IN THE UNITED STATES DISTRICT COURT



IN THE UNITED STATES DISTRICT COURTFOR THE SOUTHERN DISTRICT OF WEST VIRGINIACHARLESTON DIVISIONIn Re: Ethicon Inc., Pelvic Repair System Products Liability Litigation MDL No. 2327Civil Action No. __________________________________________________________________________________________SHORT FORM COMPLAINTCome now the Plaintiff(s) named below, and for their Complaint against the Defendants named below, incorporate The First Amended Master Complaint in MDL No. 2327 by reference. Plaintiff(s) further show the court as follows:Female Plaintiff ___________________________Plaintiff’s Spouse (if applicable)___________________________Other Plaintiff and capacity (i.e., administrator, executor, guardian, conservator)___________________________State of Residence___________________________District Court and Division in which venue would be proper absent direct filing.______________________________________________________________________________________________________________________Defendants (Check Defendants against whom Complaint is made): FORMCHECKBOX A. Ethicon, Inc. FORMCHECKBOX B. Johnson & Johnson FORMCHECKBOX C. American Medical Systems, Inc. (“AMS”) FORMCHECKBOX D. Boston Scientific Corporation FORMCHECKBOX E. C. R. Bard, Inc. (“Bard”) FORMCHECKBOX F. Sofradim Production SAS (“Sofradim”) FORMCHECKBOX G. Tissue Science Laboratories Limited (“TSL”) FORMCHECKBOX H. Mentor Worldwide LLC FORMCHECKBOX I. Coloplast Corp. FORMCHECKBOX J. Cook Incorporated FORMCHECKBOX K. Cook Biotech, Inc. FORMCHECKBOX L. Cook Medical, Inc. FORMCHECKBOX M. Desarrollo e Investigación Médica Aragonesa, S.L. (“DIMA”) FORMCHECKBOX N. Neomedic International, S.L. FORMCHECKBOX O. Neomedic Inc. FORMCHECKBOX P. Specialties Remeex International, S.L.Basis of Jurisdiction FORMCHECKBOX Diversity of Citizenship FORMCHECKBOX Other: ______________________________A. Paragraphs in Master Complaint upon which venue and jurisdiction lie:_________________________________________________________________________________B. Other allegations of jurisdiction and venue:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Defendants’ products implanted in Plaintiff (Check products implanted in Plaintiff) FORMCHECKBOX Prolift FORMCHECKBOX Prolift +M FORMCHECKBOX Gynemesh/Gynemesh PS FORMCHECKBOX Prosima FORMCHECKBOX TVT FORMCHECKBOX TVT-Obturator (TVT-O) FORMCHECKBOX TVT-SECUR (TVT-S) FORMCHECKBOX TVT-Exact FORMCHECKBOX TVT-Abbrevo FORMCHECKBOX Other__________________________________________________________________________________Defendants’ Products about which Plaintiff is making a claim. (Check applicable products): FORMCHECKBOX Prolift FORMCHECKBOX Prolift +M FORMCHECKBOX Gynemesh/Gynemesh PS FORMCHECKBOX Prosima FORMCHECKBOX TVT FORMCHECKBOX TVT-Obturator (TVT-O) FORMCHECKBOX TVT-SECUR (TVT-S) FORMCHECKBOX TVT-Exact FORMCHECKBOX TVT-Abbrevo FORMCHECKBOX Other__________________________________________________________________________________Date of Implantation as to Each Product:________________________________________________________________ ________________________________ Hospital(s) where Plaintiff was implanted (including City and State):____________________________________________________________________Implanting Surgeon(s):______________________________________________________________________Counts in the Master Complaint brought by Plaintiff(s): FORMCHECKBOX Count I – Negligence FORMCHECKBOX Count II – Strict Liability – Manufacturing Defect FORMCHECKBOX Count III – Strict Liability – Failure to Warn FORMCHECKBOX Count IV – Strict Liability – Defective Product FORMCHECKBOX Count V – Strict Liability – Design Defect FORMCHECKBOX Count VI – Common Law Fraud FORMCHECKBOX Count VII – Fraudulent Concealment FORMCHECKBOX Count VIII – Constructive Fraud FORMCHECKBOX Count IX – Negligent Misrepresentation FORMCHECKBOX Count X – Negligent Infliction of Emotional Distress FORMCHECKBOX Count XI – Breach of Express Warranty FORMCHECKBOX Count XII – Breach of Implied Warranty FORMCHECKBOX Count XIII – Violation of Consumer Protection Laws FORMCHECKBOX Count XIV – Gross Negligence FORMCHECKBOX Count XV – Unjust Enrichment FORMCHECKBOX Count XVI – Loss of Consortium FORMCHECKBOX Count XVII – Punitive Damages FORMCHECKBOX Count XVIII – Discovery Rule and Tolling FORMCHECKBOX Other Count(s) (Please state factual and legal basis for other claims below):________________________________________________________________________________________________________________________________________________________________________________________________________________________s/Attorney(s) for PlaintiffAddress, phone number, email address and bar information: ................
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