Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_04-cv-02084/USCOURTS-cand-3_04-cv-02084-0/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

NORTHERN DISTRICT OF CALIFORNIA

ROGER ELLIS ANDERSON,

Plaintiff,

 v.

Warden CADEN; et al.,

Defendants.

 /

No. C 04-2084 SI (pr)

ORDER GRANTING DEFENDANTS’

MOTION FOR SUMMARY

JUDGMENT

INTRODUCTION

Roger Anderson, an inmate at Salinas Valley State Prison, filed this pro se civil rights

action under 42 U.S.C. § 1983 concerning the allegedly improper administration of antipsychotic

medications. Defendants now move for summary judgment on the grounds that the undisputed

facts show that they are entitled to judgment as a matter of law on Anderson's due process claim

and on their qualified immunity defense. For the reasons discussed below, the motion for

summary judgment will be granted.

BACKGROUND

This action concerns the administration of antipsychotic medications to Anderson on

November 7, 2003 at Salinas Valley State Prison. The only two defendants remaining in this

action are two correctional officers who physically restrained Anderson while medical staff

administered the antipsychotic medication that day. Unless otherwise noted, the following facts

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In Keyhea v. Rushen, 178 Cal. App. 3d 526 (Cal. App. 1986), the state appellate court

"upheld a consent decree affirming the right of state prisoners to refuse antipsychotic

medications except under certain limited circumstances." In re Qawi, 32 Cal. 4th 1, 21 (Cal.

2004). 

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are undisputed.

Anderson was an inmate and defendants Hildreth and Baker were correctional officers

at Salinas Valley State Prison on November 7, 2003.

Under California law, the Keyhea procedures govern the involuntary administration of

antipsychotic medications.

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 The Keyhea procedures are set out in the October 31, 1986 Order

Granting Plaintiffs' Motion For Clarification And Modification of Injunction And Permanent

Injunction filed in Keyhea v. Rushen, Solano County Superior Court Case No. 67432. See

http://www.oah.dgs.ca.gov/laws/keyhea.asp. The Keyhea injunction provides procedural

requirements and substantive standards for medication of different durations. In order for an

individual to be involuntarily medicated in excess of three days, a notice of certification must

be signed by both the chief psychiatrist at the treatment facility and a physician or psychologist

who participated in the evaluation of the prisoner, and it must be delivered to the prisoner. The

notice of certification permits involuntary medication of the prisoner for no more than 21

additional days, and the prisoner is entitled to a certification review hearing within 10 days of

the initial involuntary medication. Involuntarily medication more than 24 days after the initial

medication requires a court order.

Before any of the events complained of in this action occurred, Anderson had been under

another Keyhea order for involuntary medication. The earlier Keyhea order expired in May

2003, about five months before the events occurred that form the basis for the present complaint.

On October 30, 2003, Anderson was admitted to the Correctional Treatment Center

("CTC") at Salinas Valley to initiate the Keyhea process. Psychologist A. Thompson wrote a

lengthy progress report about his decision to send Anderson to the CTC for the Keyhea process.

Id. Dr. Thompson wrote that (a) Anderson had attacked another inmate (apparently without

provocation) by trying to hit him and then grabbing him by the neck to choke him, (b)

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Anderson's behavior had become increasingly aggressive and psychotic, and his paranoid

delusions had become more pervasive, (c) Anderson's behavior seemed "to be directly linked to

his mental illness," and (d) Anderson had been refusing to take his medications on a consistent

basis since his previous Keyhea order had expired in May 2003. Morelos Decl., Exh. 1. Dr.

Thompson wrote that Anderson was being sent to the CTC to be stabilized and to have the

Keyhea procedure initiated; Anderson was "unable to program on this EOP [extended outpatient

placement] yard due to his hostile and aggressive behaviors towards others." Id. at 4. 

Dr. Tashavi admitted Anderson to the CTC and wrote in the interdisciplinary progress

notes dated October 30, 2003, that he would "admit to CTC - SC & begin Keyhea meds."

