1

2

3 IN THEUNITED STATES DISTRICT COURT

4 FOR THE DISTRICT OFARIZONA

5 IN RE BARD IVC FILTERS 

PRODUCTS LIABILITY LITIGATION

6

7

No.

AMENDED MASTER SHORT FORM

COMPLAINT FOR DAMAGES FOR 

INDIVIDUAL CLAIMS

8 Plaintiff(s) named below, for their Complaint against Defendants named below,

9 incorporate the Master Complaint for Damages in MDL 2641 by reference (Doc. 364 ).

10 Plaintiff(s) further show the Court asfollows:

11 1. Plaintiff/Deceased Party:

12 Clifford Jones

13 2. Spousal Plaintiff/Deceased Party’s spouse or other party making loss of

14 consortium claim:

15 N/A

16 3. Other Plaintiff and capacity (i.e., administrator, executor, guardian,

17 conservator):

18 N/A

19 4. Plaintiff’s/Deceased Party’s state(s) [if more than one Plaintiff] of residence at

20 the time of implant: Michigan 

21

22

Case 2:15-md-02641-DGC Document 9841-1 Filed 01/26/18 Page 1 of 7 Case 2:17-cv-03846-DGC Document 1 Filed 10/20/17 Page 1 of 5
1 5. Plaintiff’s/Deceased Party’s state(s) [if more than one Plaintiff] of residence at

2 the time of injury:

3 Michigan 

4 6. Plaintiff’s current state(s) [if more than one Plaintiff] of residence:

5 Michigan 

6 7. District Court and Division in which venue would be proper absent directfiling:

7 United States District Court for the Eastern District of Michigan

8. Defendants (check Defendants against whom Complaint is made):

8  C.R. Bard Inc.

9  Bard Peripheral Vascular, Inc.

10 9. Basis of Jurisdiction:

11  Diversity of Citizenship

12 □ Other:

13 a. Other allegations of jurisdiction and venue not expressed in Master

14 Complaint:

16 Multi-District Litigation

17

18

19 10. Defendants’ Inferior Vena Cava Filter(s) about which Plaintiff(s) is making a

20 claim (Check applicable Inferior Vena Cava Filter(s)):

21  Recovery® Vena Cava Filter

22  G2® Vena Cava Filter

-2-

Case 2:15-md-02641-DGC Document 9841-1 Filed 01/26/18 Page 2 of 7 Case 2:17-cv-03846-DGC Document 1 Filed 10/20/17 Page 2 of 5
1  G2® Express(G2®X)VenaCavaFilter

2  Eclipse® Vena Cava Filter

3  Meridian® Vena Cava Filter

4  Denali® VenaCavaFilter

5  Other: Rival®

6 11. Date of Implantation as to each product:

7 November 12, 2013

8 

9 12. Counts in the Master Complaint brought by Plaintiff(s):

10  Count I: Strict Products Liability – Manufacturing Defect

11  Count II: Strict Products Liability – Information Defect (Failure to

12 Warn)

13  Count III: Strict Products Liability – Design Defect

14  Count IV: Negligence - Design

15  Count V: Negligence - Manufacture

16  Count VI: Negligence – Failure to Recall/Retrofit

17  Count VII: Negligence – Failure to Warn

18  Count VIII: Negligent Misrepresentation

19  Count IX: Negligence Per Se

20  Count X: Breach of Express Warranty

21  Count XI: Breach of Implied Warranty

22  Count XII: Fraudulent Misrepresentation

-3-

Case 2:17-cv-03846-DGC Document 1 Filed 10/20/17 Page 3 of 5

November 20, 2012

x

Case 2:15-md-02641-DGC Document 9841-1 Filed 01/26/18 Page 3 of 7
1

2

3

4

5

 Count XIII: Fraudulent Concealment

 Count XIV: Violations of Applicable Michigan Law 

Prohibiting Consumer Fraud and Unfair and Deceptive Trade

Practices

 Count XV: Loss of Consortium 

6 □ Count XVI: Wrongful Death

7 □ Count XVII: Survival

8  Punitive Damages

9 □ Other(s): (please state the facts supporting

10 this Count in the space immediately below) 

11 

12 

13 

14 

15 

16 13. Jury Trial demanded for all issues so triable?

