Preview
1 FAEGRE DRINKER BIDDLE & REATH LLP
TARIFA B. LADDON (SBN 240419)
2 tarifa.laddon@faegredrinker.com
DAVID P. KOLLER (SBN 328633)
3 david.koller@faegredrinker.com
1800 Century Park East, Suite 1500
4 Los Angeles, CA 90067
Telephone: (310) 203-4000
5 Facsimile: (310) 229-1285
6 KING & SPALDING LLP
MATTHEW J. BLASCHKE (SBN 281938)
7 mblaschke@kslaw.com
ALBERT Q. GIANG (SBN 224332)
8 blangner@kslaw.com
50 California Street, Suite 3300
9 San Francisco, CA 94111
Telephone: (415) 318-1200
10 Facsimile: (415) 318-1300
11 Attorneys for Defendants
TIKTOK INC. and BYTEDANCE INC.
12
[Additional Counsel on following page]
13
SUPERIOR COURT OF THE STATE OF CALIFORNIA
14
FOR THE COUNTY OF LOS ANGELES
15
IN RE: SOCIAL MEDIA ADOLESCENT Judicial Council Coordination Proceeding
16 ADDICTION. JCCP No.: 5255 – Social Media Cases
17
CHRISTINA ARLINGTON SMITH, et al. LASC Case No.: 22STCV21355
18
Plaintiffs,
19 NOTICE OF ENTRY OF ORDER RE
v. AMENDED CASE MANAGEMENT
20 ORDER NO. 7
TIKTOK INC., BYTEDANCE, INC., and
21 Does 1–100, Inclusive,
Complaint Filed: June 30, 2022
22 Defendants. Cases Coordinated: December 22, 2022
23
24
25
26
27
28
FAEGRE DRINKER BIDDLE &
REATH LLP
ATTORNEYS AT LAW NOTICE OF ENTRY OF ORDER RE AMENDED CASE MANAGEMENT ORDER NO. 7
LOS ANGELES
JCCP NO. 52555
1 FAEGRE DRINKER BIDDLE & REATH LLP
ANDREA R. PIERSON (Admitted Pro Hac Vice)
2 andrea.pierson@faegredrinker.com
300 N. Meridian Street, Suite 2500
3 Indianapolis, IN 46204
Telephone: (317) 237-1424
4 Facsimile: (317) 237-1000
5 KING & SPALDING LLP
GEOFFREY M. DRAKE (Admitted Pro Hac Vice)
6 gdrake@kslaw.com
1180 Peachtree Street, NE, Suite 1600
7 Atlanta, GA 30309-3521
Telephone: (404) 572-4600
8 Facsimile: (404) 572-5100
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FAEGRE DRINKER BIDDLE &
REATH LLP
1
ATTORNEYS AT LAW NOTICE OF ENTRY OF ORDER RE AMENDED CASE MANAGEMENT ORDER NO. 7
LOS ANGELES
JCCP NO. 52555
1 TO ALL PARTIES AND THEIR COUNSEL OF RECORD:
2 PLEASE TAKE NOTICE that on January 18, 2024, the court issued an order entering
3 the Parties’ Amended Case Management Order No. 7, a true a correct of which is attached hereto
4 as Exhibit "A."
5
Dated: January 22, 2024 FAEGRE DRINKER BIDDLE & REATH LLP
6
7 By:
TARIFA B. LADDON
8 DAVID P. KOLLER
9 Attorneys for Defendants
TIKTOK INC. AND BYTEDANCE INC.
10
11 Dated: January 22, 2024 KING & SPALDING LLP
12 By: /s/ Matthew J. Blaschke (with permission)
MATTHEW J. BLASCHKE
13 ALBERT Q. GIANG
14 Attorneys for Defendants
TIKTOK INC. AND BYTEDANCE INC.
15
16
17
18
19
20
21
22
23
24
25
26
27
28
FAEGRE DRINKER BIDDLE &
REATH LLP
2
ATTORNEYS AT LAW NOTICE OF ENTRY OF ORDER RE AMENDED CASE MANAGEMENT ORDER NO. 7
LOS ANGELES
JCCP NO. 52555
EXHIBIT A
1 FAEGRE DRINKER BIDDLE & REATH LLP
TARIFA B. LADDON (SBN 240419)
2 tarifa.laddon@faegredrinker.com
DAVID P. KOLLER (SBN 328633)
3 david.koller@faegredrinker.com
1800 Century Park East, Suite 1500
4 Los Angeles, CA 90067
Telephone: (310) 203-4000
5 Facsimile: (310) 229-1285
6 KING & SPALDING LLP
MATTHEW J. BLASCHKE (SBN 281938)
7 mblaschke@kslaw.com
ALBERT Q. GIANG (SBN 224332)
8 blangner@kslaw.com
50 California Street, Suite 3300
9 San Francisco, CA 94111
Telephone: (415) 318-1200
10 Facsimile: (415) 318-1300
11 Attorneys for Defendants
TIKTOK INC. and BYTEDANCE INC.
12
13
SUPERIOR COURT OF THE STATE OF CALIFORNIA
14
COUNTY OF LOS ANGELES, CENTRAL DIVISION
15
COORDINATION PROCEEDING JUDICIAL COUNCIL COORDINATION
16 SPECIAL TITLE [RULE 3.400] PROCEEDING NO. 5255
17 SOCIAL MEDIA CASES Lead Case No. For Filing Purposes:
22STCV21355
18 THIS DOCUMENT RELATES TO:
19 [PROPOSED] AMENDED CASE
ALL PERSONAL INJURY CASES MANAGEMENT ORDER NO. 7 –
20 IMPLEMENTATION ORDER
GOVERNING ADOPTION OF PLAINTIFF
21 (CHRISTINA ARLINGTON SMITH, ET AL., V. FACT SHEET FOR PERSONAL INJURY
TIKTOK INC, ET AL., CASE NO. PLAINTIFFS
22 22STCV21355)
23 Judge: Hon. Carolyn B. Kuhl
SSC-12
24
25
26
27
28
-1-
[PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER
GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS
1 Pursuant to the Court’s authority in the above-captioned Judicial Council Coordination
2 Proceeding (“JCCP”), upon having considered the written and oral submissions of the parties
3
regarding the use of a Plaintiff Fact Sheet (“PFS”) for early discovery in the JCCP, and good
4
cause appearing for the same, the Court orders as follows:
5
1. The PFS Form:
6
7 a. Each personal injury Plaintiff1 in any case coordinated in this JCCP must
8 complete and serve verified, written responses to the Plaintiff Fact Sheet and applicable
9 Appendices, together with any responsive documents and applicable executed authorizations,
10
attached hereto as Exhibit A. Every personal injury Plaintiff is required to provide a PFS that is
11
substantially complete in all respects.
12
b. For a PFS to be “substantially complete,” the responding Plaintiff must: (1)
13
answer the questions contained in the PFS to the best of his or her ability; (2) provide all
14
15 applicable responsive documents; and (3) execute and provide all applicable authorizations.
16 2. Service and Timing of the PFS and Related Materials:
17 a. A personal injury Plaintiff must serve verified, written responses to the
18
PFS and applicable Appendices, together with any responsive documents and applicable executed
19
authorizations, within 105 days after filing a Short Form Complaint. For any Short Form
20 no later than March 28, 2024.
Complaints filed prior to the entry of this Order, a PFS shall be served within 105 days from the
21
22 date of this Order. If, however, one or more user accounts is “inaccessible” within the meaning of
23 the User Account Information Order, a Plaintiff must complete and serve verified, written
24 responses to the PFS, together with any responsive documents and applicable executed
25 authorizations, within 30 days of receipt of all Defendants’ “User Account Data Downloads,” as
26
required by the User Account Information Order.
27
28 1
This Order does not apply to coordinated School District or Government Entity Plaintiffs.
