Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-arwd-5_06-cv-05003/USCOURTS-arwd-5_06-cv-05003-1/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)

-1-

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

DOROTHY RUTH PEEK PLAINTIFF

v. Civil No. 06-5003

 

SHERIFF TIM HELDER;

DR. HOWARD; NURSE 

RHONDA BRADLEY; and 

NURSE SUSAN JOHNSON DEFENDANTS

O R D E R

On June 15, 2006, defendants filed a summary judgment motion (Doc. 18). 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, Dorothy Ruth Peek is hereby directed to complete, sign, and return the

attached response to defendants’ summary judgment motion on or before August 18, 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 17th day of July 2006.

/s/ Beverly Stites Jones 

UNITED STATES MAGISTRATE JUDGE

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 1 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-2-

IN THE UNITED STATES DISTRICT COURT

WESTERN DISTRICT OF ARKANSAS

FAYETTEVILLE DIVISION

DOROTHY RUTH PEEK PLAINTIFF

v. Civil No. 06-5003

 

SHERIFF TIM HELDER;

DR. HOWARD; NURSE 

RHONDA BRADLEY; and 

NURSE SUSAN JOHNSON DEFENDANTS

RESPONSE TO SUMMARY JUDGMENT MOTION

TO: DOROTHY RUTH PEEK

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 August 18, 2006.

1. On March 19, 2003, a warrant for your arrest was issued based on your failure to

appear on bad check charges.

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. On August 27, 2003, the State of Arkansas filed a motion for revocation of your

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 2 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-3-

probated sentence due to your failure to report as directed, your failure to make your

whereabouts known to your supervising officer, and your failure to pay your fines.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 2 and 3.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

3. Circuit Judge Gunn entered an order directing that a hearing be held on the motion

for revocation of your probation and that a warrant be issued for your arrest.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 4.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

4. A warrant was issued on August 27, 2003, and entered into NCIC/ACIC on

September 4, 2003. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 3 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-4-

page 5.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

5. On September 4, 2003, a warrant information sheet was prepared by the

Washington County Sheriff’s Office and assigned to L. Johnson.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 6.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

6. On January 28, 2004, you were arrested and brought to the Washington County

Detention Center (WCDC). The intake sheet was completed by D. Smith and it was noted

that you had a right sprained ankle.

 Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 7.

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 4 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-5-

___________________________________________________________________________

___________________________________________________________________________

7. The intake sheet noted you were in violation of your probation and there was a

hold on you by the Rogers Police Department.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

8(A). Your personal property was listed and you signed the list of your property.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 10.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). The list did not show any prescription medications.

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 5 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-6-

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

page 10.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(C). When you were brought to the jail did you bring your prescription medications

with you?

Answer: Yes _________ No ____________.

If you answered yes, please state: (a) the name of each medication you brought with

you; (b) what medical condition the medication was for; (c) who prescribed the medication;

and (d) whether you received the medication after you were booked in.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

If you answered no, please state why you did not bring your medication with you.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 6 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-7-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

9. On January 29, 2004, a warrant was served on you for violation of the Arkansas

Hot Check Law and failure to appear. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 11.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

10. You were assigned jail property including a blanket, towel, uniform, shower

shoes, mat, and identification bracelet. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 7 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-8-

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

pages 11-13.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 11. On January 29, 2004, you signed a medical release and consent for medical

services.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 14.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 12. A medical questionnaire was completed and you indicated you had epilepsy and

had a seizure the prior Monday. You indicated you saw Dr. Guarv in Texarkana for seizures

and took Dilantin twice a day. You also indicated your ankle was 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 15.

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 8 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-9-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 13. On January 29, 2004, you signed the inmate medical insurance information form

indicating you were responsible for medical bills for treatment for any injury or illness that

occurred prior to incarceration at that facility.

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. You were seen by Nurse Bradley on January 29, 2004. You told Nurse Bradley

you had a broken left ankle and had been to Washington Regional Medical Center (WRMC)

the day before and had prescriptions at home for celebrex and hydrocodone. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 9 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-10-

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

page 114. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

15. Nurse Bradley also noted that you took Dilantin and had last had it the prior day

in the morning. You told Nurse Bradley you were treated by Dr. Guarv of Texarkana and last

saw him about a month ago.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 114.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 10 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-11-

 16. Nurse Bradley called WRMC ER and spoke with a nurse named Suzy. Nurse

Bradley faxed a request to WRMC asking for the x-ray report, the discharge instructions, and

prescriptions from your ER visit on January 28, 2004, related to a left foot injury.

