IN THE CIRCUIT COURT OF [COUNTY] COUNTY, ARKANSAS
[___] DIVISION
[PLAINTIFF FULL LEGAL NAME],
in the capacity of Personal Representative of the ESTATE OF [DECEDENT FULL LEGAL NAME], Deceased,
and on behalf of the Statutory Beneficiaries identified herein,
Plaintiff,
v.
[DEFENDANT FULL LEGAL NAME(S)],
Defendant(s).
Case No.: ___
JURY TRIAL DEMANDED
COMPLAINT
(WRONGFUL DEATH & SURVIVAL ACTION)
Ark. Code Ann. § 16-62-101 et seq.
[// GUIDANCE: This template assumes the plaintiff is the duly‐appointed Personal Representative. If an estate has not been opened, substitute “Heir at Law” and adjust allegations accordingly.]
TABLE OF CONTENTS
- Definitions
- Parties
- Jurisdiction & Venue
- Factual Allegations
- Causes of Action
5.1 Count I – Negligence Resulting in Wrongful Death
5.2 Count II – Survival Action
5.3 Count III – [Optional Additional Theory] - Damages
- Prayer for Relief
- Jury Demand
- Reservation of Rights
- Verification & Rule 11 Certification
- Signature Block
1. DEFINITIONS
For purposes of this Complaint, and solely for ease of reference:
1.1 “Decedent” means [DECEDENT FULL LEGAL NAME], who died on [DATE OF DEATH] in [LOCATION].
1.2 “Personal Representative” means [PLAINTIFF FULL LEGAL NAME], duly appointed by [COURT NAME & CASE NO. OF ESTATE PROBATE] on [DATE].
1.3 “Statutory Beneficiaries” means all individuals entitled to recover under Ark. Code Ann. § 16-62-102(b), including but not limited to:
a. Surviving spouse: [NAME];
b. Children: [NAME(S)];
c. Parents: [NAME(S)];
d. [Additional Beneficiaries].
1.4 “Defendant(s)” means [DEFENDANT NAME(S)], collectively and individually, together with their officers, employees, agents, insurers, and any John/Jane Does to be identified through discovery.
[// GUIDANCE: Add or delete defined terms as the factual circumstances require. Ensure consistency throughout.]
2. PARTIES
2.1 Plaintiff [PLAINTIFF FULL LEGAL NAME] is a resident of [COUNTY, STATE] and sues in the representative capacity described above.
2.2 Defendant [DEFENDANT NAME] is a [corporation/LLC/individual/other] organized under the laws of [STATE], with principal place of business at [ADDRESS] and does business in Arkansas.
2.3 Pursuant to Ark. R. Civ. P. 4, Defendant is subject to service of process via [Registered Agent/Service Method] at [ADDRESS].
3. JURISDICTION & VENUE
3.1 This Court has subject-matter jurisdiction under Ark. Const. art. 7, § 11 and Ark. Code Ann. § 16-13-201.
3.2 Venue is proper in this County under Ark. Code Ann. § 16-60-101 because the wrongful act and resulting death occurred herein and/or Defendant resides/conducts business herein.
3.3 No binding arbitration agreement exists between the parties, or, to the extent one is asserted, Plaintiff expressly elects to proceed in this Court.
4. FACTUAL ALLEGATIONS
4.1 On [DATE], Defendant [describe wrongful conduct with particularity—e.g., operated a motor vehicle while intoxicated, manufactured a defective product, provided negligent medical care].
4.2 As a direct and proximate result of Defendant’s acts and omissions, the Decedent suffered fatal injuries on [DATE].
4.3 Prior to death, Decedent endured conscious pain and suffering and incurred medical expenses of approximately [$ AMOUNT].
4.4 Plaintiff has complied with all statutory prerequisites, including appointment of a Personal Representative and identification of Statutory Beneficiaries.
[// GUIDANCE: Add additional factual paragraphs tailored to the claim—e.g., OSHA violations, product identification, medical records, etc.]
