Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-5_05-cv-05121/USCOURTS-arwd-5_05-cv-05121-4/pdf.json

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

---

AO72A

(Rev. 8/82)

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

RONNIE KEYES PLAINTIFF

v. Civil No. 05-5121

 

DR. HOWARD; NURSE

SUSAN JOHNSON; and

NURSE RHONDA BRADLEY DEFENDANTS

O R D E R

On April 7, 2006 defendants filed a summary judgment motion (Doc. 27). To assist

plaintiff in responding to the summary judgment motion, the undersigned is propounding a

questionnaire. The court will consider plaintiff’s response to the questionnaire in issuing a report

and recommendation on the summary judgment motion. 

For this reason, Ronnie Keyes is hereby directed to complete, sign, and return the

attached response to defendants’ summary judgment motion on or before July 12, 2006.

Plaintiff’s failure to respond within the required period of time may subject this matter to

dismissal for failure to comply with a court order.

IT IS SO ORDERED this 6th day of June 2006.

/s/ Beverly Stites Jones 

UNITED STATES MAGISTRATE JUDGE

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(Rev. 8/82)

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

RONNIE KEYES PLAINTIFF

v. Civil No. 05-5121

 

DR. HOWARD; NURSE

SUSAN JOHNSON; and

NURSE RHONDA BRADLEY DEFENDANTS

RESPONSE TO SUMMARY JUDGMENT MOTION

TO: RONNIE KEYES

These questions and answers will serve as your response to defendants’ motion for

summary judgment. You may use additional sheets of paper in responding to these questions.

You must file this response by July 12, 2006.

1. You were arrested and booked into the Washington County Detention Center

(WCDC) on March 3, 2005, for possession of a controlled substance. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 1. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

2. Were you incarcerated at the WCDC solely because of the pending criminal

charges? 

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Answer: Yes ___________ No ___________.

If you answered no, please state whether you were serving a sentence or your

probation, parole, or supervised release had been revoked.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

3. During your intake, you completed and signed a medical intake form on which you

indicated you had been treated for mental illness and/or depression, were currently under a

doctor’s care and were taking depression medication, pain medication, and nerve medication,

had injured your leg and foot, your stomach hurt, had been suicidal in the past, and had never

been honest.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 8.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

4. On March 4, 2005, you were seen by Nurse Bradley. She noted you told her you

had a “broken ACLS–knee cap–reconstruction surgery a couple of years ago. You indicated

you had been scheduled for surgery on March 22, 2005, at the Veteran’s Administration (VA)

Hospital in Little Rock. You told her you were on medication for post traumatic stress

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disorder and had the medication at home but didn’t know what the medication was. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

39.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

5. Nurse Bradley called the pharmacy at the VA and left a message requesting a call

back. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

39. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

6. The VA pharmacy called Nurse Bradley back and told her you were on Riserdone,

Tylenol, Tramadol, and Sulinac. Nurse Bradley notified the transport officers that your 

medications would need to be picked up at the VA Medical Center.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

39. 

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

7. Nurse Bradley noted you had an appointment in prosthetics in North Little Rock

on March 22, 2005, at 10:00 for a brace fitting. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

39.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

8. Nurse Bradley noted that you were demanding blood pressure medication and

blood sugar medication. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

39. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

9. On March 5, 2005, Nurse Bradley checked your blood sugar before you ate a meal

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and it was 73. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

39.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

10. Nurse Bradley again called the VA pharmacy and asked whether you were on

medication for high blood pressure and/or high blood sugar.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

30.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 11. You were found guilty of failure to appear on March 7, 2005.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

12. On March 9, 2005, you submitted a grievance in which you stated you had put in

two requests for a § 1983 form based on your not being allowed to go to the hospital for your

leg and foot. You stated your foot had turned black and you needed a doctor as soon as

possible and your pain medication.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 16. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

13. In response, Nurse Bradley made a note on March 10th that you were on the list

to see the doctor that day.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 16. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

14. On March 9, 2005, you submitted a medical request indicating you needed

something for pain.

