HILLSSOROUGH COUNTY SUPERIOR COURT

NORTHERN DISTRICT

300 Chestnut Street

Manchester, N .H . 0310 1

(603) 669-7410

RECEIPT OF WRI T

Date : April 23, 200 7

DOCKET NUMBER : 07-C- 0 23 7

William Donald Hilton vs . Jeanne M . Charest, ARNP

Coos County Family Health Serv . Inc .

Androscoggin Valley Hospital

The writ in the above-captioned matter was filed with the

Clerk of this Court on : April 19, 200 7

The Plaintiff or his/her attorney is to attach a copy

of this receipt to identical copies of the original writ

and deliver them to the Sheriff cv other legally authorized

entity for service on each named defendant . Sufficient

copies shall be provided to allow for a service copy for

each named defendant and a copy for each officer completing

service to complete the return . The return copies shall be

filed with the court in accordance with Superior Court Rule 3 .

By Order of the Court

John M . Safford, Clerk

JMS/cmp

cc : Mark A . Abramson, Esq .

EXHIBIT A

Case 1:07-cv-00292-PB Document 1-1 Filed 09/13/07 Page 1 of 5
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SUPERIOR'COUR T

, iILLSBOROUGH COUNTY

NORTHERN DISTRICT

WRIT OF SUMMONS

William Donald Hilton

172 Aisace Street

Manchester, NH 03102

v.

( ) COURT

(XX) JURY

Jeanne M . Charest, ARNP

133 Pleasant St ., Berlin, NH 0357 0

Coos County Family Health Services, Inc

133 Pleasant St ., Berlin, NH 0357 0

Androscoggin Valley Hospita l

59 Page Hill Road, Berlin, NH 0357 0

The Sheriff or Deputy of any County is ordered to summon each defendant to file a written appearance with the

Superior Court at the address listed below by the return day of this writ which is the first Tuesday of August

2007 MONTH

YEAR

The PLAINTIFF(S) state(s) :

PLEASE SEE ATTACHED

A1RVE CO~ ~~5~

jj~skf f

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-

and the Plaintiff(s) claim(s) damages within the jurisdictional limits of this Cou rt.

Mark A . Abramson, Esq . and Holly B . Haines, Esq .

on behalf of the plaintiff . William Donald Hilto n

INDORSER ( sq9n and print name)

4/17/07

DATE OF WRI T

NOTICE TO THE DEFENDANT

The PiaintiFl listeu above nas begun iegai acunn anamst you You do not have to physical!y appear in Coun on tne return oay !isted above since there will be no nearing

on trial oay However it you intend to conlas! this manar. you o• your attorney mus:'Ile a wrinen appearance form with the C!erk'n Oflice by that tlata . (Appearance !orrns

may be obtained irom the C!erKS Office i You will then receive notlce fron the Coun It ali proceed!ngs concerning this case It'}ou fail to lile an appearan^.e by the -P.RRr

dayiutlgn',un' wi ll ne entered against you ier a sum of money wnich you Will then be ooliga!ed to pa y

Witness, Robe rt J . Lynn, Chief Justice, Superior Cou rt.

~-- .

r

ohn M. Safford, Cler k

NH Superior Court Hillsborough County

Northern District

300 Chestnut St

Manchester NH 03101-2490

(603) 669-7410

: I

PRINTE PED NAME

Abramson, Brown

1819 Elm Street

ADDRESS

~~CPi V z ~..~~~' -~ /

~ $ATURE OF PLAINTIFF/ATTO NEY

Mark A . Abramson, Esq ./Holly B .

& Dugan

SERVICE COPY Manchester, NH 03104

Haines, Esq .

