VF 3022. Violation of Prisoners Federal Civil Rights Eighth Amendment Medical Care (42 U.S.C. § 1983)

VF-3022. Violation of Prisoner's Federal Civil Rights--Eighth Amendment-- Medical Care (42 U.S.C. § 1983) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 We answer the questions submitted to us as follows: 1. Did [name of plaintiff] have a serious medical need? ____ Yes ____ No If your answer to question 1 is yes, then answer question 2. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 2. Did [name of defendant] know that [name of plaintiff] faced a substantial risk of serious harm if [his/her] medical need went untreated? ____ Yes ____ No If your answer to question 2 is yes, then answer question 3. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 3. Did [name of defendant] consciously disregard the risk by not taking reasonable steps to treat [name of plaintiff]'s medical need? ____ Yes ____ No If your answer to question 3 is yes, then answer question 4. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 4. Was [name of defendant] acting or purporting to act in the performance of VF-3022. Violation of Prisoner's Federal Civil Rights-- Eighth Amendment--Medical Care (42 U.S.C. § 1983) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 [his/her] official duties? ____ Yes ____ No If your answer to question 4 is yes, then answer question 5. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 5. Was [name of defendant]'s deliberate indifference a substantial factor in causing harm to [name of plaintiff]? ____ Yes ____ No If your answer to question 5 is yes, then answer question 6. If you answered no, stop here, answer no further questions, and have the presiding juror sign and date this form. 6. What are [name of plaintiff]'s damages? [a. Past economic loss [lost earnings [lost profits [medical expenses [other past economic loss $ $ $ $ ] ] ] ] VF-3022. Violation of Prisoner's Federal Civil Rights-- Eighth Amendment--Medical Care (42 U.S.C. § 1983) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 Total Past Economic Damages: [b. Future economic loss [lost earnings [lost profits [medical expenses [other future economic loss $ ] $ $ $ $ ] ] ] ] ] ] ] Total Future Economic Damages: $ [c. Past noneconomic loss, including [physical pain/mental suffering:] $ $ [d. Future noneconomic loss, including [physical pain/mental suffering:] TOTAL $ Signed: Dated: Presiding Juror After [this verdict form has/all verdict forms have] been signed, notify the VF-3022. Violation of Prisoner's Federal Civil Rights-- Eighth Amendment--Medical Care (42 U.S.C. § 1983) Instruction No 1 Request by Plaintiff Given as Proposed Refused Withdrawn Request by Defendant Given as Modified Requested by Given on Court's Motion Judge Instruction No 1 [clerk/bailiff/court attendant] that you are ready to present your verdict in the courtroom. __________________________________________________________________________ New September 2003; Revised April 2007, December 2010; Renumbered from CACI No. VF-3009 December 2012; Revised June 2014, June 2015, December 2016