-1-
[PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER
GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS
1 b. In the event any single law firm has more than 50 Plaintiff Fact Sheets due
2 on the same date, the firm shall serve on Defendants at least 50 Plaintiff Fact Sheets on the due
3
date and provide notice to Defendants advising of the case names for cases with the same
4
deadline. Plaintiffs shall serve an additional 50 Plaintiff Fact Sheets within 60 days of those
5
submissions, and any additional Plaintiff Fact Sheets shall be served within 60 days of those
6
7 submissions.
8 3. Rules Applicable to Plaintiffs’ Authorizations
9 a. Plaintiff shall provide the following authorizations: authorizations
10
addressed to all healthcare providers,2 educational facilities, and health insurance providers
11
(including Medicare and Medicaid) identified in Plaintiff’s PFS. To the extent Plaintiff is
12
claiming lost wages or earning capacity, Plaintiff shall also provide authorizations for all
13
employers, worker’s compensation providers, and disability claims providers identified in
14
15 Plaintiff’s PFS.
16 b. As set forth above, all authorizations shall be completed and served by
17 uploading on MDL Centrality. Each authorization must be signed but undated. Such submission
18
via MDL Centrality shall constitute service as set forth in paragraph 4, below.
19
c. In addition to providing the addressed undated Authorizations, Plaintiff’s
20
counsel shall also maintain in their file unaddressed executed Authorizations. Plaintiff’s counsel
21
22 shall provide executed, undated Authorizations to counsel for the Defendants (or communicate
23 an objection to said request for authorizations) within 14 days of a request for such
24 Authorizations. Each of Plaintiffs’ Authorization shall be undated, which shall not constitute a
25 deficiency or be deemed to be a substantially non-complete PFS. Defendants (or the applicable
26
27 2
If a Plaintiff saw multiple health care providers within the same medical facility, they may
provide a single authorization addressed to the facility.
28
-2-
[PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER
GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS
1 records vendor, Medical Research Consultants) have permission to date (and where applicable,
2 re-date) undated Authorizations before sending them to records custodians. If an agency,
3
company, firm, institution, provider, or records custodian to whom any Authorization is
4
presented refuses to provide records in response to that Authorization, the Defendants (or the
5
applicable records vendor) shall notify a Plaintiff’s individual representative counsel and a
6
7 designated individual from Liaison Counsel.
8 d. Upon notification, counsel shall work together in good faith to resolve the
9 records issue. In the event a records custodian requires a proprietary authorization or other
10
particular form, the Defendants (or the applicable records vendor) will provide it to Plaintiff’s
11
individual representative counsel who shall thereafter execute and return the proprietary
12
authorization or other particular form, undated, within 14 days.
13
e. Defendants or their designees (including the applicable records vendor)
14
15 shall have the right to contact agencies, companies, firms, institutions, or providers for the sole
16 purpose of following up on record copying or production. Substantive communications between
17 Defendants and employees of the agencies, companies, firms and institutions, as well as any
18
conversations with a Plaintiff’s medical providers, shall be in accordance with applicable legal,
19
ethical, and notice obligations under any applicable law or applicable rules of professional
20
conduct and may be addressed by separate order.3
21
22 f. Medical Research Consultants shall make available to Plaintiffs a list of all
23 facilities from which records have been collected pursuant to Authorizations. For any record set
24 collected without a subpoena, Plaintiffs may elect to access such records for $23.10. For any
25 record set collected after issuance of a subpoena, Plaintiffs may elect to access such records for
26
27
3
28 This provision applies only to communications related to records requests.
-3-
[PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER
GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS
1 $38.10. Medical Research Consultants shall credit Defendants for any payments made by
2 Plaintiffs. In the event that Medical Research Consultants’ fees change after the issuance of this
3
order, the parties may meet and confer regarding changes to this Paragraph.
4
4. Transmission of PFS and Other Documents to Defendants:
5
a. To complete and serve the Plaintiff Fact Sheet, the parties have agreed to
6
7 utilize the online “MDL Centrality” platform designed and provided by BrownGreer PLC and
8 accessible at MDLCentrality.com. All questions regarding the use of MDL Centrality should be
9 directed to MDLCentrality@browngreer.com.
10
b. With the exception of objections for privilege, each Plaintiff shall submit
11
and serve the Plaintiff Fact Sheet, together with all applicable appendices and any responsive
12
documents and applicable executed authorizations, without objection, by submission on MDL
13
Centrality. Responses to the questions contained in the PFS shall be treated as verified
14
15 responses to interrogatories and, where documents are requested, verified responses to requests
16 for production of documents under the California Code of Civil Procedure. All responses will
17 be governed by the standards applicable to written discovery responses under the California
18
Code of Civil Procedure. In the event that Plaintiff’s case is selected for additional case-specific
19
discovery and Plaintiff receives a reasonable request for supplementation under Sections
20
20312.050 and/or 2030.070(a) of the California Code of Civil Procedure, Plaintiff must revise
21
22 the PFS to supplement any requested information.
23 c. The information that each Plaintiff must provide pursuant to this Order,
24 including completing, submitting, and serving a PFS, Appendices, Authorizations, and
25 Responsive Documents, is without prejudice to Defendants’ right to propound or seek
26
additional non-duplicative discovery in the future, and nothing in the PFS shall be deemed to
27
limit the scope of that discovery, including any inquiry at any deposition. The PFS shall not
28
-4-
[PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER
GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS
1 count against the numeric limits for written discovery including but not limited to “specially
2 prepared interrogatories” as set forth in Code Civ. Proc., section 2030.030.
3
5. PFS Deficiency Dispute Resolution
4
a. If a Plaintiff has not served a substantially complete PFS as defined in
5
Paragraph 1(b), Defendants may send a Notice of Deficiency via MDL Centrality that identifies
6
7 the alleged deficiencies, including the failure to serve a PFS. If Defendants elect to send a Notice
8 of Deficiency, Defendants shall serve the Notice of Deficiency within 60 days of receipt of the
9 PFS, or if a PFS is not served, the deadline to serve a PFS.
10
b. Following receipt of the Notice of Deficiency, Plaintiffs shall have 60 days
11
to jointly meet and confer with Defendants regarding the perceived deficiencies and possible
12
resolution by amendment to the PFS or the submission of additional documents or
13
authorizations.
14
15 6. Confidentiality
16 a. Information provided pursuant to a PFS is deemed confidential and will be
17 subject to the terms of the Protective Order.
18
7. Admissibility of Evidence
19
a. The California Code of Evidence shall govern the admissibility of
20
information contained in the PFS. Nothing in the PFS or this Order shall be deemed to limit the
21
22 admissibility of evidence during this proceeding, including at trial. This paragraph does not
23 prohibit a party from withholding or redacting information based upon a recognized privilege.
24 Documents withheld on the basis of privilege under California law shall be logged consistent
25 with California law except that a Plaintiff is not required to log privileged communications
26
occurring after the date Plaintiff retained counsel between (1) the Plaintiff and their counsel; or
27
(2) a parent, legal guardian, or guardian ad litem and Plaintiff’s counsel, to the extent Plaintiff’s
28
-5-
[PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER
GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS
1 counsel also represents such parent, legal guardian, or guardian ad litem. The Plaintiff is also
2 not required to log drafts of the PFS.
3
4
5
IT IS SO ORDERED.
6
7
8 Dated: __________________________ ____________________________________
Hon. Carolyn Kuhl
9 Judge of the Superior Court
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
-6-
[PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER
GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS
EXHIBIT A
SUPERIOR COURT OF THE STATE OF CALIFORNIA
FOR THE COUNTY OF LOS ANGELES
IN RE: SOCIAL MEDIA CASES JCCP No. 5255
[Consolidated with JCCP No. 5256]
Case No. 22STCV21355
This Document Relates to:
PLAINTIFF FACT SHEET
Case Caption and Civil Action No.:
Full Name of Plaintiff (First, Middle, and Last):
PLAINTIFF FACT SHEET
Please provide the following information for each plaintiff who claims that use of
Defendants’ platforms (Facebook, Instagram, Snapchat, TikTok, and YouTube) caused them (or
a person who died) injury as alleged in the above-captioned litigation.