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. Nurse Bradley also called Texarkana information to reach Dr. Guarv and found

no Dr. Guarv listed. Nurse Bradley obtained a phone number for a hospital in New Boston,

Texas, mentioned by you and found a Dr. Guarv there. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 114.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 11 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-12-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

18. Nurse Bradley faxed a medical release to Dr. Guarv at the New Boston hospital. 

She requested medical records regarding your treatment for seizures, current prescriptions,

and plan of care.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 19(A). Nurse Bradley received the emergency room records from WRMC on January

29, 2004.

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.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 12 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-13-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). The records indicated you had been seen complaining of pain in both ankles and

problems with your ankles rolling while you walked. 

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(C). You reported that you had not had any seizures since 1996 and were not taking

medication for seizures.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(D). You reported a past history of fracturing your right ankle in a fall with surgery

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 13 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-14-

being performed in 1993.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(E). X-rays of the ankle were negative. You were diagnosed with bilateral ankle

pain. Your left ankle was placed in a splint stirrup and you were discharged with instructions

to avoid activities that aggravated the pain. You were told to follow-up with an orthopedic

physician.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(F). You were given prescriptions for Celebrex and Ultram.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 14 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-15-

page 21.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

20. On January 31, 2004, a bail bond was issued for you by First Arkansas Bail Bond,

Inc.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

21. You were released and received your property.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 23 & 24.

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 15 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-16-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

22. On April 28, 2004, Judge Gunn dismissed the motion for revocation, withdrew

the warrant for your arrest, and reinstated the original conditions of your probation.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 25.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

23. On December 20, 2004, a warrant was issued for your arrest based on your failure

to appear and failure to pay your court fines.

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 16 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-17-

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

page 26.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 24. On March 13, 2005, Judge Storey set an arraignment date of April 6, 2005, and a

bond amount of $3,500 on you.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 28.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 25. You were arrested on March 15, 2005, by the Springdale Police for probation

violation, obstruction of governmental operations, public intoxication, and failure to appear.

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 17 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-18-

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 31.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 26. You were booked into the WCDC on March 16, 2005 by Officer Roy.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 32.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 27. You completed a medical questionnaire on which you indicated you had asthma,

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 18 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-19-

epilepsy/seizures, and had a cracked right knee/damaged knee cap. You indicated you took

Dilantin for seizures and had last had a seizure three weeks before. You also indicated you

had hydrocodone for pain for your knee cap and an Albuterol inhaler. You indicated your

doctor was Dr. James at N.W. Medical. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 33.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

28. You signed a medical release and informed consent for medical services.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 34.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 19 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-20-

___________________________________________________________________________

___________________________________________________________________________

29. You signed an inmate medical insurance form which indicated you were

responsible for any treatment for injuries or illness that existed prior to your incarceration at

the facility.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 35.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

30. You were seen by Nurse Bradley on March 16, 2005. She noted you reported

being under a doctor’s care and indicated you had damaged your right knee two weeks ago. 

You told Nurse Bradley you had a torn ligament. You also indicated you had a seizure three

weeks ago and were taking Dilantin, 100 mg., twice a day. You stated you had last had

Dilantin the morning before.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 20 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-21-

page 36.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

31. On March 16, 2005, you were given a misdemeanor citation and told to appear in

Rogers for court on April 25, 2005. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 38.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

32. On March 16, 2005, you were also given a felony citation for violation of

probation. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 21 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-22-

page 39.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

33. On March 16, 2005, a fax was received from Mike Parker, a probation officer,

regarding your probation violation. It indicated you had been placed on probation on March

7, 2003, for four years and absconded June 2003. The revocation was dismissed on April 27,

2004. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 43.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

34. On March 16, 2005, you intake sheet was completed by Officer Reynolds who

noted that you reported taking hydrocodone and Dilantin but did not have the medications

with you.

