Sample Verdict Sheet in a Medical Malpractice Case

IN THE CIRCUIT COURT FOR BALTIMORE CITY, MARYLAND

PHYLLIS FRENCH, Plaintiff,

v.

CHIAU WEN CHEN, Defendant.

CASE NO.: 24-C-08-001269-MM

VERDICT SHEET

  1. Do you find that Chiau Wen Chen failed to follow the standard of care on February 2, 2009 when he performed surgery on Phyllis French, and that this failure was a cause of an injury to Phyllis French?

YES ________ NO________

If you answer is NO, then stop and notify the bailiff. If you answer is YES then answer question number 2.

  1. What damages do you find for the Plaintiff, Phyllis French for:

Past Medical Expenses: __________________

Future Medical Expense: __________________

Past Lost Wages: __________________

Future Lost Wages: __________________

Non-economic damages to include physical injury and
the associated pain, suffering, inconvenience, and
physical impairment in the past and into the future: __________________

Jury Foreperson__________________________ Date:______________

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