Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_09-cv-01334/USCOURTS-casd-3_09-cv-01334-8/pdf.json

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

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

KEVIN DARNELL BRYANT,

 Plaintiff,

 v.

SELEAINA ANN THOMAS, et al.,

 Defendants. 

 

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Case No. 09cv1334-WQH (MDD)

REPORT AND RECOMMENDATION

RE: MOTION FOR SUMMARY

JUDGMENT

[Doc. No. 75]

This Report and Recommendation is submitted to United States District

Judge William Q. Hayes pursuant to 28 U.S.C. § 636(b) and Civil Local Rules

72.1(c) and 72.3(f) of the United States District Court for the Southern District of

California. For the following reasons, the Court RECOMMENDS that Defendants’

Motion be GRANTED.

I. Procedural History

Plaintiff filed a Complaint pursuant to 42 U.S.C. § 1983 on June 19, 2009. 

(Doc. No. 1). On November 9, 2009, the Court issued an Order sua sponte

dismissing several of the claims presented in the Complaint. (Doc. No. 16). On

November 30, 2009, Plaintiff filed a Motion to For Leave to File an Amended

Complaint. (Doc. No. 18). 

Plaintiff’s Motion was granted in part. Plaintiff was permitted to file an

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Amended Complaint, but the Amended Complaint was not to include any of the

claims previously dismissed by the Court on November 9, 2009. 

On May 23, 2011, Plaintiff filed a First Amended Complaint (“FAC”). (Doc.

No. 39). On June 3, 2011, Defendants filed an Answer to Plaintiff’s FAC. (Doc. No.

50). On May 18, 2012, Defendants Thomas, Vrooman, and Sepulveda filed the

instant Motion for Summary Judgment pursuant to Fed. R. of Civil. Proc. 56. (Doc.

No. 75). The Court issued an order pursuant to Rand v. Rowland, 154 F.3d 952 (9th

Cir. 1998) (en banc) and Klingele v. Eikenberry, 849 F.2d 409 (9th Cir. 1988),

advising Plaintiff that a Motion for Summary Judgment had been filed. (Doc. No.

80). Plaintiff filed a Response in Opposition on July 18, 2012. (Doc. No. 94). On

July 27, 2012, Defendants filed a Reply. (Doc. No. 97). Plaintiff filed a Sur-reply on

August 24, 2012. (Doc. No. 102). 

II. Statement of the Facts

According to Plaintiff, he arrived at Calipatria State Prison on July 12, 2006. 

(FAC at 2). When he arrived, Plaintiff presented his medical files to prison medical

officials. Id. Upon review of his file, medical officials referred Plaintiff to the prison

doctor and issued him a cane. Id. On July 21, 2006, Plaintiff was seen by Nurse

Practitioner Thomas. Id. Plaintiff contends that Thomas refused to examine him

and refused to honor any of the medical chronos that were issued by the previous

institution regarding Plaintiff, even though they were designated as “permanent.” 

Id. 

Specifically, Plaintiff states that a previously issued medical instruction

directed that he be assigned to a cell on a bottom bunk and on a low floor. Id.

Despite this chrono, Plaintiff was assigned to a top bunk on an upper floor. Id.

Plaintiff states that he filed several medical requests to Defendants Vrooman and

Sepulveda, and several grievances, but they were all ignored. Id. 

Defendants acknowledge that Plaintiff’s file contained a medical instruction

regarding placement in a low bunk, but state that the instruction had expired when

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Plaintiff arrived at Calipatria. Contrary to Plaintiff’s claims, Defendants contend

that Thomas conducted a comprehensive physical exam of the Plaintiff when he

arrived at Calipatria and prepared a Health History file. (Doc. No. 75 at 7-8). 

Defendants acknowledge that Plaintiff complained of joint pain in his hands, feet

and knees and that Plaintiff requested a low bunk. Defendants contend that

Thomas reviewed Plaintiff’s medical file and found that Plaintiff had previously

requested a medical instruction for a low bunk but that the request had been

deferred because Plaintiff could not establish that he was qualified for it. Id.

Specifically, the medical provider had ordered x-rays of Plaintiff’s feet and knees

and advised Plaintiff that he would not qualify for a instruction until these tests

had been performed and evaluated. Id. 

Defendants also contend that Thomas ordered a battery of tests following the

initial meeting with Plaintiff and recommended that Plaintiff be issued a

instruction allowing him to receive contact lenses from his family. Id. at 8-9. 

Thomas advised Plaintiff that when the test results came back, she would discuss

the low bunk instruction with Plaintiff. Id. at 9. On July 31, 2006, Plaintiff sent

Thomas a letter confirming that Thomas ordered several tests and had requested to

see him again. Id. 

