Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_04-cv-02291/USCOURTS-caed-2_04-cv-02291-12/pdf.json

Nature of Suit Code: 550
Nature of Suit: Prisoner - Civil Rights (U.S. defendant)
Cause of Action: 42:1983 Prisoner Civil Rights

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IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

NORMAN WASHINGTON WILLIAMS,

Plaintiff, No. CIV S-04-2291 FCD KJM P

vs.

RICHARD SANDHAM, et al.,

Defendants. FINDINGS & RECOMMENDATIONS

 /

Plaintiff is a California prisoner proceeding pro se with an action for violation of

civil rights under 42 U.S.C. § 1983. Defendant Rohlfing’s May 19, 2006 motion for summary

judgment is before the court. 

I. Summary Judgment Standard

Summary judgment is appropriate when it is demonstrated that there exists “no

genuine issue as to any material fact and that the moving party is entitled to a judgment as a

matter of law.” Fed. R. Civ. P. 56(c).

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Under summary judgment practice, the moving party 

always bears the initial responsibility of informing the district court

of the basis for its motion, and identifying those portions of “the

pleadings, depositions, answers to interrogatories, and admissions

on file, together with the affidavits, if any,” which it believes

demonstrate the absence of a genuine issue of material fact.

Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986) (quoting Fed. R. Civ. P. 56(c)). “[W]here the

nonmoving party will bear the burden of proof at trial on a dispositive issue, a summary

judgment motion may properly be made in reliance solely on the ‘pleadings, depositions, answers

to interrogatories, and admissions on file.’” Id. Indeed, summary judgment should be entered,

after adequate time for discovery and upon motion, against a party who fails to make a showing

sufficient to establish the existence of an element essential to that party’s case, and on which that

party will bear the burden of proof at trial. See id. at 322. “[A] complete failure of proof

concerning an essential element of the nonmoving party’s case necessarily renders all other facts

immaterial.” Id. In such a circumstance, summary judgment should be granted, “so long as

whatever is before the district court demonstrates that the standard for entry of summary

judgment, as set forth in Rule 56(c), is satisfied.” Id. at 323.

If the moving party meets its initial responsibility, the burden then shifts to the

opposing party to establish that a genuine issue as to any material fact actually does exist. See

Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986). In attempting to

establish the existence of this factual dispute, the opposing party may not rely upon the

allegations or denials of its pleadings but is required to tender evidence of specific facts in the

form of affidavits, and/or admissible discovery material, in support of its contention that the

dispute exists. See Fed. R. Civ. P. 56(e); Matsushita, 475 U.S. at 586 n.11. The opposing party

must demonstrate that the fact in contention is material, i.e., a fact that might affect the outcome

of the suit under the governing law, see Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248

(1986); T.W. Elec. Serv., Inc. v. Pacific Elec. Contractors Ass’n, 809 F.2d 626, 630 (9th Cir.

1987), and that the dispute is genuine, i.e., the evidence is such that a reasonable jury could

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return a verdict for the nonmoving party, see Wool v. Tandem Computers, Inc., 818 F.2d 1433,

1436 (9th Cir. 1987).

In the endeavor to establish the existence of a factual dispute, the opposing party

need not establish a material issue of fact conclusively in its favor. It is sufficient that “the

claimed factual dispute be shown to require a jury or judge to resolve the parties’ differing

versions of the truth at trial.” T.W. Elec. Serv., 809 F.2d at 631. Thus, the “purpose of summary

judgment is to ‘pierce the pleadings and to assess the proof in order to see whether there is a

genuine need for trial.’” Matsushita, 475 U.S. at 587 (quoting Fed. R. Civ. P. 56(e) advisory

committee’s note on 1963 amendments).

In resolving the summary judgment motion, the court examines the pleadings,

depositions, answers to interrogatories, and admissions on file, together with the affidavits, if

any. Fed. R. Civ. P. 56(c). The evidence of the opposing party is to be believed. See Anderson,

477 U.S. at 255. All reasonable inferences that may be drawn from the facts placed before the

court must be drawn in favor of the opposing party. See Matsushita, 475 U.S. at 587. 

Nevertheless, inferences are not drawn out of the air, and it is the opposing party’s obligation to

produce a factual predicate from which the inference may be drawn. See Richards v. Nielsen

Freight Lines, 602 F. Supp. 1224, 1244-45 (E.D. Cal. 1985), aff’d, 810 F.2d 898, 902 (9th Cir.

1987). Finally, to demonstrate a genuine issue, the opposing party “must do more than simply

show that there is some metaphysical doubt as to the material facts . . . . Where the record taken

as a whole could not lead a rational trier of fact to find for the nonmoving party, there is no

‘genuine issue for trial.’” Matsushita, 475 U.S. at 587 (citation omitted).

