Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_03-cv-04269/USCOURTS-cand-3_03-cv-04269-9/pdf.json

Nature of Suit Code: 340
Nature of Suit: Marine Personal Injury
Cause of Action: 46:688 Jones Act

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For the Northern District of California

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States District C

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For the Northern District of California

IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

JOSEPH F. ARISPE,

Plaintiff,

 v.

TOM TIMMER,

Defendant.

 /

No. C 03-04269 CRB

VERDICT FORM

We, the jury in the above-entitled case, find the following:

JONES ACT–NEGLIGENCE CLAIM

1. Were the defendants negligent?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

If you answered yes, please answer question nos. 2 and 3, otherwise skip to question

no. 4.

2. Did the defendants’ negligence cause plaintiff’s shoulder injury?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

Case 3:03-cv-04269-CRB Document 134 Filed 11/15/05 Page 1 of 7
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3. Did defendants’ negligence cause plaintiff’s back injury?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

UNSEAWORTHINESS CLAIM–BOUNTIFUL

4. Was the vessel Bountiful unseaworthy?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

If you answered yes, please answer question nos. 5 and 6, otherwise skip to question

no. 7.

5. Was the unseaworthiness of the Bountiful a substantial factor in causing plaintiff’s

shoulder injury?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

6. Was the unseaworthiness of the Bountiful a substantial factor in causing plaintiff’s

back injury?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

UNSEAWORTHINESS CLAIM–DONITA

7. Was the Donita unseaworthy?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

If you answered yes, please answer question nos. 8 and 9, otherwise skip to question

no. 10.

Case 3:03-cv-04269-CRB Document 134 Filed 11/15/05 Page 2 of 7
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8. Was the unseaworthiness of the Donita a substantial factor in causing plaintiff’s

shoulder injury?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

9. Was the unseaworthiness of the Donita a substantial factor in causing plaintiff’s back

injury?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

NEGLIGENCE/UNSEAWORTHINESS DAMAGES

If you answered yes to question nos. 2,3,5,6, 8, or 9 please answer questions nos. 10 and 11.

10. Without taking into consideration any reduction of damages due to plaintiff’s

negligence, what do you find to be the total amount of damages, if any, suffered by

plaintiff as a result of his shoulder injury and/or back injury?

Answer:

(a) Past loss of income: ___________________

(b) Future loss of income: ___________________

(c) Pain and suffering: ___________________

(d) Future medical expenses: ___________________

(e) Household services: ___________________

Case 3:03-cv-04269-CRB Document 134 Filed 11/15/05 Page 3 of 7
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11. If you awarded damages for plaintiff’s shoulder injury and back injury, do you find

that those damages can be allocated between the shoulder injury and back injury, and,

if so, how are they allocated?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

If you answered yes, please allocate the damages where appropriate on the following

lines. The total for each line (shoulder plus back) should equal the total for each line in your

answer to question no. 10. If you do not find that the damages can be allocated for a

particular line item, please leave that line item blank.

Shoulder Injury Back Injury

(a) Past loss of income: _____________ _____________

(b) Future loss of income: _____________ _____________

(c) Pain and suffering: _____________ _____________

(d) Future medical expenses: _____________ _____________

(e) Household services: _____________ _____________

NEGLIGENCE/UNSEAWORTHINESS

COMPARABLE NEGLIGENCE

If you awarded a damages amount in question no. 10, please answer the following

question:

12. Was the plaintiff negligent?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

If you answered yes, please answer question nos. 13 and 15 (and 14 and 16 where

appropriate), otherwise skip to question no. 17.

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13. Did plaintiff’s negligence cause his shoulder injury?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

If you answered yes, please answer question nos. 14 and 15, otherwise skip to

question no. 15.

14. Assuming that 100% represents the total amount of harm suffered by plaintiff as a

result of his shoulder injury, what percentage of plaintiff’s harm was due to his own

negligence and what percentage is attributable to either defendants’ negligence or the

unseaworthiness of the vessels?

Answer:

Defendants/vessels ______ %

Plaintiff ______ %

 [Total must equal 100%]

15. Did plaintiff’s negligence cause his back injury?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

If you answered yes, please answer question no. 16, otherwise skip to question no. 17.

16. Assuming that 100% represents the total amount of harm suffered by plaintiff as a

result of his back injury, what percentage of plaintiff’s harm was due to his own

negligence and what percentage is attributable to either defendants’ negligence or the

unseaworthiness of the vessels?

Answer:

Defendants/vessels ______ %

Plaintiff ______ %

 [Total must equal 100%]

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MAINTENANCE AND CURE CLAIM

17. Did the defendants fail to provide plaintiff with maintenance to which he was

entitled?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

If you answered yes, please answer question nos. 18 and 19, otherwise skip to

question no. 20.

18. What is the amount of money that will compensate plaintiff for the amount of

maintenance that you find he is entitled to recover?

Answer: ____________________.

19. Was the defendants’ failure to provide maintenance willful or arbitrary?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

20. Did the defendants fail to provide plaintiff with the “cure” to which he was entitled in

a timely fashion?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

If you answered yes, please answer question no. 21, otherwise skip to question no. 22.

21. Was the defendants’ failure to provide cure in a timely fashion willful or arbitrary?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

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STATUTE OF LIMITATIONS

22. Did the plaintiff know, or by the exercise of reasonable diligence should he have

known, prior to September 17, 2000, that he had suffered the shoulder injury for

which he claims damages in this lawsuit?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

23. Did the plaintiff know, or by the exercise of reasonable diligence should he have

known, prior to September 17, 2000, that he had suffered the back injury for which he

claims damages in this lawsuit?

Answer “Yes” or “No.”

Answer: YES_____ NO_____

Dated:___________________ _________________________________

Jury Foreperson

Case 3:03-cv-04269-CRB Document 134 Filed 11/15/05 Page 7 of 7