On August 16, 2006, Thomas referred Plaintiff to an optometrist for an eye

exam and issued Plaintiff a temporary instruction for contact lenses. On August 16

and August 20, 2006, Plaintiff fell while climbing down from the top bunk. Plaintiff

contends he was severely injured in each fall. (FAC at 4). Plaintiff was sent to the

medical clinic after each fall, but contends that Defendants Vrooman and Sepulveda

refused to let him in the clinic and refused to treat his wounds. Id. Plaintiff also

contends that they failed to file an incident report even though CDCR regulations

require that they do so. 

Thomas met with Plaintiff again on August 23, 2006, to review the results of

the blood tests she had ordered. (Doc. No. 75 at 10). Thomas informed Plaintiff

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that the tests were negative for arthritis. Id. On August 25, 2006, the chief medical

officer at Calipatria requested an orthopedic exam of Plaintiff to address his

complaints of joint pain. Id. The request was approved by the prison medical

committee on September 25, 2006. 

Plaintiff contends that on August 27, 2006, he fell down a flight of metal

stairs and hit the back of his head on the concrete floor. (FAC at 4). Plaintiff states

that he was so severely injured that he had to be transported to the prison

emergency room via ambulance. Id. Plaintiff contends that Defendant Thomas

refused to provide him with medical care and simply released him back into the

yard without examination or treatment. Id.

Contrary to Plaintiff’s claims, Defendants contend that Plaintiff suffered only

a bruised and slightly swollen hand, a small cut, and some scraping on the back of

his arm. (Doc. No. 75 at 10). Defendants also contend that Plaintiff was treated for

his injuries. Plaintiff was prescribed 600 mg of Motrin, three times a day for one

month, and 750 mg of Robaxin twice a day for 20 days. Plaintiff was offered an ice

pack, but refused. A nurse opined that Plaintiff was evasive when questioned about

the incident, and seemed more concerned with getting a low bunk instruction than

in treating his injuries. Defendants also contend that a report from August 27,

2006, states that Plaintiff was observed moving about with no restriction of

movement or signs of discomfort. Id. Defendants also state that Plaintiff was seen

on August 27, 2006 for x-rays. Thomas examined Plaintiff on August 28, 2006, and

found that Plaintiff’s injuries were minor. Nevertheless, Thomas issued a

temporary low bunk instruction and a instruction allowing Plaintiff to obtain ice

cubes. Plaintiff was given pain killers and a bandage for his hand. Thomas also

scheduled a follow-up exam for Plaintiff. Id. at 11. 

Plaintiff contends he continued to submit medical requests over the next few

months, but that they were all ignored. (FAC at 4-5). Defendants acknowledge that

Plaintiff was not immediately seen for a follow-up exam, despite Thomas’ request,

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but dispute that Plaintiff was not seen at all. Plaintiff acknowledges that he was

seen by Thomas on September 19, 2006, in the clinic. Plaintiff contends that

Thomas and other medical staff tried to intimidate Plaintiff and ordered him to

remove his neck brace, which he did out of fear. Id. Defendants dispute that

account. According to Defendants, at that meeting Thomas determined that

Plaintiff did not have impaired mobility. In reaching that determination, Thomas

considered Plaintiff’s x-rays as well as the blood tests showing Plaintiff did not have

arthritis. (Doc. No. 75 at 12). Thomas then denied Plaintiff’s request for a low

bunk instruction. Defendants acknowledge that Thomas ordered the neck brace

removed, but contend that the order was given because the neck brace was no

longer useful. Id.

Defendants also contend that Plaintiff was seen again by Thomas on

September 22, 2006. (Doc. No. 75 at 12-13). At that meeting, Thomas prescribed

more pain killers for Plaintiff, ordered an x-ray of Plaintiff’s hand and an MRI of

Plaintiff’s neck. On September 25, 2006, Plaintiff was issued a second temporary

low bunk instruction. Defendants assert that they continued to treat Plaintiff for

the next several months for his joint pain. Plaintiff was examined by an orthopedic

doctor on October 5, 2006 and by Thomas on October 18, 2006. Thomas renewed

Plaintiff’s low bunk instruction for another 90 days pending the results of Plaintiff’s

MRI. 

III. Standard of Review

Rule 56(c) of the Federal Rules of Civil Procedure authorizes the granting of 

summary judgment “if the pleadings, depositions, answers to interrogatories, and

admissions on file, together with the affidavits, if any, 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.” The standard for granting a motion for summary judgment is

essentially the same as for the granting of a directed verdict. Judgment must be

entered, “if, under the governing law, there can be but one reasonable conclusion as

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to the verdict.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 250-51 (1986). “If

reasonable minds could differ,” however, judgment should not be entered in favor of

the moving party. Id.