Morelos Decl., Exhs. 2 and 3. Anderson was admitted to the CTC with an admitting diagnosis

of "psychosis." Morelos Decl., Exh. 3.

Clinical staff at the CTC prepared a "Notice of Certification" to medicate Anderson.

McElroy Decl., Exh. 1. The form Notice was signed by Dr. Tashavi as the evaluating

physician/psychologist and by the chief psychiatrist (or designee) on October 30, 2003. The

Notice stated that based on an evaluation of Anderson, the authors concluded that Anderson was,

as a result of a mental disorder, a danger to others. See McElroy Decl., Exh. 1. In the portion

of the Notice that was for the facts that formed the basis of the allegation, Dr. Tashavi wrote

"Patient has poor insight into his mental illness. Denies having any psychiatric problems; he is

paranoid. He recently assaulted another inmate without provocation. He has been noncompliant

with his meds." Id. The Notice stated that the inmate had been notified of the evaluation and

had been advised of but unable or unwilling to accept medication on a voluntary basis. The

doctors signed on the form that they certified "this inmate to receive involuntary medication

related to the mental disorder for no more than twenty-one (21) days beginning the 30th day of

10/03 at 12:00." Id.

The involuntary medication of Anderson began at 12:00 on October 30, 2003, under the

supervision of staff psychiatrist W. H. Welcher. McElroy Decl., Exh. 3. Dr. Welcher's report

prepared November 5, 2003 discussed the commencement of involuntary medication, listed the

psychiatric diagnosis for Anderson as "schizophrenia, acute and chronic" and described the basis

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for the determination that he was a danger to others. Id. Dr. Welcher also noted that

"[o]bviously his erratic and inconsistent use of psychiatric medications has caused a worsening

of his condition until the point where he has become dangerous to others and now has a fullblown psychotic clinical picture." Id. 

The Notice of Certification was delivered to Anderson four days later by a social worker

on November 3, 2003. McElroy Decl., Exh. 1. She also filled out a form dated November 3,

2003 in which she checked off boxes that stated she had informed Anderson of the various rights

he had in connection with the involuntary medication process. McElroy Decl., Exh. 2. 

Anderson apparently took the ordered medication without incident until November 7,

2003. 

On November 7, a nurse demanded that Anderson take his medication. Anderson refused,

saying that his 21-day Keyhea certification had terminated and that he had a right to an

administrative hearing before he could be involuntarily medicated. A correctional officer,

defendant Hildreth, also ordered him to take his medication. Anderson again refused and stated

that he had a right to a hearing, to which Hildreth responded that he was not concerned with

regulations. Several other officers, including defendant Baker, then entered Anderson’s cell and

held him down while he was given an injection of medication.

On December 2, 2003, an administrative judge issued an order that Anderson was a

danger to others as a result of a mental defect or disorder, and he could therefore be treated

involuntarily with antipsychotic medications for a period of 180 days. Defendants' Exh. 1.

VENUE AND JURISDICTION

Venue is proper in the Northern District of California because the events or omissions

giving rise to the claims occurred in Monterey County, which is located within the Northern

District. See 28 U.S.C. §§ 84, 1391(b). This Court has federal question jurisdiction over this

action brought under 42 U.S.C. § 1983. See 28 U.S.C. § 1331.

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LEGAL STANDARD FOR SUMMARY JUDGMENT

Summary judgment is proper where the pleadings, discovery and affidavits show that

there is "no genuine issue as to any material fact and [that] the moving party is entitled to

judgment as a matter of law." Fed. R. Civ. P. 56(c). A court will grant summary judgment

“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 . . .

since a complete failure of proof concerning an essential element of the nonmoving party’s case

necessarily renders all other facts immaterial.” Celotex Corp. v. Catrett, 477 U.S. 317, 322-23

(1986). A fact is material if it might affect the outcome of the lawsuit under governing law, and

a dispute about such a material fact is genuine “if the evidence is such that a reasonable jury

could return a verdict for the nonmoving party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242,

248 (1986). 