In completing this Plaintiff Fact Sheet, you are under oath and must provide information
that is true and correct to the best of your knowledge. If you cannot recall all of the details
requested, provide as much information as you can, including by review of documents or
materials in your or your attorneys’ custody or possession. Be as specific as possible in all of
your answers. If you cannot recall a specific date requested, provide the approximate date to the
best of your recollection. For example, if you recall the year and month of an event, but not the
day, complete the year and month, but enter “00” for the day.
This Plaintiff Fact Sheet is an electronic version that expands to accommodate as much
information as is necessary to fully answer any of these questions, including by adding rows or
columns to tables. You must fill out the applicable appendix for each entity you have named as a
Defendant. Please do not leave any questions unanswered or blank.
You may and should consult with your attorney if you have any questions regarding the
completion of this form.
This Plaintiff Fact Sheet constitutes discovery responses subject to California Code of
Civil Procedure. This Plaintiff Fact Sheet and the information provided herein will be used only
for this litigation and is designated Confidential under the Protective Order. Plaintiffs do not
concede the relevance or admissibility of any of the information herein.
I. CASE INFORMATION
A. Name of the court in which the complaint was initially filed:
B. Case number in court in which complaint was originally filed:
C. Are you alleging in this case that you began using Facebook, Instagram,
Snapchat, TikTok, or YouTube when you were under thirteen years old?
[Click here to select your answer.]
**IMPORTANT**
DEFINITION OF “RELEVANT TIME PERIOD”
If your answer to question I.C. is “YES,” then the phrase
“Relevant Time Period” throughout this Plaintiff Fact Sheet
means from the time you turned SEVEN (7) years old to today.
If your answer to question I.C. is “NO,” then the phrase
“Relevant Time Period” throughout this Plaintiff Fact Sheet
means from the time you turned TEN (10) years old to today.
II. REPRESENTATIVE CAPACITY
Only complete this section if you have filed this lawsuit on behalf of a minor, someone
who died, or a person who lacks capacity to complete it on their own. When you
complete this section of this form (Section II, “Representative Capacity”), “you” refers
to the person filling out this form. When you complete the rest of this form “you” refers
to the person you are representing.
A. Name of individual completing this Fact Sheet:
B. Your current address:
C. What is your relationship to the person upon whose behalf you are completing
this Fact Sheet (e.g., parent, guardian, Estate Administrator)?
D. Did the person on whose behalf you are completing this Fact Sheet participate in
completing this Fact Sheet?
[Click here to select your answer.]
1. If no, did the person on whose behalf you are completing this Fact Sheet
decline to participate?
2
[Click here to select your answer.]
E. If you represent the estate of someone who died or serve as a successor-in-
interest, do you contend that use of Defendants’ platforms caused or contributed
to that person’s death?
[Click here to select your answer.]
F. Have you ever used any Defendant’s reporting features to report a negative
experience on that platform by the person on whose behalf you are completing
this Fact Sheet?
[Click here to select your answer.]
1. If yes, please provide the following information:
How Many Times Did Approximate Dates of Report
Platform Involved (select one)
You Report
☐ Facebook
☐ Instagram
☐ Snapchat
☐ TikTok
☐ YouTube
III. PERSONAL INFORMATION
If you are completing this Fact Sheet for someone else, assume that “you” means the
person who used and was allegedly harmed by Defendants’ platforms.
A. Legal name:
B. Other names by which you have been known (including maiden names, if any):
C. Gender:
D. Social Security Number:
E. Date of birth: [Click or tap to enter a date.]
F. List all addresses where you lived for the last six (6) years. Include addresses
where you lived while at school, if you lived away from home for school (e.g.,
boarding school or college). For each address, provide the approximate dates you
resided at each location:
3
Address Date Range of Residence
G. Household Information. Provide the name of all adults who resided in the same
household as you for all the addresses you listed above in III.F.
Name Relationship to You Date Range the Individual Resided with You
H. Educational History.
Provide the following information about your education for the Relevant Time
Period:
1. Primary and Secondary Schools Attended.
Name of School or Educational Grade(s)
City and State Dates of Attendance
Institution Completed
2. Post-Secondary Schools (e.g., Colleges, Trade Schools, Graduate
Schools), or Other Educational Institutions, Attended.
Name of School or Degree Major or
City and State Dates of Attendance Awarded
Educational Institution Primary Field
3. During the Relevant Time Period, have you ever been subject to
disciplinary action (i.e., detention, in-school suspension, out-of-school
suspension, expulsion) by any school or other educational institution?
[Click here to select your answer.]
(a) If yes, provide the following information for each incident of
disciplinary action to the best of your recollection:
4
Name of School or Date of Disciplinary Type of Disciplinary Action Grounds for
Educational Institution Action (select all that apply) Disciplinary Action
☐ Detention
☐ In-School Suspension
☐ Out-of-School Suspension
☐ Expulsion
I. Previous Interactions with Law Enforcement and the Legal System.
1. Have you ever been convicted, as an adult, of a felony or a crime
involving fraud or dishonesty?
[Click here to select your answer.]
(a) If yes, please answer all of the following questions that apply to
you for each instance:
Charge(s)
Court Where Action Was/Is Pending
[Click or tap to enter a date.]
Date of Conviction
Sentence Imposed
2. Have you ever been subject to a juvenile delinquency proceeding?
[Click here to select your answer.]
3. To the best of your knowledge, has any individual who regularly cared for
you ever been convicted of a crime related to your care?
[Click here to select your answer.]
IV. ABUSE / VIOLENCE / DISCRIMINATION
A. Have you ever been the victim of discrimination or harassment on the basis of
race/ethnicity, national origin, sex, sexual orientation, gender identity, transgender
status, or disability?
[Click here to select your answer.]
1. If yes, please select one of the following options to indicate when the
discrimination or harassment occurred:
[Click here to select your answer.]
5
B. Have you ever been the victim of bullying, cyberbullying, verbal abuse, or
emotional neglect?
[Click here to select your answer.]
1. If yes, please select one of the following options to indicate when the
bullying, cyberbullying, verbal abuse, or emotional neglect occurred:
[Click here to select your answer.]
C. Have you ever been the victim of physical abuse, physical assault, or physical
neglect?
[Click here to select your answer.]
1. If yes, please select one of the following options to indicate when the
physical abuse, physical assault, or physical neglect occurred:
[Click here to select your answer.]
D. Have you ever been the victim of rape, sexual abuse, or sexual assault?
[Click here to select your answer.]
1. If yes, please select one of the following options to indicate when the rape,
sexual abuse, or sexual assault occurred:
[Click here to select your answer.]
E. Have you ever experienced violence or threats of violence (e.g., a shooting, a
threatened shooting, or a bombing) in a school, place of worship, your home, or
other place?
[Click here to select your answer.]
1. If yes, please select one of the following options to indicate when the
violence or threats of violence occurred:
[Click here to select your answer.]
F. Have you ever been the victim of a crime against your person not listed above?
[Click here to select your answer.]
1. If yes, please select one of the following options to indicate when the
crime against your person occurred:
[Click here to select your answer.]
6
V. EMPLOYMENT AND MILITARY HISTORY
A. Complete the chart below detailing your current employment and all prior
employment from when you were fourteen years old through today. Please
include any part-time jobs.
Date Range of Was Your Reason for Leaving
Employment Occupation/ Related to Medical, Physical,
Employer City and State Position/Title Psychiatric, Psychological, or
(Month/Year to
Month/Year) Emotional Reasons?
