Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_04-cv-00644/USCOURTS-azd-2_04-cv-00644-0/pdf.json

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

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WO BL

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Paul Eugene Rhodes,

Plaintiff, 

vs.

Quirino Valeros, et al., 

Defendants. 

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No. CV 04-0644-PHX-JAT (LOA)

ORDER GRANTING MOTION FOR

SUMMARY JUDGMENT 

and 

ORDER TO SHOW CAUSE

Plaintiff Paul Eugene Rhodes is litigating a pro se civil 42 U.S.C. § 1983 action

against Defendants (1) Clinical Coordinator Judy Aguilar, (2) Clinical Coordinator Carrie

Feehan, (3) Nurse Practitioner Susan Buffington, (4) Dr. Vern Strubeck, (5) Facility Health

Administrator Terry Allred, (6) Facility Health Administrator Gary Pinkstaff, (7) Medical

Services Administrator Richard Pratt, (8) Bruce Shiflett, (9) David Rivas, (10) Facility

Health Administrator Gene Greeley, (11) Dr. Michael C. Lesac, (12) Dr. Kim Kumar, and

(13) Facility Health Administrator Dennis Chenail (Doc. #81). Now pending before this

Court is Defendants’ Motion for Summary Judgment and Plaintiff’s Motion for Summary

Judgment (Docs. ##56, 73). This Court will grant Defendants’ motion, deny Plaintiff’s

motion, and dismiss with prejudice the action against Aguilar, Feehan, Buffington, Strubeck,

Allred, Pinkstaff, Pratt, Shiflett, Rivas, Greeley, Lesac, and Kumar. The Court will order

Plaintiff to show cause why the remaining defendant, Defendant Chenail, should not be

dismissed without prejudice.

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I. Procedural History

Plaintiff filed a Third Amended Complaint against Defendants alleging deliberate

indifference to his medical needs based on the failure to properly treat his skin condition

(Doc. #81). Plaintiff alleged that the Medical Defendants (Aguilar, Feehan, Buffington,

Strubeck, Lesac, and Kumar) failed to provide him proper medical treatment and refer him

to a dermatologist, and that the Administrative Defendants (Allred, Pinkstaff, Pratt, Shiflett,

Rivas, Greeley, and Chenail) failed to rectify the situation and ensure that he received proper

medical treatment (Id.). Plaintiff also argued that his rights were violated because he was not

present during a medical consultation and was not provided his medical records (Id.).

Defendants moved for summary judgment, arguing that: (1) Plaintiff received

significant, and appropriate treatment for his skin condition; (2) the Hepatitis-C treatment did

not cause or aggravate the skin condition; (3) the Administrative Defendants properly and

appropriately responded to his grievances regarding his medical care; (4) Plaintiff failed to

sufficiently allege a significant injury; (5) the Administrative Defendants did not personally

participate in any alleged violation; and (6) Defendants are entitled to qualified immunity

(Docs. #56, 85). In support of the motion, Defendants filed Dr. Michael Lesac’s affidavit,

portions of Plaintiff’s deposition, and copies of inmate letters and grievances filed by

Plaintiff (Docs. ##57, 58). Plaintiff responded (Doc. # 72), and filed a Motion for Summary

Judgment (Doc. #73), and attached his medical records and copies of inmate letters and

grievances (Doc. #75).

II. Defendant Chenail

“If service of the summons and complaint is not made upon a defendant within 120

days after the filing of the complaint, the court, upon motion or on its own initiative after

notice to the plaintiff, shall dismiss the action without prejudice as to that defendant.” Fed.

R. Civ. P. 4(m). On May 18, 2006, Plaintiff named as a Defendant Dennis Chenail in his

Second Amended Complaint (Doc. #81). Plaintiff has yet to serve Defendant Chenail (Doc.

#84). Plaintiff has until September 25, 2006, to either serve Defendant Chenail or show

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cause why this action should not be dismissed against Defendant Chenail due to Plaintiff’s

failure to serve him.