Generally, when a party challenges the merits of the opponent's claim, the moving party

bears the initial burden of identifying those portions of the record which demonstrate the absence

of a genuine issue of material fact. The burden then shifts to the nonmoving party to "go beyond

the pleadings, and by his own affidavits, or by the 'depositions, answers to interrogatories, or

admissions on file,' designate 'specific facts showing that there is a genuine issue for trial.'"

Celotex, 477 U.S. at 324 (citations omitted).

Where, as is the situation with defendants' qualified immunity defense, the moving party

bears the burden of proof at trial and must come forward with evidence which would entitle the

defendant to a directed verdict if the evidence went uncontroverted at trial. See Houghton v.

Smith, 965 F.2d 1532, 1536 (9th Cir. 1992). A defendant must establish the absence of a

genuine issue of fact on each issue material to the affirmative defense. Id. at 1537; see also

Anderson v. Liberty Lobby, Inc., 477 U.S. at 248. When the defendant-movant has come

forward with this evidence, the burden shifts to the non-movant to set forth specific facts

showing the existence of a genuine issue of fact on the defense.

A verified complaint may be used as an opposing affidavit under Rule 56, as long as it

is based on personal knowledge and sets forth specific facts admissible in evidence. See

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Schroeder v. McDonald, 55 F.3d 454, 460 & nn.10-11 (9th Cir. 1995) (treating plaintiff's

verified complaint as opposing affidavit where, even though verification not in conformity with

28 U.S.C. § 1746, plaintiff stated under penalty of perjury that contents were true and correct,

and allegations were not based purely on his belief but on his personal knowledge). Anderson's

verified complaint is considered in deciding the pending motion.

The court's function on a summary judgment motion is not to make credibility

determinations or weigh conflicting evidence with respect to a disputed material fact. See T.W.

Elec. Serv. v. Pacific Elec. Contractors Ass'n, 809 F.2d 626, 630 (9th Cir. 1987). The evidence

must be viewed in the light most favorable to the nonmoving party, and the inferences to be

drawn from the facts must be viewed in a light most favorable to the nonmoving party. See id.

at 631.

DISCUSSION

A. Involuntary Medication

Both California law and the Due Process Clause itself confer upon an inmate a right to

be free from the arbitrary administration of antipsychotic medication. See Keyhea injunction,

supra; Washington v. Harper, 494 U.S. 210, 221-22 (1989). However, "given the requirements

of the prison environment, the Due Process Clause permits the State to treat a prison inmate who

has a serious mental illness with antipsychotic drugs against his will, if the inmate is dangerous

to himself or others and the treatment is in the inmate's medical interest." Id. at 227. The

decision whether to medicate an inmate against his will satisfies due process when facilitated

by an administrative review by medical personnel not then involved in the inmate's treatment.

Id. at 233. Due process does not require a judicial hearing before an inmate may be involuntarily

medicated, does not require that the hearing be conducted in accordance with the rules of

evidence, and does not require a "clear, cogent, and convincing" standard of proof. Id. at 228,

235. Due process is satisfied if the inmate is provided with notice, the right to be present at an

adversarial hearing, and the right to present and cross-examine witnesses. Id. at 235.

Appointment of counsel is not required; the provision of a lay adviser who understands the

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2The court requested defendants to address in their reply brief "whether there is any class

action consent decree, judgment or order in a federal court case that requires compliance with

the state-mandated Keyhea procedures or sets forth some other procedural steps that must be

followed in administering involuntary medications to California prisoners at Salinas Valley State

Prison." Aug. 7, 2006 Order, pp. 1-2. Defendants did not file a reply brief – perhaps because

plaintiff did not file an opposition to the motion – so the court does not have the benefit of this

potentially helpful information. 

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psychiatric issues involved is sufficient protection. Id. at 236.

Harper's procedural protections may not apply in an emergency situation. In Kulas v.

