Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_12-cv-03193/USCOURTS-cand-3_12-cv-03193-12/pdf.json

Nature of Suit Code: 555
Nature of Suit: Prisoner - Prison Condition
Cause of Action: 42:1983 Prisoner Civil Rights

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IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

GEORGE MARTIN, H-90626, 

Plaintiff(s),

 vs.

A. HEDGPETH, Warden, et al.,

Defendant(s). 

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No. C 12-3193 CRB (PR)

ORDER GRANTING 

DEFENDANTS’ MOTION FOR

SUMMARY JUDGMENT

(Dkt. #99 & 121)

Plaintiff, a prisoner at Salinas Valley State Prison (SVSP), filed a pro se

First Amended Complaint (FAC) for damages under 42 U.S.C. § 1983 and 28

U.S.C. § 1367 alleging a host of medical grievances against medical personnel at

SVSP. Per order filed on June 13, 2013, the court found that, liberally construed, 

plaintiff’s allegations appear to state a cognizable Eighth Amendment claim for

deliberate indifference to serious medical needs under § 1983 and a cognizable

California state law claim for medical negligence pursuant to the court’s

supplemental jurisdiction under § 1367 against various SVSP defendants, and

ordered the U.S. Marshal to serve them. 

Defendants moved to dismiss some of plaintiff’s alleged medical

grievances under Federal Rule of Civil Procedure 12(b)(6) on the grounds that

they fail to state a claim for deliberate indifference to serious medical needs

under § 1983 and that defendants are entitled to qualified immunity. Defendants

also argued that plaintiff’s state law medical negligence claim must be dismissed

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as to all alleged medical grievances for failure to comply with the California Tort

Claims Act. Defendants moved for summary judgment under Rule 56 on

plaintiff’s remaining medical grievances on the ground that plaintiff failed to

properly exhaust available administrative remedies as required by the Prison

Litigation Reform Act (PLRA).

Per order filed on August 7, 2014, the court granted defendants’ motion to

dismiss and motion for summary judgment for non-exhaustion as to all claims

other than plaintiff’s § 1983 deliberate indifference to serious medical needs

claim based on denial of adequate hypertension medication, denial of pain

medication on December 29, 2011 and denial of effective eye wear. The court

made clear that this action “will proceed as to plaintiff’s § 1983 deliberate

indifference to serious medical needs claim based on the [aforementioned] three

medical grievances . . . only.” Aug. 7, 2014 Order (dkt. #91) at 19-20.

Defendants move for summary judgment on the three remaining § 1983

medical grievances on the ground that there are no material facts in dispute and

that they are entitled to judgment as a matter of law. Defendants also claim that

they are entitled to qualified immunity. Plaintiff has filed an opposition and

defendants have filed a reply. 

BACKGROUND

The remaining allegations in plaintiff’s FAC pertain to his medical

grievances of denial of adequate hypertension medication, denial of pain

medication on December 29, 2011 and denial of effective eye wear. They can be

summarized as follows:

1. Denial of Adequate Hypertension Medication

Plaintiff alleges that Dr. Mack was deliberately indifferent to his

serious medical needs because Dr. Mack prescribed inadequate medications to

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treat his hypertension. Plaintiff specifically alleges that Dr. Mack refused to

provide him a previously recommended Clonidine prescription in patch form for

hypertension and instead provided him the medication in pill form that he cannot

take due to “severe adverse reactions” and “side-effects.” FAC (dkt. #18) at 3. 

2. Denial of Pain Medication on December 29, 2011

Plaintiff alleges that Dr. Mack cancelled his morning pain

medication on December 29, 2011. Id. at 5. 

3. Denial of Effective Eye Wear

Plaintiff alleges that he has been denied “effective eye wear” since

2009 and, as a result, his vision has drastically worsened. Id. Plaintiff

specifically alleges that in 2010 doctors Sepulveda and Bright cancelled a chrono

for “ADA” glasses and, in 2011, Dr. Kumar denied a chrono for “ADA tinted

glasses.” Id. at 4. 

