CITY OF RIALTO
ANEU
CITY CLERA
WRITER'S E-MAIL:
[email protected]
VIA FIRST CLASS CERTIFIED MAIL NO. 9414 8118 9876 5493 8424 52
RETURN RECEIPT REQUESTED
January 4, 2024
City Clerk's Office
City of Rialto
150 S. Palm Ave.
Rialto, CA 92376
My Client: Joel Tennyson
Date of Loss: July 5, 2023 ("Subject Accident")
Dear Sir or Madam:
Please be advised that on August 7, 2023, this office has been retained by Joel Tennyson in connection with his personal injury claims resulting from the incident that took place on July 5, 2023.
Enclosed please find an original and a copy of Mr. Tennyson's Claim for Damages to Person or Property against the City of Rialto along with a copy of the face sheet for conforming.
Please process the original and forward conformed copy in the envelope that is provided.
Please direct any questions to attorney Tim J. Pollard at (909) 655-6102 or email him at timipollard@)thefirm.com and [email protected] Very truly yours,
POLLARD
556 N. Diamond Bar Blvd. Suite 300 www.thePOLLARDfirm.com Diamond Bar, CA 91765 [email protected]
Telephone: 909.655.6102 Facsimile: 909.503.0816
CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY CITY OF RIALTO
CLAIM FOR DAMAGES 2024 JAN - 9 AMII: 33
TO PERSON OR PROPERTY RECEIVEW
CITY GLENN
1. Claims for death, injury to person, or to personal property must be filed not later than six (6) months after the occurrence (Gov. Code §911.2).
2. Claims for damages to real property must be filed not later than one (1) year after the occurrence (Gov. Code §911.2). RETURN TO:
3. READ ENTIRE CLAIM FOR BEFORE FILING Rialto City Clerk's Office
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Mail: 150 S. Palm Ave., Rialto, CA 92376 Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
JOEL TENNYSON
FULL NAME DATE OF BIRTH
ADELANTO, CA 92301 L 909) 396-1800
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO. 556 N. DIAMOND BAR BLVD. STE. 300 DIAMOND BAR, CA 91765 ( 909) 396-1800 BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE THE POLLARD FIRM, APC 556 N. DIAMOND BAR BLVD. SUITE
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
300 DIAMOND BAR, CA 91765
(if different from home address provided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: JULY STH AND 6TH 2023 TIME: 8:00 • AM IX PM
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (if applicable) locate on diagram on reverse side of this sheet.
Where appropriate, give street names and addresses, measurements and landmarks.
RIALTO POLICE DEPARTMENT 128 N. WILLOW AVENUE RIALTO, CA 92376
3. HOW DID DAMAGE OR INJURY OCCUR?
RIALTO POLICE OFFICERS, INCLUDING OFFICER MORALES AND OFFICER GREEN, USED EXCESSIVE AND UNREASONABLE FORCE AGAINST ME WHILE I WAS HANDCUFFED AND NOT A THREAT, CAUSING UNECESSARY INJURY. OFFICERS DROPPED ME ON MY FACE
WHILE THEY WERE PUTTING ME INTO A POLICE VAN DESPITE ME WARNING THEM THAT I HAD (CONTINUED ON ATTACHMENT)
4. WERE POLICE AT THE SCENE? [* YES •NO WERE PARAMEDICS AT THE SCENE? •YES NO
5. WHAT PARTICULAR ACT OR OMISSION DO YOU CLAIM CAUSED THE INJURY OR DAMAGES? Give the name of the city/town employee causing the injury or damage, if known.
RIALTO POLICE OFFICERS GREEN AND MORALES INTENTIONALLY AND MALICIOUSLY DROPPED ME ON MY FACE AS THEY PLACED ME INTO A POLICE VAN WHILE T WAS HANDCUFFED. IMMEDIATELY THEREAFTER THEY PICKED ME UP AND VIOLENTLY THREW ME INTO THE BACK OF A PATROL CAR INJURING ME FURTHER.
