IN THE DISTRICT COURT OF [COUNTY] COUNTY, KANSAS
CIVIL DEPARTMENT

[PLAINTIFF 1 NAME], individually and on behalf of all statutory beneficiaries of [DECEDENT NAME], Deceased,
and
[PLAINTIFF 2 NAME], as the duly-appointed Personal Representative of the Estate of [DECEDENT NAME],
Plaintiffs,

v. Case No. ______

[DEFENDANT 1 LEGAL NAME], a [State] [corporation/LLC/partnership/individual],
and
[DEFENDANT 2 LEGAL NAME], a [State] [corporation/LLC/partnership/individual],
Defendants.

COMPLAINT FOR WRONGFUL DEATH (K.S.A. 60-1901 et seq.)
AND SURVIVAL ACTION (K.S.A. 60-1801)

[// GUIDANCE: Remove bracketed instructions before filing. Confirm factual allegations, parties, and dates for accuracy.]

TABLE OF CONTENTS
1. Parties, Capacity, and Service ......................................... ¶ 1
2. Jurisdiction and Venue .................................................. ¶ 8
3. General Allegations (Common to All Counts) ............................... ¶ 12
4. Count I – Wrongful Death (K.S.A. 60-1901 et seq.) ........................ ¶ 28
5. Count II – Survival Action (K.S.A. 60-1801) .............................. ¶ 39
6. Damages Sought and Statutory Caps ....................................... ¶ 46
7. Demand for Jury Trial ................................................... ¶ 53
8. Prayer for Relief ....................................................... ¶ 56
9. Reservation of Rights to Amend .......................................... ¶ 64
10. Verification ............................................................ ¶ 66
11. Certificate of Service .................................................. ¶ 70

I. PARTIES, CAPACITY, AND SERVICE

1. Plaintiff [PLAINTIFF 1] is an heir-at-law and statutory beneficiary of the Decedent within the meaning of Kan. Stat. Ann. § 60-1902 (2022).

2. Plaintiff [PLAINTIFF 2] is the duly-appointed Personal Representative of the Estate of [DECEDENT NAME] (“Estate”) pursuant to Letters Testamentary/Letters of Administration issued by the Probate Division of this Court on [DATE]. Plaintiff 2 brings Count II in that fiduciary capacity.

3. Decedent [DECEDENT NAME] (“Decedent”) was, at all times relevant, a resident of [County], Kansas, and died on [DATE OF DEATH] as a direct and proximate result of Defendants’ wrongful acts described herein.

4. Defendant [DEFENDANT 1] is a [corporation/LLC/etc.] organized under the laws of [STATE OF FORMATION] with its principal place of business at [ADDRESS] and may be served via its registered agent, [NAME], at [ADDRESS].

5. Defendant [DEFENDANT 2] is an individual residing at [ADDRESS] and may be served pursuant to K.S.A. § 60-304(a) at said address or wherever found.

6. [Add additional parties as necessary.]

7. All Plaintiffs have standing under Kan. Stat. Ann. § 60-1901–1902 to prosecute the wrongful death claim, and Plaintiff 2 has standing under Kan. Stat. Ann. § 60-1801 to prosecute the survival action.

II. JURISDICTION AND VENUE

8. This Court has subject-matter jurisdiction under Kan. Stat. Ann. § 20-301 and K.S.A. Chapter 60 because the amount in controversy exceeds $75,000, exclusive of costs, and the claims arise under Kansas statutes.

9. Personal jurisdiction exists over each Defendant pursuant to K.S.A. § 60-308(b) because each Defendant transacted business, committed tortious acts, and/or maintained continuous and systematic contacts in Kansas.

10. Venue is proper in this Court under K.S.A. § 60-604 because the cause of action arose in [COUNTY] County and/or the Defendants reside, are found, or transact business in this County.

11. Plaintiffs have satisfied all statutory conditions precedent, including appointment of a personal representative and timely filing within the applicable limitations periods of K.S.A. § 60-513 and § 60-1901.

III. GENERAL ALLEGATIONS (COMMON TO ALL COUNTS)

12. On [DATE], at approximately [TIME], Decedent was lawfully present at/on [LOCATION], when Defendants, acting through employees/agents within the scope of their employment, negligently and/or recklessly caused [DESCRIPTION OF INCIDENT].

13. Defendants owed Decedent duties of reasonable care, including but not limited to:
    a. Complying with all applicable statutes, regulations, and industry standards;
    b. Properly hiring, training, and supervising personnel;
    c. Maintaining safe premises/equipment; and
    d. [Other duties].

14. Defendants breached said duties by, inter alia, [SPECIFIC ACTS OR OMISSIONS].

15. As a direct and proximate result of Defendants’ breaches, Decedent sustained severe injuries leading to pain, suffering, medical expenses, and ultimately death on [DATE OF DEATH].

16. At the time of death, Decedent was [AGE] years old, employed as [OCCUPATION], earning approximately [$] annually, and providing financial and emotional support to statutory beneficiaries.

17. [If comparative fault is anticipated, insert allegations negating comparative negligence.]

18. All corporate or organizational Defendants are vicariously liable for the acts and omissions of their officers, employees, agents, and/or apparent agents under the doctrines of respondeat superior, agency, and non-delegable duty.

19. Plaintiffs have incurred funeral and burial expenses of approximately [$] and other pecuniary losses.

20. Plaintiffs have suffered and will continue to suffer noneconomic damages, including mental anguish, bereavement, loss of society, companionship, comfort, guidance, counsel, and marital/parental care.

21. [Add any statutory notice or pre-suit requirements if applicable (e.g., governmental entity).]