III. Deliberate Indifference to Medical Needs

A. Medical Evidence

Based on the evidence before this Court, Plaintiff entered the Arizona Department of

Corrections (ADOC) on January 9, 2002, at which time he was diagnosed with Hepatitis-C

and a skin infection, which appeared as papula eruptions on his face (Doc. #57, ex. 1; Doc.

#75 at 45). Plaintiff’s skin condition was initially diagnosed as impetigo, a common and

relatively minor bacterial skin infection that produces blisters or sores on the face and hands

(Doc. #57, ex. 1). Plaintiff’s skin condition resulted in his skin itching such that he would

scratch in his sleep and wake up with blood under his fingernails (Id., ex. 2). Plaintiff was

given a prescription for oral antibiotics (Id., ex. 1). 

On August 26, 2002, Plaintiff submitted a Health Needs Request (HNR), complaining

about a rash (Doc. #57, ex. 1). Plaintiff was seen on September 17, 2002, and diagnosed with

Furunculosis, a skin condition which caused deep sores of the skin (boils) (Id.). Plaintiff was

treated with Ancef injections (an antibiotic) for two days, oral antibiotics and an

antihistamine to reduce itching and swelling (Id.). 

Plaintiff was seen twice in September 2002 (Doc. #75 at 19-20). On October 8, 2002,

during a follow-up examination, it was noted that Plaintiff’s skin condition had improved,

but was not totally controlled (Doc. #57, ex. 1). Plaintiff’s skin condition was attributed in

part to pruritus secondary to liver disease; Plaintiff’s liver problems were causing a sensation

on his skin provoking a desire to scratch, which caused sores on his skin (Id.). Plaintiff was

given an antihistamine and skin ointment (Id.).

On October 15, 2002, Plaintiff was seen for another follow-up, at which time his skin

condition was still present, and the treating physician submitted a request for a dermatologist

consultant (Doc. #57, ex. 1). The following day, Plaintiff complained that he had not

received the cream he was prescribed for his rash (Doc. #75 at 21). In November 2002, the

infirmary checked the status of the dermatologist consultant request (Id. at 23).

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Plaintiff was seen in November, December, and January, at which time he was

prescribed oral antibiotics for an infection and antihistamines to reduce itching and swelling

(Doc. #57, ex. 1). Plaintiff’s skin condition improved during this time (Id.). 

On June 12, 2003, Plaintiff had a consultation with a dermatologist via the telemed

system (Doc. #57, ex. 1; Doc. #74 at 1). During the consultation, images of Plaintiff’s skin

condition were taken and sent electronically to Dr. Norman Levine, a dermatologist (Id.).

Dr. Levine reviewed the images and Plaintiff’s medical history, and diagnosed Plaintiff’s

condition as prurigo nodularis, most likely secondary to liver insufficiency (Id.). Dr. Levine

recommended Prednisone (an anti-inflammatory), skin ointment, and Doxepin (an

antihistamine) (Id.). Plaintiff was prescribed Prednisone and Triamcinolone, medications

consistent with Dr. Levine’s recommendations (Doc. #57, ex. 1; Doc. #74 at 2). Plaintiff,

however, was not present at the consultation between Dr. Levine and the prison doctor, or

aware that it had occurred (Doc. #58, exs. 27, 29; Doc. #75 at 86-87).

Within the next eight months, Plaintiff submitted approximately eight HNR’s or

inmate letters relating to his skin conditions; Plaintiff complained about large sores which

were leaving scars (Doc. #57, exs. 1, 6). On each occasion, Plaintiff was examined and

prescribed various medications, including antibiotics, antihistamines, and skin ointments (Id.

ex. 1). Plaintiff’s skin condition fluctuated in severity during this time (Id.). On February

4, 2004, however, Plaintiff indicated that he had received nothing for his skin infection for

the past two and a half months (Doc. #75 at 25-26). Plaintiff was informed that creams

would not benefit his condition, and that a consultation was to occur shortly (Id. at 27).

