CACI No. VF-3021. Violation of Prisoner’s Federal Civil Rights - Eighth Amendment - Substantial Risk of Serious Harm (42 U.S.C. § 1983)
Judicial Council of California Civil Jury Instructions (2023 edition)
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VF-3021.Violation of Prisoner’s Federal Civil Rights - Eighth
Amendment - Substantial Risk of Serious Harm (42 U.S.C. § 1983)
We answer the questions submitted to us as follows:
1. While imprisoned, [describe violation that created risk of serious
harm, e.g., was [name of plaintiff] placed in a cell block with rival
gang members]?
1. Yes No
1. If your answer to question 1 is yes, then answer question 2. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
2. Did [name of defendant]’s conduct create a substantial risk of
serious harm to [name of plaintiff]’s health or safety?
2. Yes No
2. If your answer to question 2 is yes, then answer question 3. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
3. Did [name of defendant] know that [his/her/nonbinary pronoun]
conduct created a substantial risk of serious harm to [name of
plaintiff]’s health or safety?
3. Yes No
3. If your answer to question 3 is yes, then answer question 4. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
4. Was there a reasonable justification for the conduct?
4. Yes No
4. If your answer to question 4 is no, then answer question 5. If you
answered yes, stop here, answer no further questions, and have
the presiding juror sign and date this form.
5. Was [name of defendant] acting or purporting to act in the
performance of [his/her/nonbinary pronoun] official duties?
5. Yes No
5. If your answer to question 5 is yes, then answer question 6. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
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6. Was [name of defendant]’s conduct a substantial factor in causing
harm to [name of plaintiff]?
6. Yes No
6. If your answer to question 6 is yes, then answer question 7. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
7. What are [name of plaintiff]’s damages?
[a. Past economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
[other past economic loss $ ]
[a. Total Past Economic Damages: $ ]
[b. Future economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
[other future economic loss $ ]
[b. Total Future Economic Damages: $ ]
[c. Past noneconomic loss, including [physical
pain/mental suffering:] $ ]
[d. Future noneconomic loss, including [physical
pain/mental suffering:] $ ]
[d. TOTAL $
Signed: Presiding Juror
Dated:
After [this verdict form has/all verdict forms have] been signed, notify
the [clerk/bailiff/court attendant] that you are ready to present your
verdict in the courtroom.
New September 2003; Revised April 2007, December 2010, June 2011; Renumbered
from CACI No. VF-3008 December 2012; Revised June 2015, December 2016
VF-3021 CIVIL RIGHTS
374
Directions for Use
This verdict form is based on CACI No. 3040, Violation of Prisoner’s Federal Civil
Rights - Eighth Amendment - Substantial Risk of Serious Harm.
The special verdict forms in this section are intended only as models. They may
need to be modified depending on the facts of the case.
If specificity is not required, users do not have to itemize all the damages listed in
question 7 and do not have to categorize “economic” and “noneconomic” damages,
especially if it is not a Proposition 51 case. The breakdown of damages is optional
depending on the circumstances.
If there are multiple causes of action, users may wish to combine the individual
forms into one form. If different damages are recoverable on different causes of
action, replace the damages tables in all of the verdict forms with CACI No. VF-
3920, Damages on Multiple Legal Theories.
If the jury is being given the discretion under Civil Code section 3288 to award
prejudgment interest (see Bullis v. Security Pac. Nat’l Bank (1978) 21 Cal.3d 801,
814 [148 Cal.Rptr. 22, 582 P.2d 109]), give CACI No. 3935, Prejudgment Interest.
This verdict form may need to be augmented for the jury to make any factual
findings that are required in order to calculate the amount of prejudgment interest.
CIVIL RIGHTS VF-3021
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