Body

IN THE UNITED STATES COURT OF APPEALS

FOR THE ELEVENTH CIRCUIT

NO. 03-12226-GG

CAROL STRONSTORFF,

Plaintiff-Appellant,

versus

BLAKE MEDICAL CENTER,

INTEGRATED HEALTH SERVICES OF BRADENTON, et al,

Defendants-Appellees. /

Motion to reconsider

This motion is being filed Pursuant 11th Cir. R. 40-4, " reconsideration in a civil case in which the United States ... is a party." Blake Medical Center's motion to dismiss the appeal for lack of jurisdiction was granted on July 22nd, 2003. [The court reply to the motion for clarification of parties for applicable appeal allowed 45 days- See Appendix A {Returned Motion for Clarification and Clerk instructions}].

Appellant Stronstorff did not receive Blake Medical Center's dismissal motion until after the time to respond had passed. The Appeals Court in it's July 22nd dismissal as "not final and appealable" appended the following line: to wit:

"28 U.S.C. § 1291; Fed.R.Civ.P. 54(b); Corsello v. Lincare. Inc., 276 F.3d 1229, 1230(11th Cir. 2001); Williams v. Bishop, 732 F. 2d 885, 885-86 (11th Cir. 1984); Bon Air Hotel Inc. v. Time, Inc., 426 F.2d 858, 862 (5th Cir. 1970)."

From this one and only line, without any further comment, it appears that the collateral order doctrine was never considered by the Court. It is believed that the

district court in the 3rd appealed Order violated the obligation to defend, uphold and protect the laws and Constitution of the United States and Florida.

It refused to reconsider the issue of self-representation in the absence of an attorney. It would not allow an amendment using professional paralegal help. It did not allow any discovery to take place. It did not allow continuance [ All this was requested in the motion to reconsider in the 3rd order appealed.]

The Court allowed the alleged crimes against at least two identifiable Medicare patients cited in the complaint under the False Claims Act to be dismissed without any discovery whatsoever in order to determine the extent of the crimes.

This 3rd order effectively ended all litigation, since all remaining parties would be allowed the same dismissal based upon the questionable interpreta- tion of Local Rule 2.01(a) : relator is not to represent herself and the government.

Fed.R.Civ.P. 54(b) cannot be exercised since the dismissal was based solely upon the issue of representation of Local Rule 2.01(a). By closing the court files and denying continuance, discovery and self-representation, no judgment is possible. The litigation has been effectively made "final" without any review possibility at a later date. Any remaining party would invoke Local Rule 2.01(a) and the court cannot selectively enforce the issue of self-representation. The

collateral order doctrine should apply here, since no discovery is being allowed whatsoever, although a legal claim has been identified and sufficiently documented in order to identify a False Claim Act case according to the FCA.

Argument

28 U.S.C. § 1291 permits appeals of "all final decisions of the district courts." Williams v. Bishop, 732 F.2d 885, 886 (11th Cir. 1984) concluded that a grant of summary judgment for "fewer than all the claims or parties" is not appealable. However, exceptions to the general rule do exist. Self representation is one of the immediate appealable exceptions. In this case, due to the "without prejudice" clause and remaining party, it did not become appealable until the "irreparable harm" prong was created by the last appealed order in the series of three orders.

The April 13th order [Doc 45] closed her case without further remedy. It could not go forward without counsel, which she did not find, and effectively ending her false claims act complaint 'without allowing any discovery or judgment on the merits' of her case. As cited in U.S. v. MOATS, 961 F.2d 1198 (5th Cir. 1992) at paragraph 22, discussing the "immediately appealable collateral orders originally articulated in Cohen:

The fourth part of this test requires that there be a risk of important and "probably irreparabl[e]" loss if an immediate appeal is not heard, Cohen, 337 U.S. at 547, 69 S.Ct. at 1226, or, in the words of the court in Neches Butane, "some showing of extraordinary harm." 704 F.2d at 148 (emphasis

in original); see also Acosta v. Tenneco Oil Co., 913 F.2d 205, 208 (5th Cir. 1990). [fn2].