On April 7, 2004, Dr. Levine again reviewed electronic images of Plaintiff’s condition

(Doc. #57, ex. 1; Doc. #75 at 29). Dr. Levine opined that Plaintiff’s skin condition was

caused by seborrheic dermatitis (dandruff) and folliculitis (a superficial infection of the hair

follicle) (Id.). Dr. Levine recommended that Plaintiff continue to use his skin cream, and try

a different antibiotic (Id.). The prison medical providers prescribed medications consistent

with these recommendations (Id.). Notably, Dr. Levine opined that if Plaintiff’s condition

did not improve, he would need to undergo a diagnostic biopsy to confirm an alternative

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diagnosis of cutaneous lupus erthematosus (Id.). Again, Plaintiff was not present at or aware

of the consultation (Doc. #58, exs. 27, 29; Doc. #75 at 86-87).

During the next few months, Plaintiff was treated with a different anti-itch medication

due to his constant scratching, which worsened his condition and increased his risk for

bacterial infections (Doc. #57, ex. 1; Doc. #75 at 33-34). Further, a month after the

consultation, Dr. Lesac examined Plaintiff (Doc. #57, ex. 1; Doc. #75 at 32). At that time,

Plaintiff stated that he believed the dermatologist-recommended antibiotics were aggravating

his condition, and requested to be placed on Erythromycin (Doc. #57, ex. 1). Dr. Lesac gave

him the requested prescription (Id.).

On August 3, 2004, a biopsy was taken (Doc. #57, ex. 1). The pathologist noted that

Plaintiff had an acute skin reaction that had localized inflamation and scar tissue that

extended to the fat layer of his skin (Id.). The pathologist’s reading resulted in a conclusion

that the current treatment of antibiotics and antihistamines were proper (Id.). After the

biopsy, Plaintiff submitted numerous HNR’s and received prescription medications on

numerous occasions (Id.).

On March 3, 2004, Plaintiff began receiving Interferon and Ribavirin for his HepatitisC (Doc. #57, ex. 1). These medications often suppress the immune system, which occurred

in Plaintiff’s case (Id.). As a result, the doses of medications were reduced and eventually

discontinued (Id.). However, Plaintiff’s skin condition did not substantially worsen or

improve as a result of the Hepatitis-C treatment (Id.).

Despite the frequency of the treatment, Plaintiff continued to suffer from itching and

sores, which extended into his eyes, sinus cavity and throat (Doc. #57, exs. 6, 8, 12, 16, 18,

20, 22; Doc. #58, exs. 25, 27, 29, 31, 33, 35, 37, 39, 43). As a result of the itching, Plaintiff

has suffered various infections and scarring, and as a result of the medication Plaintiff

suffered a seizure and broken teeth (Id.; Doc. #58, ex. 31, 39; Doc. #75 at 98). Plaintiff also

contracted Methicillin Resistant Staphylococcus Aureuas (MRSA), and will always be

susceptible to related infections (Doc. #75 at 40, 56). Plaintiff was informed that there is no

long-term cure (Id. at 56). Plaintiff acknowledged that he was seen on numerous occasions,

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but believed that had he seen a dermatologist, his condition would be controlled or cured

(Doc. #57, exs. 3, 4). Plaintiff believed that when he filed grievances, the physicians got mad

and refused to prescribe him medication (Id., ex. 3).

Dr. Lesac opined that the treatment of Plaintiff’s Hepatitis-C condition was medically

appropriate and did not cause Plaintiff any serious side effects or harm (Doc. #57, ex. 1).

Moreover, Plaintiff has a recurring, minor skin condition that fluctuates in severity depending

on numerous factors, including Plaintiff’s hygiene and the degree he aggravates the condition

by scratching (Id.). Dr. Lesac further opined that Plaintiff’s skin condition was possibly

related to his liver insufficiency or other health issue, and is bacterial in nature (Id.).