603-627-1819

PHONE

Case 1:07-cv-00292-PB Document 1-1 Filed 09/13/07 Page 2 of 5
COUNT I

(Medical Negligence -Jeanne Charest, ARNP)

IN A PLEA OF THE CASE for that during February and March 2003, the plaintiff,

William Donald Hilton, then a 15 year old boy, presented to Coos County Family Health

Services, Inc . for treatment of ongoing fevers, nausea, vomiting and right sided abdominal pain

and came under the care of defendant Jeanne Charest, ARNP ; IT WAS THEN AND THERE

THE DUTY OF THE DEFENDANT, Jeanne Charest, ARNP, to provide medical care in

accordance with accepted standards of reasonable professional practice among similar health care

providers; YET, NEVERTHELESS THE DEFENDANT NEGLIGENTLY FAILED TO MEET

SUCH STANDARD in that she, among other things, failed to properly assess and diagnose the

plaintiff's condition; failed to order necessary and appropriate diagnostic tests; failed to admit

Mr. Hilton to the hospital for evaluation and treatment; failed to obtain appropriate consults with

specialists; and otherwise failed to ensure the safety of her patieni; AS A RESULT OF THE

AFORESAID BREACHES OF DUTY, Mr. Hilton suffered a ruptured appendix and subsequent

peritoneal infection requiring surgery and extended hospitalization; AS A FURTHER RESULT,

Mr. Hilton suffered extensive internal scarring resulting in urethral stricture, he requires daily

medication and self-catheterization, and he will require quarterly urethral dilation for the rest of

his life; he has experienced, and will continue to experience, physical pain and emotional

suffering, loss of enjoyment of life, loss of opportunity, loss of earnings and earning capacity,

loss of a better outcome and he has incurred and will incur substantial expenses for his care and

treatment; ALL TO THE DAMAGE OF THE PLAINTIFF, as he says, in an amount sufficient to

compensate him for his losses together with interest and costs and within the jurisdictional limits

of this Court.

COUNT II

(Vicarious Liability - Coos County Family Health Services, Inc. )

IN A PLEA OF THE CASE for that the plaintiffs incorporate by reference each of the

allegations contained in Count I; at all times relevant, Jeanne Charest, ARNP, was an agent,

employee or co-joint venturer with defendant Coos County Family Health Services, Inc., acting

within the scope of her agency, employment or joint venture ; AS A RESULT, the defend ant,

Coos County Family Health Services, Inc., is vicariously liable for her negligence as set forth

above; ALL TO THE DAMAGE OF THE PLAINTIFF as he says, in an amount sufficient to

compensate him for his losses together with interest and costs and within the jurisdictional limits

of this Court.

COUNT III

(Vicarious Liability - Androscoggin Valley Hospital )

IN A PLEA OF THE CASE for that the -p laintiffs incorporate by reference each of the

allegations contained in Count I; at all times relevant, Jeanne Charest, ARNP, was an agent,

employee or co-joint venturer with defendant Androscoggin Valley Hospital, acting within the

scope of her agency, employment or joint venture ; AS A RESULT, the defendant, Androscoggin

Case 1:07-cv-00292-PB Document 1-1 Filed 09/13/07 Page 3 of 5
Valley Hospital, is vicariously liable for her negligence as set forth above; ALL TO THE

DAMAGE OF THE PLAINTIFF as he says, in an amount sufficient to compensate him for his

losses together with interest and costs and within the jurisdictional limits of this Court.

COUNT IV

(Negligent Supervision -Coos County Family Health Services, Inc.)

IN A PLEA OF THE CASE for that during February and March 2003, the plaintiff,

William Donald Hilton, then a 15 year old boy, presented to Coos County Family Health

Services, Inc . for treatment of ongoing fevers, nausea, vomiting and right sided abdominal pain ;

IT WAS THEN AND THERE THE DUTY OF THE DEFENDANT, Coos County Family

Health Services, Inc ., acting through its agents, employees and co-joint venturers, to properly

supervise its medical care providers and staff and to ensure that its practitioners possessed the

knowledge and exercised the degree of sk-ill that the average and prudent practitioners should

under the same or similar circumstances to assure the quality of patient care being provided ;