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 22 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-23-

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

page 44.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

35. On March 16, 2005, you submitted a request asking when your court date was

and whether you had a bond. In response, you were told a Rule 8.1 hearing was scheduled

for March 18th and no bond had been set yet.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 48.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

36. You were released on March 17, 2005, due to overcrowding and your personal

property was returned to you. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 23 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-24-

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 49-52.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

37. On April 5, 2005, the State of Arkansas filed a motion for revocation of your

probated sentence.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 53.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

38. On April 6, 2005, you were given arraignment information and were to appear for

arraignment on April 6th at 7:45 a.m. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 24 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-25-

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 57.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

39. On April 6, 2005, you were found in contempt for failing to appear for

arraignment and an arrest warrant was issued on the revocation petition. Your bond was

ordered forfeited.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 58. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

40. On April 14, 2005, an arrest warrant was ordered to be issued for your failure to

appear and a felony citation issued.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 25 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-26-

page 59.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

41. On April 25, 2005, an arrest warrant was issued. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 60.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

42. On May 20, 2005, the Washington County Sheriff’s Office prepared a warrant

information sheet. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 26 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-27-

page 61.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 43. On June 1, 2005, the warrant information was entered into ACIC/NCIC.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 62.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

44. On July 5, 2005, you were served with the warrant.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 62-63.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

45. You were booked into the WCDC on July 5, 2005, on the contempt of court

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 27 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-28-

charge and on a hold for the Rogers District Court. 

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 46. You completed a medical questionnaire indicating you had problems with

epilepsy/seizures, took Dilantin for this and had a seizure about every three months, had a

deep cut on your pinky toe, were under the care of Dr. Berry at the Springdale Hospital and

had attempted suicide three weeks ago. You indicated you were no longer suicidal. 

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

47. Your intake was completed by Van Hoosen. It was noted that you had an

infection on your left little toe. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 28 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-29-

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

page 4.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

48. On July 6, 2005, you were transported to court for a Rule 8.1 hearing and your

bond was changed to $50,000. 

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

49. On July 6, 2005, you were assigned jail property, signed a medical release and

informed consent, and signed an inmate medical insurance information form.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 7-9.

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 29 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-30-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

50. On July 6, 2005, you submitted a medical request asking for Dilantin for seizures,

Ibuprofen, and neosporin.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 10.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

51. On July 7, 2005, you submitted a request asking to see the nurse that day. You

said you had swelling, redness and itching.

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.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 30 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-31-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

52. In response, the nurse stated you should have an ice pack, Ibuprofen, and Tylenol

for five 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 13.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

53. On July 7, 2005, you were seen by Nurse Bradley. You told Nurse Bradley you

had seizures and were being treated by Dr. Berry of Northwest Medical Center. You stated

you last had your medication the prior evening.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 115.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 31 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-32-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

54. On July 9, 2005, you asked for information on your court dates and holds. You

were told court was scheduled for July 29th and you had no more holds.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 15.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

55. On July 12, 2005, you submitted a medical request. You complained of pain in

your left arm and left side of your chest. You also stated you were red in the face and had a

headache.

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.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 32 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-33-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

56. Nurse Bradley saw you on July 13th. She noted that you complained of a

headache and stated it was a migraine. She gave you Excedrin Migraine, two tablets, twice a

day, for three 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 17 .

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

57. On July 12, 2005, you submitted a request stating you needed to know who your

public defender was. You stated that you needed to be to be able to talk to your kids. In

response, you were told the WCDC did not know who your public defender was but the

public defender’s office would be faxed your request.

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.

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 33 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-34-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

58. On July 13, 2005, you stated you needed to talk to the corporal regarding your

kids because the friend who was keeping them was moving to Texas. You stated you needed

your bond reduced. In response, you were told WCDC staff could not get involved in legal

matters or bond reduction and you would have to speak to your attorney.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 20.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

59. On July 15th you asked for two legal envelops. You were provided the envelops.

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.

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 34 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-35-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

60. On July 16, 2005, you requested medical care. You indicated you had been in an

accident 3 1⁄2 weeks ago and your right arm, shoulder, and hand hurt really bad. You stated

you were supposed to have surgery. You asked to have something for the pain. You asked

for Tylenol or anything.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

61. On July 20th you were seen by the doctor. He noted you claimed to have been in

a motor vehicle accident and complained of pain in your right arm and shoulder. You were

prescribed Ibuprofen.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 35 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-36-

page 114.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

62. On July 21st you requested medical care for red and irritated eyes. Nurse Bradley

gave you chloraphenramine, 4 mg., for three 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 23.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

63(A). On July 22, 2005, you asked to have a regular tray for lunch and supper. In

response, on July 23, 2005, Nurse Johnson put you on a regular diet.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 25 & page 27.