Additionally, Plaintiff had minor scarring, but suffered no physical limitations or disabilities

(Id.). Finally, Plaintiff’s condition will likely recur regardless of the treatments, which are

merely an attempt to keep the condition in remission (Id.; Doc. #75 at 88-89, 91).

Plaintiff filed multiple inmate letters and grievances complaining about the lack of

treatment for his medical condition (Docs. #57, exs. 6-22; #58, exs. 23-44; Doc. #75 at 9-12,

14-15, 39-43, 59-65, 74-91, 101). Defendants Allred, Pinkstaff, Shiflett, and Pratt

investigated Plaintiff’s complains, which included reviewing his medical records and

discussing his condition and treatment with the appropriate medical personnel, and responded

that Plaintiff was receiving proper treatment (Id.).

B. Applicable Law and Analysis.

“Under Rule 56(c), summary judgment is proper ‘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

a judgment as a matter of law.’” Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986).

“[T]he plain language of Rule 56(c) mandates the entry of summary judgment, 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.” Id. “[T]he mere existence of some alleged factual

dispute between the parties will not defeat an otherwise properly supported motion for

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summary judgment; the requirement is that there be no genuine issue of material fact.”

Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48 (1986). “Only disputes over facts

that might affect the outcome of the suit under the governing law will properly preclude the

entry of summary judgment. Factual disputes that are irrelevant or unnecessary will not be

counted.” Id. at 248.

“[D]eliberate indifference to serious medical needs of prisoners constitutes the

‘unnecessary and wanton infliction of pain.’” Estelle v. Gamble, 429 U.S. 97, 104-05 (1976).

“To demonstrate that a prison official was deliberately indifferent to an inmate’s serious . . .

health needs, the prisoner must show that ‘the official [knew] of and disregard[ed] an

excessive risk to inmate health.’” Austin v. Terhune, 367 F.3d 1167, 1172 (9th Cir. 2004)

(citing Farmer v. Brennan, 511 U.S. 825, 838 (1994)). “Further, the deliberate indifference

must be both ‘purposeful,’ and ‘substantial’ in nature.’” Ruvalcaba v. City of Los Angeles,

167 F.3d 514, 525 (9th Cir. 1999) (internal citations omitted). “Prison officials are

deliberately indifferent to a prisoner’s serious medical needs when they ‘deny, delay, or

intentionally interfere with medical treatment. . . . Mere negligence in diagnosing or treating

a medical condition, without more, does not violate a prisoner’s Eighth Amendment rights.’”

Lopez v. Smith, 203 F.3d 1122, 1132 (9th Cir. 2000) (citations omitted). 

Plaintiff alleged that the Medical Defendants (Aguilar, Feehan, Buffington, Strubeck,

Lesac, and Kumar) failed to directly provide him proper medical treatment and refer him to

a dermatologist, and that the Administrative Defendants (Allred, Pinkstaff, Pratt, Shiflett,

Rivas, Greeley, and Chenail) failed to rectify the situation and ensure that he received proper

medical treatment (Doc. #81). Initially, based on the record, there is a material question as

to whether Plaintiff suffers from a serious medical condition as a result of his skin condition.

The summary judgment evidence, however, demonstrates that Defendants were not

deliberately indifferent to Plaintiff’s medical needs. Plaintiff received significant and

appropriate treatment. He was seen on a regular basis, properly treated, and referred to an

expert. The fact that the medical staff failed to give the exact antibiotic recommended by Dr.

Levine, but prescribed one consistent with Dr. Levine’s recommendation, does not result in

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deliberate indifference to Plaintiff’s medical needs. See Toguchi v. Chung, 391 F.3d 1051,

1058 (9th Cir. 2004) (providing that “a mere ‘difference of medical opinion . . . [is]

insufficient, as a matter of law, to establish deliberate indifference’”). 