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Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 18. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

15. In response, Nurse Baker indicated that at 1850 (6:50 p.m.) she had been called to

R block. She stated that your foot was swollen and this had been an ongoing problem for

years. She noted you had been seen at the Veteran’s Administration (VA). The pulses in

your foot were present and steady. Your foot was warm and dry to the touch. She noted you

were on Tramadol for the pain. She also gave you 800 mg of Ibuprofen. She noted that you

were in no acute distress. She put you on the list to see the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 18. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

16. You submitted another medical request dated March 9, 2005. You stated you had

been in pain the last two days and needed to go to the hospital. You stated your leg was

extremely swollen and you were in serious pain.

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Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 17. 

 __________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

17. That same day at 1930, Nurse Baker responded that you were on Tramadol from

the Veteran’s Administration and were on the list to see the doctor the following day. She

noted that you had been told last night and early that day to keep your foot elevated. She

noted that you were not in any acute distress. She stated that you had indicated the night

before that you had a previous injury to your left foot. She stated you could be in the day

room with an extra mattress with your foot propped up. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 17.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 18. What was the Tramadol for?

Answer:

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

19. When did you start receiving the Tramadol?

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

20. On March 9, 2005, you submitted another medical request form in which you

stated you would like to see a doctor for your hip and leg. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 19.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

21. Nurse Bradley responded on that same day. She indicated you were on the list to

see the doctor. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 19.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

22(A). You were seen by Dr. Howard on March 11th. He noted that your right leg

and foot were swollen. He noted you denied any trauma. Dr. Howard prescribed Lasix and

Ibuprofen and told you to elevate your leg. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

40. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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(B). On March 11, 2005, you submitted a medical request in which you stated you

needed to see a real doctor. You asked that an ambulance or the hospital be called. You

stated a million psychiatrists should be called and the fire department too because they could

maybe cut off your leg if they don’t you stated you were going to lose it.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 20. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

23. Nurse Bradley responded on March 10th. She stated you were scheduled for an

x-ray. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 20. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 24. An x-ray of your right foot and ankle was done on March 11, 2005. It showed

generalized soft tissue swelling and no other abnormality. No evidence of any fracture or

dislocation was found.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 21. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

25. On March 12, 2005, you submitted a medical request asking to see the nurse that

day.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 22. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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26(A). In response, Nurse Johnson told you the x-ray results were not back yet. She

also stated she would call the VA about your medications on Monday. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 22. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). Your blood sugar was tested that day by Nurse Johnson and it was at 100.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

40. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 27. On March 13, 2005, Nurse Johnson received a call that you could not get out of

your bunk. She observed you lying in your bunk with your leg elevated to the extreme. She

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explained to you that you should not have your leg elevated in that manner. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 23. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 28. As Nurse Johnson was examining your foot and leg, she noticed you had your

knee brace on. The brace was folded up below your knee. This resulted in the brace acting

as a tourniquet which interfered with the blood flow and fluid balance in your leg. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 23.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

29. Your knee brace was removed and placed in the nurse’s office. You were moved

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to a cell up front to be more closely monitored. Assistance was provided to you for your

personal care needs and in your need for mobility. You were put on the list to see Dr.

Howard on Wednesday unless you needed medical attention sooner.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 23.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

30. On March 14, 2005, you submitted a medical request asking for cream for your

face and an ice pack for your leg.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 24. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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 31. On March 15th, Nurse Bradley denied your request for an ice pack.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 24. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

32(A). On March 16, 2005, you were seen by Dr. Howard. He noted your leg was

swollen and prescribed additional medication.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

40. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). On March 17, 2005, you were released from the WCDC.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 27. 

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(C). Following your release from custody on March 17, 2005, did you seek medical

treatment for your leg?

