IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

IN RE: BARD IVC FILTERS 

PRODUCTS LIABILITY LITIGATION 

MDL No. 2641 

DEFENDANT BARD CASE PROFILE FORM 

For each case, the Bard Defendants must complete this Defendant Profile Form ("DPF") 

in accordance with the schedule established by the Court's Pretrial Order. In completing this 

Profile Form, you must answer every question. 

I. CASE INFORMATION 

This defendant profile form pertains to the following case: 

Case caption:----------------------------

Civil Action No.: ---------------------------

Court in which action was originally filed: __________________ _ 

II. CONTACTS WITH IMPLANTING AND REMOVING PHYSICIANS 

Plaintiff has identified each healthcare provider who implanted, removed and/or 

attempted to remove Bard's Filter. With respect to each of those healthcare providers, provide 

the following information: 

A. CONSULTATION AGREEMENT 

1. As to the identified healthcare providers, state whether Bard has consulting 

agreement with the healthcare provider relating to IVC filters that Bard has been able 

to locate after a reasonable and diligent search. 

B. SALES REPRESENTATIVE AND OTHER RELATED CONTACTS 

As to each sales representative, territory manager and district manager who had any 

contact with an identified physician or healthcare provider, set forth the following: 

1. Identity and last known address and telephone number of Representative(s): 

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As to the individual who Bard believes was the territory manager and district manger for 

the territory where the filter was implanted at the time of implant, set forth the following: 

2. Identify the name of the territory manager and district manger, the dates of 

employment for each, and, if no longer employed by Bard, provide the last known 

address: 

Territory Manager: 

Employment Dates:------------------

If former, last known address: ---------------

District Manager: 

Name: -----------------------

Employment Dates:------------------

If former, last known address: ---------------

III. MANUFACTURING INFORMATION 

A. Identify the lot number(s) for the Bard filter implanted in Plaintiff: 

B. Identify the lot number for the Bard device used to remove or used to attempt to remove 

the Bard Filter implanted into Plaintiff: 

C. Identify the location and date of manufacture for each lot set forth in response to A and B 

above: -----------------------------

IV. DOCUMENTS 

A. Please produce the following: 

1. The Device History Record (DHR) for the Bard filter at issue, or, if already produced, 

provide the bates number for the DHR. 

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2. The Bard complaint file relating to plaintiffs claims, or, in the alternative if already 

produced, provide the bates number for the complaint. 

3. The bates numbers for any documents previously produced that reference the 

implanting physician and/or the hospital or facility where the device as placed, that 

Bard is able to identify after a reasonable and diligent search. 

4. Any consulting agreement relating to IVC filters that Bard has entered with the 

physician that implanted the filter. 

5. With regard to the plaintiff, any Med Watch Adverse Event Reports in Bard's 

possession. 

Attorney for C.R. Bard, Inc. and Bard Peripheral Vascular, Inc. 

[Signature] 

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