On April 28, 2005, the court advised plaintiff of the requirements for opposing a

motion pursuant to Rule 56 of the Federal Rules of Civil Procedure. See Rand v. Rowland, 154

F.3d 952, 957 (9th Cir. 1998) (en banc), cert. denied, 527 U.S. 1035 (1999); Klingele v.

Eikenberry, 849 F.2d 409 (9th Cir. 1988).

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 Plaintiff and defendant Rohlfing ask that the court take judicial notice of plaintiff’s

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complaint. Opp’n at 4 & Defs.’ Mot. for Summ. J., Req. for Judicial Notice. However, neither

party indicates why the court should take judicial notice. The request for judicial notice is

denied. The court notes, however, that plaintiff’s complaint is signed under the penalty of

perjury. It is proper for the court to consider plaintiff’s complaint, as it does here, as an affidavit

for purposes of resolving defendant’s motion for summary judgment. See Schroeder v.

McDonald, 55 F.3d 454, 460 (9th Cir. 1995) (“A verified complaint may be used as an opposing

affidavit under Rule 56.”). 

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II. Plaintiff’s Allegations Against Defendant Rohlfing

In his complaint, plaintiff alleges that in July of 2000, he had his appendix

removed. One month after returning to his prison housing unit, plaintiff was still having

“problems” with his stomach. Plaintiff complained to defendant Rohlfing, a doctor, and others. 

In response to plaintiff’s complaint, Rohlfing told plaintiff that his pain “is like a knee or a back

pain which will not goes aways [sic] . . . .” Compl. at 3. Over the course of the next five

months, plaintiff was in a lot of pain, lost 50 pounds and eventually was taken back to the

hospital in February 2001. At the hospital, plaintiff had blood transfusions and surgery due to the

fact that he had an infection caused by his ruptured appendix. Plaintiff concludes that Dr.

Rohlfing, among others, “deliberately deny [sic] and refused me medical attention on numerous

occasions.” Id.1

On April 15, 2005, the court found that plaintiff’s complaint states a claim upon

which relief may be granted against defendant Rohlfing under the Eighth Amendment. See

Docket No. 4.

III. Standard For Eighth Amendment Denial Of Medical Care Claim

The Eighth Amendment’s prohibition of cruel and unusual punishment extends to

medical care of prison inmates. Estelle v. Gamble, 429 U.S. 97, 104-05 (1976). In order to state

a section 1983 claim for violation of the Eighth Amendment based on inadequate medical care, a

prison inmate must allege “acts or omissions sufficiently harmful to evidence deliberate

indifference to serious medical needs.” Id. at 106. The nature of a defendant's responses must be

such that the defendant purposefully ignores or fails to respond to a prisoner's pain or possible

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medical need in order for “deliberate indifference” to be established. McGuckin v. Smith, 974

F.2d 1050, 1060 (9th Cir. 1992), overruled in part on other grounds, WMX Technologies, Inc. v.

Miller, 104 F.3d 1133, 1136 (9th Cir. 1997). Deliberate indifference may occur when prison

officials deny, delay, or intentionally interfere with medical treatment, or may be demonstrated

by the way in which prison officials provide medical care. Id. at 1059-60. However, a showing

of merely inadvertent or even negligent medical care is not enough to establish a constitutional

violation. Estelle, 429 U.S. at 105-06; Frost v. Agnos, 152 F.3d 1124, 1130 (9th Cir. 1998). A

difference of opinion about the proper course of treatment is not deliberate indifference nor does

a dispute between a prisoner and prison officials over the necessity for or extent of medical 

treatment amount to a constitutional violation. See, e.g., Toguchi v. Chung, 391 F.3d 1051, 1058

(9th Cir. 2004); Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir. 1989). 

IV. Defendant’s Arguments And Analysis

Among other things, defendant Rohlfing argues that he is entitled to immunity

from suit. Government officials performing discretionary functions generally are shielded from

liability for civil damages insofar as their conduct does not violate clearly established statutory or

constitutional rights of which a reasonable person would have known. Harlow v. Fitzgerald, 457

U.S. 800, 818 (1982). In determining whether a governmental officer is immune from suit based

on the doctrine of qualified immunity, the court must answer two questions. The first is, taken in

the light most favorable to the party asserting the injury, do the facts show the officer's conduct

violated a constitutional right? Saucier v. Katz, 533 U.S. 194, 201 (2001) (also explaining the

importance of resolving qualified immunity questions “at the earliest possible stage in

litigation”). A negative answer ends the analysis, with qualified immunity protecting the

defendant from liability. Id. If a constitutional violation occurred, a court must further inquire

“whether the right was clearly established.” Id. “If the law did not put the [defendant] on notice

that [his] conduct would be clearly unlawful, summary judgment based on qualified immunity is

appropriate.” Id. at 202. 

