California Civil Jury Instructions (CACI) (2017)

VF-401. Negligence—Single Defendant—Plaintiff’s Negligence at Issue—Fault of Others Not at Issue

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VF-401.Negligence—Single Defendant—Plaintiff’s Negligence at
Issue—Fault of Others Not at Issue
We answer the questions submitted to us as follows:
1. Was [name of defendant] negligent?
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. Was [name of defendant]’s negligence a substantial factor in
causing harm to [name of plaintiff]?
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. What are [name of plaintiff]’s total damages? Do not reduce the
damages based on the fault, if any, of [name of plaintiff].
[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 $
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3. If [name of plaintiff] has proved any damages, then answer
question 4. If [name of plaintiff] has not proved any damages,
then stop here, answer no further questions, and have the
presiding juror sign and date this form.
4. Was [name of plaintiff] negligent?
4. Yes No
4. If your answer to question 4 is yes, then answer question 5. If
you answered no, stop here, answer no further questions, and
have the presiding juror sign and date this form.
5. Was [name of plaintiff]’s negligence a substantial factor in
causing [his/her] harm?
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.
6. What percentage of responsibility for [name of plaintiff]’s harm
do you assign to:
[Name of defendant]: %
[Name of plaintiff]: %
TOTAL 100 %
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, December 2016
Directions for Use
This verdict form is based on CACI No. 400, Negligence—Essential Factual
Elements, and CACI No. 405, Comparative Fault of Plaintiff.
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 3. The breakdown is optional depending on the circumstances.
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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.
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