Answer: Yes __________ No ____________.

If you answered yes, please state: (a) when you sought medical treatment; (b) who 

you were treated by; and (c) what treatment you received.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

If you answered no, please explain why you did not seek treatment.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

33. You were booked back into the WCDC on June 7, 2005, on charges of failure to

appear and on a hold for another agency.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 44. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 34. As part of your intake, you completed an inmate medical form. You indicated

you had bone spurs on your knees, a hurt shoulder, and a hurt leg. You stated you were under

the care of Dr. Smits, at the Mississippi VA and were taking Sulindac 200 mg., Tramadol

HCL 500 mg., Sulindac 150 mg., and Methocarbamol 750 ml. You stated you had edema in

your calf of your right leg since March. A note was made you should see Dr. Howard that

day. You also indicated you had a gunshot wound to your right leg ten years ago. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 57. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

35. On June 8, 2005, you submitted a request in which you asked when you were

going to get your medication.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 67. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

36(A). In response, you were told you would get your medication at the normal time

when everyone else did.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 67. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

(B). You failed to respond to nurse’s call on June 8th.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

41. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(C). On June 8, 2005, Dr. Howard noted that you had been treated for a gun shot

would ten years ago. He noted you were complaining of your right leg hurting and being

swollen and the lymph glands in your right groin being swollen. He prescribed Tylenol,

Cleocin, Ibuprofen, and Xanax.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

41. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

37. On June 9, 2005, you submitted a medical request asking for cream for your face.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

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page 71. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

38. On June 10th, Nurse Johnson provided you with the cream.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 71. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

39. On June 9, 2005, you also submitted a medical request stating that you had

entered the jail with an empty bottle of Tramadol. You stated you needed the prescription

refilled. You indicated you were not sleeping because of the pain.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 72. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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40. On June 10th, Nurse Johnson noted that the prescription had been called into

Southgate for your family to pay for it. A note was also made that the sergeant was to be

talked to concerning getting your medication from the VA.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 72. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

41. Did you get your prescription refill?

Answer: Yes ___________ No _____________.

If you answered yes, please indicate whether the jail obtained the prescription or if

your family did.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

If you answered no, please explain.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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42. On June 10th, Nurse Johnson okayed your shaving.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 75. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

43. On June 10th, you requested cream for your face.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 76. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

44. On June 14th, Nurse Bradley provided you with the cream and also okayed your

having a second blanket.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 76. 

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

45. On June 10th, you submitted a medical request stating that your leg was swollen. 

You also asked about your Tramadol.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 77. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

46. In response, Nurse Johnson wrote that you wanted to take your medication on

your own schedule and that was against facility policy. She provided you with cream for

your face.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 77. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

47. On June 12, 2005, you submitted a medical request in which you stated that the

nurse had taken your medication off the medication cart. You stated you had “post domestic

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stress” and had a major problem. You stated you did not have enough dosage from the VA

hospital. When you were taken off the medication, you indicated you saw and heard things

that were not there. You stated the nurse was not qualified to take you off your medications

that had been prescribed by the doctor at the VA. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 78. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 48. Nurse Bradley noted that you had brought medications with you to the jail that

were prescribed by the VA for post traumatic stress disorder–Risperdal. She noted you

complained of numbness in the left side and left shoulder for one week. She explained to

you that the VA will not see detainees.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 78. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

49. On June 12, 2005, you requested a medical blanket. You stated your right leg

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was swelling in your foot area and your legs got cold at night. You also stated you were in

pain and needed a certain amount of medication to control your depression.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 79. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

50. In response, Nurse Baker okayed an extra blanket if one was available.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 79. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

51. On June 11, 2005, Nurse Johnson was notified that you tried to pocket your

medication. When Nurse Johnson spoke with you about this, you told her you did not like

the times the medication was given.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 80. 