The parties bear the same substantive burden of proof as would apply at a

trial on the merits, including plaintiff’s burden to establish any element essential to

his case. Liberty Lobby, 477 U.S. at 252; Celotex v. Catrett, 477 U.S. 317, 322

(1986); Taylor v. List, 880 F.2d 1040, 1045 (9th Cir. 1989). The moving party bears

the initial burden of identifying the elements of the claim in the pleadings, or other

evidence, which the moving party “believes demonstrates the absence of a genuine

issue of material fact.” Celotex, 477 U.S. at 323. Adickes v. S.H. Kress & Co., 398

U.S. 144 (1970); Zoslaw v. MCA Distrib. Corp., 693 F.2d 870, 883 (9th Cir. 1982). 

“A material issue of fact is one that affects the outcome of the litigation and

requires a trial to resolve the parties’ differing versions of the truth.” S.E.C. v.

Seaboard Corp., 677 F.2d 1301, 1305-06 (9th Cir. 1982). More than a “metaphysical

doubt” is required to establish a genuine issue of material fact. Matsushita Elec.

Indus. Co., Ltd v. Zenith Radio Corp., 475 U.S. 574, 586 (1986).

The burden then shifts to the non-moving party to establish, beyond the

pleadings, there is a genuine issue for trial. Celotex, 477 U.S. at 324. To

successfully rebut a properly supported motion for summary judgment, the

nonmoving party “must point to some facts in the record that demonstrate a

genuine issue of material fact and, with all reasonable inferences made in the

plaintiff[]’s favor, could convince a reasonable jury to find for the plaintiff[].” Reese

v. Jefferson School Dist. No. 14J, 208 F.3d 736, 738 (9th Cir. 2000)(citing Fed. R.

Civ. P. 56; Celotex, 477 U.S. at 323; Anderson, 477 U.S. at 249).

While the district court is “not required to comb the record to find some

reason to deny a motion for summary judgment,” Forsberg v. Pacific N.W. Bell Tel.

Co., 840 F.2d 1409, 1417-18 (9th Cir. 1988), Nilsson v. Louisiana Hydrolic, 854 F.2d

1538, 1545 (9th Cir. 1988), the court may nevertheless exercise its discretion “in

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appropriate circumstances,” to consider materials in the record which are on file but

not “specifically referred to.” Carmen v. San Francisco Unified Sch. Dist., 237 F.3d

1026, 1031 (9th Cir. 2001). However, the court need not “examine the entire file for

evidence establishing a genuine issue of fact, where the evidence is not set forth in

the moving papers with adequate references so that it could be conveniently found.” 

Id.

In ruling on a motion for summary judgment, the court need not accept legal

conclusions “cast in the form of factual allegations.” Western Mining Council v.

Watt, 643 F.2d 618, 624 (9th Cir. 1981). “No valid interest is served by withholding

summary judgment on a complaint that wraps nonactionable conduct in a jacket

woven of legal conclusions and hyperbole.” Vigliotto v. Terry, 873 F.2d 1201, 1203

(9th Cir. 1989).

Section 1983 imposes two essential proof requirements upon a claimant: (1)

that a person acting under color of state law committed the conduct at issue, and (2)

that the conduct deprived the claimant of some right, privilege, or immunity

protected by the Constitution or laws of the United States. See 42 U.S.C. § 1983;

Parratt v. Taylor, 451 U.S. 527, 535 (1981) (overruled on other grounds by Daniels

v. Williams, 474 U.S. 327, 3301-31 (1986). A person deprives another “of a

constitutional right, within the meaning of section 1983, if he does an affirmative

act, participates in another’s affirmative acts, or omits to perform an act which he is

legally required to do that causes the deprivation of which [the plaintiff complains].” 

Johnson v. Duffy, 588 F.2d 740, 743 (9th Cir. 1978). “The inquiry into causation

must be individualized and focus on the duties and responsibilities of each

individual defendant whose acts or omissions are alleged to have caused a

constitutional deprivation.” Leer v. Murphy, 844 F.2d 628, 633 (9th Cir. 1988). 

IV. Discussion

In their Motion, Defendants contend that Plaintiff’s claims against

Defendants Vrooman and Sepulveda fail because Plaintiff failed to exhaust his

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administrative remedies. (Doc. No. 75 at 9). Defendants also contend that

Plaintiff’s claim that Thomas was deliberately indifferent to his medical needs fails

as the evidence shows that Thomas adequately responded to Plaintiff’s medical

concerns. Id. 

A. Failure to Exhaust Administrative Remedies 

In their Motion, Defendants contend that all of Plaintiff’s claims against

Defendants Vrooman and Sepulveda, and his conspiracy claims against all three

Defendants fail as a matter of law because Plaintiff has failed to exhaust his

administrative remedies. (Doc. No. 75 at 19). In his Response, Plaintiff counters

that he properly exhausted his administrative remedies by mailing two appeals to

the CDCR director for review. (Response at 6). 

