Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_12-cv-00947/USCOURTS-caed-1_12-cv-00947-11/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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UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

ROBERT D. JOHNSON,

Plaintiff,

v.

DR. ULIT, et al.,

Defendants.

Case No. 1:12-cv-00947-SAB-PC

ORDER DISMISSING THIS ACTION FOR 

FAILURE TO STATE A CLAIM UPON 

WHICH RELIEF COULD BE GRANTED

AND THAT THIS ACTION COUNT AS A 

STRIKE UNDER 28 U.S.C. §1915(g).

Plaintiff is a state prisoner proceeding pro se and in forma pauperis pursuant to 42 U.S.C. 

§ 1983. Plaintiff has consented to magistrate judge jurisdiction pursuant to 28 U.S.C. § 636(c).1 

Pending before the Court is Plaintiff‟s April 16, 2015, Third Amended Complaint, filed in 

response to an order dismissing the Second Amended Complaint and granting Plaintiff leave to 

amend.

I.

PROCEDURAL HISTORY

Plaintiff, an inmate in the custody of the California Department of Corrections and 

Rehabilitation (CDCR) at the Substance Abuse Treatment Facility at Corcoran (SATF), brings 

this action against defendant correctional officials employed by the CDCR at SATF. Plaintiff 

names as Defendants the following individuals: Dr. W. Ulit; “Nurse Physician” P. Rouch; Chief 

 

1

Plaintiff filed a consent to proceed before a magistrate judge on June 19, 2012 (ECF No. 9).

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Medical Officer E. Clark; Executive Officer T. Macias; Prison Health Care Manager I. Zamora. 

Plaintiff claims that Defendants were deliberately indifferent to a serious medical condition of 

Plaintiff‟s, in violation of the Eighth Amendment‟s prohibition of cruel and unusual punishment.

This action was initiated by civil complaint filed on June 1, 2012. (ECF No. 1.) Plaintiff 

filed a motion for leave to file an amended complaint, which was granted. On January 14, 2013, 

Plaintiff filed a First Amended Complaint (ECF No. 21.) On November 20, 2013, Plaintiff filed 

a Second Amended Complaint. (ECF No. 26.) On January 15, 2014, Plaintiff filed a Third 

Amended Complaint, which was stricken on January 17, 2014, on the ground that Plaintiff did 

not seek leave of court to amend. (ECF NO. 28.) On March 18, 2015, an order was entered, 

dismissing the January 15, 2014, Second Amended Complaint for failure to state a claim and 

granting Plaintiff leave to file a Third Amended Complaint. (ECF No. 33.) On April 16, 2015, 

Plaintiff filed the Third Amended Complaint that is before the Court.

II.

ALLEGATIONS

Plaintiff‟s allegations stem from his treatment for diabetes. In the order dismissing the 

Second Amended Complaint, the Court noted that Plaintiff is a diabetic and has been insulin 

dependent for over fourteen years. Plaintiff alleges that he has always practiced the “sliding 

scale” method of treatment for his diabetes. Plaintiff alleges that the prison physicians have 

discontinued the sliding scale method of treatment for Plaintiff. In the order dismissing the 

Second Amended Complaint, the Court noted that Plaintiff‟s exhibits attached to his original 

complaint indicated that the decision to discontinue the sliding scale method of treatment was 

based upon professional medical opinion.2 Specifically, page 6 of Plaintiff‟s Exhibits to his 

Complaint includes the response to Plaintiff‟s grievance at the second level of appeal.

You were interviewed on 9/20/10 by P. Rouch, NP regarding your 

sliding scale insulin. You were informed that your blood sugars 

are well controlled without a sliding scale at this time. The nurse 

practitioner is a qualified medical professional that is able to make 

this determination. You may disagree with her decision but it does 

 

2 The Court is not required to accept as true conclusory allegations which are contradicted by documents referred to 

in the complaint. See Lovell v. Chandler, 303 F.3d 1039, 1052 (9th Cir. 2002); Steckman v. Hart Brewing, 143 F.3d 

1293, 1295-96 (9th Cir. 1998).

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not mean that she is wrong. It is not necessary that you agree with 

your treatment. It is necessary that you consent to your treatment. 