Valdez, 159 F.3d 453, 456 (9th Cir. 1998), cert. denied, 528 U.S. 1167 (2000), the court

appeared to agree that an emergency could excuse compliance with notice and a pre-medication

hearing, even though the facts of the case before it did not present an actual emergency: "There

is no evidence that Kulas posed such an imminent and serious danger to himself or others that

the minimal procedural requirements of Harper – notice and the right to be present at and

participate in a hearing – could not be met." Kulas, 159 F.3d at 456; see also Hogan v. Carter,

85 F.3d 1113, 1116-17 (4th Cir.), cert. denied, 519 U.S. 974 (1996) (Harper procedural

protections do not apply in emergency). 

California's Keyhea procedures differ from those approved in Harper in that the

medication starts before the hearing occurs. Under the Keyhea procedures, doctors decide that

medication is medically necessary and start the medication, with the hearing scheduled to be held

within 10 days. See McElroy Decl., Exh. 2 (patient is notified "you have been certified to

receive involuntary antipsychotic medications for a period of up to 21 days" and "you have a

right to a certification review hearing. The hearing will be held within 10 days of the initial

involuntary medication (unless you request judicial review) to determine whether probable cause

exists for the certification.") Although the Keyhea injunction has governed the administration

of antipsychotic medications for two decades in California, there does not appear to be any

published federal court case upholding or discussing its constitutionality.2 This court need not

decide the constitutionality of the Keyhea process, however, because defendants contend and

plaintiff does not dispute that this case involved an emergency that permitted medication to be

commenced without the Harper procedural safeguards. See Kulas, 259 F.3d at 456. 

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Anderson does not dispute defendants' evidence that the involuntary medication was

needed as an emergency measure because Anderson posed an imminent danger to others. It is

undisputed that the Keyhea procedure was started and medication administered after Dr.

Thompson evaluated Anderson and wrote of the incident where Anderson attacked another

inmate: 

Mr. Anderson was noticed by custody on yard to be pacing about 15' away from the

mental health bldg. As an inmate walked by pt, pt struck out @ the inmate with his fist

without any noticeable provocation by the inmate. The inmate had just retrieved his

photo identification card from custody. The inmate turned away, avoiding being struck

by pt & asked why pt struck out @ him. The two then turned toward each other & pt was

able to grab the inmate by the neck, trying to choke inmate. Custody took pt to ground

& pt released inmate.

Morelos Decl., Exh. 1. The incident was just the latest of several that showed increasingly

aggressive acts by Anderson that could provoke violent reactions by other inmates and

correctional staff. See id. at 3-4. Dr. Thompson also wrote that Anderson had become

increasingly aggressive and his psychotic symptoms, including paranoid delusions, had

escalated. The undisputed evidence shows that Anderson posed an imminent danger to others

as a result of his mental illness. Under Kulas, the urgency and immediacy of Anderson's threat

to other persons as a result of his mental illness allowed the commencement of the medication

of Anderson without a pre-medication hearing. Anderson received procedural protections,

although the review of the decision occurred after (rather than before) the medication began.

A pre-medication hearing under the circumstances might well have required that Anderson be

physically restrained for the safety of all around him until the hearing was held, but such

restraints also "can have serious physical side effects when used on a resisting inmate, . . . as

well as leaving the staff at risk of injury while putting the restraints on or tending to the inmate

who is in them." Harper, 494 U.S. at 227. Under the circumstances, the decision to medicate

Anderson before the hearing occurred did not violate his right to due process.

Anderson's complaint asserted that his medication was improper and his due process

rights were violated because the 21-day Keyhea order had expired. Anderson's math is wrong.

He does not dispute that the Notice of Certification (i.e., the document that authorized the

involuntary medication for 21 days starting on October 30, 2003) was signed on October 30,

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2003. Twenty-one days had not passed between October 30 and November 7, 2003, which was

the date on which Anderson claimed that he was impermissibly medicated and the constitutional

violation occurred. To the extent Anderson is referring to the expiration of the earlier Keyhea

order, the expiration of that order in May 2003 is irrelevant because he was not being medicated

pursuant to that order and instead was being medicated pursuant to the Notice of Certification

dated October 30, 2003.