The district court's February 13, 2003 order was not appealed until the "irreparable loss" prong occurred. Not until the harm occurred on April 13th was jurisdiction given. At this time the provable claim - that BMC [or it's agents] knowingly filed a fraudulent claim based on a known false record and known substandard services, AND 'WITHOUT ANY MEDICAL NECESSITY' - was dismissed without any further possible remedy by the Middle District of Florida Ct. The lower courts have uniformly held that according to 28 U.S.C. 1654 "parties may plead and conduct their 'own' cases personally or by counsel." Neither the United States nor Carol Stronstorff can be considered "corporations, partnerships, or associations".

The local rule invoked for case dismissal - necessity of an attorney - to prosecute her case must also be applied to all remaining parties, since they, too, are part of the same 'False Claims Act' [FCA] litigation.

Furthermore, it must be stated that inter alia Blake Medical Center is the main party responsible for this action, since fraudulent admission and false certification of medical necessity as well as fraudulent concealment of medical events determining insurance liability were the beginning of this complaint and led to the nursing home and other doctors becoming involved in this case.

To allow this suit against this HCA hospital go abandoned is not only irreparable harm to Stronstorff, but to the general taxpaying public. The record in the lower courts appears to show that this HCA hospital is allowed to defy state and federal laws and contractual and fiduciary responsibilities without any fear of accountability. It appears to be allowed to continue known practices, which harm patients and provide unjust profits with impunity.

No discovery was allowed by the lower court to finalize the claims against this hospital. In a time of health care cost crisis [ See www.spcp4u.org for detailed information], the dismissal of this case on the issue of self-representation of an FCA case further endangers responsible healthcare for everyone. QUESTIONABLE APPLICATION OF REMAINING CASES

The mention of the two case CORSELLO v. LINCARE, INC and Bon Air Hotel Inc. v. Time, Inc. by the Eleventh circuit court of Appeals is not readily understandable. CORSELLO v. LINCARE, INC., 276 F. 3d 1229 (11th Cir. 2001) is a qui tam action and there was one remaining party with an automatic stay similar to the current case. In addition to claims against several defendants, there was also an issue of terminated employment in violation of 31 U.S.C. 3730(h).

That appealed case "order specifically mentions the bankruptcy stay applicable to Rotech" in dismissing the four other defendants. The now appealed district court's order, however, did effectively end all

litigation. It does constitute a final decision. The requirement for an attorney to proceed in this false claims case [FCA] makes it impossible to reopen the case without a lawyer. This questionable decision, which the District court made for Blake Medical Center must be applied equally to all parties - not just to BMC. Therefore, the appeals court has jurisdiction over this appeal.

It is a Constitutional right to self-representation, but also there is also a right to develop the case through discovery. There can be no final hearing to be appealed in the current situation, which denied both continuance and self-representation, and thusly abrogates every Constitutional Right..

BON AIR HOTEL, INC. v. TIME, INC., 426 F.2d 858 (5th Cir. 1970) concerns granting summary judgment on fully developed by depositions and affidavits. It is an issue of malice and freedom of speech.

The District Court, against it's own local rules, has allowed zero discovery, despite the need to fully develop the case and parties. Repeated violations of state and federal law requiring an itemized bill and complete medical records be given to the Relator, were pointed out to the court. The district court, however, did not allow any discovery to take place. It was known to the court that Blake Medical Center refused to meet in conference with the relator.

JURISDICTION IS ALLOWED

This appeal is brought In Propia Persona in Federal Court, under § 1654 of 28 U.S.C. and should be immediately appealable pursuant to 28 U.S.C. § 1291 and to the 'collateral order doctrine'. Additionally, this court has jurisdiction to hear all appeals from final dismissal of complaints from district courts. On May 8th, 2003, this court asked Appellant to explain that her case " is a final and appealable decision." On May 16th her statement was filed with the court. [Please refer to this document for details]. In this statement Appellant explained that 28 U.S.C. § 1291 did apply since the district court dismissed the case [closed the case] by refusing to let her continue litigation without a lawyer and no lawyer was found by the arbitrary date set by the Court of April 1st, 2003. The court made it's intention clear that the Appellant would not be able to continue her case without a lawyer. It also denied her continuance and the possibility to amend.

Both Fed.R.Civ.P. 54(b) and Williams v. Bishop, 732 F. 2d 885 (11th Cir. 1984) did not apply to her case since there had been no type of judgment to allow for appeal. No discovery had been allowed nor a review of the merits of her case.