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ 1,500,000.00 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Item/Date: COMPREHENSIVE NEW PATIENT EXAM - OCTOBER 3, 2023 Amount: $2,000.00 Item/Date: REFERRAL TO BRAIN MRI. PAIN MANAGEMENT Amount: $ 10.000.00 + CHIRO. NOVEMBER 2, 2023
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: 12,000.00 + $
ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN: CITY OF RIALTO Item/Date: PAIN MANAGEMENT - ONGOING AN- 9 AM II: Amount: $ 10,000.00 2024 J
Item/Date: CHIROPRACTIC CARE- ONGOING Amount: $ 5,000.00 TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: RECEIVEL $15,000.00 +
CITY CLERA
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) NAME: OFFICER GREEN NAME: OFFICER MORALES
ADDRESS: 128 N. WILLOW AVENUE ADDRESS: 128 N. WILLOW AVENUE RIALTO, CA 92376 RIALTO, CA 92376
TELEPHONE: ( ) 909-820-2550 TELEPHONE: ( ) 909-820-2550
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: JOHNATHAN EZKENAZI, M.D./TBI SPECIALISTS NAME:
ADDRESS: 6363 WILSHIRE BLVD. STE 516
ADDRESS:
LOS ANGELES, CA 90048
TELEPHONE: (213 ) 224-7063 TELEPHONE: |
DATE: 10/3/2023; VARIOUS TIME: TBD LA AM PM DATE: TIME: • AM • PM
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehicle accident claims, place on the following diagram, the names of streets, including NORTH, EAST, SOUTH AND WEST directions. Indicate place of accident by 'X and by showing house numbers or distances to street comers. f a city/town vehicle was involved, designate by letter "A" location of the City/Town vehicle when you first saw it, and by "B" location of yourself or your vehicl when you first saw City/Town vehicle; location of City/Town vehicle at time of accident by "A-1" and location of yourself or your vehicle at the time of the accident by "B-1" and the point of impact by "X".
→ NOTE: IF THE DIAGRAM BELOW DOES NOT FIT THE SITUATION, PLEASE ATTACH A PROPER DIAGRAM SIGNED BY THE CLAIMANT.
CURB
PARKWAY
7 SIDEWALK
THAVE ATE ONE AN EATEN ONE TEA NE ANAS TO THESE ME IS EVE THE TO ERE EXCEPT ASTO I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNAYURE UHCHAMANY OR AGENI
TIM J. POLLARD' JANUARY 3, 2024
TYPE OR PRINT NAME DATE
ATTORNEY FOR CLAIMANT
RELATIONSHIP TO CLAIMANT
NOTE: PRESENTATION OF A FALSE CLAIM IS A FELONY (CA PENAL CODE 72) RETURN CLAIM TO: RIALTO CITY CLERK'S OFFICE - 150 S. PALM AVE., RIALTO, CA 92376 MC-025
SHORT TITLE: CASE NUMBER:
JOEL TENNYSON Vs. CITY OF RIALTO POLICE DEPT. ET AL.
ATTACHMENT (Number): ATTACHMENT
(This Attachment may be used with any Judicial Council form.)
ATTACHMENT TO CITY OF RIALTO LIABILITY CLAIM FOR DAMAGES TO PERSON OR
PROPERTY
3. HOW DID DAMAGE OR INJURY OCCUR? (CONTINUED FROM PAGE 1) DIFFICULTY WALKING DUE TO A PHYSICAL DISABILITY. OFFICER MORALES GRABBED ME
AND THREW ME INTO A POLICE CAR WHILE I WAS HANDCUFFED AND SCREAMING FOR HELP DUE TO AGONIZING PAIN. WHEN OFFICER MORALES INTENTIONALLY DROPPED ME AFTER THE LAST STEP IN THE VAN, I FELL ONTO THE LEFT SIDE OF MY FACE/HEAD, AND ELBOWS. I» WAS BLEEDING FROM MY ELBOWS DUE TO STRIKING THEM ON THE FLOOR OF THE VAN.
AFTER BEING INJURED IN THE VAN, OFFICER MORALES BECAME ENRAGED THAT I COULD
NOT STAND UP AND HE THEN GRABBED ME AND THREW ME INTO THE BACK OF A POLICE
CAR AND FORCEFULLY AND VIOLENTLY SHOVED MY LEGS INTO SAME CAUSING ADDITIONAL PAIN AND INJURY TO MY HIPS.
OFFICER MORALES REFUSED TO BELIEVE MY WARNINGS TO HIM THAT I COULD NOT WALK
NORMALLY AND THAT I WAS DISABLED EVEN CALLING ME A LIAR AND LAUGHING AT ME WHILE I WAS HAVING DIFFICULTY STANDING UP.
(If the item that this Attachment concerns is made under penalty of perjury, all statements in this Page 1 _of 1 Attachment are made under penalty of perjury.)