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Defendant Rohlfing argues, among other things, that plaintiff cannot present

evidence indicating Rohlfing was deliberately indifferent to plaintiff’s serious medical needs and,

therefore, he is entitled to qualified immunity. Mot. at 17-18.

Defendant Rohlfing presents evidence in support of his motion, most notably his

own affidavit. In the affidavit Rohlfing indicates the days he treated plaintiff between October

16, 2000 and February 4, 2001, which was after plaintiff received abdominal surgery in July 2000

and shortly after plaintiff began again to complain of ongoing problems. Rohlfing Decl. at 2:14-

5:21. Rohlfing describes the July 2000 surgery, with which he was not involved, as follows:

On July 16, 2000, [plaintiff] was treated in the Correctional

Treatment clinic at High Desert State Prison for complaints of

abdominal pain. On July 19, 2000 [plaintiff] continued to

complain of abdominal pain; therefore, Dr. Rhee ordered

[plaintiff’s] transfer from High Desert State Prison to Lassen

Community Hospital for further medical treatment. On July 20,

2000, [plaintiff] underwent surgery to remove a ruptured Meckel’s

diverticulum. . . . I understand that [plaintiff] claims that he was

treated . . . for a ruptured appendix, however, [plaintiff’s] appendix

did not rupture. Rather, [plaintiff’s] appendix was removed

secondary to the diverticulectomy in order to reduce the risk of

post-operative infection. This is standard medical procedure.

[Plaintiff] remained hospitalized at Lassen Community Hospital

until July 27, 2000. 

Id. ¶ 3.

Rohlfing indicates he did treat plaintiff on multiple occasions following surgery. 

Specifically, he indicates he examined plaintiff on October 16, 2000 for complaints of abdominal

pain, after which he prescribed Tagamet and scheduled plaintiff for a followup. Id. ¶ 4. 

Rohlfing next examined plaintiff on November 13, 2000, for abdominal and lower

back pain. During this session he diagnosed plaintiff with h. pylori gastritis, a bacterial

weakening of the stomach lining resulting in irritation. Rohlfing ordered tests to confirm the

diagnosis and prescribed Mylanta and Tylenol, the latter for the back pain. Id. ¶ 5. Rohlfing saw

plaintiff again on November 16, 2000, because plaintiff said he continued to be in pain. An

exam reconfirmed Rohlfing’s suspicions of gastritis and so Rohlfing scheduled plaintiff to come

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back the next day when test results were due. Id. ¶ 6. On the 17th, when the test results

confirmed the gastritis diagnosis, Rohlfing started plaintiff immediately on four separate

prescription medications and scheduled him for a two week followup. Id. ¶ 7. At the followup

on November 28, 2000, Rohlfing examined plaintiff, who said he felt better. Rohlfing then

prescribed Zantac to “provide additional relief,” and scheduled plaintiff for another four week

followup. Id. ¶ 8. Approximately one week later, before the scheduled followup and based on a

“man down call,” plaintiff was brought to the clinic where Rohlfing was working. Plaintiff

complained of constant abdominal and lower back pain. Rohlfing was unable to identify any

observable objective cause for plaintiff’s complaint, so he ordered a complete blood count and

urinalysis test. He also prescribed Tagamet, Tylenol and Robaxin for the stomach and back pain. 

Id. ¶ 9. When plaintiff’s blood and urinalysis tests came back within normal limits Rohfling

determined, in his medical opinion, “that [plaintiff] was most likely continuing to experience

residual pain associated with his surgery. There was no medical indication that [plaintiff] was

suffering from a disease process or infection . . . “ Id. ¶ 10. 

Between December 5, 2000 and January 30, 2001, Rohlfing was not involved in

treating plaintiff. Id. ¶ 11.

On January 30, 2001, Rohlfing again saw plaintiff, who was complaining of

abdominal pain and gastrointestinal bleeding. Rohlfing examined him but was unable to

determine the cause of his discomfort. During six days of treatment, no other medical

professional at the prison was able to diagnose plaintiff’s condition. Id. ¶ 12.

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On February 4, 2001, plaintiff was transferred to Northern Nevada Medical Center for

consultations. There, according to Rohlfing, 

[i]t was determined that [plaintiff] had an obstruction of the

terminal ileum. The terminal ileum is the most distal portion of the

small intestine and is important because it can be affected by

numerous infections or inflammatory conditions. [Plaintiff]

underwent an ileocecectomy, a resection of the small intestine and

cecum, to remove the obstruction. Following the procedure,

specimens of [plaintiff’s] terminal ileum and colon were sent to

pathology where it was determined that the inflammation found in

the specimens was consistent with Crohn’s disease. 