[Click here to select your
answer.]
B. Have you ever served in any branch of the military?
[Click here to select your answer.]
1. If yes, provide the following information:
(a) Branch of service: __________________________
(b) Rank upon discharge: __________________________
(c) Type of discharge: __________________________
VI. MEDICAL BACKGROUND
You must complete and execute the attached authorization to release your medical
records and answer the following questions.
A. For the Relevant Time Period, identify each healthcare provider that you saw on
an outpatient basis for any physical, mental, or neurodevelopmental condition that
lasted more than three months. Include all doctors, psychiatrists, dieticians,
nutritionists, neuropsychologists, psychologists, therapists, licensed clinical social
workers, nurse practitioners, and physician assistants. If you saw multiple health
care providers within the same medical practice, you are not required to list each
doctor, nurse practitioner, or physician assistant you may have seen as part of
that group; rather, include the name of the health care provider you primarily
saw at the medical practice, and identify the medical specialties of all healthcare
providers you saw.
7
Name of Provider’s Address,
Date Range as Condition/Reason
Medical Practice Specialty Phone Number, and
Patient for Consultation
or Provider Email
B. Identify every hospital, clinic, or facility where you were admitted as an in-
patient or presented for an emergency room visit for any physical, mental, or
neurodevelopmental condition or treatment/surgery during the Relevant Time
Period. You may exclude emergency room visits for common colds, viruses, or
high fevers.
Dates of ER Visit or Name and Address Reason for
Hospital Admission of Facility Admission Treatment Received
and Discharge
C. List all prescription anti-depressants, anti-anxiety medications, anti-psychotic
medications, and other medications for the treatment of any mental health
problem that you took for three (3) months or more during the Relevant Time
Period:
Prescribing Physician or
Pharmacy Used
Date Range of Healthcare Provider
Medication (Name, Address, and Phone
Use (Name, Address, and Phone
Number)
Number)
[Click here to select or write
in a medication.]
D. Except for those pharmacies identified in your response to question VI.C, identify
every pharmacy that has dispensed medication to you during the Relevant Time
Period:
Address and
Name of Medication(s) Date Range You Used
Name of Pharmacy Phone
Dispensed Pharmacy
Number
8
E. Please identify whether you have ever experienced the following conditions and
provide the requested information.
Injury, Illness, or Condition Date Injury, Illness or If Not Ongoing, Date Injury,
(check all that apply) Condition Began Illness, or Condition Ended
☐ Anxiety [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Depression [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Body dysmorphia1 [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Anorexia [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Bulimia [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Binge Eating Disorder [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Other eating disorder [Click or tap to enter a date.] [Click or tap to enter a date.]
(specify):
☐ Sleep disorder(s) [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Self-harm [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Suicidal thoughts [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Suicide attempt(s) [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Death by suicide [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Other Injury You Attribute [Click or tap to enter a date.] [Click or tap to enter a date.]
to Conduct of a Defendant
(specify):
VII. ALLEGED INJURIES, ILLNESSES, AND CONDITIONS
A. Identify all physical and mental injuries, illnesses, or conditions that you allege
were caused or worsened by Defendant’s platforms.
Injury, Illness, or Condition Date Injury, Illness, or If Not Ongoing, Date Injury,
(check all that apply) Condition Began Illness, or Condition Ended
☐ Social media addiction [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Anxiety [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Depression [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Body dysmorphia2 [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Anorexia [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Bulimia [Click or tap to enter a date.] [Click or tap to enter a date.]
1
An unreasonable preoccupation with an imagined defect in appearance that causes clinically significant distress or
impairment in social, occupational or other areas of functioning.
2
An unreasonable preoccupation with an imagined defect in appearance that causes clinically significant distress or
impairment in social, occupational or other areas of functioning.
9
☐ Binge Eating Disorder [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Other eating disorder [Click or tap to enter a date.] [Click or tap to enter a date.]
(specify):
☐ Sleep disorder(s) [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Self-harm [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Suicidal thoughts [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Suicide [Click or tap to enter a date.] [Click or tap to enter a date.]
Attempt(s)
☐ Death by suicide [Click or tap to enter a date.] [Click or tap to enter a date.]
☐ Other Injury You [Click or tap to enter a date.] [Click or tap to enter a date.]
Attribute to Conduct of a
Defendant (specify):
B. Diagnosis of Alleged Injuries, Illnesses, or Conditions
1. Have you been diagnosed by a healthcare professional for any injury,
illness, or condition identified in VII.A?
[Click here to select your answer.]
(a) If yes, please provide the following information:
Injury, Illness, or Condition Name of Diagnosing Provider/ Address of
Diagnosed (list all that apply) Facility/Counselor Provider/Facility/Counselor
C. Treatment of Alleged Injuries, Illnesses, or Conditions
1. Have you sought medical treatment for any of the injury, illness, or
condition identified in VII.A? Medical treatment includes counseling or
therapy sought for psychological, psychiatric, mood, or behavioral
disorders or conditions, as well as social, emotional, or other related
services at a community health center, school, or other educational
institution you attended.
[Click here to select your answer.]
(a) If yes, please provide the following information:
10
Injury, Illness, or
Address of
Condition Name of Provider/ Date Range of Treatment
Provider/Facility/
Treated (list all Facility/Counselor Counselor Treatment Received
that apply)
2. Have you been hospitalized or received in-patient treatment for any of the
injury, illness, or condition identified in VII.A?
[Click here to select your answer.]
(a) If yes, please provide the following information:
Injury, Illness,
or Condition Type of Name and Date of Date of
Address Treatment Received
Treated (list Facility Admission Discharge
all that apply)
[Choose [Click or tap to [Click or tap
an item.] enter a date.] to enter a
date.]
3. Has any physician or other healthcare provider told you that any injury,
illness, or condition identified in VII.A is related to your use of any of
Defendants’ platforms? You do not need to list any retained expert
witnesses.
[Click here to select your answer.]
(a) If yes, provide the physician’s or healthcare provider’s name and
address and the approximate date of that discussion:
Healthcare Provider’s Name Address Approximate Date of Discussion
[Click or tap to enter a date.]
11
VIII. INSURANCE
A. Provide the following information for each private or public health insurance
program with whom you had health insurance coverage during the Relevant Time
Period. Include all private insurance and public assistance, if applicable:
Name and Address of
Approx. Dates of
Insurance Company or Policy Number Name of Policy Holder
Coverage
Public Assistance
IX. ALCOHOL, TOBACCO, AND DRUG USE
A. Alcohol
1. During the Relevant Time Period, have you consumed alcohol regularly
(i.e., once or more per week)?
[Click here to select your answer.]
2. Have you ever sought treatment or been given a professional
recommendation or referral for treatment for alcohol addiction?
[Click here to select your answer.]
3. Have you ever received treatment for alcohol addiction?
[Click here to select your answer.]
(a) If yes, when?
B. Tobacco
1. During the Relevant Time Period, have you used tobacco (including
cigarettes, cigars, pipes, chewing tobacco/snuff, vaping devices, dissolving
tobacco, hookah, and/or electronic cigarettes) regularly (i.e., once or more
per week)?
[Click here to select your answer.]
2. Have you ever sought treatment or been given a professional
recommendation or referral for treatment for a tobacco-related addiction?
[Click here to select your answer.]
3. Have you ever received treatment for a tobacco-related addiction?
[Click here to select your answer.]
12
(a) If yes, when?
C. Drugs
1. During the Relevant Time Period, have you consumed or ingested (in any
manner, including swallowing, smoking, snorting, injecting, or using
suppositories) recreational drugs (i.e., legal or illegal drugs used without
medical supervision)?
[Click here to select your answer.]
2. Have you ever sought treatment or been given a professional
recommendation or referral for treatment related to drug use?
