§ Form 3 Medical Malpractice--Interrogatories to Plaintiff

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Form 3. Medical Malpractice--Interrogatories to Plaintiff

    (These interrogatories should be used in conjunction with the General Personal Injury Negligence Interrogatories to Plaintiff.)

    23. Do you contend that you have experienced any injury or illness as a result of any negligence of this defendant? If so, state the date that each such injury occurred, a description of how the injury was caused, and the exact nature of each such injury.

    24. What condition, symptom, or illness caused you to obtain medical care and treatment from this defendant?

    25. Do you claim this defendant neglected to inform or instruct or warn you of any risk relating to your condition, care, or treatment? If so, state of what, in your opinion, the defendant failed to inform, instruct, or warn you.

    26. If you contend that you were not properly informed by this defendant regarding the risk of the treatment or the procedure performed, state what alternative treatment or procedure, if any, you would have undergone had you been properly informed.

    27. State the date and place and a description of each complaint for which you contend the defendant refused to attend or treat you.

    28. State the date you became aware of the injuries sued on in this action, and describe in detail the circumstances under which you became aware of each such injury; state the date you became aware that the injuries sued on in this action were caused or may have been caused by medical negligence; and describe in detail the circumstances under which you became aware of the cause of said injuries.

    29. State the name and address of every person or organization to whom you have given notice of the occurrence sued on in this case because you, your agents, or your attorneys believe that person or organization may be liable in whole or in part to you.