Id. ¶ 13 & Ex. A.

Rohlfing goes on to explain:

Crohn’s disease is a chronic inflammatory disease that can affect

any portion of the digestive tract. Crohn’s disease is extremely

difficult to diagnose because its symptoms mimic the symptoms of

other, more common diseases. Furthermore, Crohn’s disease is

difficult to diagnose because the symptoms come and go. Thus, it

is not uncommon for a patient suffering from Crohn’s disease to

seemingly respond in a positive manner to treatment for a medical

condition with symptoms similar to Crohn’s disease only to have

symptoms recur. The symptoms of Crohn’s disease are very

similar to the symptoms of h. pylori gastritis. I believe that this

explains why [plaintiff] responded positively to the treatment for h.

pylori gastritis only to experience similar complaints one week

later. It is impossible to ascertain when the symptoms of Crohn’s

disease will appear in a patient affected with the disease. There is

no cure for Crohn’s disease; therefore, a person affected with

Crohn’s disease will experience the symptoms of the disease for

life. Often, the only way to diagnose Crohn’s disease is to have

specimens of the digestive tract tested by pathology.

Based upon my review of [plaintiff’s] medical records, it is my

medical opinion that plaintiff suffers from Crohn’s disease. In my

medical opinion, there is no other explanation for plaintiff’s

medical condition. 

Id. ¶¶ 14-15.

In his opposition, plaintiff generally agrees with defendant Rohlfing’s summary of

Rohlfing’s treatment of plaintiff. In particular, he does not dispute that he received regular

examinations and treatment in response to his complaints. Opp’n at 158-170. Plaintiff suggests,

mostly through the use of rhetorical questions, that defendant Rohlfing should have done more,

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 Exhibit D attached to defendant Rohlfing’s declaration is a collection of medical 2

records from plaintiff’s February 2001 stay at the Northern Nevada Medical Center. A review of

these documents indicates that several physicians had a difficult time determining the cause of

plaintiff’s abdominal problems and the role that Crohn’s disease played in those problems. 

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or something different than he did, and this is why Rohlfing was deliberately indifferent to

plaintiff’s serious medical needs. Id. Plaintiff’s primary complaint, at this stage, appears to be

that Rohlfing’s indifference is illustrated by his failure to even check for Crohn’s disease – which

plaintiff’s says is a “common” disease – earlier on. But plaintiff offers no evidence to support

his position, and thus fails to establish a factual dispute sufficient to overcome summary

judgment. In fact, evidence in the record contradicts his argument, as does defendant Rohfling’s 2

expert opinion regarding the difficulty of diagnosing Crohn’s disease. Rodriguez v. Pacificare,

980 F.2d 1014, 1019 (5th Cir. 1993) (nothing prevents a party such as a medical doctor from

serving as his own expert witness at summary judgment). Plaintiff disagrees with the treatment

he was provided, but, as noted above, this is not enough to suggest deliberate indifference. 

Toguchi, 391 F.3d at 1058. Rohlfing in effect admits that he initially misdiagnosed plaintiff, but

this is not enough to establish a genuine issue of material fact as to whether Rohlfing was

deliberately indifferent. Estelle, 429 U.S. at 105-06. Plaintiff fails to point to anything

indicating Rohlfing purposefully ignored or failed to respond to plaintiff’s pain or possible

medical need, see McGuckin, 974 F.2d at 1060, or anything suggesting Rohlfing intended

plaintiff harm.

For these reasons, the court finds that there are no facts before the court that could

lead a reasonable factfinder to conclude that defendant Rohlfing violated plaintiff’s Eighth

Amendment rights. Therefore, Rohlfing is entitled to immunity from suit under the doctrine of

qualified immunity. In light of the fact that the court is recommending that defendant Rohlfing

be granted summary judgment based on qualified immunity, the court need not address the other

arguments presented in his motion for summary judgment.

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In accordance with the above, IT IS HEREBY RECOMMENDED that:

1. Defendant Rohlfing’s May 19, 2006 motion for summary judgment be granted;

and

2. Defendant Rohlfing be dismissed from this action.

These findings and recommendations are submitted to the United States District

Judge assigned to the case, pursuant to the provisions of 28 U.S.C. § 636(b)(l). Within twenty

days after being served with these findings and recommendations, any party may file written

objections with the court and serve a copy on all parties. Such a document should be captioned 

“Objections to Magistrate Judge’s Findings and Recommendations.” Any reply to the objections

shall be served and filed within ten days after service of the objections. The parties are advised

that failure to file objections within the specified time may waive the right to appeal the District

Court’s order. Martinez v. Ylst, 951 F.2d 1153 (9th Cir. 1991). 

DATED: February 13, 2007.

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will2291.57

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