[Click here to select your answer.]
3. Have you ever received treatment related to drug use?
[Click here to select your answer.]
(a) If yes, when?
D. Video Games
1. Have you played video games during the Relevant Time Period?
[Click here to select your answer.]
(a) If yes, provide the following information:
(i) At any point during the Relevant Time Period, did you play
video
Preview
1 FAEGRE DRINKER BIDDLE & REATH LLP TARIFA B. LADDON (SBN 240419) 2 tarifa.laddon@faegredrinker.com DAVID P. KOLLER (SBN 328633) 3 david.koller@faegredrinker.com 1800 Century Park East, Suite 1500 4 Los Angeles, CA 90067 Telephone: (310) 203-4000 5 Facsimile: (310) 229-1285 6 KING & SPALDING LLP MATTHEW J. BLASCHKE (SBN 281938) 7 mblaschke@kslaw.com ALBERT Q. GIANG (SBN 224332) 8 blangner@kslaw.com 50 California Street, Suite 3300 9 San Francisco, CA 94111 Telephone: (415) 318-1200 10 Facsimile: (415) 318-1300 11 Attorneys for Defendants TIKTOK INC. and BYTEDANCE INC. 12 [Additional Counsel on following page] 13 SUPERIOR COURT OF THE STATE OF CALIFORNIA 14 FOR THE COUNTY OF LOS ANGELES 15 IN RE: SOCIAL MEDIA ADOLESCENT Judicial Council Coordination Proceeding 16 ADDICTION. JCCP No.: 5255 – Social Media Cases 17 CHRISTINA ARLINGTON SMITH, et al. LASC Case No.: 22STCV21355 18 Plaintiffs, 19 NOTICE OF ENTRY OF ORDER RE v. AMENDED CASE MANAGEMENT 20 ORDER NO. 7 TIKTOK INC., BYTEDANCE, INC., and 21 Does 1–100, Inclusive, Complaint Filed: June 30, 2022 22 Defendants. Cases Coordinated: December 22, 2022 23 24 25 26 27 28 FAEGRE DRINKER BIDDLE & REATH LLP ATTORNEYS AT LAW NOTICE OF ENTRY OF ORDER RE AMENDED CASE MANAGEMENT ORDER NO. 7 LOS ANGELES JCCP NO. 52555 1 FAEGRE DRINKER BIDDLE & REATH LLP ANDREA R. PIERSON (Admitted Pro Hac Vice) 2 andrea.pierson@faegredrinker.com 300 N. Meridian Street, Suite 2500 3 Indianapolis, IN 46204 Telephone: (317) 237-1424 4 Facsimile: (317) 237-1000 5 KING & SPALDING LLP GEOFFREY M. DRAKE (Admitted Pro Hac Vice) 6 gdrake@kslaw.com 1180 Peachtree Street, NE, Suite 1600 7 Atlanta, GA 30309-3521 Telephone: (404) 572-4600 8 Facsimile: (404) 572-5100 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 FAEGRE DRINKER BIDDLE & REATH LLP 1 ATTORNEYS AT LAW NOTICE OF ENTRY OF ORDER RE AMENDED CASE MANAGEMENT ORDER NO. 7 LOS ANGELES JCCP NO. 52555 1 TO ALL PARTIES AND THEIR COUNSEL OF RECORD: 2 PLEASE TAKE NOTICE that on January 18, 2024, the court issued an order entering 3 the Parties’ Amended Case Management Order No. 7, a true a correct of which is attached hereto 4 as Exhibit "A." 5 Dated: January 22, 2024 FAEGRE DRINKER BIDDLE & REATH LLP 6 7 By: TARIFA B. LADDON 8 DAVID P. KOLLER 9 Attorneys for Defendants TIKTOK INC. AND BYTEDANCE INC. 10 11 Dated: January 22, 2024 KING & SPALDING LLP 12 By: /s/ Matthew J. Blaschke (with permission) MATTHEW J. BLASCHKE 13 ALBERT Q. GIANG 14 Attorneys for Defendants TIKTOK INC. AND BYTEDANCE INC. 15 16 17 18 19 20 21 22 23 24 25 26 27 28 FAEGRE DRINKER BIDDLE & REATH LLP 2 ATTORNEYS AT LAW NOTICE OF ENTRY OF ORDER RE AMENDED CASE MANAGEMENT ORDER NO. 7 LOS ANGELES JCCP NO. 52555 EXHIBIT A 1 FAEGRE DRINKER BIDDLE & REATH LLP TARIFA B. LADDON (SBN 240419) 2 tarifa.laddon@faegredrinker.com DAVID P. KOLLER (SBN 328633) 3 david.koller@faegredrinker.com 1800 Century Park East, Suite 1500 4 Los Angeles, CA 90067 Telephone: (310) 203-4000 5 Facsimile: (310) 229-1285 6 KING & SPALDING LLP MATTHEW J. BLASCHKE (SBN 281938) 7 mblaschke@kslaw.com ALBERT Q. GIANG (SBN 224332) 8 blangner@kslaw.com 50 California Street, Suite 3300 9 San Francisco, CA 94111 Telephone: (415) 318-1200 10 Facsimile: (415) 318-1300 11 Attorneys for Defendants TIKTOK INC. and BYTEDANCE INC. 12 13 SUPERIOR COURT OF THE STATE OF CALIFORNIA 14 COUNTY OF LOS ANGELES, CENTRAL DIVISION 15 COORDINATION PROCEEDING JUDICIAL COUNCIL COORDINATION 16 SPECIAL TITLE [RULE 3.400] PROCEEDING NO. 5255 17 SOCIAL MEDIA CASES Lead Case No. For Filing Purposes: 22STCV21355 18 THIS DOCUMENT RELATES TO: 19 [PROPOSED] AMENDED CASE ALL PERSONAL INJURY CASES MANAGEMENT ORDER NO. 7 – 20 IMPLEMENTATION ORDER GOVERNING ADOPTION OF PLAINTIFF 21 (CHRISTINA ARLINGTON SMITH, ET AL., V. FACT SHEET FOR PERSONAL INJURY TIKTOK INC, ET AL., CASE NO. PLAINTIFFS 22 22STCV21355) 23 Judge: Hon. Carolyn B. Kuhl SSC-12 24 25 26 27 28 -1- [PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS 1 Pursuant to the Court’s authority in the above-captioned Judicial Council Coordination 2 Proceeding (“JCCP”), upon having considered the written and oral submissions of the parties 3 regarding the use of a Plaintiff Fact Sheet (“PFS”) for early discovery in the JCCP, and good 4 cause appearing for the same, the Court orders as follows: 5 1. The PFS Form: 6 7 a. Each personal injury Plaintiff1 in any case coordinated in this JCCP must 8 complete and serve verified, written responses to the Plaintiff Fact Sheet and applicable 9 Appendices, together with any responsive documents and applicable executed authorizations, 10 attached hereto as Exhibit A. Every personal injury Plaintiff is required to provide a PFS that is 11 substantially complete in all respects. 12 b. For a PFS to be “substantially complete,” the responding Plaintiff must: (1) 13 answer the questions contained in the PFS to the best of his or her ability; (2) provide all 14 15 applicable responsive documents; and (3) execute and provide all applicable authorizations. 16 2. Service and Timing of the PFS and Related Materials: 17 a. A personal injury Plaintiff must serve verified, written responses to the 18 PFS and applicable Appendices, together with any responsive documents and applicable executed 19 authorizations, within 105 days after filing a Short Form Complaint. For any Short Form 20 no later than March 28, 2024. Complaints filed prior to the entry of this Order, a PFS shall be served within 105 days from the 21 22 date of this Order. If, however, one or more user accounts is “inaccessible” within the meaning of 23 the User Account Information Order, a Plaintiff must complete and serve verified, written 24 responses to the PFS, together with any responsive documents and applicable executed 25 authorizations, within 30 days of receipt of all Defendants’ “User Account Data Downloads,” as 26 required by the User Account Information Order. 27 28 1 This Order does not apply to coordinated School District or Government Entity Plaintiffs. -1- [PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS 1 b. In the event any single law firm has more than 50 Plaintiff Fact Sheets due 2 on the same date, the firm shall serve on Defendants at least 50 Plaintiff Fact Sheets on the due 3 date and provide notice to Defendants advising of the case names for cases with the same 4 deadline. Plaintiffs shall serve an additional 50 Plaintiff Fact Sheets within 60 days of those 5 submissions, and any additional Plaintiff Fact Sheets shall be served within 60 days of those 6 7 submissions. 8 3. Rules Applicable to Plaintiffs’ Authorizations 9 a. Plaintiff shall provide the following authorizations: authorizations 10 addressed to all healthcare providers,2 educational facilities, and health insurance providers 11 (including Medicare and Medicaid) identified in Plaintiff’s PFS. To the extent Plaintiff is 12 claiming lost wages or earning capacity, Plaintiff shall also provide authorizations for all 13 employers, worker’s compensation providers, and disability claims providers identified in 14 15 Plaintiff’s PFS. 16 b. As set forth above, all authorizations shall be completed and served by 17 uploading on MDL Centrality. Each authorization must be signed but undated. Such submission 18 via MDL Centrality shall constitute service as set forth in paragraph 4, below. 19 c. In addition to providing the addressed undated Authorizations, Plaintiff’s 20 counsel shall also maintain in their file unaddressed executed Authorizations. Plaintiff’s counsel 21 22 shall provide executed, undated Authorizations to counsel for the Defendants (or communicate 23 an objection to said request for authorizations) within 14 days of a request for such 24 Authorizations. Each of Plaintiffs’ Authorization shall be undated, which shall not constitute a 25 deficiency or be deemed to be a substantially non-complete PFS. Defendants (or the applicable 26 27 2 If a Plaintiff saw multiple health care providers within the same medical facility, they may provide a single authorization addressed to the facility. 