The Ninth Circuit has held that “failure to exhaust nonjudicial remedies is a

matter in abatement, not going to the merits of the claim, and as such is not

properly raised in a motion for summary judgment.” Id. at 368. “When a defendant

files a summary judgment motion that raises the issue of exhaustion of non-judicial

remedies, the motion should be treated as a ‘nonenumerated’ motion to dismiss

under Federal Rule of Civil Procedure 12(b).” Irvin v. Zamora, 161 F. Supp. 2d

1125, 1128 (S.D. Cal. 2001) (citing Ritza, 837 F. 2d. at 368-69). Because Defendants

claim that Plaintiff failed to exhaust his administrative remedies, this Court will

treat the Defendants’ Motion for Summary Judgment as a nonenumerated motion

under Federal Rule 12(b), rather than a summary judgment motion pursuant to

Federal Rule 56, when considering that claim. 

When presented with a motion to dismiss for a failure to exhaust non-judicial

remedies the standard of review is broadened beyond the normal scope of 12(b). See

Wyatt v. Terhune, 315 F.3d 1108, 1119-20 (9th Cir. 2003). In deciding a motion to

dismiss for a failure to exhaust non-judicial remedies the Court may look beyond

the pleadings and decide disputed issues of fact. Id. “[N]o presumptive

truthfulness attaches to plaintiff's allegations, and the existence of disputed

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material facts will not preclude the trial Court from evaluating for itself the merits

of jurisdictional claims.” Ritza, 837 F. 2d. at 369. 

1. Claims against Defendants Vrooman and Sepulveda

In his FAC, Plaintiff contends that Defendants Vrooman and Sepulveda

acted with deliberate indifference when they refused to treat his injuries. 

Specifically, Plaintiff alleges that Defendants Vrooman and Sepulveda refused to

file an incident report after he fell, and refused to honor his medical instructions. 

(FAC at 6). 

Defendants contend that Plaintiff’s claims against Defendants Vrooman and

Sepulveda should be dismissed because Plaintiff failed to exhaust his

administrative remedies as to those claims. Defendants acknowledge that Plaintiff

filed several grievances regarding his falls and his medical instructions, but contend

that he did not file a final, director’s level appeal on any grievance involving

Defendants Vrooman and Sepulveda. 

In support of their Motion, Defendants provide the sworn declaration of

Pedro Alaniz, the Appeals Coordinator at Calipatria State Prison. (Doc. No. 75, Ex.

3, Decl. of Pedro Alaniz). Alaniz states that he reviewed all appeals filed by

Plaintiff and found only four related to medical care that had been properly

exhausted. (Alaniz Decl. ¶ 2). None of the exhausted claims involve Defendants

Vrooman or Sepulveda. Id. Defendants also provide copies of Plaintiff’s grievances

and the prison’s responses. (Doc. No. 75, Ex. 3). These records do not contain any

decision at the Director’s level of review regarding Plaintiff’s claims against

Vrooman or Sepulveda. 

In his Response, Plaintiff counters that he did file appeals at the Director’s

Level of Review. (Response at 6). In support, Plaintiff provides a copy of an

attachment to an appeal form dated September 24, 2006, and numbered CAL-D0602105. (Response, Ex. D). In the attachment, Plaintiff states that Defendant

Thomas refused to see him until after Ms. Edwards spoke with Defendant Vrooman. 

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(Response, Ex. D., pg 87). 

It is unclear if this attachment was part of Plaintiff’s actual appeal, as the

appeal itself is dated August 20, 2006, and was thus submitted over a month before

the attachment was drafted. Even if the attachment was a part of the appeal,

however, it would not establish that Plaintiff properly exhausted his claim against

Vrooman or Sepulveda. Neither the appeal nor the attachment describe improper

conduct by Vrooman or Sepulveda. Rather, the appeal is directed at Defendant

Thomas’ failure to treat Plaintiff. Id. Defendants do not dispute that Plaintiff

properly exhausted his claims against Defendant Thomas. 

Thus, Plaintiff’s own exhibits confirm Alaniz’s sworn declaration. 

Defendants have established that Plaintiff failed to exhaust his administrative

remedies with regard to all claims against Defendants Vrooman and Sepulveda. 

Accordingly, those claims are not properly before the Court and the Court

RECOMMENDS that those claims be DISMISSED without prejudice. 

2. Conspiracy Claims

In his FAC, Plaintiff contends that since his August 27, 2006 fall, Defendants

“conspired together to cover up their actions and failures to act resulting from

defendant Thomas’ actions[.]” (FAC at 6). In their Motion, Defendants contend that

Plaintiff provides no support for this claim beyond this initial statement, and that

according to the sworn declaration of Alaniz, Plaintiff failed to exhaust a conspiracy

claim against any Defendant. (Doc. No. 75 at 25). A review of the appeals records

provided by Plaintiff reveals that Plaintiff has failed to exhaust a conspiracy claim

against any Defendant. Plaintiff does not address his conspiracy claims in his

Response or in his Sur-Reply. 