(Add pages as required)
Form Approved for Optional Use ATTACHMENT www.courtinfo.ca.gov Judicial Council of California
MC-025 (Rev. July 1, 2009) to Judicial Council Form
CITY OF RIALTO
2024 JAN - 9 AM||: 33
RECEIVLI
TBI SPECIALIST CITY CLERK
NEUROLOGICAL CONSULTATION
October 03, 2023
RE: Tennyson, Joel
DOB:
DOL: 07/05/2023
Contact Nos: (909) 301-7704
Mr. Joel Tennyson is a 38-year-old, right -handed male, here for evaluation of symptoms resulting after an accidental fall.
HISTORY OF PRESENT ILLNESS:
On July 05, 2023, the patients states that he was being detained by officers. During this time, he was asked to step inside a van, he said that he was disabled due to his hip replacement surgery and arthritis in the hip. He was then lifted using his arms to the van, and the officers let go of him early causing him to fall face first in the van. Upon falling, he felt pain in his hip, elbow and head, he experienced headaches and then he thinks he lost consciousness and woke up in another cop car.
After sometime, he was able to visit a hospital to undergo an x-ray scan. He denies receiving any other therapy or seeing any doctors.
Currently, he complains of intermittent headaches located at the left side of the head. This headache happens once or twice a week associated with dizziness, poor balance, ringing in the ears, light and sound sensitivity. He rates the headache as 8/10 in general.
He still complains of constant pain in the hips with tension-like sensation. He rates the pain as 8/10 on a good day and 10/10 on a bad day. The pain radiates to his legs. Walking, standing and sitting or 20-30 minutes aggravate the pain. Ice packs and massages help alleviate the pain.
He also complains of intermittent pain in his elbow with associated bruising. He rates the pain as 7/10. Ice packs and massages helps alleviate the pain.
6363 Wilshire Bl., Ste 516, Los Angeles, Ca., 90048 | 4480 E. Milis Circle, Ontario, Ca., 91764
CITY OF RIALTO
2924 JAN -9 AMII: 33
TBI SPECIALIST CITY CLERK
When asked about his mood, he reports stress, depression and lack of motivation due to his current pain. He also reports eating more since the incident and has gained around 10 pounds.
He reports flashbacks of the incident.
Cognitively, he patient reports difficulty concentrating, focusing and being easily distracted. He denies spacing or zoning out, memory issues, speech changes and issues with finishing tasks.
Regarding his sleeping pattern, he has difficulty falling asleep and maintaining sleep. He sleeps around five hours per night, interrupted twice or thrice because of the pain in his hips. He does not know if he is snoring. In the morning, he feels tired. He reports fatigue during the daytime and he takes afternoon naps.
FAMILY HISTORY:
There is no family history of neurological disease.
SOCIAL HISTORY:
The patient denies drinking alcoholic beverages.
He reports smoking 1 pack of cigarettes per week
There is no history of allergies to medications.
PAST MEDICAL HISTORY:
The patient has not been hospitalized in the past.
There is no history of cardiac, renal, blood or neurological diseases.
There is no history of hypertension, diabetes, tuberculosis or cancer.
CURRENT MEDICATIONS:
The patient is not taking any medication
6363 Wilshire Bl., Ste 516, Los Angeles, Ca., 90048 | 4480 E. Milis Circle, Ontario, Ca., 91764
CITY OF RIALTO
2074 JAN - 9 AMII: 33
KECEIVED
GITY CLERK
TBI SPECIALIST
REVIEW OF SYSTEMS:
Constitutional: The patient reports fatigue and gaining 10 pounds of weight ENT: The patient reports blurred vision. He denies or a history of glaucoma, tinnitus or recent loss of hearing, sinusitis, difficulty swallowing or dry mouth, sore throat lumps painful chewing, teeth grinding, or TMJ dysfunction
Respiratory System: The patient denies sleep apnea, shortness of breath or wheezing. The patient denies dyspnea on exertion, cough, asthma, hemoptysis, rhonchi, or bronchitis. There is no history of tuberculosis or chemical exposure.
Cardiovascular System: The patient denies chest pain or hypertension. The patient denies any syncope, malignant arrhythmias, palpitations, coronary artery disease, heart attack or heart murmur.
Gastrointestinal System: The patient denies nausea, vomiting, diarrhea, abdominal pain and constipation. The patient reports acid reflux. He denies any, melena, bright red blood per rectum, peptic ulcer disease, or hepatitis.
Genitourinary System: The patient reports hesitancy in urinating. He denies any sexual dysfunction. There is no history of renal stones or incontinence.
Endocrine System: The patient denies diabetes mellitus, hyperlipidemia, or thyroid disease.