There had been only a series of orders, which effectively did prevent Stronstorff from litigating her 'False Claims Act' [FCA] suit. The order of February 13, 2002 [Doc 40] combined with the following orders on March 17th [Doc 43] and April 14th [Doc 45] and events [ The Relator was unable to obtain a lawyer

within the time limit set by the court [last date April 1st, 2003.] which effectively ended the litigation on her case with finality.

Recognized exceptions to the finality rule of 28 U.S.C. § 1291 using the series of orders are stated in Ryan v. Occidental Petroleum Corp., 577 F.2d 298, 301 (5th Cir. 1978) and Jetco Electronic Industries, Inc. v. Gardiner, 473 F.2d 1228, 1231 (5th Cir. 1973) and Csx Transp. v. City of Garden city, 235 F.3d 1325 (11th Cir. 2000), No. 99-12799. In Jetco the court cited Gillespie v. U.S.Steel Corp., 379 U.S. 148, 152 (1949), that "practical, not technical considerations are to govern the application of principles of finality.

The appeal was filed timely with the exhaustion of all possibilities given by the district court to continue her litigation under Fed.R.Civ.P. 52(b). The finality required to be reviewed by this Court occurred only with the denial of her motion for reconsideration on April 13th. Only at this time did the series of three orders dismiss her case with finality and fall under the "collateral order" doctrine adopted by the Supreme Court in Cohen v. Beneficial Indus. Loan Corp.,337 U.S. 541 (1949).

At this time, it has been established that the Court, and both parties [Stronstorff and Blake Medical Center [BMC]] agree that the District Court's February 13th order [dismissing Stronstorff's case without prejudice and with the stipulation that counsel should be obtained] was not a final appealable order. [Appellee Brief, p. 2, United States Court of Appeals for the Eleventh Circuit 07/22/2003 Order by GBT/JFD/EEC]. The first District Court order was without prejudice and allowed her to reopen with counsel. There was no irreparable harm at this point.

This order did not become appealable under the 'collateral order doctrine' until the Court failed to reconsider it's own order of February 13th with the denial of her motion for reconsideration on April 13th. In the meantime, BMC states that the first order was not an appealable order because of the remaining party: IHS. However, the denial of continuing an FCA claim as was done on April 13th would preclude litigation by the Relator against IHS as well as against BMC or any other party. The Court prejudicially decided that she could not continue without a lawyer and April 1st, 2003 was the last day given to reopen the FCA case. This last order of April 13th made the first order appealable as a final order, since this order barred any further action in this FCA case whatsoever without a lawyer. It denied her, her right to self-representation in federal court! The order denying the reconsideration of the February 13th order irreparably harms the Relator. All motions and the appeal of the series of orders were filed timely. Fed. R. Civ. P. 4(a)(1)(B) gives the Relator 60 days to appeal since the United States is a party. In Doc. 46 Counsel for BMC stated that Relator misunderstood the dismissal. Relator understood that only BMC's cited court cases were being used by the Court and hers were being omitted other than to point out her "enigmatic" overuse of the

"motion for clarification ." There appeared to be no fairness and equability in balancing the scales.

The entire FCA claim was dismissed on April 14, 2003 [Doc. 45] with the refusal to reconsider allowing Relator to proceed In Propina Persona in the absence of a lawyer. This bars all avenues of litigating her complaint and is therefore appealable and the appeal is timely. There is no reason to believe that IHS would not be granted the same benefit of Local Rule 2.01(a) in this case ,if it were an issue, as well as all other parties.

The 'collateral order doctrine' as cited in paragraph 7 of

O'Reilly v. New York Times, 692 F.2d 863 (2nd Cir. 1982) fits this appeal. It mentions Coopers & Lybrand v. Livesay, 437 U.S. 463, 467 (1978) and Firestone Tire & Rubber Co. v. Risjord, 449 U.S. 368, 375 (1981).

"Under this test an order comes within the Cohen doctrine if it "conclusively determine[s] the disputed question, resolve[s] an important issue completely separate from the merits of the case, and [is] effectively unreviewable on appeal from a final judgment."

"RESHARD v. BRITT, 819 F.2d 1573 (11th Cir. 1987") stated that the denial of self-representation orders are immediately appealable. Yet the February 13th order had not caused irreparable harm. It was in no case a final order, since it was without prejudice and time was given until March 11 to reopen the action. The issues of the FCA case and the issue of self-representation are two separate issues, which must be decided now and cannot wait for a "final order, since there will be no trial nor judgment without any discovery or thru representation by some lawyer." "An order denying self-representation is analogous to other orders courts have found immediately appealable."