Accordingly, Plaintiff’s conspiracy claim is not properly before the Court, and

the Court RECOMMENDS that the claim be DISMISSED without prejudice.

/ / / 

/ / /

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B. Eighth Amendment Claims

In his FAC, Plaintiff asserts that Defendants were deliberately indifferent to

his serious medical needs in violation of the Eighth Amendment. (FAC at 3). 

Plaintiff contends that Defendants refused to honor a previously issued medical

instruction that stated that Plaintiff should be assigned to a low bunk on the

ground floor. (FAC at 2-3). Defendants assigned Plaintiff to a top bunk on a high

level. Plaintiff alleges that he fell repeatedly, causing severe injury. Id. Plaintiff

also contends that Defendants repeatedly refused to treat him. Id. As discussed

above, the claims against Vrooman and Sepulveda are not properly exhausted. 

Thus, the Court will only address Plaintiff’s claims against Defendant Thomas. 

“[W]hen the State takes a person into its custody and holds him there against

his will, the Constitution imposes upon it a corresponding duty to assume some

responsibility for his safety and general well-being.” DeShaney v. Winnebago

County Dept. of Social Services, 489 U.S. 189, 199-200 (1989). Medical care is one

of the responsibilities placed on the State, because a prisoner “must rely on prison

authorities to treat his medical needs.” Estelle v. Gamble, 429 U.S. 97, 103 (1976). 

A prison official violates the Eighth Amendment when the official acts with

deliberate indifference to a prisoner’s serious medical needs. Id. at 104-105. For a

prisoner to demonstrate an Eighth Amendment violation two components must be

satisfied. The plaintiff must allege that he/she (1) suffered an objectively serious

medical need and (2) that the defendant was deliberately indifferent to this need. 

See Wilson v. Seiter, 501 U.S. 294, 298 (1991). 

The objective component of an Eighth Amendment violation requires the

showing of a serious medical need. Id. A serious medical need is demonstrated by a

showing that the “failure to treat a prisoner's condition could result in further

significant injury or the unnecessary and wanton infliction of pain.” Jett v. Penner,

439 F.3d 1091, 1096 (9th Cir. 2006) (internal citation omitted). “The existence of an

injury that a reasonable doctor or patient would find important and worthy of

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comment or treatment; the presence of a medical condition that significantly affects

an individual's daily activities; or the existence of chronic and substantial pain” are

indications that a prisoner has a serious need for medical treatment. McGuckin v.

Smith, 974 F.2d 1050, 1059-1060 (9th Cir.1992) (overruled on other grounds by

WMX Techs. v. Miller, 104 F.2d 1133, 1136 (9th Cir.1997) (en banc)). 

1. Objective Medical Need

In their Motion, Defendants contend that because Plaintiff did not have a

valid medical instruction, he fails to establish that he had a serious medical need. 

Defendants acknowledge that Plaintiff was issued a medical instruction at a

previous institution. (Doc. No. 75 at 11). Defendants state that the instruction,

which was issued in 2003, had expired by the time Plaintiff was transferred to

Calipatria in 2006. Id. Defendants contend they were prohibited from honoring an

expired instruction and that Plaintiff bore the responsibility for requesting a new

instruction. 

In support, Defendants provide the sworn declaration of Carmelita Martin, a

Health Program Specialist at Calipatria. In her declaration, Martin states that

according to Chapter 23 of the CDCR’s Inmate Medical Services Program Policies

and Procedures Mandate/Manual (“CDCR Manual”), any accommodation

instruction designated as “permanent” must be reviewed annually and it is the

responsibility of the inmate to request review prior to the instruction’s expiration. 

(Martin Decl. At ¶ 2-3). A copy of the CDCR manual was attached as Exhibit A to

Martin’s Declaration. 

Defendants also point to additional evidence that Plaintiff’s instruction had

expired. Defendants provide the sworn of declaration of Defendant Thomas, in

which Thomas asserts that Plaintiff’s medical file contained an instruction issued in

April 2005 which deferred Plaintiff’s request to be placed in a low bunk because

Plaintiff did not meet the requisite criteria. (Thomas Decl. ¶ 8, Ex. C). Thomas

also states that a review of Plaintiff’s medical file on July 21, 2006, showed that

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Plaintiff’s previous request for a low bunk was not granted. Instead, the medical

provider ordered x-rays or Plaintiff’s feet and knees to determine if Plaintiff

actually had a need for a medical instruction, and determined that Plaintiff could

not be considered qualified for the instruction until the x-rays were reviewed. Id. ¶

8, Ex. C. Defendants contend that this evidence establishes conclusively that

Plaintiff did not have an objective, serious medical need, and therefore Plaintiff fails

the first prong of the Eighth Amendment analysis. 