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

52(A). Nurse Johnson explained that the times the medication was given could have

been changed for you. You admitted to Nurse Johnson that you knew it was against the rules

to pocket your medication.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 80 & exhibit 2 at page 42. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). You became angry and yelled at everyone. You stated they should just take your

medication. Nurse Johnson decided to give you a second chance. Less than eighteen hours

later, you again violated the rules by trying to walk away with the medication. In response,

the medications were pulled.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 80 & exhibit 2 at page 42. 

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

53(A). On June 15, 2005, you were seen by Dr. Howard. You were complaining of

pain in your left chest and arm and of some numbness. You stated you had an enlarged heart. 

Dr. Howard noted they needed to obtain your medical records concerning your heart. He

diagnosed you as having muscle pain and prescribed Tylenol.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

41. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). On June 22, 2005, you were seen by the nurse. You complained of chest pain in

the upper left chest area, of your hand going numb, and of having difficulty breathing. Your

vital signs were taken and you were diagnosed with possible chest wall pain. You were not

in any acute distress at the time. You were prescribed Aleve.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

42. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

54. On June 25, 2005, you submitted a medical request asking for some cream for

your face and to be put on the doctor’s list.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 84. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

55. In response, you were put on the list to see the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 84. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

56(A). On June 29, 2005, you submitted a medical request asking for cream for a

rash on your face.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

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page 85. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). In response, Nurse Bradley noted you had no rash that she could see and no other

problem. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 85. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

57. You were seen by the doctor on June 29th. You complained of your right knee

hurting. He diagnosed you as having bursitis and prescribed Ibuprofen for two weeks.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

43. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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58(A). On June 30, 2005, you submitted a medical request. You asked for a medical

shave. You stated your face hurt.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 86. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). It also looks like you requested medication. Was the medication for your face or

for some other condition?

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

59. In response, you were given Aleve tablets. However, a shave was denied.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 1, at

page 86. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

60(A). On July 1, 2005, you submitted a medical request stating you needed your

medicine.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 1. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). What medicine were you referring to?

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(C). In response, Nurse Johnson wrote that you were to talk to the sergeant. She

indicated you wanted your old medication back but had been caught pocketing pills.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 1. 

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

(D). Did you talk to the sergeant? 

Answer: Yes _________ No ___________.

If you answered yes, please state what response you received from the sergeant.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

If you answered no, please state why you did not talk to the sergeant.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

61. On July 4, 2005, you submitted a grievance about Casey Ruiz getting two trays

each meal by using another person’s name.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 2. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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62. On July 4, 2005, you submitted a medical request asking Nurse Rhonda if you

could get two Aleve tablets three times a day.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 3. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

63. In response, Nurse Rhonda authorized you to have two tablets of Aleve twice a

day.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 3. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

64(A). On July 12, 2005, you asked if you could get two tablets of medicine twice a

day. You indicated one tablet didn’t do anything. You also asked if you could get Ibuprofen.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 5. 

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). On July 5th Nurse Bradley had authorized you to get two tablets of Aleve twice

a day. Had you been receiving the Aleve?

Answer: Yes __________ No ___________.

If you answered no, please explain.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(C). In response to your July 12th request, Nurse Bradley discontinued the Aleve and

prescribed Ibuprofen, 400 mg., three times a day, for fourteen days.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 5. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

65. On July 15, 2005, you submitted a medical request. You stated you needed

something for anxiety and pain. You indicated your chest was feeling tight and you had chest

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pain. You stated sometimes it felt like you could not breathe. You stated you had been

diagnosed with post traumatic stress disorder and your muscles were tense all the time. You

indicated your knee had also been hurting. You stated that the medicine you were receiving

was not helping. You noted you had been on Risperdal. You asked to see the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 6. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

66. Nurse Bradley noted that you were demanding to see the doctor and placed you

on the list to see the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 6. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

67. On July 16, 2005, you submitted a medical request asking when you would be put

back on your medicine. You stated you were hurting and about to have an anxiety attack.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 9. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

68. On July 18, 2005, you submitted a request. You stated Corporal Freeman had

said your medicine was going to be put back on the cart. You noted that you needed your

medication. You stated your chest was hurting and you were about to have an anxiety attack.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 11. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

69(A). In response, a note was made that your family had paid for your medication

and it was put back on the cart when they did so.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 11. 