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 36 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-37-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(B). What kind of diet had you been on?

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(C). Why were you on a special diet?

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

64. On July 23, 2005, you requested medical care. You stated your throat was

swelling, you were dizzy and light headed, and you were shaking uncontrollably.

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 37 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-38-

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

page 26.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

65. Nurse Bradley was contacted and advised jail staff to give you Benadryl.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

66. Nurse Bradley then came to check on you and noted no throat swelling and that

your skin was dry and warm. You were still shaking and Nurse Bradley told you to drink

plenty of fluids.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 38 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-39-

page 26.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

67. On July 29, 2005, you appeared in court and your bond was changed to $2,500. 

You plead not guilty to the contempt of court charge. You were served with a post-arrest

warrant for a probation violation, a violation of the hot check law, and failure to appear.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 29-30.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

68. On July 30, 2005, you submitted a medical request stating you had slipped and fell

off the bed hitting your side and back on the bar. You stated the pain in your back was major.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 39 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-40-

page 31.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

69. You were seen by Nurse Johnson who noted no redness, no swelling, and no

bruising.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

70. On August 2, 2005, you requested a pregnancy test because you had not had a

period in three months. You also stated that your back was hurting and your stomach

swelling.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 40 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-41-

page 33.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

71. On August 3rd Nurse Bradley responded that a pregnancy test would be done.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

72. On August 5, 2005, you were released after you bonded out.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 34-36, 38-39.

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 41 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-42-

___________________________________________________________________________

___________________________________________________________________________

73. On September 27, 2005, an order for the issuance of an arrest warrant for you was

entered by Judge Gunn after you failed to appear in court on September 16, 2005. Bail bond

was set at $150,000.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 40.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

74. An arrest warrant was issued that same day for your arrest for contempt of court,

violation of the hot check law, and failure to appear.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 41.

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 42 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-43-

___________________________________________________________________________

___________________________________________________________________________

75. On October 6, 2005, you were discharged from Northwest Medical Center after

being treated for pelvic pain. You were instructed to follow up with AHEC clinic in

Springdale in three to five days. You were prescribed Lortab and doxycycline.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 44-45.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

76. You were arrested on October 6, 2005, by the Springdale Police Department. You

were booked and then released to the Washington County Sheriff’s Office.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 46.

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 43 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-44-

___________________________________________________________________________

___________________________________________________________________________

77. You were booked into the WCDC on October 7, 2005. A medical questionnaire

was completed as part of the intake. You reported suffering from depression. You also

indicated you had epilepsy and had been having two seizures a day lately. You indicated you

had been bleeding heavily for three weeks and had a pelvic infection. You also stated you fell

at the Motel 8 in Springdale the prior Friday and sprained your right knee. You indicated you

had prescriptions for hyrocodone and doxycycline but had not filled them. You also indicated

you had cut your wrists two weeks before trying to commit suicide but stated you were no

longer suicidal.

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

78. You were evaluated by Nurse Johnson who felt you could be placed in B pod.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 44 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-45-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

79. On November 7, 2005, note was made that you had a questionable red dye allergy.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 57.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

80. On October 8, 2005, you submitted a request to see the nurse. You stated you

needed your antibiotics for your bad pelvic infection and something for the pain. You stated

you had a doctor’s order.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 58.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 45 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-46-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

81. Nurse Johnson noted that the jail doctor had not given the order for the antibiotics. 

Instead, it was an ER physician. She stated you would be given the antibiotic until you saw

Dr. Howard on October 12th.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 58.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

82. On October 9, 2005, you were moved from cell B to MH2 because of multiple

seizures.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 59.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 46 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-47-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

83. On October 12, 2005, you were treated by Dr. Howard for dizzy spells and ears

hurting.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 116.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

84. On October 13, 2005, Corporal Sharp and Deputy Western responded to a report

of a seizure in progress in “J” block. They found you lying on your mat on the floor. You

were clutching your chest saying it hurts. You complained of a sharp bruising pain just inside

and slightly below your right breast.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 65.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 47 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-48-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

