Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-5_07-cv-05020/USCOURTS-arwd-5_07-cv-05020-0/pdf.json

Nature of Suit Code: 555
Nature of Suit: Prisoner - Prison Condition
Cause of Action: 42:1983 Prisoner Civil Rights

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AO72A

(Rev. 8/82)

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IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

REUBEN DURHAM, JR. PLAINTIFF

v. Civil No. 07-5020 

BENTON COUNTY DETENTION

CENTER MEDICAL STAFF DEFENDANTS

O R D E R

Plaintiff’s complaint was filed in this case on February 1, 2007. Before the undersigned

is the issue of whether the complaint should be served. In order to assist the court in making

such determination, it is necessary that plaintiff provide additional information.

Accordingly, it is ordered that plaintiff, Reuben Durham, Jr., complete and sign the

attached addendum to his complaint, and return the same to the court by April 6, 2007. Plaintiff

is advised that should he fail to return the completed and executed addendum by April 6,

2007, his complaint may be dismissed without prejudice for failure to prosecute and/or for

failure to obey an order of the court.

IT IS SO ORDERED this 8th day of March 2007.

/s/ J. Marschewski 

HON. JAMES R. MARSCHEWSKI 

UNITED STATES MAGISTRATE JUDGE

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AO72A

(Rev. 8/82)

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IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

REUBEN DURHAM, JR. PLAINTIFF

v. Civil No. 07-5020 

BENTON COUNTY DETENTION

CENTER MEDICAL STAFF DEFENDANTS

ADDENDUM TO COMPLAINT

TO: REUBEN DURHAM, JR.

This form is sent to you so that you may assist the court in making a determination as to

the issue of whether the complaint should be served upon the defendants. Accordingly, it is

required that you fill out this form and send it back to the court by April 6, 2007. Failure to do

so will result in the dismissal of your complaint.

The response must be legibly handwritten or typewritten, and all questions must be

answered completely in the proper space provided on this form. If you need additional space,

you may attach additional sheets of paper to this addendum.

RESPONSE

In your complaint, you allege you are being denied adequate medical treatment.

Specifically, you indicate you were denied treatment for injuries you sustained and also for

shortness of breath and chest pain. You indicate there is a history of heart disease in your family.

1. Provide the dates of your incarceration at the Benton County Detention Center

(BCDC). (In answering, be specific).

Answer:

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

2. Are you incarcerated at the BCDC solely because of pending criminal charges? 

Answer: Yes __________ No ____________.

If you answered yes, please state what charges are pending against you.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

If you answered no, please state whether you are serving a sentence or if your probation,

parole, or supervised release has been revoked.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

3. You have named the jail medical staff as defendants. Do you know the name of the

jail nurses or doctors that you contend denied you medical treatment?

Answer: Yes _________ No _________.

If you answered yes, please state the name of each jail nurse or jail doctor you intended

to name as defendants. 

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

If you answered no, please state the date or dates on which you believe you were denied

medical treatment and indicate if you were denied treatment by the jail nurse, or jail doctor, or

both on that date.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

4. Please describe what your serious medical needs are that you believe you have been

denied medical treatment for.

Answer:

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

5. With respect to each jail nurse or jail doctor you intend to name as defendants, state

how he or she exhibited deliberate indifference to your serious medical needs.

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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AO72A

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_______________________________________________________________________________________ ________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

6. Did you suffer any physical injury as a result of not receiving medical care when you

requested it? 

Answer: Yes _________ No __________.

If you answered yes, please state: (a) what injury you suffered; (b) the symptoms you

experienced; (c) the severity of the symptoms; and (d) how long it took you to recover from this

injury.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

7. Since you filed the complaint, have you received medical treatment?

Answer: Yes _________ No __________.

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If you answered yes, please state what medical treatment you received and who you

received the treatment from.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

I CERTIFY THAT THE INFORMATION CONTAINED HEREIN IS COVERED BY

THE VERIFICATION MADE BY ME ON MY INITIAL COMPLAINT.

_________________________________________

REUBEN DURHAM, JR.

_________________________________________

DATE

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