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

(B). Did you begin receiving your medication after this?

Answer: Yes __________ No ____________.

Explain your answer.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(C). You submitted a second request on July 18, 2005, in which you stated Corporal

Freeman was going to have your medication put back on the cart. In response, your request

was forwarded to medical.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 12. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

70. On July 20, 2005, you were taken to the nurse’s station and seen by Nurse

Bradley. You were complaining of chest pain. Nurse Bradley checked your blood pressure,

pulse and noted your lungs were clear. She decided you should be monitored.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

43. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

71. You were seen by Dr. Howard on July 20th. He noted your blood pressure was

okay. He said you could have Xanax if your family covered the cost. He also prescribed

silver nitrate for a canker sore and diagnosed you as having anxiety.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

43. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

72. On July 21, 2005, you asked what happened to the medication for your mouth.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 13. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

73. In response, Nurse Baker responded “silver nitrate to mouth ulcer.”

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 13. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

74. On July 22, 2005, submitted a medical request asking to know what pharmacy the

medication that had been prescribed the previous day was at. You indicated your family was

going to wire the funds directly to the pharmacy.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 14. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

75. In response, Nurse Johnson provided you with the name and phone number of the

pharmacy.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

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page 14. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

76. On July 23, 2005, you asked if you could have both Tylenol and Ibuprofen for

your pain until your other medication arrived. You stated you had pain medication and

muscle relaxers from the VA that you had brought to the jail with you but they had been

taken away. You stated you wanted those returned to you.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 16. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

77. When Nurse Bradley spoke to your about your request you told her to never

mind.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 16. 

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

78. On July 26, 2005, you submitted a medical request in which you stated your

medicine had been delivered to the jail and you were not receiving it. You stated you had

this information from the pharmacist.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 17. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

79. Nurse Bradley responded on July 27th that your Xanax and Tramadol had been

received and a medication card had been made out.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 17. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

80. On July 26, 2005, you submitted a medical request asking if your medication was

going to be on the cart that night. You stated you were in pain. In response, you were told

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the medication was there and would be started.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 18. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

81. On July 26, 2005, you requested a medical shave. In response, you were placed

on the shave list by Nurse Bradley because of ingrown hairs.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 19. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

82. On July 28, 2005, you submitted a request asking Nurse Rhonda to check on your

Xanax prescription. You indicated you thought the doctor said you were to take it three times

a day but you were only getting it once a day. In response, Nurse Bradley informed you that

the prescription was for once daily at HS.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

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page 20. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

83. What is HS?

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

84. On July 29, 2005, you asked if you could have a couple of Tylenol to take with

your medication. In response, Nurse Johnson placed you on the list to see the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 21. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

85. On July 29, 2005, you submitted a medical request. You stated you were in pain

from the top of your head to the middle of your back. You stated it was hard for you to walk

because of the pain.

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Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 22. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

86. In response, you were put on the list to see the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 22. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

87(A). On August 1, 2005, you submitted a medical request complaining that it hurt

to walk. You stated you had no appetite. You asked if you could have something for pain.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 23. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

(B). You were seen by Nurse Bradley on August 1st. She noted you were

complaining of shooting pain from your groin to your foot that had lasted a couple of days. 

You also complained of burning with urination. She decided an urinalysis should be done.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

43. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

88. Nurse Bradley responded to your request by noting that a urinalysis had been

done the day before and it was negative.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 23. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

89. On August 2, 2005, you asked for an ice pack for your groin where the nurse had

made it sore from squeezing the lymph nodes. In response, you were given Ibuprofen, put on

the list to see the doctor, and an ice pack was given to you.

