Sample jury questionnaire
Here is a proposed jury questionnaire in a med mal wrongful death case involving death from untreated heart disease
1. Do you or any members of your immediate family or household see a doctor or other medical practitioner regularly for any ongoing medical problem?
Yes o No o If Yes, please explain: _________________
________________________________________________
2. Have you or any members of your family ever suffered any major illness or injury?
Yes o No o If Yes, please explain: _________________
________________________________________________
3. Have you or anyone close to you ever experienced childbirth with serious complications?
Yes o No o If Yes, please explain: ________________
________________________________________________
4. How would you describe your (spouse’s or mate’s) pregnancy, labor and delivery?
________________________________________________
5. Do you know anyone who has or had a child who was diagnosed with severe brain damage?
Yes o No o If Yes, please explain: _________________
________________________________________________
6. Do you know anyone who has or has had a child who has or had brain damage or a serious illness or medical condition since birth?
Yes o No o If Yes, please explain: _________________
________________________________________________
7. Have you ever had any experience with caring for a severely ill, disabled or injured person?
Yes o No o If Yes, please explain: _________________
________________________________________________
8. Have you or anyone close to you ever had a problem with abuse of drugs or alcohol?
Yes o No o If Yes, please explain: _________________
9. Would you be unwilling to consider the responsibility of anyone else for problems that developed at birth if you heard that the labor nurse who was caring for the mother was using a narcotic pain medication?
Yes o No o If Yes, please explain: _________________
________________________________________________
10. a) Have you or anyone in your family ever sued or been sued by anyone?
Yes o No o If Yes: Who: _________________________
Why: ___________________________________________
When:__________________________________________
What was the result of the claim? ___________________
Were you satisfied with the result? __________________
b) Have you or anyone in your family ever considered suing anyone?
Yes o No o If Yes, please explain: _________________
_________________________________________________________
11. Have you or any members of your family or close friends ever worked for a company that has been sued?
Yes o No o If yes, please explain, including whether you thought the suits were fair or unfair.
_________________________________________________________
12. Have you ever been part of a lawsuit in any other capacity (e.g., party, witness, expert, etc.)?
Yes o No o If Yes, please explain:_________________________
________________________________________________________
13. a) Do you believe:
There are too many lawsuits? Yes o No o No Opinion o
Jury awards are too high? Yes o No o No Opinion o
People are too ready to sue? Yes o No o No Opinion o
Lawsuits are costing us all too much money? Yes o No o No Opinion o
b) If you answered yes or no to any of the above, please explain:
14. Do you have any hesitations about making a multi-million dollar award if the evidence warrants such an award?
Yes o No o If Yes, please explain: _______________________
________________________________________________________
15. Do you believe the monies awarded by juries today are (check one): o Too low o About right o Too large o Much too large
16. How do you feel about awarding damages for:
Past medical expenses: ____________________________________
Future medical expenses: _________________________________
Future wage loss: ________________________________________
17. Do you support legislative reforms to place caps or limits on the amount of money juries can award?
Yes o No o If Yes, please explain: _______________________
________________________________________________________
18. If you or someone close to you were seriously harmed due to the negligence of a doctor, would you consider bringing a lawsuit?
Yes o No o If Yes, please explain: _______________________
________________________________________________________
19. Do you believe (please check the ONE that BEST applies):
o Lawsuits against hospitals and doctors for negligence are a good way to help maintain medical standards.
OR
o Lawsuits against hospitals and doctors for negligence only pressure the medical profession and raise costs.
Please explain: ___________________________________________
________________________________________________________
20. Do you have a belief or opinion that people today do not take enough responsibility for the consequences of their actions?
Yes o No o If Yes, please explain: __________________________
________________________________________________________
21. Do you have any feelings about lawsuits being brought against a doctor, nurse, or other medical providers?
Yes o No o If Yes, please explain: __________________________
________________________________________________________
22. Do you know or have you heard of any of the following people?
Yes o No o [list names] ___________________________________
________________________________________________________
If you answered yes to any of the above, please explain: _______
________________________________________________________
23. Is there anything else that you think we ought to know about your ability to serve as a trial juror on this case?
If Yes, please explain: _____________________________________
________________________________________________________
Shirley Watkins
Bio as of April 2011:
Since 1982, Shirley K. Watkins has focused her practice primarily on medical malpractice. She is an Emeritus Board member of CAALA and past member of the Board of Trustees of the Los Angeles County Bar Association, Board of Governors of Women Lawyers Association of Los Angeles and Board of Directors of Trial Lawyers for Public Justice. She was twice nominated as Trial Lawyer of the Year by CAALA, and was named one of the Top 50 Women Attorneys in Southern California by SuperLawyers.
Updated April 2016: She is now a judge.
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2025 by the author.
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