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IN THE CIRCUIT COURT OF COUNTY, MISSISSIPPI
PLAINTIFF
VS. NO.
DEFENDANT
COMPLAINT
COMES NOW , Plaintiff, by and through counsel, and files this Complaint against
and for cause of same would state the following:
1. That Plaintiff is an adult resident citizen of County, Mississippi.
2. That the Defendant, , is a non - profit corporation existing and doing
business pursuant to the laws of the State of Mississippi. That the Defendant may be served with
the process of this Court by service of process upon its registered agent, , , ,
Mississippi or upon such other persons authorized to be served by the Mississippi Rules of Civil
Procedure at its business address, , , County, Mississippi.
3. That between , , and , , Plaintiff sought and received
medical treatment at the Defendant's facility in , Mississippi, under the primary care of Dr.
, a physician employee of the Defendant. That at all times related hereto, Dr. was
the employee of the Defendant and Defendant was and is liable for the actions, omissions and
negligence of said employee.
4. That Plaintiff's primary complaints related to , , and . That
these symptoms persisted throughout his/her treatment without a diagnosis of the particular
cause of the symptoms, physical illness or condition that afflicted the Plaintiff, notwithstanding
Defendant's treatment, by and through its employee, Dr. , medical tests and medications.
5. That on or about , , Plaintiff was treated by physicians who
immediately diagnosed, , hospitalized Plaintiff, performed surgery and removed ,
the largest of which measures x cm. Following the and , Plaintiff
made a normal recovery and returned to full normal health.
6. That the Defendant, by and through its employee physician , was negligent
in failing to diagnose Plaintiff's medical condition and render treatment consistent with a proper
diagnosis.
7. That Defendant's negligence directly and proximately resulted in unnecessary
severe physical, mental and emotional pain and suffering and unnecessary medical treatment,
tests and expense over a period of twenty months and Plaintiff is entitled to recover damages of
from and against the Defendant for said negligence.
WHEREFORE, Plaintiff files this Complaint and demands judgment of, from and against
the Defendant in the sum of $ actual damages together with prejudgment interest and all
costs of court accrued herein.
Respectfully submitted,
_______________________________________
Attorney for
Of Counsel:
Telephone:
MSB #
Attorney for
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