YET, NEVERTHELESS, the defendant, Coos County Family Health Services, Inc ., acting

through its agents, employees and co-joint venturers, failed in the performance thereof in that it

failed to supervise its medical care providers and staff in their work to ensure that its staff could

properly diagnose the plaintiff's condition, refer the plaintiff for additional necessary and

appropriate diagnostic tests, refer the plaintiff for additional consideration, consultation, care and

treatment, and it otherwise failed to exercise due care ; AS A RESULT OF THE AFORESAID

BREACHES OF DUTY, Mr. Hilton suffered a ruptured appendix and subsequent peritoneal

infection requiring surgery and extended hospitalization ; AS A FURTHER RESULT, Mr . Hilton

suffered extensive internal scarring resulting in urethral stricture, he requires daily medication

and self-catheterization, and he will require quarterly urethral dilation for the rest of his life ; he

has experienced, and will continue to experience, physical pain and emotional suffering, loss of

enjoyment of life, loss of opportunity, loss of earnings and earning capacity, loss of a better

outcome and he has incurred and will incur substantial expenses for his care and treatment ; ALL

TO THE DAMAGE OF THE PLAINTIFF, as he says, in an amount sufficient to compensate

him for his losses together with interest and costs and within the jurisdictional limits of this

Court.

COUNT V

(Medical Negligence - Androscoggin Valley Hospital)

IN A PLEA OF THE CASE for that during February and March 2003, the plaintiff,

William Donald Hilton, then a 15 year old boy, sought treatment of ongoing fevers, nausea,

vomiting and ri ght sided abdominal pain and came under the care of defend ant Androscoggin

Valley Hospital; IT WAS THEN AND THERE THE DUTY OF THE DEFENDANT

HOSPITAL, to provide medical care in accordance with accepted st andards of reasonable

professional practice among similar health care providers ; YET, NEVERTHELESS THE

DEFENDANT NEGLIGENTLY FAILED TO MEET SUCH STANDARD in that it among other

things, failed to properly assess and diagnose the plaintiff's condition; failed to order necessary

and appropri ate diagnostic tests; failed to admit Mr . Hilton for evaluation and treatment; failed to

provide appropriate consults with specialists; failed to provide approp riate monitoring and care

Case 1:07-cv-00292-PB Document 1-1 Filed 09/13/07 Page 4 of 5
upon admission, and otherwise failed to ensure the safety of the patient; AS A RESULT OF THE

AFORESAID BREACHES OF DUTY, Mr . Hilton suffered a ruptured appendix and subsequent

peritoneal infection requiring surgery and extended hospitalization ; AS A FURTHER RESULT,

Mr. Hilton suffered extensive internal scarring resulting in urethral stricture, he requires daily

medication and self-catheterization, and he will require quarterly urethral dilation for the rest of

his life; he has experienced, and will continue to experience, physical pain and emotional

suffering, loss of enjoyment ofli fe, loss of opportunity, loss of earnings and earning capacity,

loss of a better outcome and he has incurred and will incur substantial expenses for his care and

treatment; ALL TO THE DAMAGE OF THE PLAINTIFF, as he says, in an amount sufficient to

compensate him for his losses together with interest and costs and within the jurisdictional limits

of this Court.

COUNT VI

(RSA 507-E:2, III Claim - All Defendants)

IN A PLEA OF THE CASE for that the plaintiff incorporates by reference each of the

allegations contained in Counts I through IV ; regardless of the ch ances of survival or recovery

from his underlying condition, the negligence of the defendants proximately caused William

Donald Hilton to suffer physical pain and emotional distress, loss of enjoyment of life, and

proximately caused him to incur medical expenses and other costs; ALL TO THE DAMAGE OF

THE PLAINTIFF in an amount sufficient to compensate him for his losses, together with interest

and costs, and within the jurisdictional limits of this court.

Case 1:07-cv-00292-PB Document 1-1 Filed 09/13/07 Page 5 of 5