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Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 24. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

90(A). You were seen by Dr. Howard on August 3, 2005. He noted you had swollen

glands in the right groin and were complaining of pain in your right leg. He noted slight

swelling in your right foot. He prescribed Cephalexin and stated you could have Xanax if

your family covered the cost of it. He diagnosed you as having a possible infection in the

right groin.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

44. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). On August 3, 2005, you were ordered by the doctor to have three days of bed

rest. The doctor stated that no fifteen minute checks were needed.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

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page 25. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

91(A). On August 5, 2005, you submitted a medical request in which you stated that

you seemed to be having a problem with the nurse. You stated the doctor had prescribed

Xanax three times a day but you were not getting the medication as prescribed.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 26. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). In response, Nurse Johnson explained that you only had an HS card and that

your family would need to pay for more in seven days.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 26. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

92(A). On August 9, 2005, you submitted a medical request asking to see the doctor. 

In response, you were put on the list to see the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 27. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). You were seen by Dr. Howard on August 10, 2005. You told him the Xanax

was not helping. Dr. Howard changed your medication to Risperdal if your family would

cover the cost. He also ordered a CBC and diagnosed you with anxiety.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

44. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

93(A). On August 11, 2005, you submitted a request asking to see Ms. Jane about

your medicine.

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Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 28. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). Who is Ms. Jane?

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(C). On August 12th, Nurse Bradley noted that you were complaining of your right

leg hurting and being swollen. She noted lab tests had been ordered for the following week. 

She also noted that your medication would be there from the VA in Mississippi the following

week.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 28. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

94. On August 13, 2005, you submitted a medical request asking Nurse Rhonda to be

on the look out for your medication from the VA. You told her you were throwing up

everything.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 30. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

95. In response, Nurse Bradley noted that the VA was going to be sending the

medication. She also noted that the officer had not reported anything about your throwing

up.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 30. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

96(A). On August 15, 2005, you had a blood test (a CBC) run at Washington

Regional Medical Center at Dr. Howard’s request for a lymph gland infection.

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Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 31. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). On August 17th, Dr. Howard noted that your CBC was normal and you were

feeling better. He noted the Risperdal was not stabilized yet and should be soon. Dr.

Howard okayed the use of Risperdal or Xanax but not the two together. He prescribed

Tylenol. His diagnosis was anxiety headache.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

44. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

97. On August 18, 2005, you submitted a medical request in which you stated you

did not like paying for medication that was then stolen. You asked that the schedule be

checked so it could be determined how many times you were to have your medication from

the VA. You stated your new medicine was supposed to be there today. You indicated you

were talking about your Xanax.

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Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 32. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

98. Nurse Bradley noted that you stated people were stealing your medication.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 32. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

99. On August 21, 2005, you submitted a medical request stating you would like to

know why your medication was not on the cart. You stated your Mother had gotten the

medication the day before. You asked that your Xanax be found.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 33. 

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

100. In response, Nurse Bradley noted that she would look into your medications

Risperdal and Xanax. She stated she called Southgate IGA and talked with Phil who

indicated that 30 tablets of Xanax had been paid.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 33. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

101. On August 23, 2005, you submitted a request asking to know why your new

medication was not on the cart. Your request was forwarded to the nurse.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 34. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

102. On August 28, 2005, you were moved from F pod to MH2 for medical reasons.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 35. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

103(A). On August 28, 2005, you were transported to Medi-Serve for a swollen right

leg since March. You were given an injection of Rocephin and a prescription for

Doxycycline. A follow-up appointment was to be scheduled for the VA on August 29th.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 36. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). On August 29, 2005, you were taken back to Medi-Serve where you were given

another injection of Rocephin and instructed to continue your Doxycycline. You were to

follow-up with the doctor at the jail on August 31st.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 37. 