85. While Sharp and Western were talking to you, you began to pump your legs up

and down. Western raised your right arm with no resistance. Cell mates indicated this was

your second seizure. You were awake and were able to talk and answer questions. Your

upper body and arms were relaxed. Your blood pressure and heart rate were normal.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 65.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

86. On October 14, 2005, you were transported to court and pled guilty. You were

sentenced to serve 1 1⁄2 years.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 61 & 66.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 48 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-49-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

87. You were given a judicial transfer to the Department of Community Punishment

and signed the form stating that you understood you must abide by the rules or be transferred

back to the 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

page 62.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

88. On October 17, 2005, you submitted a medical request. You stated you had severe

chest pain. You indicated you had previously had problems with your potassium level and the

symptoms were similar.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 67.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 49 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-50-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

89. The nurse was contacted and she stated she would check you in the morning. She

did and noted your chest was bruised. She prescribed Ibuprofen for five 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 67.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

90. On October 19, 2005, Nurse Bradley was called to A pod because you were

unresponsive and laying on the floor on your side. Nurse Bradley noted no seizure activity but

you refused to respond to verbal stimuli. You opened your eyes and rolled away as soon as an

ammonia inhalant was busted. Your blood pressure was checked.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 116.

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 50 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-51-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

91. On October 19, 2005, Dr. Howard noted that you reported that you passed out

from low potassium. Dr. Howard ordered a check of your potassium and CBC and noted: “?

seizure disorder.”

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 116.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

92. On October 20, 2005, your blood was drawn for routine blood counts.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 68.

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 51 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-52-

___________________________________________________________________________

___________________________________________________________________________

93. Your potassium level was found to be 4.4 which was within the normal reference

range.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 69.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

94. On October 21, 2005, you were observed by Nurse Johnson who noted no seizure

activity.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 116.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 52 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-53-

___________________________________________________________________________

95. On October 22, 2005, you were observed by Nurse Johnson who noted no seizure

activity.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 116.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

96. On October 24, 2005, you were seen by Nurse Bradley after complaining of falling

and hitting the left side of your face, right shoulder, and neck on the toilet. Nurse Bradley

noted no redness, bruising, or deformities.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 117.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 53 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-54-

___________________________________________________________________________

97. On November 5, 2005, you requested medication or a wrap for your left hand. 

Nurse Johnson prescribed antibiotic cream for a scrape on your left knuckle and noted there

was no swelling. Nurse Johnson also noted that you stated you sometimes had a headache.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 72.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

98. On November 6, 2005, you requested treatment for a big knot on the back of your

leg that was making your leg feel numb.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 73.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 54 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-55-

___________________________________________________________________________

99. Nurse Johnson examined you and noted you had a small fatty knot behind your

right knee. 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. 2 at

page 73.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

100. On November 7, 2005, you submitted a grievance asking to return to your pod. 

You complained that you felt like you were being punished for being sick. Sgt. Charles

responded that he would look into it.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 75.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 55 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-56-

___________________________________________________________________________

101. On November 9, 2005, you were seen by Dr. Howard. He prescribed Ibuprofen

for your right 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 117.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

102. On November 10, 2005, you asked to be moved to A pod or G pod. You stated

you wanted to be around your friends. You stated you would not have any more seizures. In

response, you were told you were not going to be moved at that time.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 76.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 56 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-57-

___________________________________________________________________________

103. Please state when you were moved to an observation cell and the reason you

were moved to an observation cell.

Answer:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

104. On November 16, 2005, you asked to be moved to A pod. You stated you had

not had a seizure in four days and were doing better. In response, you were told to contact

Sgt. Charles or Sgt. Mason since they had approved your placement in ISO4.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 78.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

105. On November 18, 2005, you submitted a medical request. You stated your right

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 57 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-58-

leg was worse on the back. You indicated it was red and had gotten bigger. You stated you

needed immediate medical attention.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 79.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

106. Nurse Johnson noted that the nodule behind your knee had not changed in size. 

However, she stated it was red from you rubbing it. She stated it was about the 1⁄2 the size of a

dime. 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. 2 at

page79.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 58 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-59-

107. On November 22, 2005, you were treated by Dr. Howard for a cyst behind your

right knee. Dr. Howard ordered doxycycline for one 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 117.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

108. On November 23, 2005, you submitted a medical request stating you had broken

out in big, red whelps and needed to be seen.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 82.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

