SUPERIOR COURT OF THE STATE
OF CALIFORNIA
COUNTY OF ________
- [PLAINTIFF(S) NAMES]
- Plaintiffs,
- v.
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- [DEFENDANT(S) NAMES]
- Defendants
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-
- ________________________________
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- CASE NO: _______
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- COMPLAINT FOR DAMAGES
- (Wrongful Death)
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Plaintiff complains and for causes of
action alleges as follows:
FIRST COUNT
(Negligence)
1. The only surviving heirs of __________
[name],
deceased (referred to in this complaint as "decedent"),
are:
Name: Address: Relationship Age:
to Decedent:
__________ __________ __________ __________
__________ __________ __________ __________
__________ __________ __________ __________
__________ __________ __________ __________
2. Plaintiffs are the surviving heirs
at law of the
decedent. __________ [Plaintiff __________ (name) is the
surviving spouse of the decedent and plaintiff __________
(name) is the surviving minor child of decedent.]
3. __________ [Add if applicable: For
the purposes of
this action, __________ (name) was duly appointed guardian
ad litem of plaintiff __________ (name of minor child) on
__________ (date) by order of this court. A copy of the
order is attached and incorporated by reference.]
4. __________ [Add if applicable: __________
(Names of
heirs) are joined as defendants in this action pursuant to
section 382 of the Code of Civil Procedure for the reason
that __________ [state why the heirs are not named as
plaintiffs, such as: their consent to be joined as
plaintiffs was sought and refused.]
5. Plaintiffs do not know the true names
of defendants
DOES 1 through 50, inclusive, and therefore sue them by
those fictitious names. __________ [Optionally, in addition
to language in charging allegations that includes
fictitiously named defendants: Plaintiffs are informed and
believe, and on the basis of that information and belief
allege, that each of those defendants was in some manner
negligently and proximately responsible for the events and
happenings alleged in this complaint and for plaintiffs'
damages.]
6. Plaintiffs are informed and believe,
and on the
basis of that information and belief allege, that at all
times mentioned in this complaint, defendants were the
agents and employees of their codefendants, and in doing the
things alleged in this complaint were acting within the
course and scope of that agency and employment.
7. Defendant __________ [name of manufacturer]
is now,
and at all times mentioned in this complaint was, a
corporation organized and existing under the laws of the
State of California, with its principal place of business in
__________ County, California.
8. Defendant __________ [name of manufacturer]
is now,
and at all times mentioned in this complaint was, in the
business of designing, manufacturing, constructing, and
assembling __________ [type of product] for use by members
of the general public.
9. Defendant __________ [name of retailer]
is now, and
at all times mentioned in this complaint was, a corporation
organized and existing under the laws of the State of
California, with its principal place of business in
__________ County, California.
10. Defendant __________ [name of retailer]
is now,
and at all times mentioned in this complaint was, in the
business of selling __________ [type of product] for use by
members of the general public.
11. Sometime prior to __________ [date],
decedent
purchased from defendant __________ [name of retailer] a
__________ [describe specific product, giving model number,
serial number, or other identifying information] made by
defendant __________ [name of manufacturer] for the sum of
$_____.
12. At all times mentioned in this complaint,
defendants and each of them so negligently and carelessly
designed, manufactured, constructed, assembled, and sold the
__________ [product] described above that it was dangerous
and unsafe for its intended uses.
13. As a direct and proximate result
of defendants'
negligence and carelessness as described above, decedent was
seriously injured on __________ [date], while using the
__________ [product] in the manner for which it was
intended.
14. The injuries so inflicted on the
decedent resulted
in the decedent's death on __________ [date].
15. As the direct and proximate result
of the foregoing
and the death of the deceased, plaintiff __________ [name
of surviving spouse] has been deprived of a kind and loving
spouse and of __________ [his or her] care, comfort,
society, protection, love, companionship, affection, solace,
moral support, loss of marital consortium, physical
assistance in the operation and maintenance of the home, and
financial support.
16. As a further direct and proximate
result of the
foregoing death of the deceased, plaintiff __________ [name
of minor heir] has been deprived of a kind and loving parent
and of __________ [his or her] care, comfort, love,
protection, advice, society, physical assistance, and
financial support.
17. As a further direct and proximate
result of the
foregoing, plaintiffs have been generally damaged in a sum
to be established according to proof, as provided by Code of
Civil Procedure sections 425.10 and 425.11.
18. As a further direct and proximate
result of the
death of the deceased, plaintiffs have incurred reasonable
and necessary expenses for decedent's funeral, burial, and
memorial services to their damage in a presently
unascertained sum. Plaintiffs request permission to insert
the amount when it is finally determined.
Wherefore, plaintiffs demand judgment
as set forth
below.
SECOND COUNT
(Strict Products Liability)
19. Plaintiffs incorporate by this reference
each and
all of the allegations contained in Paragraphs 1 through 18
of the First Count of this complaint as though fully set
forth here.
20. At all times mentioned in this complaint,
the
__________ [product] and its component parts were defective
as to design, manufacture, and warnings, causing the
__________ [product] and its component parts to be in a
defective condition that made them dangerous and unsafe for
their intended uses.
21. As a direct and proximate result
of the dangerous
and defective condition of the __________ [product] as
described above, decedent was seriously injured on
__________ [date], while using the __________ [product] in
the manner for which it was intended.
WHEREFORE plaintiffs demand judgment
against defendants,
and each of them, jointly and severally, as follows:
(1) For general damages according to
proof;
(2) For special damages according to
proof;
(3) For costs of suit;
(4) For prejudgment interest and post-judgment
interest
according to law; and
(5) For such other and further relief
as the court may
deem just and proper.
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DATED: _______________ |
__________________________________________ |
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(Signature) |
VERIFICATION
I, ___, am a ___in the above-entitled
action. I have read the foregoing ___and know the contents
thereof. The same is true of my own knowledge, except as to those
matters which are therein alleged on information and belief,
and as to those matters, I believe it to be true.
I declare under penalty of perjury that
the foregoing is true and correct and that this declaration was
executed at Long Beach, California.
DATED: _________________ ___________________________________