17  Yes

18 No

19 

20 

21 

22 

-4-

Case 2:15-md-02641-DGC Document 9841-1 Filed 01/26/18 Page 4 of 7 Case 2:17-cv-03846-DGC Document 1 Filed 10/20/17 Page 4 of 5
1 RESPECTFULLY SUBMITTED this 20th day of October, 2017. 

2 MARC J. BERN & PARTNERS LLP

3 By: /s/ Debra J. Humphrey 

Debra J. Humphrey

One Grand Central Place 

60 East 42nd St., Suite 950

New York, New York 10165

(212) 702-5000

5

Attorneys for Plaintiff(s)

6

7

8

9

10

11

12 I hereby certify that on this 20th day of October, 2017, I electronically transmitted

13 the attached document to the Clerk’s Office using the CM/ECF System for filing and

14 transmittal of a Notice of Electronic Filing. 

15

/s/ Debra J. Humphrey

16

5131774

17

18

19

20

21

22

-5-

Case 2:15-md-02641-DGC Document 9841-1 Filed 01/26/18 Page 5 of 7 Case 2:17-cv-03846-DGC Document 1 Filed 10/20/17 Page 5 of 5
http://www.azd.uscourts.gov/cgi-bin/generate_civil_js44.pl[10/20/2017 12:54:46 PM]

UNITED STATES DISTRICT COURT

DISTRICT OF ARIZONA

Civil Cover Sheet

This automated JS-44 conforms generally to the manual JS-44 approved by the Judicial Conference of the United States in September 1974. The

data is required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. The information contained herein neither

replaces nor supplements the filing and service of pleadings or other papers as required by law. This form is authorized for use only in the District

of Arizona.

The completed cover sheet must be printed directly to PDF and filed as an attachment to the

Complaint or Notice of Removal.

Plaintiff(s): Clifford Jones Defendant(s): C.R. Bard, Inc. ; Bard Peripheral

Vascular, Inc.

County of Residence: Outside the State of Arizona County of Residence: Maricopa

County Where Claim For Relief Arose: Outside the State

of Arizona

Plaintiff's Atty(s): Defendant's Atty(s):

Debra J. Humphrey 

Marc J. Bern & Partners, LLP

60 E 42nd Street, Suite 950

New York, New York 10165

212-702-5000

II. Basis of Jurisdiction: 4. Diversity (complete item III)

III. Citizenship of Principal Parties

(Diversity Cases Only)

Plaintiff:-2 Citizen of Another State

Defendant:-4 AZ corp or Principal place of Bus. in AZ

IV. Origin : 6. Multidistrict Litigation

V. Nature of Suit: 367 Health Care/Pharmaceutical Personal Injury Product Liability

VI.Cause of Action: IN RE: BARD IVC FILTERS PRODUCTS LIABILITY LITIGATION

VII. Requested in Complaint

Class Action:No

Dollar Demand:

Jury Demand:Yes

VIII. This case IS RELATED to Case Number MDL No. 2641 assigned to Judge David G. Campbell.

Case 2:15-md-02641-DGC Document 9841-1 Filed 01/26/18 Page 6 of 7 Case 2:17-cv-03846-DGC Document 1-1 Filed 10/20/17 Page 1 of 2
http://www.azd.uscourts.gov/cgi-bin/generate_civil_js44.pl[10/20/2017 12:54:46 PM]

Signature: Debra J. Humphrey

 Date: 10/20/2017

If any of this information is incorrect, please go back to the Civil Cover Sheet Input form using the Back button in your browser and

change it. Once correct, save this form as a PDF and include it as an attachment to your case opening documents.

Revised: 01/2014

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