The Court finds that there are material facts in dispute that preclude

summary judgment on this prong on the Eighth Amendment analysis. Defendants

provide evidence that Plaintiff’s last instruction request had been deferred pending

the results of x-rays. Defendants also acknowledge, however, that Plaintiff had

previously been granted a medical instruction, which indicates that Plaintiff had a

serious medical need in the past. (Doc. No. 75 at 9). Also, Defendant Thomas

issued a temporary low bunk instruction to Plaintiff on three separate occasions,

indicating that even Thomas acknowledged the existence of an injury requiring

treatment. (Doc. No. 75 at 9). Defendants are correct that Plaintiff’s objective

medical tests, including x-rays and blood tests, failed to show a determinable

impairment to Plaintiff, leading Thomas to conclude that Plaintiff did not have

impaired mobility. Nevertheless, Thomas concluded that Plaintiff’s condition

justified a low bunk instruction. The existence of an injury that medical officials

find worthy of treatment is sufficient to satisfy the objective component of the

Eighth Amendment analysis. McGuckin, 974 F.2d at 1059-1060. Accordingly, even

though the exact nature and extent of Plaintiff’s joint pain is unknown, there is

sufficient evidence on the record to support Plaintiff’s contention that he had an

objectively serious medical need.

Even if Plaintiff’s pre-existing joint pain is insufficient to establish an

objectively serious injury, Plaintiff’s injuries following his August 27, 2006, fall

would likely qualify. Defendants acknowledge that Plaintiff suffered cuts, bruises,

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and scrapes, and that Plaintiff was prescribed pain killers. While some injuries

may be so insignificant as to be de minimus and therefore insufficient to satisfy the

Eighth Amendment analysis, it is not clear from the record before the Court that

Plaintiff’s injuries were so minimal. 

2. Deliberate Indifference

The subjective component of an Eighth Amendment claim requires that the

prison official acted with deliberate indifference to the plaintiff’s serious medical

need. See Wilson, 501 U.S. at 298. A prison official acts with deliberate

indifference when he/she denies, delays or interferes with the treatment of the

serious medical needs of a prisoner. Estelle, 429 U.S. at 104-5. “This is true

whether the indifference is manifested by prison doctors in their response to the

prisoner's needs or by prison guards in intentionally denying or delaying access to

medical care or intentionally interfering with the treatment once prescribed.” Id.

“[D]eliberate indifference describes a state of mind more blameworthy than

negligence.” Farmer v. Brennan, 511 U.S. 825, 835 (1994). “[A] complaint that a

physician has been negligent in diagnosing or treating a medical condition does not

state a valid claim of medical mistreatment under the Eighth Amendment.” 

Estelle, 429 U.S. at 106. The indifference to medical needs must be substantial;

mere malpractice, or even gross negligence, does not constitute cruel and unusual

punishment. Id.

Plaintiff contends that Defendant Thomas was deliberately indifferent

because she repeatedly refused to examine him, refused to treat him following his

falls, and refused to issue him a permanent low bunk instruction. (FAC at 5). 

Plaintiff offers no support, other than his pleadings, to show that Defendant

Thomas acted with deliberate indifference. 

Defendants counter that there is considerable evidence that Thomas

responded appropriately to Plaintiff’s medical needs. Specifically, Defendants note

that Plaintiff’s medical file contains numerous entries detailing exams by

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Defendant Thomas, and that Plaintiff was promptly seen and treated following

every injury. 

1. Refusal to Examine Plaintiff Upon Arrival at Calipatria

and Refusal to Issue a Permanent Low Bunk Instruction

First, in his FAC, Plaintiff contends that Defendant Thomas was deliberately

indifferent because she refused to examine him when he arrived at Calipatria,

refused to honor the low bunk instruction issued at a previous institution, and

because she refused to issue him a permanent low bunk instruction when she

examined him on July 21, 2006. (FAC at 2). 

In their Motion, Defendants contend that Thomas was not deliberately

indifferent, as she was required to follow prison procedure before honoring

Plaintiff’s pre-existing instruction, and because she took steps to facilitate Plaintiff

being provided with a new low bunk instruction. 

As discussed above, Defendants have provided significant evidence showing

that Plaintiff’s previous instruction was expired, and that medical personnel at the

previous institution to house Plaintiff had deferred issuing an instruction until

Plaintiff underwent objective testing to determine if an instruction was required. 

This evidence is also supported by Thomas’ sworn declaration. 

According to her sworn declaration, Defendant Thomas examined Plaintiff’s

medical file and found that Plaintiff’s previous request for an instruction was

deferred because no objective evidence supported Plaintiff’s request. (Thomas Decl.

¶ 8). Thomas states that she did not have the authority to issue a new instruction,

which is the responsibility of a Medical Instruction Committee. Id. Thomas also

states that because Plaintiff’s previous request was deferred pending objective

testing, she was also required to defer Plaintiff’s request pending those tests. Id.

