walker testified that when he first saw Walker after the collision, “I 

found my wife was in pain, discomfort.” (RR 3:90). He also testified about having 

to massage his wife’s back to relieve the pain from back spasms. (RR 3:90-91).

Walker herself testified to the “intense pain” she experienced after the 

collision that she had never experienced prior. (RR 3:113). She also testified that 

while she had experienced slight numbness prior to the collision, she had not 

experienced the type of intense pain she had afterwards. (RR 3:133).

As to future physical pain and mental anguish, Walker testified that even at 

the time of trial, she had to wear patches to control the pain and spasms. (R 3:133). 

The fact that the pain persisted more than two years after the collision makes it a 

near certainty that it would continue after the trial and that she would experience at 

least some amount of physical pain and mental anguish in the future.

The jury also awarded Walker no damages for past or future physical 

impairment despite undisputed evidence that she had suffered physical impairment 

as a result of the collision.
14

In addition to seeing bone spurring and disc bulging in Walker’s MRI (RR 

3:23), Dr. Solis detected inflamed joints (RR 3:21), general inflammation, and 

tightness and tenderness when he examined Walker after the collision. (RR 3:52).

Blalock also testified to Walker’s physical impairment. After the collision,

Walker objectively had flexibility deficits, mobility deficits, and muscle weakness 

in her spinal and core musculature. (RR 3:70). She also had difficulty tolerating 

exercises and “required frequent position changes due to difficulty tolerating one 

position for longer than five minutes.” (RR 3:70-71).

Gregory Walker provided ample evidence of Walker’s physical impairment. 

He testified that prior to the collision, Walker gardened. (RR 3:87). After the 

collision, Walker was no longer able to garden. (RR 3:91). He testified that prior 

to the collision, he and Walker took regular trips (RR 3:86). After the collision, 

she was unable to sit for the period of time required to travel on a regular basis. 

(RR 3:91).

He testified that Walker did not feel physically up to doing her daughter’s 

hair after the collision (RR 3:92) and that she was no longer able to attend her 

son’s basketball games. (RR 3:92, 95). Furthermore, she stopped cooking and 

stopped sleeping through the night as a result of the physical impairment she 

suffered as a result of the collision. (RR 3:93).
15

Gregory Walker also provided some evidence of future physical impairment. 

He testified that his wife has gotten better, but she still needed to stretch more and 

was still trying to regain a sense of normalcy. (RR 3:95).

Walker’s own testimony was that she had experienced no lingering neck or 

back problems from her previous collision. (RR 3:105). She testified that she 

could no longer drive or ride in a car for more than an hour under normal 

circumstances after the collision. (RR 3:111). She testified that she could no 

longer engage in regular sexual activity with her husband (RR 3:114), which he 

corroborated. (RR 3:91). 

She also testified that she had spasms while testifying at the trial itself (RR 

3:133), making it a near certainty that the impairment would continue in the future.

None of the evidence that Walker sustained damages in the collision was 

disputed in any way. All of Scopel’s evidence, including the photographs (D. Ex. 

1), the email (D. Ex.2), and the excerpt of Walker’s medical records (D. Ex. 3), go 

to the degree to which she suffered damage, not whether she suffered damage. 

The evidence is thus undisputed that Walker suffered some damages as a result of 

the collision and the jury was not at liberty to award zero damages.
16

PRAYER

For the foregoing reasons, Appellant respectfully requests this honorable 

court to reverse the judgment, grant a new trial, and remand this case to the district 

court.

Respectfully submitted,

Law Offices of Reginald E. 

McKamie, Sr., P.C.

/s/ Reginald E. McKamie, Sr_____

REGINALD E. MCKAMIE, SR.

TBN: 13686750

1210 Antoine, Suite 100

Houston Texas 77055

(713) 465-2889

(713) 465-2894 fax

Attorney for Appellant:

PAMELA WALKER
17

CERTIFICATE OF SERVICE

I certify that a copy of this instrument has been served upon opposing 

counsel.

/s/ Reginald E. McKamie, Sr_____

 REGINALD E. MCKAMIE, SR.

CERTIFICATE OF COMPLIANCE

This document complies with the typeface requirements of Tex. R. App. P. 

9.4(e) because it has been prepared in a conventional typeface no smaller than 14-

point for text and 12-point for footnotes. This document also complies with the 

word-count limitations of Tex. R. App. P. 9.4(i) because it contains 3,422 words.

/s/ Reginald E. McKamie, Sr____

 REGINALD E. MCKAMIE, SR.
18

APPENDIX







Texas Rules of Evidence

Rule 403.

Excluding Relevant Evidence for Prejudice, Confusion, or Other Reasons 

The court may exclude relevant evidence if its probative value is 

substantially outweighed by a danger of one or more of the following: unfair 

prejudice, confusing the issues, misleading the jury, undue delay, or 

needlessly presenting cumulative evidence. 
I i; 08S 

l J.IBIHX3 

S,J.NVON3:130 

£0::JS 
Walker, Pamela D (MR # 07282551) 

Author Note Status 

Cherice M Conley-Harvey, Signed 

MD 

Telephone Encounter 

From: WALKER.PAMELA 0 

To: Cherice M Conley-Harvey, MD 

Sent: Tue Jun 28, 2011 9:47 AM 

Subject: Physical Therapy 

Good Morning, 

Last Update User 

Cherice M ConleyHarvey, MD 

Encounter Date: 06/28/2011 

Last Update DatefTime 

6/30/2011 9:50 AM 

I wa$ in a hiVrun car accident last week and in need of a physical therapist. Would you please schedule me 

with one? I injured my left hand however; my neck and back are beginning to hurt. Thanks! 

