Free Other Notice - District Court of Arizona - Arizona

A. James Clark, #002901 CLARK & ASSOCIATES 2 256 South Second Avenue, #E Yuma, AZ 85364 3 Telephone (928) 783-6233
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Attorneys for Plaintiff Rubecca Mikkelsen, et al.

John A. Micheaels -- 05917 BEALE, MICHEAELS & SLACK, P.C. 6 1440 E. Missouri Avenue, #150 Phoenix, Arizona 85014 7 (602) 285-1444
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Attorneys for Plaintiff Dennis Mikkelsen UNITED STATES DISTRICT COURT DISTRICT OF ARIZONA RUBECCA MIKKELSEN, as) surviving spouse of Kelly Mikkelsen,) d e c e a s e d , a n d a s P e r s o n a l) Representative of the Estate of Kelly) Mikkelsen, deceased, on behalf of) MILES MIKKELSEN, JERRET) MIKKELSEN and ALLISON) MIKKELSEN, the minor children of) Kelly Mikkelsen, deceased, and on) behalf of DENNIS MIKKELSEN,) natural father of Kelly Mikkelsen,) deceased; TAYLOR R. FOX, a minor,) by her next friend and natural mother,) ) TRACY FOX-TANGA, ) ) Plaintiffs, ) ) vs. ) C O R R E C T I O N A L H E A L T H) RESOURCES, INC., a foreign) corporation; KENNETH L. FAIVER) and JANE DOE FAIVER, husband and) wife; JOSEPH EDWARD RICH, M.D.) and JANE DOE RICH, husband and) wife; DOES I through V, inclusive, ) ) ) Defendants. ______________________________ ) ) No. CIV 02-2252-PHX-JAT PLAINTIFFS MIKKELSEN'S REVISED PROPOSED VERDICT FORMS (Assigned to the Honorable James A. Teilborg)

The plaintiffs Mikkelsen offer the following forms of verdict to be given to the jury at the end of the trial in this matter:

Case 2:02-cv-02252-JAT

Document 300

Filed 11/15/2005

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VERDICT FORM 1 (State Law Wrongful Death Claim)

We, the jury, duly empaneled and sworn in the above-captioned action, upon our oaths, do find in favor of Plaintiffs and against Defendants CHR, Faiver and Rich on Plaintiffs' state law wrongful death claims. We find Plaintiffs' total wrongful death compensatory damages to be: Miles Mikkelsen: Jerret Mikkelsen: Allison Mikkelsen: Dennis Mikkelsen: Taylor Fox: $_____________________ $_____________________ $_____________________ $_____________________ $_____________________

Date:

Presiding Juror

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VERDICT FORM 2

We, the jury, duly empaneled and sworn in the above-entitled action, upon our oaths, do find in favor Rubecca Mikkelsen, as personal representative of the Estate of Kelly Mikkelsen, and against Defendant Correctional Health Resources, Inc., on Plaintiff's claim that a CHR policy or custom caused the deprivation of Kelly Mikkelsen's Eighth Amendment rights. We find compensatory damages on this claim in the total amount of:

Rubecca Mikkelsen, personal representative of the Estate of Kelly Mikkelsen:

$__________________ _____

Date:
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Presiding Juror

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VERDICT FORM 3
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We, the jury, duly empaneled and sworn in the above-entitled action, upon our oaths,
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do find in favor of Rubecca Mikkelsen, as personal representative of the Estate of Kelly
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Mikkelsen and against Defendant Faiver and/or Defendant Rich on Plaintiffs' claim that said
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defendants violated Kelly Mikkelsen's Eighth Amendment rights. We find the
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compensatory damages on this claim in the total amount of:
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Rubecca Mikkelsen, personal representative of the Estate of Kelly Mikkelsen:

$___________________________

Date:
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Presiding Juror

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VERDICT FORM 4

We, the jury, duly empaneled and sworn in the above-entitled action, upon our oaths, do find in favor of Rubecca Mikkelsen, as personal representative of the Estate of Kelly Mikkelsen, and against Defendant CHR on Plaintiffs' punitive damages claim and assess punitive damages against Defendant CHR in the total amount of: $___________________________________

Date:

Presiding Juror

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VERDICT FORM 5

We, the jury, duly empaneled and sworn in the above-entitled action, upon our oaths, do find in favor of Rubecca Mikkelsen, as personal representative of the Estate of Kelly Mikkelsen and against Defendant Faiver on Plaintiffs' punitive damages claim and assess punitive damages against Defendant Faiver in the total amount of: $___________________________________

Date:

Presiding Juror

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VERDICT FORM 6

We, the jury, duly empaneled and sworn in the above-entitled action, upon our oaths, do find in favor of Rubecca Mikkelsen, as personal representative of the Estate of Kelly Mikkelsen and against Defendant Rich on Plaintiffs' punitive damages claim and assess punitive damages against Defendant Rich in the total amount of: $___________________________________

Date:

Presiding Juror

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DATED this 15th day of November, 2005. BEALE, MICHEAELS & SLACK, P.C.

By ____/s/ John A. Micheaels John A. Micheaels 1440 East Missouri Avenue, #150 Phoenix, Arizona 85014 Attorneys for Plaintiff Dennis Mikkelsen CLARK & ASSOCIATES

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By
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/s/ A. James Clark A. James Clark 256 South Second Avenue, Suite E Yuma, Arizona 85364 Attorneys for Plaintiffs Rubecca Mikkelsen, et al

E-Filed with the U.S. District Court this 15th day of November, 2005; and Copy of the foregoing delivered this 15th day of November, 2005, to:

Honorable James A. Teilborg U. S. District Court 401 West Washington Street 18 Phoenix, Arizona 85003
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By

/s/ Mary Beth Boat