109. Nurse Johnson noted you had what appeared to be a possible allergic reaction to

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 59 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-60-

the antibiotic. She stopped the antibiotic and started you on Benadryl. If it was not improving

by the next day, you were to be given a Medrol dose pack.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

pages 82.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

110. On November 27, 2005, you submitted a grievance stating that your rash was

worse and the knot on the back of your leg was worse. You stated another one was coming up

next to it.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 83.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 60 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-61-

111. Nurse Bradley responded that you had been taken care of.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 83.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

112. On November 29, 2005, you submitted a medical request asking for something to

help you relax. You stated your grandmother had passed away and you were having difficulty

sleeping.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 84.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

113. You were seen by Dr. Howard on November 30, 2005. He noted you were doing

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 61 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-62-

better and recommended that antibiotic cream be applied until it was healed.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 117.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

114. On December 8, 2005, Nurse Bradley sent a health services request to the

Arkansas Department of Correction (ADC) regarding your complaint of right leg swelling. 

The ADC approved your examination by the jail 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 87.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

115. On December 9, 2005, you were seen in the emergency room of Northwest

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 62 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-63-

Medical Center because you had a seizure. You were prescribed Dilantin.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 95.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

116. On December 14, 2005, you were seen by the doctor for a sore on your right leg

which was healing.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 118.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

117. On December 14, 2005, you submitted a grievance about being locked down. 

You stated you needed to be with your friends. You stated you were being punished for being

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 63 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-64-

sick.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 94.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

118. In response, you were told that due to your medical situation, personnel had to

keep you in an environment more suitable and convenient for supervision.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 94.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

119. On December 17, 2005, you submitted a request to be moved out of ISO#4. You

stated the new medicine was helping and it would be better for you to be with friends. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 64 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-65-

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 98.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

120. In response, you were told you would remain in ISO#4 so you could be

monitored for your safety.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 98.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

121. On December 21, 2005, you submitted a medical request stating your head was

hurting bad and so was your underneath your ribs. 

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 65 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-66-

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

page 80.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

122. In response, Nurse Bradley prescribed Tylenol and noted that you wanted out of

ISO and had no seizures.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 80 .

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

123. On December 22, 2005, you requested that you be moved out of ISO#4. You

stated you had not had a seizure since the prior Wednesday. In response, you were told you

would remain in there awhile longer so they could keep an eye on your medical.

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 66 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-67-

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

page 100.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

124. On December 28, 2005, you asked to be moved out of ISO#4. You stated you

had not had a seizure in two weeks. In response, you were told you did much better while you

were in the ISO#4. You were told they were afraid if they moved you out your seizures would

start up again.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 101.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

125. On December 30, 2005, you submitted a request stating you had three bad teeth

that were infected. You indicated they were making you sick to your stomach.

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 67 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-68-

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

page 105.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

126. Nurse Johnson noted that you were not complaining of a toothache. She stated

you were worried about your leg. Your leg was bandaged and wrapped and your paperwork

sent to the ADC.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 105.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

127. On December 31, 2005, Nurse Bradley completed a health services request form

to be sent to the ADC regarding your care for seizures, abscessed teeth, and a boil on your

right leg.

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 68 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-69-

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

page 106.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

128. On January 1, 2006, Nurse Moss was called to the ISO because your leg was

bleeding. You were taken to the nurse’s station and your leg cleaned. Your sore had popped

open and drained the excess blood build up. The sore looked much better and you said there

was less pressure and it felt better. The sore was redressed.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 118.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

129. On January 3, 2006, the ADC approved your evaluation and treatment for the

seizures and boil by the jail doctor. Approval was also given for you to be treated by a local

dentist for the abscessed teeth including application of antibiotics, simple fillings, and

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 69 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-70-

extractions.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 107.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

130. On January 3, 2006, you submitted a request asking to be moved out of ISO#4. 

You stated you had been in there a month and had not had a seizure in two weeks. You stated

your leg was very infected. In response, you were told that you were going to stay in ISO until

further notice so you could be closely monitored.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 108.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 70 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-71-

131. On January 4, 2006, you were seen by Dr. Howard. He examined the abscess

around your right knee and noted it was still draining. He prescribed cephalexin for ten days

and ordered the would re-dressed as needed.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 118.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

132. On January 13, 2006, you were treated by Nurse Johnson. She prescribed

erythrocin for seven days and your dressing was changed.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 118.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 71 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-72-