22. Plaintiffs satisfied all procedural prerequisites under Kansas law.

IV. CAUSES OF ACTION

COUNT I – WRONGFUL DEATH (Kan. Stat. Ann. § 60-1901 et seq.)

23. Plaintiffs incorporate Paragraphs 1–22 as if fully set forth herein.

24. Under Kan. Stat. Ann. § 60-1901, when a wrongful act, neglect, or default causes death, the wrongdoer is liable to an action for damages notwithstanding the death.

25. Defendants’ negligent, reckless, and/or unlawful conduct directly and proximately caused Decedent’s death.

26. Plaintiffs, as statutory heirs and beneficiaries under § 60-1902, are entitled to recover all damages allowed by § 60-1903, including pecuniary damages and noneconomic damages, subject to the statutory cap of $250,000 for non-pecuniary losses.

27. WHEREFORE, Plaintiffs demand judgment as set forth in the Prayer for Relief.

COUNT II – SURVIVAL ACTION (Kan. Stat. Ann. § 60-1801)

28. Plaintiffs incorporate Paragraphs 1–27 as if fully set forth herein.

29. Prior to death, Decedent experienced conscious pain and suffering, incurred medical bills, and lost wages.

30. Kan. Stat. Ann. § 60-1801 preserves any cause of action Decedent could have maintained had death not ensued.

31. Plaintiff [PERSONAL REPRESENTATIVE] is entitled to recover, for the benefit of the Estate, damages including but not limited to:
    a. Pre-death pain and suffering;
    b. Medical and hospital expenses;
    c. Lost earnings and earning capacity until death; and
    d. Property damage, if any.

32. WHEREFORE, Plaintiffs demand judgment as set forth in the Prayer for Relief.

V. DAMAGES SOUGHT AND STATUTORY CAPS

33. Economic Damages (Wrongful Death):
    a. Funeral and burial expenses (approx. [$]);
    b. Loss of financial support;
    c. Loss of services, care, and assistance;
    d. [Other pecuniary losses].

34. Noneconomic Damages (Wrongful Death): Pursuant to Kan. Stat. Ann. § 60-1903, Plaintiffs seek an amount to be determined by the trier of fact, not to exceed the statutory cap of $250,000 for non-pecuniary losses.

35. Survival Damages: All damages allowed by law for Decedent’s personal injury and losses prior to death.

36. Pre- and post-judgment interest as allowed by law under K.S.A. § 16-201.

37. Costs of this action, including reasonable attorney’s fees where authorized by statute or contract.

[// GUIDANCE: If a punitive damages claim is contemplated, comply strictly with K.S.A. § 60-3703 procedures; consider filing motion to amend after discovery.]

VI. DEMAND FOR JURY TRIAL

38. Pursuant to the Kansas Constitution and K.S.A. § 60-238, Plaintiffs demand trial by jury on all issues so triable.

VII. PRAYER FOR RELIEF

WHEREFORE, Plaintiffs respectfully request that the Court enter judgment in their favor and against Defendants, jointly and severally, as follows:

a. Economic wrongful-death damages in an amount to be proven at trial;
b. Noneconomic wrongful-death damages up to the statutory maximum of $250,000;
c. Survival damages for Decedent’s pre-death losses;
d. Costs, expenses, and allowable attorney’s fees;
e. Pre- and post-judgment interest;
f. Such other and further relief—legal or equitable—as the Court deems just and proper.

VIII. RESERVATION OF RIGHT TO AMEND

39. Plaintiffs expressly reserve the right to amend this Complaint to conform to the evidence as discovery progresses and pursuant to K.S.A. § 60-215.

IX. ARBITRATION, INJUNCTIVE RELIEF, AND OTHER REMEDIES

40. Plaintiffs do not consent to arbitration at this time but are amenable to Court-ordered mediation under K.S.A. § 60-452.
41. Plaintiffs seek limited preliminary and permanent injunctive relief as necessary to prevent spoliation of evidence and to preserve the status quo.

X. VERIFICATION

STATE OF KANSAS )
) ss:
COUNTY OF [COUNTY] )

I, [PLAINTIFF NAME], being first duly sworn, depose and state that I have read the foregoing Complaint, know the contents thereof, and that the same is true and correct to the best of my knowledge, information, and belief.

[PLAINTIFF NAME]

Subscribed and sworn to before me this ___ day of ____, 20__.

Notary Public
My Commission Expires: _____

[// GUIDANCE: Verification format may vary by local rule; confirm requirements.]

XI. CERTIFICATE OF SERVICE

I hereby certify that on this ___ day of ____, 20__, a true and correct copy of the foregoing Complaint was served upon all counsel of record via [Kansas Courts e-Filing System / hand delivery / U.S. Mail], pursuant to K.S.A. Supreme Court Rule 123.

[ATTORNEY NAME], #______
Counsel for Plaintiffs

SIGNATURE BLOCK

Respectfully submitted,

[LAW FIRM NAME]
[Street Address]
[City, State ZIP]
Telephone: [( ) ]
Facsimile: [( ) ]
Email: [EMAIL ADDRESS]

By: ______
[ATTORNEY NAME], KS Bar #____
Attorneys for Plaintiffs

[// GUIDANCE:
1. Confirm statute citations reflect the current Kansas Statutes Annotated.
2. Review local rules for caption requirements, font, spacing, and signature compliance.
3. Insert factual details, correct parties, and update dollar amounts before filing.
4. Evaluate comparative fault defenses and governmental immunities early.
5. Monitor legislative changes to the non-economic damage cap (§ 60-1903).]