DEVINE v. INDIAN RIVER COUNTY SCHOOL BOARD, 121 F.3d 576 (11th Cir. 1997), n. 7. See Roberts v. United States Dist. Court for the N. Dist. of Cal., 339 U.S. 844, 70 S.Ct. 954, 955, 94 L.Ed. 1326 (1950); Brotherhood of R.R. Trainmen v. Baltimore & O.R. Co., 331 U.S. 519, 524-25, 67 S.Ct. 1387, 1390, 91 L.Ed. 1646 (1947).

The district court's orders are effectively unreviewable on appeal from final judgment and, therefore, should give jurisdiction over this appeal now.

FRAP 3(a)(1) and 3(c)(1)(A)(B)(C) and 3(d)(3) and 3(e) and

FRAP 4(a)(1)(B) and 4(a)(4)(A)(ii) and 4(a)(4)(B)(ii) were met.

"The collateral order doctrine permits immediate appellate review of a trial court order only when strict observance of the final judgment rule "would render impossible any review whatsoever" (United States v. Ryan, 402 U.S. 530, 533 (1971)) or "'would practically defeat the right to any review at all'" (Flanagan, 465 U.S. at 265 (citation omitted). The doctrine has therefore been limited to "trial court orders affecting rights that will be irretrievably lost in the absence of an immediate appeal" (Richardson-Merrell, slip op. 6). See also Hollywood Motor Car Co., 458 U.S. at 266; United States v. MacDonald, 435 U.S. 850, 860 (1978). [fn4].

See DEVINE v. INDIAN RIVER COUNTY SCHOOL BOARD, 121 F.3d 576

(11th Cir. 1997) at:

[10]..."The harm in erroneously denying a party leave to proceed 'pro se' in that it injures his/her dignity and autonomy, and this harm cannot be repaired after a judgment based on the merits."

The court seems to have erred in closing the case citing only Local Rule 2.01(a), since the 'Federal Claims Act' clearly states that when the United States declines to participate, the action becomes the Relator's own action. The Supreme Court decision Vermont Agency of Nat. v. U.S. ex rel. Stevens, 529 U.S. 765 (2000) makes this convincingly clear. The Court avoided all mention of United

States cx. rel. Trice v. Westinghouse Hansford Co., 2000 U.S. Dist. Lexis

8838(E.D. ash. Mar. 2000), 30

United States ex rel. Kelly v. The Boeing Co., 9 F.3d 743, 748 (9th Cir. 1993), cert. denied, 510 U.S. 1140, 127 L. Ed. 2d 433, 114 S. Ct. 1125 (1994) held that qui tam plaintiffs have Article III standing:

" In sum, the Ninth Circuit held "Congress intended to assign the government's fraud claims to individual qui tam plaintiffs in cases where the government itself chooses not to pursue such claims."

Judge Wm. fremming nielsen in Trice , id. used Kelly and held that:

"[C]ase law and statutes prohibit a corporation's claims from being pursued by a 'pro se' individual. No such bar exists for the Government's claims." at Trice, id., 33.

THE FALSE CLAIMS ACCUSATIONS ARE GRAVE

This Relator alleged that Blake Medical Center falsified legal documents of two patients, not only her own mother, Zoe. The other case occurred over a year later. The newer case appears to be obvious upcoding, and in both cases the stroke victims were harassed to receive a stomach tube operation without following the normal rules for identifying the condition of dysphagia. In both cases the tests [video swallow study] were reported destroyed/missing to the family survivors. Both parties were deceived to it's medical necessity. All operations are potentially dangerous and increase the risk of infection and death. When there is no true necessity, the act is a form of elder abuse. It is unknown how many such cases were performed at Blake Medical Center or under some other alias name, yet, abuse of the federal Medicare/Medicaid program could be massive. Contract

breach in the form of substandard services and medical records keeping as well as laboratory ordering and medication management is clearly documented , as well as laws against violation of patients' rights.