In March 2004, Plaintiff began receiving Interferon and Ribavirin for his Hepatitis-C,

which suppressed his immunity system and had to be reduced and eventually discontinued

(Doc. #57, ex. 1). However, Plaintiff’s skin condition was not caused or aggravated by the

treatment (Id.). The danger that the treatment would result in a suppressed immunity system

did not result in deliberate indifference to Plaintiff’s medical needs as Defendants were

attempting to treat Plaintiff’s Hepatitis-C and properly monitored him to ensure his skin

condition would not worsen. Moreover, although Plaintiff maintained that the

dermatological consultations never occurred, the record demonstrates that they did (Doc. #

73). Plaintiff’s absence at, and lack of knowledge of, the consultation does not result in

deliberate indifference to his medical needs. Dr. Levine reviewed the record and made

appropriate recommendations, which were followed. Finally, Defendants responded

promptly and appropriately to Plaintiff’s grievances and inmate letters.

In sum, Plaintiff’s skin condition will never be resolved, merely treated and put into

remission (Doc. #57, ex. 1; Doc. #75 at 88-89, 91). However, the inability to “cure”

Plaintiff, and Plaintiff’s belief that he could be cured, does not result in a conclusion that

Defendants were deliberately indifferent to his medical needs. Plaintiff was seen on a regular

basis, and appropriately treated by the Medical Defendants for his skin condition. In

addition, the Administrative Defendants investigated his complaints, reviewed his record, and

ensured that Plaintiff was receiving prompt and proper treatment. Accordingly, there is no

disputed issue of material fact and Defendants Aguilar, Feehan, Buffington, Strubeck, Allred,

Pinkstaff, Pratt, Shiflett, Rivas, Greeley, Lesac, and Kumar are entitled to summary

judgment. The Court will thus grant summary judgment, dismissing with prejudice

Plaintiff’s deliberate indifference claims against Defendants Aguilar, Feehan, Buffington,

Strubeck, Allred, Pinkstaff, Pratt, Shiflett, Rivas, Greeley, Lesac, and Kumar. 

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IV. Count II

Plaintiff alleged in his Second Amended Complaint that his rights were violated when

he was not present during a medical consultation and was not provided his medical records

(Doc. #81). Because the Second Amended Complaint was filed after the Defendants filed

their Motion for Summary Judgment, the motion did not address this count. However, the

Court is required to screen complaints brought by prisoners seeking relief against a

governmental entity or officer or employee of a governmental entity. 28 U.S.C. § 1915A(a).

If the Court determines that a claim could be cured by the allegation of other facts, a pro se

litigant is entitled to an opportunity to amend. See Lopez v. Smith, 203 F.3d 1122, 1127-29

(9th Cir. 2000) (en banc). The Court is required to grant leave to amend “if a [claim] can

possibly be saved” but not if a claim “lacks merit entirely.” Id. at 1129. Because Plaintiff

does not have a constitutional right to be present at a consultation or to obtain his medical

records, and can not alleged that he suffered an injury, he has failed to state a claim and

Count II will be dismissed with prejudice.

IT IS ORDERED:

(1) Defendants’ Motion for Summary Judgment (Doc. #56) is granted. The Clerk of

Court must dismiss with prejudice Defendants Aguilar, Feehan, Buffington, Strubeck, Allred,

Pinkstaff, Pratt, Shiflett, Rivas, Greeley, Lesac, and Kumar. 

(2) Plaintiff’s Motion for Summary Judgment (Doc. # 73) is denied.

(3) Count II is dismissed for failure to state a claim pursuant to 28 U.S.C.

§1915(e)(2)(B)(ii).

(4) Plaintiff, by September 25, 2006, must either serve Defendant Chenail with his

Second Amended Complaint or show cause why Defendant Chenail should not be dismissed

without prejudice. 

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(5) If Plaintiff, by September 25, 2006, fails to serve Defendant Chenail or show

cause why he should not be dismissed, the Clerk of Court must, without further notice, enter

a judgment of dismissal of this action with prejudice.

DATED this 24th day of August, 2006.

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