28 -2- [PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS 1 records vendor, Medical Research Consultants) have permission to date (and where applicable, 2 re-date) undated Authorizations before sending them to records custodians. If an agency, 3 company, firm, institution, provider, or records custodian to whom any Authorization is 4 presented refuses to provide records in response to that Authorization, the Defendants (or the 5 applicable records vendor) shall notify a Plaintiff’s individual representative counsel and a 6 7 designated individual from Liaison Counsel. 8 d. Upon notification, counsel shall work together in good faith to resolve the 9 records issue. In the event a records custodian requires a proprietary authorization or other 10 particular form, the Defendants (or the applicable records vendor) will provide it to Plaintiff’s 11 individual representative counsel who shall thereafter execute and return the proprietary 12 authorization or other particular form, undated, within 14 days. 13 e. Defendants or their designees (including the applicable records vendor) 14 15 shall have the right to contact agencies, companies, firms, institutions, or providers for the sole 16 purpose of following up on record copying or production. Substantive communications between 17 Defendants and employees of the agencies, companies, firms and institutions, as well as any 18 conversations with a Plaintiff’s medical providers, shall be in accordance with applicable legal, 19 ethical, and notice obligations under any applicable law or applicable rules of professional 20 conduct and may be addressed by separate order.3 21 22 f. Medical Research Consultants shall make available to Plaintiffs a list of all 23 facilities from which records have been collected pursuant to Authorizations. For any record set 24 collected without a subpoena, Plaintiffs may elect to access such records for $23.10. For any 25 record set collected after issuance of a subpoena, Plaintiffs may elect to access such records for 26 27 3 28 This provision applies only to communications related to records requests. -3- [PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS 1 $38.10. Medical Research Consultants shall credit Defendants for any payments made by 2 Plaintiffs. In the event that Medical Research Consultants’ fees change after the issuance of this 3 order, the parties may meet and confer regarding changes to this Paragraph. 4 4. Transmission of PFS and Other Documents to Defendants: 5 a. To complete and serve the Plaintiff Fact Sheet, the parties have agreed to 6 7 utilize the online “MDL Centrality” platform designed and provided by BrownGreer PLC and 8 accessible at MDLCentrality.com. All questions regarding the use of MDL Centrality should be 9 directed to MDLCentrality@browngreer.com. 10 b. With the exception of objections for privilege, each Plaintiff shall submit 11 and serve the Plaintiff Fact Sheet, together with all applicable appendices and any responsive 12 documents and applicable executed authorizations, without objection, by submission on MDL 13 Centrality. Responses to the questions contained in the PFS shall be treated as verified 14 15 responses to interrogatories and, where documents are requested, verified responses to requests 16 for production of documents under the California Code of Civil Procedure. All responses will 17 be governed by the standards applicable to written discovery responses under the California 18 Code of Civil Procedure. In the event that Plaintiff’s case is selected for additional case-specific 19 discovery and Plaintiff receives a reasonable request for supplementation under Sections 20 20312.050 and/or 2030.070(a) of the California Code of Civil Procedure, Plaintiff must revise 21 22 the PFS to supplement any requested information. 23 c. The information that each Plaintiff must provide pursuant to this Order, 24 including completing, submitting, and serving a PFS, Appendices, Authorizations, and 25 Responsive Documents, is without prejudice to Defendants’ right to propound or seek 26 additional non-duplicative discovery in the future, and nothing in the PFS shall be deemed to 27 limit the scope of that discovery, including any inquiry at any deposition. The PFS shall not 28 -4- [PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS 1 count against the numeric limits for written discovery including but not limited to “specially 2 prepared interrogatories” as set forth in Code Civ. Proc., section 2030.030. 3 5. PFS Deficiency Dispute Resolution 4 a. If a Plaintiff has not served a substantially complete PFS as defined in 5 Paragraph 1(b), Defendants may send a Notice of Deficiency via MDL Centrality that identifies 6 7 the alleged deficiencies, including the failure to serve a PFS. If Defendants elect to send a Notice 8 of Deficiency, Defendants shall serve the Notice of Deficiency within 60 days of receipt of the 9 PFS, or if a PFS is not served, the deadline to serve a PFS. 10 b. Following receipt of the Notice of Deficiency, Plaintiffs shall have 60 days 11 to jointly meet and confer with Defendants regarding the perceived deficiencies and possible 12 resolution by amendment to the PFS or the submission of additional documents or 13 authorizations. 14 15 6. Confidentiality 16 a. Information provided pursuant to a PFS is deemed confidential and will be 17 subject to the terms of the Protective Order. 18 7. Admissibility of Evidence 19 a. The California Code of Evidence shall govern the admissibility of 20 information contained in the PFS. Nothing in the PFS or this Order shall be deemed to limit the 21 22 admissibility of evidence during this proceeding, including at trial. This paragraph does not 23 prohibit a party from withholding or redacting information based upon a recognized privilege. 24 Documents withheld on the basis of privilege under California law shall be logged consistent 25 with California law except that a Plaintiff is not required to log privileged communications 26 occurring after the date Plaintiff retained counsel between (1) the Plaintiff and their counsel; or 27 (2) a parent, legal guardian, or guardian ad litem and Plaintiff’s counsel, to the extent Plaintiff’s 28 -5- [PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS 1 counsel also represents such parent, legal guardian, or guardian ad litem. The Plaintiff is also 2 not required to log drafts of the PFS. 3 4 5 IT IS SO ORDERED. 6 7 8 Dated: __________________________ ____________________________________ Hon. Carolyn Kuhl 9 Judge of the Superior Court 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -6- [PROPOSED] AMENDED CASE MANAGEMENT ORDER NO. 7 – IMPLEMENTATION ORDER GOVERNING ADOPTION OF PLAINTIFF FACT SHEET FOR PERSONAL INJURY PLAINTIFFS EXHIBIT A SUPERIOR COURT OF THE STATE OF CALIFORNIA FOR THE COUNTY OF LOS ANGELES IN RE: SOCIAL MEDIA CASES JCCP No. 5255 [Consolidated with JCCP No. 5256] Case No. 22STCV21355 This Document Relates to: PLAINTIFF FACT SHEET Case Caption and Civil Action No.: Full Name of Plaintiff (First, Middle, and Last): PLAINTIFF FACT SHEET Please provide the following information for each plaintiff who claims that use of Defendants’ platforms (Facebook, Instagram, Snapchat, TikTok, and YouTube) caused them (or a person who died) injury as alleged in the above-captioned litigation. In completing this Plaintiff Fact Sheet, you are under oath and must provide information that is true and correct to the best of your knowledge. If you cannot recall all of the details requested, provide as much information as you can, including by review of documents or materials in your or your attorneys’ custody or possession. Be as specific as possible in all of your answers. If you cannot recall a specific date requested, provide the approximate date to the best of your recollection. For example, if you recall the year and month of an event, but not the day, complete the year and month, but enter “00” for the day. This Plaintiff Fact Sheet is an electronic version that expands to accommodate as much information as is necessary to fully answer any of these questions, including by adding rows or columns to tables. You must fill out the applicable appendix for each entity you have named as a Defendant. Please do not leave any questions unanswered or blank. You may and should consult with your attorney if you have any questions regarding the completion of this form. This Plaintiff Fact Sheet constitutes discovery responses subject to California Code of Civil Procedure. This Plaintiff Fact Sheet and the information provided herein will be used only for this litigation and is designated Confidential under the Protective Order. Plaintiffs do not concede the relevance or