DISCUSSION

A. Standard of Review

Summary judgment is proper where the pleadings, discovery and

affidavits show that there is “no genuine dispute as to any material fact and the

[moving party] is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). 

Material facts are those which may affect the outcome of the case. Anderson v.

Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A dispute as to a material fact is

genuine if there is sufficient evidence for a reasonable jury to return a verdict for

the nonmoving party. Id.

The moving party for summary judgment bears the initial burden of

identifying those portions of the pleadings, discovery and affidavits which

demonstrate the absence of a genuine issue of material fact. Celotex Corp. v.

Cattrett, 477 U.S. 317, 323 (1986). Where the moving party will have the burden

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of proof on an issue at trial, it must affirmatively demonstrate that no reasonable

trier of fact could find other than for the moving party. But on an issue for which

the opposing party will have the burden of proof at trial, as is the case here, the

moving party need only point out “that there is an absence of evidence to support

the nonmoving party’s case.” Id.

Once the moving party meets its initial burden, the nonmoving party must

go beyond the pleadings to demonstrate the existence of a genuine dispute of

material fact by “citing to specific parts of materials in the record” or “showing

that the materials cited do not establish the absence or presence of a genuine

dispute.” Fed. R. Civ. P. 56(c). A triable dispute of fact exists only if there is

sufficient evidence favoring the nonmoving party to allow a jury to return a

verdict for that party. Anderson, 477 U.S. at 249. If the nonmoving party fails to

make this showing, “the moving party is entitled to judgment as a matter of law.” 

Celotex, 477 U.S. at 323.

B. Analysis

Defendants argue that they are entitled to summary judgment and qualified

immunity from plaintiff’s three remaining § 1983 medical grievances. Under

Saucier v. Katz, 533 U.S. 194 (2001), the court must undertake a two-step

analysis when a defendant asserts qualified immunity in a motion for summary

judgment. The court first faces “this threshold question: Taken in the light most

favorable to the party asserting the injury, do the facts alleged show the officer’s

conduct violated a constitutional right?” 533 U.S. at 201. If the court determines

that the conduct did not violate a constitutional right, the inquiry is over and the

officer is entitled to qualified immunity.

If the court determines that the conduct did violate a constitutional right, it

then moves to the second step and asks “whether the right was clearly

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Although the Saucier sequence is often appropriate and beneficial, it is not 

mandatory. A court may exercise its discretion in deciding which prong to

address first, in light of the particular circumstances of each case. See Pearson v.

Callahan, 555 U.S. 223, 236 (2009).

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established” such that “it would be clear to a reasonable officer that his conduct

was unlawful in the situation he confronted.” Id. at 201-02. Even if the violated

right was clearly established, qualified immunity shields an officer from suit

when he makes a decision that, even if constitutionally deficient, reasonably

misapprehends the law governing the circumstances he confronted. Brosseau v.

Haugen, 543 U.S. 194, 198 (2004); Saucier, 533 U.S. at 205-06. If “the officer’s

mistake as to what the law requires is reasonable . . . the officer is entitled to the

immunity defense.” Id. at 205.1

A prison official violates the Eighth Amendment’s proscription against

cruel and unusual punishment when he acts with deliberate indifference to the

serious medical needs of a prisoner. Farmer v. Brennan, 511 U.S. 825, 828

(1994). To establish an Eighth Amendment violation, a plaintiff must satisfy

both an objective standard – that the deprivation was serious enough to constitute

cruel and unusual punishment – and a subjective standard – deliberate

indifference. Snow v. McDaniel, 681 F.3d 978, 985 (9th Cir. 2012). To meet the

objective standard, the denial of a plaintiff’s serious medical need must result in

the “‘unnecessary and wanton infliction of pain.’” Id. (quoting Estelle v. Gamble,

429 U.S. 97, 104 (1976)). To meet the subjective standard of deliberate

indifference, a prison official must know that a prisoner faces a substantial risk of

serious harm and disregard that risk by failing to take reasonable steps to abate it. 

Farmer, 511 U.S. at 837. 