133. On January 16, 2006, Nurse Bradley noted you were crying and complaining of

severe pain in the right knee area. You asked for stronger pain medication. Dr. Howard

called and prescribed Ibuprofen, 600 mg., for three days, with Tylenol. You were placed on

the list to see the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

134. On January 17, 2006, you were released to the ADC for transfer to Pine Bluff.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

page 113.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 72 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-73-

135. From October 9, 2005, through November 4, 2006, you were on fifteen minute

jail checks.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, Vol. 3 at

pages 1-46.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

136. You received a variety of medications including Dilantin while at the WCDC.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 1, Vol. 3 at

pages 47 to 75.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

137. Medical records from Washington Regional Medical Center dated September 16,

2003, through February 20, 2005, indicate you were treated for an accidental overdose, left rib

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 73 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-74-

pain, a sprained ankle, left arm, left leg, and back pain. There is no mention of you being

treated for a “staph” infection.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

138. When your intake physical was done at the ADC, note was made that you had an

open ulcer on your right lower extremity.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 3 at page 4.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

139. On January 17, 2006, during your intake physical note was made that you had a

wound 216 mm width by 28 length on the inside right outer aspect of your right knee. The

wound was red on the inside and blue bruising was noted 1⁄2 inch out around from it. No

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 74 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-75-

drainage was noted at the time. Signs of infection were present. The wound was examined

by the doctor, cleaned, and a dressing applied.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 3 at page 24.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

140. Your ertyhrocin tablets were discontinued and you were put on bactrim.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 3 at page 32.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

141. On February 3, 2006, you submitted a medical request because your prescription

for antibiotics had run out. Note was made you had an infected knee and that it was oozing,

raw, and sore. You were referred to the doctor for a re-order of antibiotics.

Agree______ Disagree________Without knowledge to agree or disagree________. 

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 75 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-76-

If you disagree, explain. In explaining, please refer to defendants’ exhibit 3 at page 10.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

142. On March 2, 2006, note was made that the ulcerated lesion on your right leg had

done significant healing and there was no sign of infection.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 3 at page 16.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

143. On March 19, 2006, you requested medical treatment because the scar was

getting infected, turning red, and irritated. You were referred to the doctor.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. In explaining, please refer to defendants’ exhibit 3 at page 8.

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 76 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-77-

___________________________________________________________________________

___________________________________________________________________________

144. While you have been at the ADC, you have had seizures a number of times.

Agree______ Disagree________Without knowledge to agree or disagree________. 

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

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

145. You received all medical care Dr. Howard and the jail nurses believed, in the

exercise of their medical judgment, that you needed.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you disagree, explain. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

146. Do you contend Dr. Howard was deliberately indifferent to your serious medical

needs?

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 77 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-78-

Answer: Yes __________ No ___________.

If you answered yes, please state what your serious medical needs were and how Dr.

Howard exhibited deliberate indifference to your needs.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 78 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-79-

147. Do you contend Nurse Bradley was deliberately indifferent to your serious

medical needs?

Answer: Yes __________ No ___________.

If you answered yes, please state what your serious medical needs were and how Nurse

Bradley exhibited deliberate indifference to your needs.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 79 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-80-

___________________________________________________________________________

___________________________________________________________________________

148. Do you contend Nurse Johnson was deliberately indifferent to your serious

medical needs?

Answer: Yes __________ No ___________.

If you answered yes, please state what your serious medical needs were and how Nurse

Johnson exhibited deliberate indifference to your needs.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 80 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-81-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

149. Sheriff Tim Helder personally made no decisions about the medical care you

should received.

Agree______ Disagree________Without knowledge to agree or disagree________. 

If you agree, please explain how you believe Sheriff Helder violated your federal

constitutional rights. 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 81 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-82-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

If you disagree, please explain how Sheriff Helder was personally involved in deciding

what medical care you should receive.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 82 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-83-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

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.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 83 of 84 PageID #: <pageID>
AO72A

(Rev. 8/82)

-84-

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

I DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE

AND CORRECT.

EXECUTED ON THIS _________ DAY OF ________________ 2006.

__________________________________________

DOROTHY RUTH PEEK

Case 5:06-cv-05003-JLH Document 21 Filed 07/17/06 Page 84 of 84 PageID #: <pageID>