Rather than reject Plaintiff’s request outright, however, Thomas ordered the

testing necessary to determine if Plaintiff qualified for a low bunk, including x-ray

tests and blood tests for arthritis. (Thomas Decl. ¶ 6-10). Defendants provide

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Thomas’ notes from her July 21, 2006 exam of Plaintiff. (Thomas Decl., Exs. A

(Chronic Care Program Baseline Health History), B (Interdisciplinary Progress

Notes), C (Physician’s Progress Notes), D (Physician’s Orders). According to the

notes, Thomas ordered a battery of tests, including a series of tests to address

Plaintiff’s joint pain. (Thomas Decl. ¶ 9). Contrary to Plaintiff’s statement that

Thomas refused to examine his extremities for joint pain, Thomas’ notes indicate

that she examined Plaintiff extensively, including his extremities. (Thomas Decl.,

Ex. B-D). Thomas prescribed medication for Plaintiff, including pain killers for his

joint pain, and Thomas submitted a request that Plaintiff be given a medical

instruction for contact lenses. (Thomas Decl., Ex. D at 597; Ex. F). That request

was eventually denied by the review board. Thomas also ordered all of Plaintiff’s

medical records and directed Plaintiff to return after he had completed his testing. 

(Thomas Decl. ¶ 11). Thomas states that Plaintiff acknowledged these instructions,

and sent a follow-up letter on July 31, 2006, acknowledging that Thomas had

ordered testing and a follow-up visit. Defendants provide a copy of that letter along

with Thomas’ Declaration. (Thomas Decl., Ex. G). 

Defendants have provided evidence that Thomas thoroughly examined

Plaintiff upon his arrival, considered his prior medical history, and treated Plaintiff

appropriately. Plaintiff has provided no evidence that Thomas deliberately

withheld treatment, delayed treatment, or interfered with treatment. Rather, the

evidence on record indicates that Thomas considered Plaintiff’s medical history and

undertook appropriate actions to determine if Plaintiff should be given a medical

instruction. While Plaintiff contends that Thomas refused to consider his previous

instructions and refused to acknowledge his obvious ailments, that account is

contradicted by Thomas’ extensive notes from her July 21, 2006 exam, in which she

discusses Plaintiff’s medical history, explicitly considers Plaintiff’s previous

instructions, and determines that the appropriate course was to obtain objective

test results that would confirm the need for a medical instruction. (Thomas Decl.,

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Exs. A-G). Nothing in the record suggests that Plaintiff’s injuries were so obvious

that Thomas was indifferent for failing to respond, and nothing suggests that

immediate action by Thomas was necessary to prevent future harm to Plaintiff. 

Estelle, 429 U.S. at 104-5. At most, Plaintiff has described a difference in opinion

with Thomas, in that he would prefer she had taken a different course of action. 

Such a dispute, however, is not actionable under the Eighth Amendment. Id. Only

if Thomas deliberately denied or delayed treatment would her actions be prohibited

by the Eighth Amendment. Even if Thomas was negligent in not responding to

Plaintiff sooner or following up with Plaintiff earlier, a proposition which is not

supported by the record, such negligence would not rise to the level of an Eighth

Amendment violation. Farmer v. Brennan, 511 U.S. at 835. 

In light of the evidence provided by Defendants that refutes Plaintiff’s

contentions in his FAC, and Plaintiff’s failure to provide any evidence in support of

his claims beyond the statements in his FAC, the Court RECOMMENDS that

Defendants’ Motion be GRANTED as to this claim. 

3. Subsequent Medical Treatment

In his FAC, Plaintiff contends that following his initial exam, Thomas

continuously refused to treat him. (FAC at 2-5). Plaintiff contends he filed

numerous requests for treatment, but Thomas ignored them all. Plaintiff provides

no support for this claim beyond the statements in his FAC. 

In their Motion, Defendants contend that Thomas was attentive to Plaintiff’s

needs and treated him appropriately. Defendants provide Thomas’ sworn

declaration and medical records drafted by Thomas in support of their Motion. 

According to Thomas’ sworn declaration, she met with Plaintiff again on August 17,

2006, and on August 23, 2006. (Thomas Decl. ¶ 10-17, Exs. J and M). At the

August 16, 2006 meeting, Thomas submitted an urgent Physician Request for

Plaintiff, referring him to an optometrist for an eye exam so that Plaintiff could

receive an instruction for contact lenses. Id. Thomas also issued a temporary

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instruction for contact lenses. Id. At the August 23, 2006 meeting, Thomas

discussed the results of Plaintiff’s blood test with him, and informed him that the

tests were negative for rheumatoid arthritis. Id.

Defendants have provided evidence that Thomas responded promptly and

appropriately to Plaintiff’s medical needs. While Plaintiff states that his medical

needs were ignored, the medical records and sworn declaration of Thomas refute his

claim. Plaintiff contends that he required more treatment, but he does not

establish that Thomas deliberately denied, delayed, or interfered with any

treatment. Even if Thomas was negligent in not following up sooner with Plaintiff

regarding his test results, such negligence does not rise of the level of deliberate

indifference and is not actionable under the Eighth Amendment. Farmer v.

