UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF FLORIDA

PENSACOLA DIVISION

IN RE: 3M COMBAT ARMS

EARPLUG PRODUCTS 

LIABILITY LITIGATION 

This Document Relates to: 

________________________ 

PLAINTIFF(S), 

v.

3M COMPANY

DEFENDANTS.

Case No. 3:19-md-2885

Judge M. Casey Rodgers

Magistrate Judge Gary R. Jones

MASTER SHORT FORM 

COMPLAINT AND

JURY TRIAL DEMAND

Civil Action No.: ________________

MASTER SHORT FORM COMPLAINT AND JURY TRIAL DEMAND

Plaintiff(s) incorporate(s) by reference the Master Long Form Complaint and 

Jury Trial Demand filed in In re: 3M Combat Arms Earplug Products Liability 

Litigation on September 20, 2019. Pursuant to Pretrial Order No. ______, this Short 

Form Complaint adopts the allegations, claims, and requested relief as set forth in 

the Master Long Form Complaint. As necessary herein, Plaintiff(s) may include:

(a) additional claims and allegations against Defendants, as set forth in Paragraphs

10 and 11 or an additional sheet attached hereto; and/or (b) additional claims and

CHRISTOPHER CISEK, et al.

3:22-cv-21686

17

Case 3:19-md-02885-MCR-HTC Document 3647-2 Filed 01/24/23 Page 1 of 6
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allegations against other Defendants not listed in the Master Long Form Complaint,

as set forth in Paragraphs 12 and 13 or an additional sheet attached hereto. 

Plaintiff(s) further allege(s) as follows:

I. DEFENDANTS

1. Plaintiff(s) name(s) the following Defendants in this action:

______ 3M Company 

______ 3M Occupational Safety LLC 

______ Aearo Holding LLC

______ Aearo Intermediate LLC

______ Aearo LLC

______ Aearo Technologies LLC 

II. PLAINTIFF(S)

2. Name of Plaintiff:

3. Name of spouse of Plaintiff (if applicable to loss of consortium

claim):

4. Name and capacity (i.e., executor, administrator, guardian, conservator,

etc.) of other Plaintiff, if any:

Christopher Cisek

N/A

X

Christopher Cisek

Sarah Cisek

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5. State(s) of residence of Plaintiff(s):

III. JURISDICTION

6. Basis for jurisdiction (diversity of citizenship or other):

7. Designated forum (United States District Court and Division) in which

venue would be proper absent direct filing:

IV. USE OF DUAL-ENDED COMBAT ARMS EARPLUG

8. Plaintiff used the Dual-Ended Combat Arms Earplug:

______ Yes

______ No

V. INJURIES

9. Plaintiff alleges the following injuries and/or side effects as a result of

using the Dual-Ended Combat Arms Earplug:

______ Hearing loss

______ Sequelae to hearing loss

______ Other [specify below]

California

Diversity of citizenship

Southern District of California

T nnitus Right Ear, Tinnitus Left Ear, Tinnitus Extent Unknown, Sleep Disturbances,

Headaches.

California

Diversity of citizenship

Southern District of California

X

X

X

X

Tinnitus Right Ear, Tinnitus Left Ear, Tinnitus Extent Unknown, Sleep Disturbances,

Headaches.

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VI. CAUSES OF ACTION

10. Plaintiff(s) adopt(s) in this Short Form Complaint the following claims

asserted in the Master Long Form Complaint and Jury Trial Demand,

and the allegations with regard thereto as set forth in the Master Long

Form Complaint and Jury Trial Demand:

______ Count I – Design Defect – Negligence 

______ Count II – Design Defect – Strict Liability 

______ Count III – Failure to Warn – Negligence 

______ Count IV – Failure to Warn – Strict Liability 

______ Count V – Breach of Express Warranty

______ Count VI – Breach of Implied Warranty

______ Count VII – Negligent Misrepresentation

______ Count VIII – Fraudulent Misrepresentation

______ Count IX – Fraudulent Concealment 

______ Count X – Fraud and Deceit

______ Count XI – Gross Negligence 

______ Count XII – Negligence Per Se 

______ Count XIII – Consumer Fraud and/or Unfair Trade Practices

______ Count XIV – Loss of Consortium

______ Count XV – Unjust Enrichment

______ Count XVI – Punitive Damages

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

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______ Count XVII – Other [specify below]

11. If additional claims against the Defendants identified in the Master

Long Form Complaint and Jury Trial Demand are alleged in Paragraph

10, the facts supporting these allegations must be pleaded. Plaintiff(s)

assert(s) the following factual allegations against the Defendants

identified in the Master Long Form Complaint and Jury Trial Demand:

12. Plaintiff(s) contend(s) that additional parties may be liable or

responsible for Plaintiff(s)’ damages alleged herein. Such additional

parties, who will be hereafter referred to as Defendants, are as follows

(must name each Defendant and its citizenship):

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13. Plaintiff(s) assert(s) the following additional claims and factual

allegations against other Defendants named in Paragraph 12:

WHEREFORE, Plaintiff(s) pray(s) for relief and judgment against 

Defendants and all such further relief that this Court deems equitable and just as set 

forth in the Master Long Form Complaint and Jury Demand and any additional relief 

to which Plaintiff(s) may be entitled.

Dated: ______________

L 1dsay Stevens, Esq.

Gomez Trial Attorneys

655 West Broadway, Ste. 1700

San Diego, CA 92101

Tel: (619) 237-3490

Fax: (619) 237-3496

Istevens@thegomezfirm.com

January 24, 2023

Lindsay Stevens, Esq.

Gomez Trial Attorneys

655 West Broadway, Ste. 1700

San Diego, CA 92101

Tel: (619) 237-3490

Fax: (619) 237-3496

lstevens@thegomezfirm.com

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