admissibility of any of the information herein. I. CASE INFORMATION A. Name of the court in which the complaint was initially filed: B. Case number in court in which complaint was originally filed: C. Are you alleging in this case that you began using Facebook, Instagram, Snapchat, TikTok, or YouTube when you were under thirteen years old? [Click here to select your answer.] **IMPORTANT** DEFINITION OF “RELEVANT TIME PERIOD” If your answer to question I.C. is “YES,” then the phrase “Relevant Time Period” throughout this Plaintiff Fact Sheet means from the time you turned SEVEN (7) years old to today. If your answer to question I.C. is “NO,” then the phrase “Relevant Time Period” throughout this Plaintiff Fact Sheet means from the time you turned TEN (10) years old to today. II. REPRESENTATIVE CAPACITY Only complete this section if you have filed this lawsuit on behalf of a minor, someone who died, or a person who lacks capacity to complete it on their own. When you complete this section of this form (Section II, “Representative Capacity”), “you” refers to the person filling out this form. When you complete the rest of this form “you” refers to the person you are representing. A. Name of individual completing this Fact Sheet: B. Your current address: C. What is your relationship to the person upon whose behalf you are completing this Fact Sheet (e.g., parent, guardian, Estate Administrator)? D. Did the person on whose behalf you are completing this Fact Sheet participate in completing this Fact Sheet? [Click here to select your answer.] 1. If no, did the person on whose behalf you are completing this Fact Sheet decline to participate? 2 [Click here to select your answer.] E. If you represent the estate of someone who died or serve as a successor-in- interest, do you contend that use of Defendants’ platforms caused or contributed to that person’s death? [Click here to select your answer.] F. Have you ever used any Defendant’s reporting features to report a negative experience on that platform by the person on whose behalf you are completing this Fact Sheet? [Click here to select your answer.] 1. If yes, please provide the following information: How Many Times Did Approximate Dates of Report Platform Involved (select one) You Report ☐ Facebook ☐ Instagram ☐ Snapchat ☐ TikTok ☐ YouTube III. PERSONAL INFORMATION If you are completing this Fact Sheet for someone else, assume that “you” means the person who used and was allegedly harmed by Defendants’ platforms. A. Legal name: B. Other names by which you have been known (including maiden names, if any): C. Gender: D. Social Security Number: E. Date of birth: [Click or tap to enter a date.] F. List all addresses where you lived for the last six (6) years. Include addresses where you lived while at school, if you lived away from home for school (e.g., boarding school or college). For each address, provide the approximate dates you resided at each location: 3 Address Date Range of Residence G. Household Information. Provide the name of all adults who resided in the same household as you for all the addresses you listed above in III.F. Name Relationship to You Date Range the Individual Resided with You H. Educational History. Provide the following information about your education for the Relevant Time Period: 1. Primary and Secondary Schools Attended. Name of School or Educational Grade(s) City and State Dates of Attendance Institution Completed 2. Post-Secondary Schools (e.g., Colleges, Trade Schools, Graduate Schools), or Other Educational Institutions, Attended. Name of School or Degree Major or City and State Dates of Attendance Awarded Educational Institution Primary Field 3. During the Relevant Time Period, have you ever been subject to disciplinary action (i.e., detention, in-school suspension, out-of-school suspension, expulsion) by any school or other educational institution? [Click here to select your answer.] (a) If yes, provide the following information for each incident of disciplinary action to the best of your recollection: 4 Name of School or Date of Disciplinary Type of Disciplinary Action Grounds for Educational Institution Action (select all that apply) Disciplinary Action ☐ Detention ☐ In-School Suspension ☐ Out-of-School Suspension ☐ Expulsion I. Previous Interactions with Law Enforcement and the Legal System. 1. Have you ever been convicted, as an adult, of a felony or a crime involving fraud or dishonesty? [Click here to select your answer.] (a) If yes, please answer all of the following questions that apply to you for each instance: Charge(s) Court Where Action Was/Is Pending [Click or tap to enter a date.] Date of Conviction Sentence Imposed 2. Have you ever been subject to a juvenile delinquency proceeding? [Click here to select your answer.] 3. To the best of your knowledge, has any individual who regularly cared for you ever been convicted of a crime related to your care? [Click here to select your answer.] IV. ABUSE / VIOLENCE / DISCRIMINATION A. Have you ever been the victim of discrimination or harassment on the basis of race/ethnicity, national origin, sex, sexual orientation, gender identity, transgender status, or disability? [Click here to select your answer.] 1. If yes, please select one of the following options to indicate when the discrimination or harassment occurred: [Click here to select your answer.] 5 B. Have you ever been the victim of bullying, cyberbullying, verbal abuse, or emotional neglect? [Click here to select your answer.] 1. If yes, please select one of the following options to indicate when the bullying, cyberbullying, verbal abuse, or emotional neglect occurred: [Click here to select your answer.] C. Have you ever been the victim of physical abuse, physical assault, or physical neglect? [Click here to select your answer.] 1. If yes, please select one of the following options to indicate when the physical abuse, physical assault, or physical neglect occurred: [Click here to select your answer.] D. Have you ever been the victim of rape, sexual abuse, or sexual assault? [Click here to select your answer.] 1. If yes, please select one of the following options to indicate when the rape, sexual abuse, or sexual assault occurred: [Click here to select your answer.] E. Have you ever experienced violence or threats of violence (e.g., a shooting, a threatened shooting, or a bombing) in a school, place of worship, your home, or other place? [Click here to select your answer.] 1. If yes, please select one of the following options to indicate when the violence or threats of violence occurred: [Click here to select your answer.] F. Have you ever been the victim of a crime against your person not listed above? [Click here to select your answer.] 1. If yes, please select one of the following options to indicate when the crime against your person occurred: [Click here to select your answer.] 6 V. EMPLOYMENT AND MILITARY HISTORY A. Complete the chart below detailing your current employment and all prior employment from when you were fourteen years old through today. Please include any part-time jobs. Date Range of Was Your Reason for Leaving Employment Occupation/ Related to Medical, Physical, Employer City and State Position/Title Psychiatric, Psychological, or (Month/Year to Month/Year) Emotional Reasons? [Click here to select your answer.] B. Have you ever served in any branch of the military? [Click here to select your answer.] 