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

104. On August 30, 2005, you were seen by Dr. Howard. He noted your right lower

leg was swollen. He continued the Doxycycline and Cleocin and instructed you to keep your

leg elevated.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

45. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

105. On September 2, 2005, you submitted a grievance asking for immediate medical

attention for your leg. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 38. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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Serve twice on the prior weekend. She also noted you were on medication. You were

additionally told you could write the sheriff a letter.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 38. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

107. Did you write Sheriff Helder?

Answer: Yes ___________ No ____________.

If you answered yes, please describe your letter and any response you received. If you

have a copy of the letter, please attach it to this response.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

If you answered no, please explain why you did not write the sheriff.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

108. You submitted a second grievance/medical request on September 2, 2005, in

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which you stated it was an emergency situation and you had blood poisoning in your leg. 

You stated you needed professional help as soon as possible.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 40. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

109. In response, Nurse Johnson wrote that you would be given Aleve for the

discomfort.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 40. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

110. On September 3, 2005, you submitted a grievance addressed to Sheriff Helder. 

You stated that you had blood poisoning and were afraid you were going to lose your leg. 

You stated you needed to go to court so you could get an injunction so you could have

surgery on your leg or be taken to the hospital.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 41. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

111. On September 4, 2004, you submitted a medical request asking Nurse Johnson

to read your medication record again. You stated the record did not say anything about you

not wearing a knee brace. Instead, you state there was merely a notation that you didn’t wear

it to your appointment.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 43. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

112. On September 6, 2005, you submitted a medical request asking to see the

doctor. You also asked if your military medical records could be returned to you.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 44. 

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

113. In response, Nurse Bradley put you on the list to see the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 44. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

114. On September 7, 2005, you plead guilty and were sentenced to ninety-six

months in the Arkansas Department of Correction.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

pages 46 to 48. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

115(A). On September 8, 2005, you were seen by the doctor and treated for cellulitis.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

45. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). Please state what type of treatment you received.

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

116. On September 11, 2005, you requested something for the pain in your leg.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 49. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

117. In response, Nurse Bradley authorized you to have Tylenol twice a day.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

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page 49. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

118. On September 12, 2005, you submitted a grievance in which you stated the VA

had sent to the jail on August 11th ketoconazole cream, Sulindac for pain and inflammation,

and Methocarbamol. You asked what was happening to your medication.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 50. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

119. Officer Smith responded that some medications similar to the ones you

described were in your property.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 50. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

120. On September 16, 2005, you submitted a medical request. You stated you had

gotten a bill from the VA in Mississippi but didn’t have any medication from them. Sgt.

Staton responded that the VA in Mississippi did not send any medication to the jail.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 51. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

121. On September 17, 2005, you asked if Nurse Johnson would allow you to have

both Aleve and Tylenol. You stated Nurse Bradley had authorized it but apparently forgotten

to put them on the cart. You also indicated you needed someone to check up front and see if

someone put the medication from the VA into your property. You stated the VA said it had

been sent to the jail on August 11th. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 52. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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122. On September 18, 2005, you requested Tylenol and Aleve for the pain in your

leg or your pain pills that had been taken off the cart in June.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 53. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

123. In response, Nurse Bradley authorized you to have Ibuprofen, three times a day

for fourteen days. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

page 53. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

124. You were released to the Arkansas Department of Correction on September 20,

2005. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, vol. 2, at

pages 57 & 58. 

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

125. You received Risperidone on March 5-16.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

1, 8. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

126. You received Sulindac on the following days: March 5-16, June 9-11 (twice a

day); March 17 (once a day).

