Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-5_05-cv-05121/USCOURTS-arwd-5_05-cv-05121-0/pdf.json

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

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AO72A

(Rev. 8/82)

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

RONNIE KEYES PLAINTIFF

v. Civil No. 05-5121

 

SHERIFF TIM HELDER; and the

WASHINGTON COUNTY DETENTION

CENTER MEDICAL STAFF DEFENDANTS

ORDER

Plaintiff’s complaint was filed in this case on July 11, 2005. Before the undersigned is

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

determination, it is necessary that plaintiff provide additional information with respect to his

claim.

Accordingly, it is ordered that plaintiff, Ronnie Keyes, complete and sign the attached

addendum to his complaint, and return the same to the court by October 7, 2005. Plaintiff is

advised that should he fail to return the completed and executed addendum by October 7,

2005, his complaint may be dismissed without prejudice for failure to prosecute and/or for

failure to obey an order of the court.

IT IS SO ORDERED this 8th day of September 2005.

/s/ Beverly Stites Jones 

UNITED STATES MAGISTRATE JUDGE

Case 5:05-cv-05121-JLH Document 6 Filed 09/08/05 Page 1 of 5 PageID #: <pageID>
AO72A

(Rev. 8/82)

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

RONNIE KEYES PLAINTIFF

v. Civil No. 05-5121

 

SHERIFF TIM HELDER; and the

WASHINGTON COUNTY DETENTION

CENTER MEDICAL STAFF DEFENDANTS

ADDENDUM TO COMPLAINT

TO: RONNIE KEYES

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

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

required that you fill out this form and send it back to the court by October 7, 2005. Failure to

do so will result in the dismissal of your complaint.

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

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

you may attach additional sheets of paper to this addendum.

RESPONSE

In your complaint, you allege that your constitutional rights are being violated because

your medication “Sulindac, Methocarbamol depression medicine” was taken off the medical cart

by the jail medical staff. You state the medication was replaced with Tylenol. 

1. Please provide the dates of your incarceration at the Washington County Detention

Center (WCDC).

Answer:

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AO72A

(Rev. 8/82)

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

2. Are you incarcerated solely because of pending criminal charges, or are you serving

a sentence, or has your probation, parole, or supervised release been revoked?

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

3. You indicate your medication was taken away from you. Please state: (a) when you

were first prescribed the medication; (b) who prescribed the medication; (c) what condition the

medication was prescribed for; (d) whether you took the medication for a period of time after you

were incarcerated at the WCDC; and (e) what day the medication was taken away from you.

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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AO72A

(Rev. 8/82)

___________________________________________________________________________

4. You have named the jail medical staff as defendants. Please state: (a) whether you

are referring to a jail nurse, or jail doctor, or both; (b) the name of the jail nurse, or jail doctor,

or both; and (c) with respect to each, describe how he or she violated your federal constitutional

rights.

Answer:

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

_____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

_____________________________________________________________________________

5. You have named Sheriff Helder as a defendant. Was Sheriff Helder personally

involved in having your medication taken off the medicine cart?

Answer: Yes ________ No ________.

If you answered yes, please describe Sheriff Helder’s actions.

___________________________________________________________________________

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AO72A

(Rev. 8/82)

___________________________________________________________________________

____________________________________________________________________________

If you answered no, please state why you believe Sheriff Helder is liable for the actions

taken by others.

___________________________________________________________________________

___________________________________________________________________________

____________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

_____________________________________________________________________________

I CERTIFY THAT THE INFORMATION CONTAINED HEREIN IS COVERED BY

THE VERIFICATION MADE BY ME ON MY INITIAL COMPLAINT.

_________________________________________

RONNIE KEYES

_________________________________________

DATE

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