Musculoskeletal System: The patient reports pain in hips and elbow. The patient reports arthritis.
He denies any fibromyalgia, systemic lupus erythematosus, degenerative joint disease or gout.
Hematologic System: The patient denies easy bruisability and blood dyscrasias. There is no history/history of anemia.
TELE EXAMINATION:
Mental Status: Alert and oriented to person, place, time and situation.
Language is fluent without paraphasias.
Was able to repeat long sentences (more than 6 words)
6363 Wilshire Bl., Ste 516, Los Angeles, Ca., 90048 | 4480 E. Milis Circle, Ontario, Ca., 91764
CITY OF RIALTO
2024 JAN - 9 AMII: 34
RECEIVEN
TBI SPECIALIST CITY CLERK
Naming was intact, comprehension was intact
Registration was 3/3 on the first attempt. Recalled 2/3 at 5 minutes; improved to 3/3 with cues.
IMPRESSION:
1. POSTCONCUSSIVE SYNDROME SP FALL
2. POSTCONCUSSIVE HEADACHE
Based on the mechanism of injury and denial of previous injury with high medical probability, the accident was the cause of the injury and related symptoms.
RECOMMENDATIONS:
1. Pain management consult for upper and lower back pain
2. Chiroptractic treatment
3. Advance MRI technique including 3 Tesla MRI of the brain without contrast with SWI and DTI and volumetric analysis
4. EEG routine
5. VAT combo with ENG and vestibular exercises
6. Neurological follow-up in-person, in 1 month
Electronically signed and approved by Jonathan Eskenazi MD Assistant Professor in Neurology at UCLA School of Medicine Clinical Faculty Cedars Sinai Medical Center
Board Certified Neurologist
Board Certified Brain injury specialist
6363 Wilshire Bl., Ste 516, Los Angeles, Ca., 90048 | 4480 E. Milis Circle, Ontario, Ca., 91764
CITY OF RIALTO
2024 JAM - 9 AMII: 34
RECEITLO
TBI SPECIALIST GITY CLLRF
6363 Wilshire Bl., Ste 516, Los Angeles, Ca., 90048 | 4480 E. Milis Circle, Ontario, Ca., 91764
CITY OF RIALTO
JAN - 9 AMII: 34
ECEliLL
ATY CLERA
TBI SPECIALIST
JONATHAN ESKENAZI, M,D
6363 WILSHIRE BLVD SUITE 516
LOS ANGELES, CA 90048
TEL. 213-224-7063 FAX 213-289-7714
Patient Name DOB
Tennyson, Joel
Address Gender
M
Advance MRI technique including 3 Tesla MRI of the brain without contrast with SWI and DTI and volumetric analysis
E Do not substitute
Refill NR 1 2 3 4 5 PRN
10/03/2023
Date
CITY OF RIALTO
2024 JAN -9 AMII: 34
RECEIVED
CITY CLERK
TBI SPECIALIST
JONATHAN ESKENAZI, M,D
6363 WILSHIRE BLVD SUITE 516
LOS ANGELES, CA 90048
TEL. 213-224-7063 FAX 213-289-7714
Patient Name DOB
Tennyson, Joel
Address Gender
M
Rx
1. Pain management consult for upper and lower back pain E Do not subsiure
Refill NR 12345 PRN
10/03/2023
Date
CITY OF RIALTO
2024 JAN-9 AMI|: 34
RECEIVEL
CITY CLERA
TBI SPECIALIST
JONATHAN ESKENAZI, M,D
6363 WILSHIRE BLVD SUITE 516
LOS ANGELES, CA 90048
TEL. 213-224-7063 FAX 213-289-7714
Patient Name DOB
Tennyson, Joel
Address Gender
M
Rx
1. Chiroptractic treatment
B Do not substitute
Refill NR12345 PRN
10/03/2023
X Date
USPS CERTIFIED MAIL™
THE POLLARD FIRM, APC $7.66 US POSTAGE
556 N DIAMOND BAR BLVD STE 300 FIRST-CLASS
DIAMOND BAR CA91765-1066 Jan 04 2024
Mailed from ZIP 91765
3 OZ FIRST-CLASS MAIL LETTER 110 0
RATE
USPS CERTIFIED MAIL 11923275
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9414 8118 9876 5493 8424 52
Rialto City Clerks Office
City of Rialto
150 S PALM AVE
RIALTO CA 92376-6406
CITY CLERK REbhirLu 20% MN - ? AMM: 33 CITY OF RIALTO