Brennan, 511 U.S. at 835. Accordingly, the Court RECOMMENDS that

Defendants’ Motion be GRANTED as to this claim. 

4. Treatment Following Plaintiff’s August 27, 2006 Fall

In his FAC, Plaintiff contends that Thomas refused to examine him following

his August 28, 2006 fall, despite his obvious and significant injuries, and that

Thomas was deliberately indifferent when she ordered him discharged from the

outpatient housing unit. (FAC at 4). 

Defendants provide significant evidence to refute Plaintiff’s claim that

Thomas refused to treat him following his fall. According to Thomas’ sworn

declaration, Plaintiff was treated immediately following his fall. (Thomas Decl.¶

19). Thomas states that Plaintiff’s medical records from August 27, 2006 and

August 28, 2006, indicate that Plaintiff suffered minor injuries to his right hand,

right arm, and left wrist. Id. The notes, which are attached to Thomas’ Declaration

as Exhibit O, state that Plaintiff showed no signs of discomfort following his fall,

was able to move freely, and that he refused an ice pack. (Thomas Decl., Ex. O). 

Plaintiff was prescribed pain killers and a muscle relaxer, and scheduled Plaintiff

for hand and spinal x-rays. Id. 

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Thomas examined Plaintiff the next day, and ordered a temporary low bunk

instruction and an ACE bandage. (Thomas Decl. ¶ 22). Plaintiff was also scheduled

for a follow up visit. Id. Thomas saw Plaintiff again on September 22, 2006. Id. at

25. Thomas states that she never refused to see Plaintiff. Id. 

Nothing in Plaintiff’s medical records suggests that Thomas was deliberately

indifferent to his medical needs. Rather, the records indicate that Thomas

thoroughly reviewed Plaintiff’s medical file, examined Plaintiff, and treated all of

Plaintiff’s apparent injuries. Even if Plaintiff disagreed with the treatment he

received, nothing in the record suggest that Thomas denied, delayed, or interfered

with Plaintiff’s treatment. Plaintiff contends that he should have been seen sooner,

but such a complaint has no bearing on his claim against Thomas, as the record

indicates that Thomas requested a follow-up appointment with Plaintiff. (Thomas

Decl., Ex. O). Plaintiff has put forth no evidence to rebut Thomas’ contention that

she is not in charge of scheduling and has no authority to determine scheduling

beyond putting in a request for an appointment. Accordingly, the evidence on

record shows that Thomas treated Plaintiff thoroughly and promptly following his

fall. 

In light of Plaintiff’s failure to provide any evidence in support of his claim

that Thomas was deliberately indifferent to his medical needs following his fall or

that he was harmed by his discharge from the Outpatient Housing Facility, and in

light of Defendants’ evidence that Thomas treated all of Plaintiff’s apparent injuries

and sought additional treatment, the Court RECOMMENDS that Defendants’

Motion be GRANTED as to this claim. 

5. Conclusion

Plaintiff has failed to establish that Defendant Thomas was deliberately

indifferent to his medical needs. Plaintiff provides no support for his claims other

than assertions in his FAC that he should have been treated more. Defendants, on

the other hand, provide evidence to refute Plaintiff’s claims and support their

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assertion that Thomas reacted appropriately to all of Plaintiff’s medical needs, and

was in fact diligent in assisting Plaintiff, including Thomas’ sworn declaration and

medical records detailing the extensive treatment Plaintiff received. Accordingly,

Plaintiff has failed to satisfy the second prong of his Eighth Amendment claim, and

the Court RECOMMENDS that Defendants’ Motion be GRANTED as to this

claim. 

V. Conclusion

For the reasons set forth herein, it is RECOMMENDED that Plaintiff’s

claims against Defendants Vrooman and Sepulveda be DISMISSED for failure to

exhaust, and that unless Plaintiff can establish that those claims are timely, leave

to amend those claims should not be granted. The Court also RECOMMENDS

that Defendant’s Motion for Summary Judgment be GRANTED as to claims

against Defendant Thomas. 

IT IS ORDERED THAT:

This Report and Recommendation will be submitted to the United States

District Judge assigned to this case, pursuant to the provisions of 28 U.S.C. §

636(b)(1) (1988). 

Any party may filed written objections with the court and serve a copy on all

parties by September 28, 2012. The document shall be captioned “Objections to

Report and Recommendation.” Any reply to the objections shall be served and filed

by October 12, 2012. The parties are advised that failure to file objections within

the specific time may waive the right to raise those objections on appeal of the

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

IT IS SO ORDERED

DATED: September 7, 2012

 

 Hon. Mitchell D. Dembin

 U.S. Magistrate Judge

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