Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_09-cv-01288/USCOURTS-azd-2_09-cv-01288-0/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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1

Consistent with Plaintiff’s First Amended Complaint and Ninth Circuit case law

involving a prisoner’s gender dysphoria/transsexualism, the Court uses feminine pronouns

to refer to Plaintiff (see Doc. 7 at 3B). See Schwenk v. Hartford, 204 F.3d 1187, 1192 n. 1

(9th Cir. 2000).

WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Kelly Bologna, 

Plaintiff, 

vs.

C. Renault, et al.,

Defendants. 

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No. CV 09-01288-PHX-NVW (MEA)

ORDER

Plaintiff Kelly Bologna brought this civil rights action under 42 U.S.C. § 1983

against various Arizona Department of Corrections (ADC) employees (Doc. 7). Before

the Court are the parties’ cross-motions for summary judgment (Docs. 96, 111).

Plaintiff’s motion will be denied, and Defendants’ motion will be granted.

I. Procedural Background

Plaintiff’s claims arose in October 2008 during her confinement at the Arizona

State Prison Complex (ASPC)-Lewis Rast Unit in Buckeye, Arizona (Doc. 7 at 1).1

 In

Count I, relating to grievance #L22-016-009, Plaintiff alleges that Correctional Officers

Christina Renault and Dolores Valenzuela acted with deliberate indifference to threats to

Plaintiff’s safety by refusing to grant Plaintiff “Do Not House With” status separating her

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2

After Plaintiff filed her combined response-reply, the Court issued the Notice

required under Rand v. Rowland, 154 F.3d 952, 962 (9th Cir. 1998), that advised Plaintiff

of her obligation to respond to Defendants’ cross-motion (Doc. 127). The Court provided

Plaintiff time to supplemental her response (id.), but she opted not to file a supplemental

memorandum (Doc. 128).

3

Each party objects to numerous factual assertions set forth by the opposing party

(Docs. 112 (DSCF), 124 (PSCF)). The Court addresses some of the objections herein;

however, those objections regarding factual assertions that are immaterial or that are

repetitive and simply restate the parties’ disputes, are not specifically addressed.

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from an inmate who assaulted her (id. at 3-3A). In Count II, relating to grievance #L22-

004-009, Plaintiff alleged that ADC dentists Dr. Gary Grant, Dr. Raphael Ricard, and Dr.

Gregory Joseph acted with deliberate indifference to Plaintiff’s serious dental needs by

depriving her of adequate pain medication (id. at 4-4D). 

Plaintiff moved for summary judgment on both counts (Doc. 96), and Defendants

responded and cross-moved (Doc. 111). Plaintiff filed a combined reply in support of her

motion and response to Defendants’ cross-motion (Doc. 124).2

 The parties each

submitted a separate Statement of Facts (Doc. 97, Pl.’s Statement of Facts (PSOF); Doc.

112 at 5-18, Defs.’ Statement of Facts (DSOF)) and a Statement of Controverting Facts

(Doc. 112 at 1-5, (DSCF); Doc. 124, (PSCF)). Plaintiff supports her factual assertions

with her own declaration and attached exhibits, including copies of inmate letters, ADC

policies, interrogatory responses, and medical records (Doc. 97, Attach. 1, Exs. A-Y). 

Defendants support their factual assertions with their own declarations and various

attachments (Doc. 112, Exs. A-F).3

II. Summary Judgment Standard

A court must grant summary judgment “if the movant shows that there is no

genuine dispute as to any material fact and the movant is entitled to judgment as a matter

of law.” Fed. R. Civ. P. 56(a); see also Celotex Corp. v. Catrett, 477 U.S. 317, 322-23

(1986). Under summary judgment practice, the movant bears the initial responsibility of

presenting the basis for its motion and identifying those portions of the record, together