It appears that the lower court has no desire to grant any discovery to finalize her claims, although the FCA is "intended to reach all types of fraud, without qualification, that might result in financial loss to the Government. ..... The Court has consistently refused to accept a rigid, restrictive reading [of the Act]." (United States v. Neifert-White Co., 390 U.S. 228, 233, 19 L. Ed. 2d 1061, 88 S. Ct. 959 (1968).

Relator accused the Appellee in Document 17, page 5, her response to the motion to dismiss:

Blake Medical Center, however, clearly allowed massive alteration of the medical records as to the condition and location of the patient, suppression/destruction of diagnostic tests and apparent falsification of ambulance reports. The exact party responsible for these actions is yet unknown.

Discovery is necessary and was repeatedly requested.

The 9th circuit has held that one "who submits a false claim for payment may still be liable under the FCA for statutory penalties, even if it did not actually induce the Government to pay out funds or to suffer any loss." United States v. Rivera, 55 F.3d 703, 709 (9th Cir. 1995); see, also, United States ex rel. Hagood v. Sonoma County Water Agency, 929 F.2d 1416, 1421 (9th Cir. 1991).

Relator pleaded further her response to the motion to dismiss on page 10:

It is understandable that Defendant would like to bar her from proceeding 'pro se', since this in effect would allow the alleged crimes to continue: Medicare fraud, patient - especially elder abuse, medical records falsification including radiographic (x-rays) and laboratory test falsification/suppression. There is a health care/cost crisis today. This case is important for that reason.

Relator has sought counsel in Florida, yet, health lawyers are few. Those found represent the big repeat customers - health care providers and suppliers. Beneficiaries seldom find a lawyer based on their economic value - retired and old! All FAC cases hope the government will step in but so far it has not!

The United States is not even stepping in on 10 million dollar cases represented by contingency lawyers. The FBI does not even look at a case under $100,000. Medical malpractice (even criminal) is seldom prosecuted by the State Attorney.

Consequently, corporate crime has a free hand to abuse the federal health programs. They can bank on the inadequacy of government regulation ---ENFORCEMENT.

In this case, there is no question of medical records fraud and there is no question that if patients' rights were followed by the two corporations involved here, this claim would not have been paid, since Zoe would have had home health care in her own home. Whether, she would have died anyway or not is yet another case, but she and her legal health surrogate would not have been abused by the health care facilities involved. Zoe would not have died in an "on paper unknown place" without a decent painkiller. She would have been eating, if nothing else at least Jell-O! Pain was of major concern and you can be sure it would not have been ignored at home by a home care professional!

Not only has the government been harmed by unjust enrichment by the

Appellee, but citizens have been harmed and will continue to be harmed if the Court ignores violations of law by simply dismissing the case and denying Stronstorff her 'Right' to self-representation or to at least to allow discovery!

The mention of the overuse of "motion for clarification" would never have been used, had the District Court not mistakenly closed the entire case after the Motion for automatic stay from Integrated Health services of Lester, Inc. It is felt that both Document 33 and 17 illustrate that Appellant is capable of citing case law. Blake Medical Center counsel refused to allow any discovery until the Court decision on the dispositive motion. Whether the Court can deny self-representation of this government claim is not clear, yet this decision has seemingly terminated the litigation process at this point!

Not allowing any discovery in the face of known violations of law appears to be an abuse of discretion in itself, when the courts must uphold the law.

US v. Walker, 142 F3d 103 (2nd Cir. 1998) recognizes the Sixth Amendment Right as absolute. See also Title 28 U.S.C. 1654 and Faretta V. California, 422 U.S. 806. In Farnsworth v. Procter & Gamble Co., 758 F.2d 1545 (11th Cir. 1985), this Court held that the Federal Rules of Civil Procedure strongly favor full discovery whenever possible! There has been none allowed by the district court yet!

To leave these claims without access to any discovery - including legal requirements: complete medical records production and an itemized bill/insurance claim forms - is a violation of equal protection guarantees: The patient/relator,

whom the law gives rights is being ignored in favor of the defendant, this big healthcare corporation.

Again, if Appellee is entitled to have his case dismissed on the self- representation issue, every other defendant must be allowed the same ruling. It appears the District court chose this strange "Catch-22" ruling, denying discovery, continuance and self-representation "without prejudice" in order to avoid the substantive merits: a false claim has been submitted and fraud and damage has been perpetrated on patients and their families. Blake Medical Center is the initial cause of this false claim! If the suppressed records of the heparin administration on admission night show damage to the on admission stable patient, the entire liability for claim payment is at issue. Dismissal in this manner is not fair to the citizens, who may very well be patients as well as all taxpayers.