Negligence cannot establish liability under the Eighth Amendment. Id. at

835-36 n.4. An “official’s failure to alleviate a significant risk that he should

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have perceived but did not . . . cannot under our cases be condemned as the

infliction of punishment.” Id. at 838. Instead, “the official’s conduct must have

been ‘wanton,’ which turns not upon its effect on the prisoner, but rather, upon

the constraints facing the official.” Frost v. Agnos, 152 F.3d 1124, 1128 (9th Cir.

1998) (citing Wilson v. Seiter, 501 U.S. 294, 302-03 (1991)). Prison officials

violate their constitutional obligation only by “intentionally denying or delaying

access to medical care.” Estelle, 429 U.S. at 104-05.

A showing of nothing more than a difference of medical opinion as to the

need to pursue one course of treatment over another is generally insufficient to

establish deliberate indifference. Toguchi v. Chung, 391 F.3d 1051, 1058 (9th

Cir. 2004). To prevail on a claim involving choices between alternative courses

of treatment, a prisoner-plaintiff must show that the course of treatment the

doctor-defendants chose was medically unacceptable under the circumstances

and that they chose this course in conscious disregard of an excessive risk to

plaintiff’s health. Id.

1. Denial of Adequate Hypertension Medication

Defendants argue that Dr. Mack is entitled to summary judgment

on plaintiff’s § 1983 claim of denial of adequate hypertension medication

because the evidence in the record shows that Dr. Mack and other prison doctors

adequately treated plaintiff for hypertension and did not consciously disregard

plaintiff’s hypertension. In support, defendants submit declarations and

documentary evidence showing that Dr. Mack and other prison doctors have

prescribed plaintiff various hypertension medications, including “preferred” firstline hypertension medications such as calcium channel blockers, ACE inhibitors

and diuretics. When plaintiff takes them as prescribed, his hypertension can be

controlled. But plaintiff often refuses to take prescribed hypertension medication

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other than a previously recommended Clonidine prescription in patch form. 

There is no medical evidence that plaintiff would suffer from adverse reactions or

side effects to any of the first-line hypertension medications Dr. Mack and other

prison doctors have prescribed (or offered to prescribe) him. Dr. Mack

nonetheless relented and prescribed plaintiff Clonidine in pill form as early as

April 2012. There is no medical evidence that plaintiff would suffer from

adverse reactions or side effects to Clonidine in pill form rather than patch form. 

In fact, plaintiff has been taking Clonidine in pill form for over a year now – 0.2

mg three times a day, administered by a nurse to monitor his compliance – and

his blood pressure has intermittently been under control without any adverse

reactions or side effects. Dr. J. Dunlap reviewed plaintiff’s extensive medical

records and, in his medical opinion, “Dr. Mack’s prescribing Clonidine in a pill

form, instead of the previously recommended patch form, was an appropriate

medical alternative to manage [plaintiff’s] high blood pressure . . . and did not

pose any substantial risk of harm to [plaintiff].” Dunlap Decl. (dkt. #100) at 3-4.

On plaintiff’s medical record and evidence submitted by defendants, no

reasonable jury could find that Dr. Mack disregarded plaintiff’s hypertension by

failing to take reasonable steps to abate it. See Farmer, 511 U.S. at 837. 

Plaintiff’s mere insistence that the previously recommended Clonidine in patch

form was the only acceptable course of treatment for his hypertension does not

compel a different conclusion. There simply is no evidence that the course of

treatment Dr. Mack chose was medically unacceptable under the circumstances

and that Dr. Mack chose this course in conscious disregard of an excessive risk to

plaintiff’s health. See Toguchi, 391 F.3d at 1058. Defendants are entitled to

summary judgment on plaintiff’s § 1983 deliberate indifference claim based on

denial of adequate hypertension medication. See Celotex, 477 U.S. at 323.

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At minimum, Dr. Mack is entitled to qualified immunity because a

reasonable prison doctor could have believed that his conduct was lawful under

the circumstances. See Saucier, 533 U.S. at 201-02. A reasonable prison doctor 

could have believed that prescribing plaintiff first-line hypertension medications

and/or Clonidine in pill form, rather than Clonidine in patch form, was medically

acceptable and not an excessive risk to plaintiff’s health where there was no

medical evidence that plaintiff could not tolerate any hypertension medication

other than Clonidine in patch form. 