Please reply_ lo this message by electronic messaging. 

- • '" •n """"'"n"'"' ee I ' n .._.:_ .. _ ... t... •• r _ T--- r n d Tr. A C l - · C l, I,, .., .::.A n A AA 

KELSEY SEYBOLD CLIN IC - ivIEDICAL [5442558-04] 90 
16 Clinic 

Patient Information (continued) 

Meds Comments as of 2127/2012 

LAKES AT 610 

8900 LAKES AT 610 

HOUSTON, TX 77054-2525 

KSC COMPLETE CHART 

WALKER.PAMELA D 

MRN: 07282551 

DOB: 12114/1966, Sex: F 

Enc. Date:04/03/12 

2127/2012 Pt. Stopped reflux med. One week ago. Takes Nutrilite multi-vii. 

Ordered Medications 

Pregabalin (L YRICA) 25 MG OR CAPS 

(Discontinued) 

Sig: 1 po hs for one week, then bid 

All Results 

No results found 

Vitals - Last Recorded 

Disp 

60 each 

Refills 

0 

Start 

4/3/2012 

End 

5/4/2012 

Ht Wt 

5' r {1.702 m) 140 lb (63.504 kg) 

BMI 

21.93 

kg/m2 

LMP 

03/1212012 

Vitals History Recorded 

Progress Notes 

Keosha Albert Cma I Certified Medical Assistant I 4/3/2012 9: 11 AM Signed 

Referral? Self referral 

Chief complairit: 

Chief Complaitit 

Patient with 

• Back Pain 

Pain: 2110 

A) Chief complaint or Subjective: 

Where is your pain?: left arm pain for approx. 4-5 years, left arm tingling and numbness, leg tingling 

and numbness - emg 2010 neg for peripheral neuropathy. emg 2011 of left upper limb was normal. Reports 

aching and tingling/numbness in left arm is worse following an mva in early 2012. 

When did this problem start? 3 month(s); sx also present prior for approx. 4 years, no inciting 

event 4 years ago 

How did this pain start? gradually 4 years ago 

Any inciting event?: yes - nothing in particular but cites an mva 3 mo ago making left arm 

symptoms worse 

Is the pain improving, worsening, or stable over time?: worsening left shoulder and neck/lower 

back improving . 

Have you had this pain before? - reports no initially, but later states she's had left arm tingling 

and numbness for several years. 

Typical pain severity: 2/10 

Printed on 5/31/2013 6:41 AM 

KELSEY SEYBOLD CLINIC - MEDICAL 

DEFENDANT'S I EXHIBIT 

lJ 3 Page 35 of 80 

[5442558-04] 36 
9' Kelsey-Seybold Clinic 

Patient Information (continued) 

Progress Notes (continued) 

HOUSTON, TX 77054-2525 

KSC COMPLETE CHART 

Pain severity during flare-ups: 4/10 

WALKER,PAMELA D 

MRN: 07282551 

DOB: 12/14/1966, Sex: F 

Enc. Date:04/03112 

How often do you get a flare up? Several times a week and Factors that cause a flare up: 

prolonged sitting/lifting and bending 

What is the duration of your pain? M1nutues/hours/daily 

Describe your pain: Burning arm/shoulder, Dull, Pins/Needles back, Numbness arms and 

shoulder 

What activity increases your pain? Sitting, Bending, Lifting, Driving 

What have you tried for this pain? Rest, Heat. Physical Therapy, Medications - (ibuprofen). 

exercise 

Prior experience with neurontin: Caused suicidal ideation; SSRI, sx did not improve 

Do you have any .. Weakness yes .. left arm and hand and Numbness yes - left arm and hand 

What position/activities improve the pain?: None in particular 

Which doctors have you seen for this problem? Physical Therapist and Neurologist 

What diagnostic tests have you had for this pain? MRI Scan: Results: and CT Scan: Results: 

Blood Thinners: 

Allergies 

Allergen 

• Azithromycin 

Felt like her throat was closing up. 

• Codeine 

• Nitrofurantoin 

Current Outpatient PrescrfpUons 

Medication 

• Ergocalcif erol 50000 UNIT OR 

CAPS 

• Ibuprofen 600 MG OR TABS 

• IRONOR 

• OMEPRAZOLE 40 MG OR CPDR 

• Venlafaxine HCI (EFFEXOR XR) 

37.5 MG OR CP24 

Printed on 5/31/2013 6:41 AM 

KELSEY SEYBOLD CLINIC - lvfEDICAL 

Sig 

Reactions 

Rash 

Hives 

Take 1 capsule by mouth once a 

week 

Take 600 mg by mouth every 6 

hours as needed 

Take by mouth 

TAKE 1 CAPSULE BY MOUTH 

EVERY MORNING 1/2 HOUR 

PRIOR TO BREAKFAST 

Take 1 capsule by moulh daily 

Dispense 

4capsule 

• 

30 capsule · 

30capsule 

Refill 

1 

0 

2 

Page 36of80 

[5442558-04] 37