5. CAUSES OF ACTION
5.1 Count I – Negligence Resulting in Wrongful Death
(Ark. Code Ann. § 16-62-102)
5.1.1 Plaintiff realleges §§ 1–4.
5.1.2 Defendant owed Decedent a duty of reasonable care [describe duty].
5.1.3 Defendant breached that duty by [specific breach].
5.1.4 The breach was the proximate cause of Decedent’s death.
5.1.5 Under § 16-62-102, Plaintiff and the Statutory Beneficiaries are entitled to recover all damages permissible by law.
5.2 Count II – Survival Action
(Ark. Code Ann. § 16-62-101)
5.2.1 Plaintiff realleges §§ 1–4.
5.2.2 Decedent’s claims for conscious pain, suffering, medical expenses, and property loss survive death and vest in the Estate.
5.2.3 Plaintiff seeks recovery of such damages for the benefit of the Estate.
5.3 Count III – [OPTIONAL ADDITIONAL THEORY]
(e.g., Strict Liability under Ark. Code Ann. § 4-86-102)
5.3.1 Plaintiff realleges §§ 1–4.
5.3.2 [Allege elements of additional theory].
[// GUIDANCE: Insert or delete additional counts such as negligence per se, breach of implied warranty, punitive damages, etc.]
6. DAMAGES
6.1 Wrongful-Death Damages (Beneficiaries’ Claims):
a. Loss of financial support and contributions;
b. Loss of services, care, comfort, and companionship;
c. Mental anguish.
6.2 Survival Damages (Estate’s Claims):
a. Medical expenses;
b. Conscious pain and suffering;
c. Property damage;
d. Funeral and burial expenses.
6.3 Punitive Damages: Plaintiff seeks punitive damages to punish and deter egregious conduct, in an amount allowable under Arkansas law and any applicable constitutional or statutory caps.
6.4 All damages are sought jointly and severally against all Defendants, plus pre- and post-judgment interest, costs, and such other relief as the Court deems just.
[// GUIDANCE: Confirm current status of Ark. Code Ann. § 16-55-208 (punitive damage cap) and any constitutional developments before filing.]
7. PRAYER FOR RELIEF
WHEREFORE, Plaintiff prays for judgment against Defendant(s) as follows:
a. Compensatory damages in an amount to be determined by a jury;
b. Survival damages to the Estate;
c. Punitive damages as allowed by law;
d. Costs of suit, expert fees, and discretionary costs;
e. Pre- and post-judgment interest;
f. Limited injunctive relief, if necessary, to prevent destruction of evidence; and
g. All other just and proper relief.
8. JURY DEMAND
Pursuant to Ark. Const. art. 2, § 7 and Ark. R. Civ. P. 38, Plaintiff demands a trial by jury on all issues so triable.
9. RESERVATION OF RIGHTS
Plaintiff reserves the right to amend this Complaint to add parties, claims, and prayers for relief as discovery may warrant.
10. VERIFICATION & RULE 11 CERTIFICATION
I, [PLAINTIFF NAME], being duly sworn, state under penalty of perjury that I have read the foregoing Complaint, that it is true and correct to the best of my knowledge, information, and belief, and that it is not interposed for any improper purpose. I further certify that the factual allegations have evidentiary support and that the legal contentions are warranted under existing law or a good-faith argument for its extension, modification, or reversal, in accordance with Ark. R. Civ. P. 11.
[PLAINTIFF NAME]
Personal Representative
Subscribed and sworn before me on this ___ day of _, 20.
Notary Public
My Commission Expires: ____
11. SIGNATURE BLOCK
Respectfully submitted,
[LAW FIRM NAME]
By: _____
[ATTORNEY NAME] (Ark. Bar No. ____)
[ADDRESS]
[PHONE] | [EMAIL]
ATTORNEYS FOR PLAINTIFF
[// GUIDANCE:
1. Review local circuit‐court rules for additional pleading or formatting requirements (e.g., cover sheet, civil case information form).
2. File Letters of Administration or other proof of representative capacity contemporaneously.
3. Consider early preservation letters and motions to secure evidence (black-box data, medical records, etc.).
4. Serve written notice of claim to potential governmental defendants within the statutory period if Ark. Code Ann. § 19-10-204 applies.
5. Confirm time-bar under Ark. Code Ann. § 16-62-102(c) (generally three-year limitation).]