Blake Medical Center attempts to portray this case as without merit. However, qui tam litigation is complex and expensive. The United States government did not recommend dismissal, yet does not always have the resources to investigate. It was not extensively investigated! Resources are limited! Finding a lawyer for such complex litigation is difficult! Lawyers face experienced "ethical" attorneys. IHS is in bankruptcy! This alone is a handicap in locating a competent dedicated lawyer. [fn1].

[fn1]. It is known that the United States settled the over $304 million claims with IHS under the FCA, Civil Monetary Penalties Law, Program Fraud Civil Remedies, common law theories of payment by mistake, unjust enrichment, breach of contract, and fraud for $19,100,000. Chapter Eleven Bankruptcy is convenient for dropping crime along with debt! Approximately six percent of the debt and everything was pardoned! The estimated recovery on the remaining unsecured claims is only 1.9 -4.2% - hardly a sum that any lawyer will lick His chops at!

However, the court-allowed time to find a lawyer made it almost impossible for a law firm to check for conflict of interest, when so many parties were involved in this fraud. Manatee County Case 2001 CA 003194 involving Blake Medical Center, whistle blowing ICU nurses {The same ICU, where Appellant's mother, Zoe, was located} recovered $275,000 for back wages and pain and suffering. The law firm asked for $1.7 million in cost and was awarded $884,471 by the court. This discrepancy shows that not every law firm including our government has the resources for such a case.

Dismissal of this case against the main defendant, in the manner it was done, appears to be an abuse of judicial discretion and unfair to Relator and complainant as well as other concerned citizens! As long as corporate healthcare is allowed to escape it's contractual obligations and fiduciary duties, both the quality will suffer and costs will explode as is now the case in our country.

Amendment was to be allowed without counsel, according to the last order, which rejected a reconsideration to proceed without counsel or continuance.

Thereby, there are remaining "due process liberty interests" in rejecting unwanted medical treatment among others as well as an EMTALA claim. Discovery is entirely and crucially necessary and has been withheld!

In Document 33 p.4, Stronstorff stated:

The conspiracy claim cannot be finalized until all facts concerning billing and medical records keeping, as well as departmental claims [emergency department, cardiology department, radiology department, pharmacy, a laboratory] as well private contractual agreements with nursing homes, ambulance services, physicians, peer Review Organizations and off-site radiographic facilities are known. Aside from this, the actual physician names of the treating [ordering/attending] physicians are not identifiable from the medical records [medical chart] as to provided to date. The names of the nurses are also often unidentifiable and unknown to the Relator.

One cannot speak of an undue burden for Blake Medical Center. The necessity of this discovery is caused by not fulfilling contractual obligations to the United States Government and the beneficiary patient under conditions of participation in the federal Medicare program....

On Page 9: According to The Discovery practice Manual of this Court (MIDDLE DISTRICT DISCOVERY (2001) at I.E.) under discovery in general under. Timeliness and Sanctions under Stays of Discovery "pendency of a motion to dismiss will not justify what a unilateral motion to stay discovery pending resolution of the dispositive motion. Such motions for stay are rarely granted . "

Defendant has failed to show any prejudice or undue burden to justify granting such a motion. Furthermore, it appears that Blake Medical Center finds it an unnecessary burden to comply with its federal contract on conditions of participation in the Medicare program, which demand for providing an itemized bill and an explanation for any discrepancies.

It has been shown that Medicare has reported billings by facilities, which supposedly treated Z. Stronstorff. It was assumed that these Medicare Summary Notice reports were submitted by Blake Medical Center for the decedent's care. Blake Medical Center as a Medicare provider/supplier is required to bill for services provided. If some other provider has falsely billed Medicare, it would be necessary to establish the party involved.

Discovery must be allowed to proceed to finalize all potential claims.