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4

Defendants object to PSOF ¶ 7 on the ground that it lacks foundation as to who

attacked Plaintiff (DSCF ¶ 7). The objection is overruled; Plaintiff has personal knowledge

to testify as to who attacked her, and this factual assertion is supported by her sworn

statement (Doc. 97-1 at 5-6, Pl. Decl. ¶ 9). Also, Defendants assert that “the only basis for

identification given is in a report” that they claim is insufficient, but they do not identify this

report or cite to it in the record (DSCF ¶ 7). See LRCiv 56.1 (for any paragraph of the

movant’s separate statement of facts that the nonmovant disputes, the nonmovant must

provide a reference to the specific admissible portion of the record that supports the

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with affidavits, that it believes demonstrate the absence of a genuine issue of material

fact. Celotex, 477 U.S. at 323.

If the movant meets its initial responsibility, the burden then shifts to the

nonmovant to demonstrate the existence of a factual dispute and that the fact in

contention is material, i.e., a fact that might affect the outcome of the suit under the

governing law, and that the dispute is genuine, i.e., the evidence is such that a reasonable

jury could return a verdict for the nonmovant. Anderson v. Liberty Lobby, Inc., 477 U.S.

242, 248, 250 (1986); see Triton Energy Corp. v. Square D. Co., 68 F.3d 1216, 1221 (9th

Cir. 1995). The nonmovant need not establish a material issue of fact conclusively in its

favor, First Nat’l Bank of Ariz. v. Cities Serv. Co., 391 U.S. 253, 288-89 (1968);

however, it must “come forward with specific facts showing that there is a genuine issue

for trial.” Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 587

(1986) (internal citation omitted); see Fed. R. Civ. P. 56(c)(1).

At summary judgment, the judge’s function is not to weigh the evidence and

determine the truth but to determine whether there is a genuine issue for trial. Anderson,

477 U.S. at 249. In its analysis, the court must assume the nonmovant’s evidence to be

true and draw all inferences in the nonmovant’s favor. Id. at 255.

III. Count I—Threat to Safety

A. Facts

On October 20, 2008, inmate Rowland attacked Plaintiff in the sallyport of

Building 1 in the Rast Unit, which caused Plaintiff a broken jaw, split gums, several

loosened teeth, a split right ear, and a sprained finger on her right hand (PSOF ¶ 7).4

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nonmovant’s position).

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Plaintiff initiated the grievance procedure informally for grievance #L22-016-009 by an

inmate letter dated October 24, 2008 (Docs. 13 at 6, 13-1 at 22). The inmate letter

identifies the subject of the letter as “10-20-08 Assault by inmate Nicholas

Rowlands/Informal Resolution” (Doc. 13-1 at 22). It states that Renault attempted to

house Plaintiff in an area where Plaintiff had a “Do Not House With” order regarding

another inmate after Plaintiff had several conversations with Renault concerning

Renault’s relationship with Rowland. It also states that Rowland told Plaintiff specific

details about the conversations that Rowland could have only learned from Renault. It

further states that on October 8, 2008, Valenzuela told Plaintiff that Rowland knew

Plaintiff “was snitching on him,” and on October 20, 2008, Rowland assaulted Plaintiff. 

Through the informal grievance procedure initiated by the October 24, 2008 inmate letter,

Plaintiff sought to press charges against Rowland, have Renault charged with conspiracy

and fired, and have Renault and Rowland pay for Plaintiff’s medical bills. The October

24, 2008 inmate letter does not allege that Plaintiff made any oral or written requests to

be housed separately from Rowland.

On November 24, 2008, Plaintiff formally initiated grievance #L22-016-009 by

submitting an Inmate Grievance to appeal the response to her request for informal

resolution dated October 24, 2008 (Doc. 13-1 at 24). On the Inmate Grievance form,

Plaintiff states that Renault and Valenzuela should be investigated and fired because

Renault told Rowland that Plaintiff had exposed their relationship and because

Valenzuela knew about it and failed to protect Plaintiff. The Inmate Grievance states that

on October 8, 2008, Valenzuela told Plaintiff that Rowland knew that Plaintiff “was

snitching on him.” It does not allege that Plaintiff made any oral or written requests to be

housed separately from Rowland.