Your medical history indicates that you have refused lab draws, 

finger stick blood sugar checks and insulin. These actions impact 

the ability to control your blood sugar levels. Dr. Ulit also 

determined that your blood sugar levels are well controlled without 

a sliding scale. The basis of the decision to deny the reinstatement 

of the sliding scale is that your blood sugar levels are well 

controlled at this time.

(Exhibit to Complaint, p. 6). 

III.

ANALYSIS

Under the Eighth Amendment, the government has an obligation to provide medical care 

to those who are incarcerated. See Lopez v. Smith, 203 F.3d 1122, 1131 (9th Cir. 2000). “In 

order to violate the Eighth Amendment proscription against cruel and unusual punishment, there 

must be “a deliberate indifference to serious medical needs of prisoners.” Id. (quoting Estelle v. 

Gamble, 429 U.S. 97, 104 (1976)). Lopez takes a two-prong approach to evaluating whether 

medical care, or lack thereof, rises to the level of “deliberate indifference.” First, a court must 

examine whether the plaintiff‟s medical needs were serious. Id. Second, a court must determine 

whether “officials intentionally interfered with [the plaintiff‟s] medical treatment.” Id. at 1132.

The Court advised Plaintiff that he could not prevail in a section 1983 action where only 

the quality of treatment is subject to dispute. “A difference of opinion between a physician and 

the prisoner – concerning what medical care is appropriate does not amount to deliberate 

indifference.” Snow v. McDaniel, 681 F.3d 978, 987 (9th Cir. 2012)(citing Sanchez v. Vild, 891 

F.2d 240, 242 (9th Cir. 1989)), overruled in part on other grounds, Peralta v. Dillard, 744 F.3d 

1076, 1082-83 (9th Cir. 2014); Wilhelm v. Rotman, 680 F.3d 1113, 1122-23 (9th Cir. 

2012)(citing Jackson v. McIntosh, 90 F.3d 330, 332 (9th Cir. 1986)). Rather, Plaintiff “must 

show that the course of treatment the doctors chose was medically unacceptable under the 

circumstances and that the defendants chose this course in conscious disregard of an excessive 

risk to [his]health.” Snow, 681 F.3d at 988 (citing Jackson, 90 F.3d at 332)(internal quotation 

marks omitted). 

The Court noted that Plaintiff had not alleged any facts indicating that a medical 

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professional deemed the decision to discontinue the sliding scale method to be medically 

unacceptable. Plaintiff was specifically advised that he must allege facts indicating that each 

individual defendant knew of and disregarded a serious risk to Plaintiff‟s health. 

In the Third Amended Complaint that is before the Court, Plaintiff provides greater 

factual detain regarding his medical condition, but does not allege any facts that link any of the 

named Defendants to conduct that constitutes deliberate indifference. Plaintiff alleges generally 

that “deliberate indifference with malpractice began when Johnson‟s 602 grievance appeal . . . 

having pain, dizziness, loss of breath, body aches.” (Page 1 of narrative attachment to Third

Amended Complaint, lines 5-6.) Plaintiff alleges generally that his “deteriorating health and 

loss of breath” was not a concern of Defendants Clark, Macias and Zamora. (Id. at 1:11.) 

The Third Amended Complaint consists of a narrative interspersed with legal argument. 

Plaintiff sets forth numerous generalized allegations regarding the treatment for his diabetes, but 

fails to specifically allege dates as to when he was seen by particular Defendants. Plaintiff 

contends that he “is not arguing that this is simply a difference of „opinion,‟ as Rouch suggest. 

But that all insulin, especially sliding-scale most importantly out of it all, is a serious need and a 

mandatory daily need.” (Id. 1:14-15.) Plaintiff alleges that he continues to suffer from 

neuropathy that is directly related to Ulit‟s treatment. Plaintiff does not, however, allege that he 

was seen by a medical professional and diagnosed with neuropathy that resulted directly from his 

insulin treatment. Plaintiff is not a medical professional, and may not hold Defendants liable 

because, in his view, he suffers as a result of his treatment regimen.

