Free Proposed Jury Instructions - District Court of Colorado - Colorado

Case 1:01-cv-02089-MSK-CBS

Document 250-5

Filed 05/08/2006

Page 1 of 3

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO Civil Action No. 01-CV-2089-MSK-CBS DEAN A. BRAMLET, M.D., Plaintiff, v. ASPEN VALLEY HOSPITAL DISTRICT, Defendant. ______________________________________________________________________________ VERDICT FORM ______________________________________________________________________________ We, the Jury, answer the questions submitted as follows: Plaintiff's Age Discrimination Claim Under the Age Discrimination in Employment Act 1. Did Aspen Valley Hospital District discriminate against Dr. Bramlet on the basis of his age in violation of the Age Discrimination in Employment Act? Yes _____ No _____

If "No," proceed to question 4. If "Yes," proceed to the next question. 2. Did Aspen Valley Hospital District prove that it would have made the same decisions or taken the same actions regarding Dr. Bramlet, regardless of his age? Yes _____ No _____

If "No," proceed to the next question. If "Yes," proceed to question 4. 3. If you answered "Yes" to question #1 and "No" to question #2, please answer the following question: Did Aspen Valley Hospital District willfully violate federal law, namely, the Age Discrimination in Employment Act, by discriminating against Dr. Bramlet on the basis of his age? Yes _____ No _______

Case 1:01-cv-02089-MSK-CBS

Document 250-5

Filed 05/08/2006

Page 2 of 3

Please proceed to the next question, regardless of your answer. Plaintiff's § 1983 Claim 4. Did Aspen Valley Hospital District violate Dr. Bramlet's constitutional rights in violation of 42 U.S.C. §1983? Yes _______ No _______

Please proceed to the next question, regardless of your answer. Plaintiff's Breach of Contract Claim 5. Did Aspen Valley Hospital enter into a contract with Dr. Bramlet? If "No," proceed to question 7. If "Yes," proceed to the next question. 6. Did Aspen Valley Hospital enter into a contract with Dr. Bramlet? Yes ________ No _______

Please proceed to the next question, regardless of your answer. Damages If you answered "Yes" to question #1 and "No" to question #2, please answer the following question: 6. What amount of damages, if any, do you award in favor of Dr. Bramlet and against Aspen Valley Hospital District for back pay that he would have received from Aspen Valley Hospital District if the age discrimination had not occurred? $ ______________________ If you answered "Yes" to question #4, please answer the following question: 7. What amount of compensatory damages, if any, do you award in favor of Dr. Bramlet and against Aspen Valley Hospital District, over and above the back amount included in your answer to question # 6, for the Hospital's violation of Dr. Bramlet's constitutional rights under §1983?

If you answered "Yes" to question #5, please answer the following question: 8. What amount of actual or nominal damages, if any, do you award in favor of Dr. Bramlet and against Aspen Valley Hospital District, over and above the back pay amount

Case 1:01-cv-02089-MSK-CBS

Document 250-5

Filed 05/08/2006

Page 3 of 3

included in your answer to question # 6 and the compensatory damages amount included in your response to question #7 , for the Hospital's breach of contract? $__________________

Please sign and date this verdict form: _____________________________ Foreperson _____________________________ Juror _____________________________ Juror _____________________________ Juror _____________________________ Juror _____________________________ Juror _____________________________ Juror _____________________________ Juror _____________________________ Juror _____________________________ Juror _____________________________ Juror _____________________________ Juror ________________________ Date ________________________ Date ________________________ Date ________________________ Date ________________________ Date ________________________ Date ________________________ Date ________________________ Date ________________________ Date ________________________ Date ________________________ Date ________________________ Date