On page 10 ff.:

There is Prejudice to Relator by not denying a Stay. It will not promote judicial economy and reduce litigate time and expense to stay discovery but lengthen it and endanger various unfilled claims because of statute limitations. This Court also has jurisdiction review of agency processes, in civil rights, See 42 U.S.C. 21, Section 1981-equal rights under the law. This Court has jurisdiction to determine if... failed to in it's duty to ensure Stronstorff received 'due process' and whether octuplets " in accordance with law " or acted " arbitrarily in a constitutional sense "-see county of Sacramento. V. Lewis commonplace 523 U.S. 286 (1999). Wolf vs. McDonnell 418 U.S. 539, 558 (1974) " the touchstone of due process is protection of the individual against arbitrary action of government " with the fault lies in a denial of fundamental procedural fairness, see,

e.g., Fuentes vs.Shevin, 407 U.S. 67, 82 (1972)

similar its shares were dealt in Hell's Canyon, Robertson et. al vs. Methow Valley Citizens Council 490 U.S. 332, 349 (1989)

Herbert vs. Lando for 411 s 3, 177 (1979) to court has more than once declared that the deposition-discovery rules are to be accorded a broad and liberal treatment to affect their purpose of to adequately informing the litigants in civil trials. Sclagenhauf v. Holder (379 U.S. 1 04, 114-115 (1964), Hickman vs. Taylor, 329 U.S. 495, 501, 507 (1974). But the discovery provisions, like all the federal civil procedure, are subject to the injunction of rule one that they " be construed to secure that they just, speedy, and inexpensive determination of every action. "

Discovery and admissions will bring clarity for this Court. Relator was denied any discovery and with this questionable District court decision will never be allowed to make use of discovery to finalize a claim, which could lead to judgment. The Court has effectively ended all litigation by citing a local rule, which denies amendment, continuance and discovery. It is also denying Carol Stronstorff, the daughter, who had patient Zoe's durable power of attorney during her hospitalization/nursing home stay and now is her court designated personal representative the constitutional right to self-representation! Carol is not a

corporation, but is a taxpayer and witness to crimes, which should be covered under the FCA. To learn more about the background of the healthcare system in the US, please refer to www.spcp4u.org, which has extended information on these issues. Under the 'Cohen Collateral doctrine' and the importance of this case under the meaning of the False Claims Act, this Court does have Jurisdiction to hear it.

WHEREAS it is requested that the honorable Court vacate the dismissal for lack of jurisdiction, since the Cohen doctrine and the facts presented appear to show abuse of discretion. The use of local Rule 2.01(a) appears to be a novel manner of dismissing an unwanted, though thoroughly legal FCA case. The issue of Self-representation, when faced with factual final dismissal of her case, should give immediate jurisdiction to review if the case should not be remanded with instructions to vacate the order dismissing the claims against Blake Medical Center and remand for discovery.

WHEREAS for the aforementioned reasons, causes and sited cases this petitioner requests of this Most Honorable Court an Order allowing this case to proceed along the lines of fair, equitable and unbiased acts and for any other such other relief as this Court may deem fair, unbiased and just.

Respectfully submitted,

Carol Stronstorff, In Propina Persona

1840 Restful Dr., Bradenton, FL 34207

Tel: 941-758-4768 / Fax: 775-257-6489

Exhibits

A. August 6th, 2003 Clerical Instructions in response to:

B. Motion for Clarification stamped 31 July 2003 [3-pages]

C. July 22, 2003 Court Dismissal as not final and appealable published separately on site

United States Court of Appeals

Eleventh Circuit

56 Forsyth Street, N.W.

Atlanta, Georgia 30303

Thomas K. Kahn In Replying Give Number

Clerk Of Case and Names of Parties

In Replying Give Number

Of Case and Names of Parties

August 6, 2003

Carol Stronstorff

809 Olive Street sent by the court to 1809

Florence , NJ 08518

RE: 03-12226-GO Carol Stronstorff v. Blake Medical Center

DC DKT NO.: 01-00844 CV-T-MSS

The following action has been taken in the referenced case:

We are returning the "Motion for Clarification of 1 it Cir.R. 40-4" UNFILED. In light of the

nature of this appeal, a motion for reconsideration can be filed up to 45 days with no mail time

included.

