1 Pleading - Civil Case Cover Sheet - Final_070105

UNITED STATES DISTRICT COURT, EASTERN DISTRICT OF CALIFORNIA CIVIL COVER SHEET I (a) PLAINTIFFS (Check box if you are representing yourself 0) JADWIN, David F., D.O.

DEFENDANTS (See Attachment I)

(b) County of Residence of First Listed Plaintiff (Except in U.S. Plaintiff Cases): Los Angeles County, California.

County of Residence of First Listed Defendant (In U.S. Plaintiff Cases Only): Kern County, California

(c) Attorneys (Firm Name, Address and Telephone Number. If you are representing yourself, provide same.) Eugene Lee (S8# 236812) LAW OFFICE OF EUGENE LEE 555 West Fifth St, Suite 3100, Los Angeles, CA 90013 Telephone: (213) 992-3299

Attorneys (If Known)

II. BASIS OF JURISDICTION (Place an X in one box only.)

o I U.S. Government Plaintiff 02 U.S. Government Defendant

III. CITIZENSHIP OF PRINCIPAL PARTIES - For Diversity Cases Only (Place an X in one box for plaintiff and one for defendant.)

KI 3 Federal Question (U.S. Government Not a Party)

PTF DEF 01 01

Citizen of This State

04 Diversity (Indicate Citizenship Citizen of Another State of Parties in Item III)

Incorporated or Principal Place of Business in this State

PTF DEF 04 04

02

02

Incorporated and Principal Place 05 of Business in Another State

05

Citizen or Subject of a Foreign Country 0 3

0 3

Foreign Nation

06

06

IV. ORIGIN (Place an X in one box only.) ~

I Original Proceeding

02 Removed from State Court

V. REQUESTED IN COMPLAINT:

03 Remanded from Appellate Court

04 Reinstated or Reopened

JURY DEMAND: KJ Yes

CLASS ACTION under F.R.C.P. 23: 0 Yes

0 No

05 Transferred from another district (specify):

06 MultiDistrict Litigation

o7

Appeal to District Judge from Magistrate Judge

0 No (Check 'Yes' only if demanded in complaint.)

0 MONEY DEMANDED IN COMPLAINT: $ To Be Detennined

VI. CAUSE OF ACTION (Cite the U.S. Civil Statute under which you are filing and write a brief statement of cause. Do not cite jurisdictional statutes unless diversity.) 29 U.S.C. §§ 2601, et seq., Interference with FMLA Rights; ; 42 U.S.C. § 1983, Violation of Procedural Due Process Guaranteed byl4th Amendment of U.S. Constitution; 29 U.S.C. §201 et seq., Violation ofFLSA (unpaid wages); and pendent state claims. VII. NATURE OF SUIT (Place an X in one box only.)

0400 0410 0430 0450 0460 0470

o 480 o 490 o 810 o 850 0875 0891 0892 0893 0894 0895 0900

0950 0890

State Reapportionment Antitrust Banks and Banking Commerce/ICC Rates/etc. Deportati on Racketeer Influenced and Corrupt Organizations Consumer Credit Cable/Sat TV Selective Service Securities/Commodities /Exchange Customer Challenge 12 USC 3410 Agricultural Act Economic Stabilization Act Environmental Matters Energy Allocation Act Freedom of Info. Act Appeal of Fee Determination Under Equal Access to Justice Constitutionality of State Statutes Other Statutory Actions

0110 0120 0130 0140 0150

0151 0152

0153

0160 0190 0195

0210 0220 0230 0240 0245 0290

Insurance Marine Miller Act Negotiable Instrument Recovery of Overpayment & Enforcement of Judgment Medicare Act Recovery of Defaulted Student Loan (Exc1. Veterans) Recovery of Overpayment of Veteran's Benefits Stockholders' Suits Other Contract Contract Product Liability

Land Condemnation Foreclosure Rent Lease & Ejectment Torts to Land Tort Product Liability All Other Real Property

0310 Airplane 0315 Airplane Product Liability 0320 Assault, Libel & Slander 0330 Fed. Employers' Liability 0340 Marine 0345 Marine Product Liability 0350 Motor Vehicle 0355 Motor Vehicle Product Liability 0360 Other Personal Injury 0362 Personal InjuryMed Malpractice 0365 Personal InjuryProduct Liability 0368 Asbestos Personal Injury Product Liability

o 370

Other Fraud 0371 Truth in Lending 0380 Other Personal Property Damage o 385 Property Damage Product Liability

Ilill:IJi!I!!!~_.III¢YI'II

o 422 0423

Appeal 28 USC 158 Withdrawal28 USC 157 illli: •.• ··· Voting Employment Housing!Accommodations Welfare American with Disabilities Employment American with Disabilities Other Other Civil Rights

0510 Motions to Vacate Sentence Habeas Corpus 0530 General 0535 Death Penalty 0 540 Mandamus/ Other 0 550 Civil Rights 0 555 Prison Condition

l:i.CIl\Il1.iig• • 0441 iii 442 o 443 0444 o 445

o 446 o 440

VIII(a). IDENTICAL CASES: Has this action been previously filed and dismissed, remanded or closed? III No

0625

0630 0640 0650 0660 0690

Agriculture Other Food & Drug Drug Related Seizure of Property 21 USC 881 Liquor Laws R.R. & Truck Airline Regs Occupational Safety /Health Other

o 720 o 730 o 740 o 790

Fair Labor Standards Act Labor/Mgmt. Relations Labor/Mgmt. Reporting & Disclosure Act Railway Labor Act Other Labor Litigation Empl. Ret. Inc.

o 820

Copyrights 0830 Patent o 840 Trademark

Th.~$~~lImI\,).'W.~;:

o 861

HIA (1395fl) 0862 Black Lung (923) 0863 DIWC/DIWW (405(g» o 864 SSID Title XVI [] 8?5 RSI(495(g)J . ......•

.::::H:~~~_$ ••l~

o 870 o

Taxes (U.S. Plaintiff or Defendant) 871 IRS-Third Party 26 USC 7609

0 Yes

If yes, list case number(s): FOR OFFICE USE ONLY: EDCA-JS44 (01/05)

Case Number:

_ CIVIL COVER SHEET

Page I of2

SHORT TITLE: JADWIN v. COUNTY OF KERN, et al. ATTACHMENT 1

1 2

CASE NUMBER:

DEFENDANTS

3 COUNTY OF KERN, 4 5

PETER BRYAN (both individually and in his former official capacity as Chief Executive Officer Of Kern Medical Center),

6

IRWIN HARRIS, M.D;

7

EUGENE KERCHER, M.D. (both individually and in his official capacity as a President of Medical Staff of Kern Medical Center);

8 9 10

JENNIFER ABRAHAM, M.D. (both individually and in her official capacity as Immediate Past President of Medical Staff at Kern Medical Center); SCOTT RAGLAND, M.D. (both individually and in his official capacity as President-Elect of Medical Staff of Kern Medical Center);

11 12

TONI SMITH, (both individually and in her official capacity as Chief Nurse Executive of Kern Medical Center);

13

WILLIAM ROY, M.D.; and

14

DOES 1 through 10, inclusive

15 16 17 18 19 20 21 22 23 24 25 26 27 28

1 ATTACHMENT