Plaintiff alleges that, in his view, “all suffering, fear, cell-damage, pain could/should have 

been safely avoided had all Defendants not intentionally interfered with „A.D.A.‟ American 

Diabetes Ass. Safety requirements by Defendants committing themselves in practicing the exact 

opposite protocols that A.D.A. teach. Ulit, Rouch, Clark, Macias, cohearsed [sic] together.” (Id. 

2:13-16.) Plaintiff appears to argue that Defendants‟ violated the American Diabetes 

Association protocols. Plaintiff alleges that Defendant Ulit provided “the exact opposite” of 

what the protocols require. (Id. 3:13.) 

Throughout the Third Amended Complaint, Plaintiff sets forth generalized allegations 

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that Defendants were deliberately indifferent to his serious medical needs, but does not allege 

facts indicating that each Defendant engaged in particular conduct on a particular occasion that 

constituted deliberate indifference, as that term is defined above. Plaintiff alleges that Defendant 

Zamora “knew the extent of Johnson‟s pain, no food, black-out, continual insulin being took 

outside of sliding scale is a one way course of treatment being largely ineffective, wrong, and 

just doesn‟t work, and still declined to do anything.” (Id. 3:21-23.) Plaintiff also refers to the 

effects of his refusal to eat meals. Plaintiff alleges that he “did constantly refuse (and Rouch, 

Clark, Zamora failed to do due-process) between August 2010 through March 2011, due to not 

having enough insulin, was to eat many of meals[sic].” (Id. 6:18-19.) 

Plaintiff alleges that it was “clearly proven” that he had high blood sugar and not enough 

insulin. (Id. 6:24.) Plaintiff contends that “this also shows that Defendants didn‟t care how 

Plaintiff was going to eat nor give due-process in answering this grievance by Johnson.” (Id. 

6:26.) Plaintiff alleges that he couldn‟t eat dinner because he did not have enough insulin to 

protect him. Plaintiff alleges that the only way that he could avoid high blood sugar was to 

throw away food. Plaintiff alleges that “daily finger stick/accu-check showing several meals 

being thrown away on days with high blood sugar.” (Id. 7:2.) 

Plaintiff refers to an accommodation chrono that he requested, which would authorize 

Plaintiff to eat only after his blood sugar was 130 mg or less. The chrono would have authorized 

Plaintiff to store food, which is otherwise not allowed. Plaintiff alleges that Defendants‟ refusal 

to authorize such a chrono constituted deliberate indifference. Plaintiff also alleges that when he 

was transferred to another prison, the physicians there returned him to the sliding scale method 

of treatment. 

The Court dismissed the Second Amended Complaint for failure to state a claim upon 

which relief could be granted. In the March 18, 2015 order, the Court informed Plaintiff of the 

deficiencies in his complaint, and dismissed the complaint on the ground that Plaintiff had failed 

to state a claim upon which relief could be granted. Plaintiff was advised that the central claim 

in his action – that he disagreed with the decision to discontinue the sliding scale method of 

treatment – constituted a difference of opinion with medical professionals and thus did not state a 

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claim for relief. In his Third Amended Complaint, Plaintiff re-states his allegations, albeit at 

greater length and interspersed with legal argument. 

Plaintiff also alleges that the failure to provide him with a medical chrono authorizing 

him to eat when his blood sugar was at a particular level fails to state a claim for relief. As 

noted, when there is a difference of opinion between a prisoner and a prison medical 

professional, Plaintiff “must show that the course of treatment the doctors chose was medically 

unacceptable under the circumstances and that the defendants chose this course in conscious 

disregard of an excessive risk to [his]health.” Snow, 681 F.3d at 988 (citing Jackson, 90 F.3d at 

332)(internal quotation marks omitted). Plaintiff has not alleged any facts here indicating that a 

medical professional determined that the denial of the chrono was medically acceptable under 

the circumstances. That Plaintiff believes it is so does not state a claim for relief. 

Further, even if Plaintiff were to allege facts indicating that officials were deliberately 

indifferent to a serious medical need, he has failed to link any of the named Defendants to 

particular conduct that constitutes deliberate indifference. In the order dismissing the Second

Amended Complaint, Plaintiff was specifically advised that in order to hold each individual 

defendant liable, he must name the individual defendant and explain how that Defendant 

deprived Plaintiff of a protected right. An allegation that Plaintiff has diabetes and that 

Defendants in general have refused to accommodate Plaintiff‟s requests do not state a claim for 

relief. 