1. If yes, provide the following information: (a) Branch of service: __________________________ (b) Rank upon discharge: __________________________ (c) Type of discharge: __________________________ VI. MEDICAL BACKGROUND You must complete and execute the attached authorization to release your medical records and answer the following questions. A. For the Relevant Time Period, identify each healthcare provider that you saw on an outpatient basis for any physical, mental, or neurodevelopmental condition that lasted more than three months. Include all doctors, psychiatrists, dieticians, nutritionists, neuropsychologists, psychologists, therapists, licensed clinical social workers, nurse practitioners, and physician assistants. If you saw multiple health care providers within the same medical practice, you are not required to list each doctor, nurse practitioner, or physician assistant you may have seen as part of that group; rather, include the name of the health care provider you primarily saw at the medical practice, and identify the medical specialties of all healthcare providers you saw. 7 Name of Provider’s Address, Date Range as Condition/Reason Medical Practice Specialty Phone Number, and Patient for Consultation or Provider Email B. Identify every hospital, clinic, or facility where you were admitted as an in- patient or presented for an emergency room visit for any physical, mental, or neurodevelopmental condition or treatment/surgery during the Relevant Time Period. You may exclude emergency room visits for common colds, viruses, or high fevers. Dates of ER Visit or Name and Address Reason for Hospital Admission of Facility Admission Treatment Received and Discharge C. List all prescription anti-depressants, anti-anxiety medications, anti-psychotic medications, and other medications for the treatment of any mental health problem that you took for three (3) months or more during the Relevant Time Period: Prescribing Physician or Pharmacy Used Date Range of Healthcare Provider Medication (Name, Address, and Phone Use (Name, Address, and Phone Number) Number) [Click here to select or write in a medication.] D. Except for those pharmacies identified in your response to question VI.C, identify every pharmacy that has dispensed medication to you during the Relevant Time Period: Address and Name of Medication(s) Date Range You Used Name of Pharmacy Phone Dispensed Pharmacy Number 8 E. Please identify whether you have ever experienced the following conditions and provide the requested information. Injury, Illness, or Condition Date Injury, Illness or If Not Ongoing, Date Injury, (check all that apply) Condition Began Illness, or Condition Ended ☐ Anxiety [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Depression [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Body dysmorphia1 [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Anorexia [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Bulimia [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Binge Eating Disorder [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Other eating disorder [Click or tap to enter a date.] [Click or tap to enter a date.] (specify): ☐ Sleep disorder(s) [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Self-harm [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Suicidal thoughts [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Suicide attempt(s) [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Death by suicide [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Other Injury You Attribute [Click or tap to enter a date.] [Click or tap to enter a date.] to Conduct of a Defendant (specify): VII. ALLEGED INJURIES, ILLNESSES, AND CONDITIONS A. Identify all physical and mental injuries, illnesses, or conditions that you allege were caused or worsened by Defendant’s platforms. Injury, Illness, or Condition Date Injury, Illness, or If Not Ongoing, Date Injury, (check all that apply) Condition Began Illness, or Condition Ended ☐ Social media addiction [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Anxiety [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Depression [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Body dysmorphia2 [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Anorexia [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Bulimia [Click or tap to enter a date.] [Click or tap to enter a date.] 1 An unreasonable preoccupation with an imagined defect in appearance that causes clinically significant distress or impairment in social, occupational or other areas of functioning. 2 An unreasonable preoccupation with an imagined defect in appearance that causes clinically significant distress or impairment in social, occupational or other areas of functioning. 9 ☐ Binge Eating Disorder [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Other eating disorder [Click or tap to enter a date.] [Click or tap to enter a date.] (specify): ☐ Sleep disorder(s) [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Self-harm [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Suicidal thoughts [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Suicide [Click or tap to enter a date.] [Click or tap to enter a date.] Attempt(s) ☐ Death by suicide [Click or tap to enter a date.] [Click or tap to enter a date.] ☐ Other Injury You [Click or tap to enter a date.] [Click or tap to enter a date.] Attribute to Conduct of a Defendant (specify): B. Diagnosis of Alleged Injuries, Illnesses, or Conditions 1. Have you been diagnosed by a healthcare professional for any injury, illness, or condition identified in VII.A? [Click here to select your answer.] (a) If yes, please provide the following information: Injury, Illness, or Condition Name of Diagnosing Provider/ Address of Diagnosed (list all that apply) Facility/Counselor Provider/Facility/Counselor C. Treatment of Alleged Injuries, Illnesses, or Conditions 1. Have you sought medical treatment for any of the injury, illness, or condition identified in VII.A? Medical treatment includes counseling or therapy sought for psychological, psychiatric, mood, or behavioral disorders or conditions, as well as social, emotional, or other related services at a community health center, school, or other educational institution you attended. [Click here to select your answer.] (a) If yes, please provide the following information: 10 Injury, Illness, or Address of Condition Name of Provider/ Date Range of Treatment Provider/Facility/ Treated (list all Facility/Counselor Counselor Treatment Received that apply) 2. Have you been hospitalized or received in-patient treatment for any of the injury, illness, or condition identified in VII.A? [Click here to select your answer.] (a) If yes, please provide the following information: Injury, Illness, or Condition Type of Name and Date of Date of Address Treatment Received Treated (list Facility Admission Discharge all that apply) [Choose [Click or tap to [Click or tap an item.] enter a date.] to enter a date.] 3. Has any physician or other healthcare provider told you that any injury, illness, or condition identified in VII.A is related to your use of any of Defendants’ platforms? You do not need to list any retained expert witnesses. [Click here to select your answer.] (a) If yes, provide the physician’s or healthcare provider’s name and address and the approximate date of that discussion: Healthcare Provider’s Name Address Approximate Date of Discussion [Click or tap to enter a date.] 11 VIII. INSURANCE A. Provide the following information for each private or public health insurance program with whom you had health insurance coverage during the Relevant Time Period. Include all private insurance and public assistance, if applicable: Name and Address of Approx. Dates of Insurance Company or Policy Number Name of Policy Holder Coverage Public Assistance IX. ALCOHOL, TOBACCO, AND DRUG USE A. Alcohol 1. During the Relevant Time Period, have you consumed alcohol regularly (i.e., once or more per week)? [Click here to select your answer.] 2. Have you ever sought treatment or been given a professional recommendation or referral for treatment for alcohol addiction? [Click here to select your answer.] 3. Have you ever received treatment for alcohol addiction? [Click here to select your answer.] (a) If yes, when? B. Tobacco 1. During the Relevant Time Period, have you used tobacco (including cigarettes, cigars, pipes, chewing tobacco/snuff, vaping devices, dissolving tobacco, hookah, and/or electronic cigarettes) regularly (i.e., once or more per week)? [Click here to select your answer.] 2. Have you ever sought treatment or been given a professional recommendation or referral for treatment for a tobacco-related addiction? [Click here to select your answer.] 3. Have you ever received treatment for a tobacco-related addiction? [Click here to select your answer.] 12 (a) If yes, when? C. Drugs 1. During the Relevant Time Period, have you consumed or ingested (in any manner, including swallowing, smoking, snorting, injecting, or using suppositories) recreational drugs (i.e., legal or illegal drugs used without medical supervision)? [Click here to select your answer.] 2. Have you ever sought treatment or been given a professional recommendation or referral for treatment related to drug use? [Click here to select your answer.] 3. Have you ever received treatment related to drug use? [Click here to select your answer.] (a) If yes, when? D. Video Games 1. Have you played video games during the Relevant Time Period? [Click here to select your answer.] (a) If yes, provide the following information: (i) At any point during the Relevant Time Period, did you play video