2. Denial of Pain Medication on December 29, 2011

Defendants argue that Dr. Mack is entitled to summary judgment

on plaintiff’s § 1983 claim of denial of pain medication on December 29, 2011

because the evidence in the record shows that Dr. Mack did not deny plaintiff

pain medication on December 29, 2011, but rather made a reasoned decision to

change plaintiff’s pain medication prescription from morphine to methadone. In

support, defendants submit declarations and documentary evidence showing that

on December 29, 2011, plaintiff was receiving morphine extended release (ER)

three times a day (30 mg in am, 60 mg at noon and 60 mg at bedtime) for chronic

neck and lower back pain. But Dr. Mack elected to change plaintiff’s morphine

ER prescription to methadone 20 mg twice a day at noon and at bedtime because

plaintiff was constantly seeking pain medications and was known to be at high

risk of “diverting” his morphine ER tablets, i.e., selling the tablets in the prison

black market. Methadone is an opiate pain reliever equivalent to morphine, but

unlike the morphine ER tablets plaintiff was receiving, methadone can be crushed

into a powder form and mixed with a liquid thereby reducing the risk of diversion

into the prison back market. In Dr. Dunlap’s medical opinion, “Dr. Mack’s

December 29, 2011 decision to change [plaintiff’s] pain medication to methadone

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was a reasonable and appropriate medical decision under the circumstances that

were present at the time” and “did not pose a substantial risk of harm” to

plaintiff. Dunlap Decl. at 5. 

On plaintiff’s medical record and evidence submitted by defendants, no

reasonable jury could find that Dr. Mack disregarded plaintiff’s chronic neck and

lower back pain by failing to take reasonable steps to abate it. See Farmer, 511

U.S. at 837. Plaintiff’s assertion that Dr. Mack cancelled his morning pain

medication on December 29, 2011 does not compel a different conclusion. At

most it suggests that plaintiff disagrees with Dr. Mack’s decision to change his

pain prescription from morphine ER three times a day (morning, noon and

bedtime) to methadone twice a day (noon and bedtime), but it is well established

that “[a] difference of opinion between a prisoner-patient and prison medical

authorities regarding treatment does not give rise to a § 1983 claim.” Franklin v.

Oregon, 662 F.2d 1337, 1344 (9th Cir. 1981). Nor is there any evidence in the

record that the change in pain medication Dr. Mack chose was medically

unacceptable under the circumstances and that Dr. Mack chose this change in

pain medication in conscious disregard of an excessive risk to plaintiff’s health. 

See Toguchi, 391 F.3d at 1058. Defendants are entitled to summary judgment on

plaintiff’s § 1983 deliberate indifference claim based on his medical grievance

that Dr. Mack cancelled his morning pain medication on December 29, 2011. 

See Celotex, 477 U.S. at 323.

At minimum, Dr. Mack is entitled to qualified immunity because a

reasonable prison doctor could have believed that his conduct was lawful under

the circumstances. See Saucier, 533 U.S. at 201-02. A reasonable prison doctor 

could have believed that changing plaintiff’s pain medication from morphine ER

to methadone in order to decrease the risk of diversion of opiates into the prison

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back market was medically acceptable and not an excessive risk to plaintiff’s

health. After all, Dr. Dunlap points out under penalty of perjury that the change

“was consistent with the California Physician’s Health Care Services (CPHCS)

Pain Management Guidelines.” Dunlap Decl. at 5.