On the undisputed facts, Anderson's medication was in compliance with the procedural

requirements of the Keyhea injunction. The Notice of Certification tracks the Keyhea

injunction's form language and provides all the information needed to administer involuntary

medications for 21 days. The Notice and an advisement of the inmate's rights were delivered

to Anderson within four days, also in compliance with the Keyhea injunction. 

On the undisputed facts, Anderson's medication met the substantive criteria for

medication under Keyhea and Harper. Dr. Tashavi and the chief psychiatrist or his designee

concluded that Anderson suffered a harmful mental disorder and was a danger to others. "[T]he

decision, if made by a professional, is presumptively valid; liability may be imposed only when

the decision by the professional is such a substantial departure from accepted professional

judgment, practice, or standards as to demonstrate that the person responsible actually did not

base the decision on such a judgment." Youngberg v. Romeo, 457 U.S. 307, 323 (1982).

Although Youngberg involved decisions for the appropriate training of institutionalized mentally

retarded persons, it does reflect the Court's deference to professional medical opinions. Indeed,

Harper itself acknowledged that medical personnel were better-suited to deciding the treatment

issues than were judicial officers: "We cannot make the facile assumption that the patient's

intentions, or a substituted judgment approximating those intentions, can be determined in a

single judicial hearing apart from the realities of frequent and ongoing clinical observation by

medical professionals." Harper, 494 U.S. at 231-32; see also id. at 230-31 n. 12 (Court should

not discount the "benefits of these [antipsychotic] drugs, and the deference that is owed to

medical professionals who have the full time responsibility of caring for mentally ill inmates like

respondent and who possess, as courts do not, the requisite knowledge and expertise to

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determine whether the drugs should be used in an individual case.") 

Anderson does not demonstrate a triable issue of fact that the doctors who signed the

Notice of Certification failed to comply with due process requirements. He does not present

probative evidence which calls into question the presumptive reliability of the doctors' decisions.

On the submissions of the parties, Anderson's constitutional rights were not violated by the

decision to medicate him involuntarily.

The only defendants remaining in this case are two correctional officers who restrained

Anderson so that a nurse could inject the medication into him on November 7, when he resisted

the injection. There is no evidence that they played any role in the decision-making process

about whether to medicate Anderson, but simply assisted in restraining him so that the medical

decision made by medical staff could be implemented by medical staff. While it is far from

certain that the correctional officers would be liable if the involuntary medication order was

unconstitutional, it is certain that they would not be liable for merely restraining Anderson while

he received his medications when the medication decision was constitutionally permissible. The

medication decision was constitutionally permissible. The defendants are entitled to judgment

as a matter of law on Anderson's claim that they violated his right to due process by restraining

him while he was involuntarily medicated on November 7, 2003.

B. Qualified Immunity

The defense of qualified immunity protects “government officials . . . 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). Qualified immunity “provides ample protection to all but the plainly

incompetent or those who knowingly violate the law.” Malley v. Briggs, 475 U.S. 335, 341

(1986). 

To determine whether an official is entitled to qualified immunity, the court must decide

whether the facts alleged show the official’s conduct violated a constitutional right; and, if so,

whether it would be clear to a reasonable officer that his conduct was unlawful in the situation

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he confronted. Saucier v. Katz, 533 U.S. 194, 201 (2001). The first prong is a threshold

question; “if no constitutional right would have been violated were the allegations established,

there is no necessity for further inquiries concerning qualified immunity.” Id. 

The court has concluded that the undisputed evidence fails to show a violation of

Anderson's constitutional rights. There is no need to proceed to the second step of the Saucier

analysis. Defendants are entitled to qualified immunity as a matter of law.

CONCLUSION

For the foregoing reasons, defendants are entitled to judgment as a matter of law on

Anderson's claim and on their defense of qualified immunity. Defendants’ motion for summary

judgment is GRANTED. (Docket # 35.) Judgment will now be entered in favor of defendants

and against Anderson. The clerk shall close the file.

IT IS SO ORDERED.

Dated: February 9, 2007 _____________________

 SUSAN ILLSTON

United States District Judge

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