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

2, 6, 17. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

127. You received Potassium on March 17.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page 3. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

128. You received Lasix twice on March 11-15, and once on March 17.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

4, 9. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

129. You received Ibuprofen on the following days: March 17 (once a day); March

11-16, July 1, September 19 (twice a day); March 30, August 1-2, 4, 13, 15, 30 (three times a

day); July 2-14, August 3, 5-12, 14, 16-29, 31 (four times a day) 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

5, 10, 20, 27, 34, 37. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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130. You received Tramadol on the following days: March 7, 17, August 13 (twice a

day);and March 8-16, July 28-31, August 1-12, 14-30 (three times a day). 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

7, 21, 31. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

131. You received Aleve on the following days: June 24 (once a day); June 23, June

25-29, July 1, 13, August 4-17 (twice a day); July 3-5, 6, (three times a day); and July 2, 7-12

(four times a day). 

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

11, 18, 19, 33. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

132. You received Tylenol, two 500 mg., tablets on the following days: June 14,

August 17-18, 30 (once a day); August 21 (twice a day); June 15, August 20, 26-28, 31 

(three times a day); and June 16-29, August 19, 22-25, 29 (four times a day).

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

12, 13, 26. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

133. You received Clindamycin on the following days: June 8, August 30 (once a

day); June 11, 14, September 8 (three times a day); and June 9, 12-13, 15-17, August 31,

September 1-7 (four times a day).

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

14, 28, 35. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

134. You received Tylenol PM on the following days: June 8-12.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

15. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

135. You received Methocarbamol on the following days: June 9-11 (three times a

day).

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

16. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

136. You received Alprazolam on the following days: July 27-31, August 1-5,

September 13 (once a day); August 13, 25, September 8, 10 (twice a day); and August 6-12,

26-31, September 1-7, 9, 11-12, 14-19 (three times a day).

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

22, 23, 24, 30, 38. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

137. You received Cephalexin on the following days: August 4-10 (four times a

day).

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at page

25. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

138. You received Doxycycline on the following days: September 8 (once a day);

August 31, September 1-7 (twice a day); and August 29 (three times a day).

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 2 at pages

29, 32, 36. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

139. On September 26, 2005, you underwent your intake physical at the ADC. You

reported that you took Xanax for your nerves. You were noted to have healed scarring from a

gun shot wound repair, decreased visual acuity, surgical repair of the right femoral artery in

the 1990's, current chronic swelling of the right lower extremity, a right femoral hernia, right

knee laxity, and a history of polysubstance abuse. It was noted that you had suffered from

chronic right lower extremity swelling every since your gun shot wound repair with lymph

node dissection in the 1990's. You were prescribed Paxil and given a TED hose for your leg.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 3 at pages

4-6. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

140. On February 16, 2006, note was made that your current mental status was within

normal limits. It was believed you were looking for a sedating medication (Xanax or

Valium) as that is what you were accustomed to getting through the VA. You denied any

thought of harming yourself or others. You were referred to a psychiatrist since you reported

having some problems since you were taken off Paxil on January 19th.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 3 at page

15. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

141. You received medical treatment from the VA on numerous occasions prior to

your incarceration including a lymph node biopsy of the right groin on November 2, 2004;

and right knee ACL reconstruction meniscetomy on November 23, 2004. The VA records

note a history of substance abuse.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. In explaining, please refer to defendants’ exhibit 5 at page

15, 16, 49, 80. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

142. While you were incarcerated at the WCDC, all decisions regarding the medical

care and treatment you should receive were made by medical personnel.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

143. All orders of the medical personnel were carried out by personnel at the

WCDC.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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If you disagree, explain. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

144. Under § 1983 a defendant can be sued in his official capacity, or his individual

capacity, or both. An official capacity claim is the same as suing the governmental entity for

whom the defendants work. Did you intend to sue the defendants in their individual

capacities, their official capacities, or in both capacities?

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Detail below any further response you would like to make to defendants’ summary

judgment motion. If you have any exhibits you would like the court to consider, you may

attach them to this response.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

I DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING IS

TRUE AND CORRECT.

EXECUTED ON THIS _________ DAY OF ________________ 2006.

__________________________________________

RONNIE KEYES

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