3. Denial of Effective Eye Wear

Defendants argue that doctors Sepulveda, Bright and Kumar are

entitled to summary judgment on plaintiff’s § 1983 claim of denial of effective

eye wear because the evidence in the record shows that they and other prison

medical staff repeatedly have offered plaintiff prescription glasses deemed

medically necessary (including prescription glasses that are tinted gray II, with

transitional lenses) and only denied plaintiff glasses not deemed medically

necessary (such as dark tinted glasses and solar shields). In support, defendants

submit declarations and documentary evidence showing the following:

To be considered visually impaired, a prisoner must be enrolled by his

primary care physician in the Disability Placement Program (DPP) for visual

impairment. DPP for visual impairment applies to prisoners whose correctable

central visual acuity is not better than 20/200 with corrective lenses in at least one

eye. If a prisoner meets the criteria for placement in DPP for visual impairment

then glasses prescribed for him would be considered an accommodation for

visual impairment. Plaintiff is not in DPP for visual impairment because his

central visual acuity is better than 20/200 with corrective lenses in at least one –

his most recent visual acuity was measured on August 27, 2014 as 20/70 in his

right eye and 20/400 in his left eye.

Prison doctors repeatedly have recommended prescription glasses for

plaintiff to correct his central visual acuity to better than 20/200. They also have

offered plaintiff gray tinted, transition lenses, but plaintiff repeatedly has refused

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the recommended prescription glasses. He instead repeatedly has requested dark

glasses – either “ADA” dark tinted glasses or solar shields (polarized sunglasses

that set over regular prescription glasses). There are no glasses defined as

“ADA” glasses, and neither dark tinted glasses nor solar shields would assist in

correcting plaintiff’s visual acuity.

Doctors Sepulveda, Bright and Kumar have denied plaintiff’s requests for

“ADA” dark tinted glasses or solar shields because plaintiff has been offered

prescription glasses with gray tinted, transition lenses and there is no evidence

that dark tinted glasses or solar shields are medically necessary for plaintiff. In

Dr. Dunlap’s medical opinion, the eye wear decisions of doctors Sepulveda,

Bright and Kumar “were reasonable and appropriate medical judgments” and

“did not adversely affect [plaintiff’s] visual acuity.” Dunlap Decl. at 6. Dr.

Dunlap further opines that plaintiff’s condition “does not meet the criteria for

participation in the [DPP] for visual impairment.” Id.

On plaintiff’s medical record and evidence submitted by defendants, no

reasonable jury could find that doctors Sepulveda, Bright and Kumar were

deliberately indifferent to plaintiff’s medical needs for corrective eye wear. See

Farmer, 511 U.S. at 837. The evidence makes clear that prison doctors offered

plaintiff prescription glasses deemed medically necessary and only denied him

glasses deemed not medically necessary. Plaintiff’s mere disagreement with

prison medical staff as to what type of eye wear is medically necessary to correct

his vision is not enough to establish deliberate indifference or even “give rise to a

§ 1983 claim.” Franklin, 662 F.2d at 1344. Defendants are entitled to summary

judgment on plaintiff’s § 1983 deliberate indifference claim based on his medical

grievance that doctors Sepulveda, Bright and Kumar denied him effective eye

wear. See Celotex, 477 U.S. at 323.

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2

Plaintiff’s motion (dkt. #121) for an order of contempt against defendants

is DENIED as moot and without merit.

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Plaintiff raises a host of new claims in his opposition papers. He is free

to bring the new claims in a new action after exhausting available administrative

remedies as to each claim, but the new claims are not a basis for defeating

judgment in favor of defendants in this protracted case. 

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At minimum, doctors Sepulveda, Bright and Kumar are entitled to

qualified immunity because a reasonable prison doctor could have believed that

his conduct was lawful under the circumstances. See Saucier, 533 U.S. at 201-

02. A reasonable prison doctor could have believed that denying plaintiff’s

request for dark tinted glasses or solar shields where neither would assist in

correcting plaintiff’s visual acuity, and where plaintiff already was offered

prescription glasses with gray tinted, transition lenses, was medically acceptable

and not an excessive risk to plaintiff’s health. 

CONCLUSION

For the foregoing reasons, defendants’ motion for summary judgment 

(dkt. #99) is GRANTED.2

 

The clerk shall enter judgment in favor of defendants and close the file.3

SO ORDERED.

DATED: May 13, 2015 

CHARLES R. BREYER

United States District Judge

G:\PRO-SE\CRB\CR.12\Martin, G.12-3193.msj2.wpd

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