Sincerely,

THOMAS K. KAHN, Clerk

Reply To: Elora Jackson (404) 335-6176

______________________________________

UNITED STATES COURT OF APPEALS

ELEVENTH CIRCUIT

ATLANTA, GA 30303

UNITED STATES OF AMERICA, ex rel. Case: 03-12226-GG

CAROL STRONSTORFF

Appellant,

BLAKE MEDICAL CENTER, et al.,

Appellee. LT No.: 8:01-cv-844-T-23MSS

________________________________

MOTION FOR ClarificatioN OF 11th Cir. R. 40-4

Appellee, Stronstorff, at the current time, plans to file a motion for reconsideration of the order dismissing an appeal for lack of jurisdiction. She did not receive the jurisdictional position of Appellee, Blake Medical Center [BMC], with it's embedded motion to dismiss, until well after the time for a response had expired.

Upon consultation with BMC counsel Bronis for his position on her intent to file a motion to file a belated response to BMC's motion to dismiss, she was told that it was unnecessary, since they had filed an Appellee Brief. The case would be decided on merits and also the extended jurisdictional position in her Appellant Brief.

Upon reading the local rules [11th Cir. R. 31-1(e)], it appears that the filing of the Appellee Brief should not have been made until after the court ordered it. Appellee's and Appellant's Briefs were not considered in the dismissal of the appeal on the issue of jurisdiction. Stronstorff's extended argumentation addressing the Cohen Collateral doctrine was not properly mentioned in her pro se jurisdictional position of May 14,2003. The grave issues of this case appear to allow for it's application. It appears, the Court has not considered them. [Stronstorff has not yet seen the order of case dismissal].

R. 40-4 Review of Order Dismissing Appeal for Lack of Jurisdiction states:

A motion for reconsideration of an order dismissing an appeal for lack of jurisdiction must be filed within 21 days of the entry of such order, except that a motion for reconsideration in a civil case in which the United States or an officer or agency thereof is a party must be filed within 45 days of the entry of such order.

Appellee has pointed out that there is disagreement as to the handling of the issue

of the a party [relator/United States] in an appeal:

Blake Medical Center submits that Appellant had thirty days (through mid-March 2003) to appeal from the February 13, 2003 order. Appellant maintains that she had sixty days (through April 14, 2003) to file her notice of appeal because the United States is deemed to be a party to this appeal. The appellate courts are in disagreement on this issue. See United States ex rel. McAllan v. City of New York, 248 F.3d 48, 51 (2d Cir. 2001) (assuming that qui tam relator has only 30 days to appeal adverse decision when United States declines to intervene); Cohen v.Empire Blue Cross and Blue Shield, 176 F.3d 35, 39-40 (2d Cir. 1999) (same); United States ex rd. Russell v. Epic Healthcare Management Group, 193 F.3d 304, 308 (5th Cir. 1999) (holding that qui tam relator has 60 days to appeal adverse decision, even when United States declines to intervene); United States ex ref Haycock v. Hughes Aircrafl Co., 98 F.3d 1100 (9th Cir. 1996) (same); United States ex rel. Petrofsky v. Van Cott, Bagley, Cornwall, McCarthy, 588 F.2d 1327, 1329 (10th Cir. 1978) (holding that qui tam relator has only 30 days to appeal adverse decision when United States declines to intervene).

Stronstorff has not yet checked out the validity of the above cases. However, since the current appeal involves a relator, herself, who has continued an FCA case after the United States declined to intervene, the issue of whether she has only 21 or 45 days to deliver her motion to court is of utmost importance in determining the date the motion must arrive in court.

Wherefore, Stronstorff requests the Court to inform her whether this case must be delivered within 21 or 45 days and inform the parties of their decision as soon as possible.

Respectfully SUBMITTED on July 24, 2003,

Carol Stronstorff, pro se

Florence, NJ 08518 D-56170 Bendorf

941-751-1069 011-49-2622-14728

Fax: 775-257-6489

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a copy of the foregoing is being furnished by

German Mail this 24th day of July, 2003, to the following:

LATOUR LAFFERTY

Assistant United States Attorney

400 North Tampa Street, Suite 3200

Tampa, Florida 33602

Christopher J. Schulte

100 S. Ashley Dr. -Ste.600

Tampa, FL 33602 Counsel for PREMIER INTERNAL MEDICINE , PA

Stephen J. Bronis/ Walter J. Tache

Zuckerman Spaeder LLP

201 5. Biscayne Blvd. -Ste. 900

Miami, FL 33131 Counsel for Blake Medical Center

______________________________________________

C. July 22, 2003 Court Dismissal as not final and appealable published separately on site