Plaintiff has amended his complaint as a matter of right, and has further amended the 

complaint in response to an order that specifically identified the deficiencies in the Second

Amended Complaint. The Court finds that the Third Amended Complaint cannot be cured by 

further amendment. The facts alleged clearly indicate that Plaintiff has been treated for diabetes, 

and that Plaintiff disagrees with the course of that treatment. Plaintiff does not allege any facts 

suggesting that a medical professional deemed Plaintiff‟s course of treatment to be medically 

unacceptable. Throughout his Third Amended Complaint, Plaintiff asserts his belief that his 

Defendants‟ conduct was negligent. Even assuming Defendants erred, an Eighth Amendment 

claim may not be premised on even gross negligence by a physician. Wood v. Housewright, 900 

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F.2d 1332, 1334 (9th Cir. 1990). Allegations indicating medical malpractice do not state a claim 

under the Eighth Amendment. Estelle v. Gamble, 429 U.S. 97, (1977); Snow v. McDaniel, 681 

F.3d 978, 987-88 (9th Cir. 2012), overruled in part on other grounds, Peralta v. Dillard, 744 F.3d 

1076, 1082-83 (9th Cir. 2014); Wilhelm v. Rotman, 680 F.3d 1113, 1122 (9th Cir. 2012)(“The 

deliberate indifference doctrine is limited in scope.”).

Further, Plaintiff was clearly advised that he must link each Defendant with conduct that 

constituted deliberate indifference. Plaintiff was advised that in order to state a claim against an 

individual, he must “name the individual defendant, describe where that defendant is employed 

and in what capacity, and explain how that defendant acted under color of state law. Plaintiff 

should state clearly, in his own words, what happened. Plaintiff must describe what each 

defendant, by name, did to violate the particular right described by Plaintiff.” (ECF No. 33, 

4:10-13.) In the Third Amended Complaint, Plaintiff has failed to link any of the individual 

Defendants to conduct that constitutes deliberate indifference. Throughout the Third Amended 

Complaint, Plaintiff refers to defendants in general, and asserts conclusory allegations against 

medical and correctional officials generally.

Plaintiff also names supervisory Defendants Chief Medical Officer Clark, Executive 

Officer T. Macias and Prison Health Care Manager I. Zamora. Government officials may not be 

held liable for the actions of their subordinates under a theory of respondeat superior. Ashcroft 

v. Iqbal, 556 U.S. 662, 673 (2009). Since a government official cannot be held liable under a 

theory of vicarious liability for section 1983 actions, Plaintiff must plead that the official has 

violated the Constitution through his own individual actions. Id. at 673. In other words, to state 

claim for relief under section 1983, Plaintiff must link each named defendant with some 

affirmative act or omission that demonstrates a violation of Plaintiff‟s federal rights. He has 

failed to do so here. 

IV.

CONCLUSION AND ORDER

Because Plaintiff has not filed a Third Amended Complaint that corrects the deficiencies 

identified by the Court in the order dismissing the First Amended Complaint, the Court dismisses 

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this action with prejudice for failure to state a claim upon which the Court could grant relief. See

Lopez v. Smith, 203 F.3d 1122, 1127 (9th Cir. 2007)(recognizing longstanding rule that leave to 

amend should be granted even if no request to amend was made unless the court determines that 

the pleading could not be cured by the allegation of other facts); See Ferdik v. Bonzelet, 963 

F.2d 1258, 1261 (9th Cir. 1992)(dismissal with prejudice upheld where court had instructed 

plaintiff regarding deficiencies in prior order dismissing claim with leave to amend). 

Accordingly, IT IS HEREBY ORDERED that:

1. This action is dismissed for failure to state a claim upon which relief can be granted; 

2. This action counts as a strike under 18 U.S.C. § 1915(g); and

3. The Clerk of Court is directed to close this case. 

IT IS SO ORDERED.

Dated: December 23, 2015 

UNITED STATES MAGISTRATE JUDGE

 

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