On June 15, 2009, Plaintiff filed her Original Complaint in this action (Doc. 1). It

alleged that on October 8, 2008, Valenzuela told Plaintiff that Rowland knew Plaintiff

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5

Defendants object to PSOF ¶ 6 on hearsay grounds as to statements said to have been

made by Rowland (DSCF ¶ 6). The objection is overruled; Plaintiff’s factual assertion is

supported by her declaration, she has personal knowledge of threats personally made against

her, and her statement goes to her state of mind (Doc. 97-1 at 4-5, Pl. Decl. ¶¶ 6-7). See Fed.

R. Civ. P. 56(c)(4); Fed. R. Evid. 803(3).

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“was snitching on him” (Doc. 1 at 7). The Original Complaint alleged that on October 8,

2008, Plaintiff requested that correctional officers Renault, Ponce, and Mejia move

Rowland, and they refused. The Original Complaint states, “Plaintiff was refused

adequate personal safety, and requested separation from assailant 12 days before 10-20-

08 assault.” It does not allege that Plaintiff submitted any written requests for separation.

On October 2, 2009, Plaintiff filed her First Amended Complaint, in which she

alleges that on October 8, 2008, she requested that Renault separate Plaintiff and

Rowland based on Plaintiff’s conversation with Valenzuela, but they were not separated

(Doc. 7 at 5). The First Amended Complaint does not allege that Plaintiff submitted any

written requests for separation. 

On October 6, 2010, in support of her motion for summary judgment, Plaintiff

states that she wrote an inmate letter to Renault on October 8, 2008, and “subsequently”

handed it to Renault (PSOF ¶ 5). In the letter Plaintiff attached to her declaration

supporting summary judgment, Plaintiff stated that Valenzuela told Plaintiff that Rowland

knew Plaintiff “was snitching on him” and that Rowland could only know that because

Renault told him (Doc. 97-1 at 25). In that letter, Plaintiff requested that Renault move

Rowland before he became violent toward Plaintiff (id.). Valenzuela states that she did

not have any conversations with Plaintiff on October 7 or 8, 2008, and Plaintiff did not

ask to be separated from Rowland (DSOF ¶¶ 10-11). Renault states that she never

received an inmate letter dated October 8, 2008, from Plaintiff (id. ¶ 5). 

Plaintiff also attached to her declaration inmate letters she claims to have written

on October 16, 2008, addressed to Renault and Valenzuela (PSOF ¶ 6). In these letters

she reported that on October 16, 2008, Rowland accused Plaintiff of snitching on him

about his relationship with Renault and threatened Plaintiff with violence (id.).5

 The

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6

Defendants’ objection to PSOF ¶ 11 on relevancy grounds is overruled (DSCF ¶ 11).

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letters request that a Do-Not-House-With order be placed between Plaintiff and Rowland

(id.). Plaintiff’s declaration does not state when or if Plaintiff gave the letters to anyone. 

Both Renault and Valenzuela state that they never received either of the October 16

inmate letters or any similar inmate letter from Plaintiff (DSOF ¶¶ 6, 13). 

Plaintiff states that Rowland was not subsequently placed on her Do-Not-HouseWith list, and Rowland was released from prison in May 2009 (PSOF ¶¶ 11, 13; DSCF

¶ 13).6

B. Legal Standard

The Eighth Amendment protects prisoners from violence at the hands of other

prisoners. Farmer v. Brennan, 511 U.S. 825, 833 (1994). To prevail on an Eighth

Amendment claim, a plaintiff must demonstrate facts that satisfy a two-part test that

shows the defendant was deliberately indifferent. Id. at 834. First, the plaintiff must

prove that objectively she suffered a sufficiently serious deprivation. Wilson v. Seiter,

501 U.S. 294, 298 (1991). Then, she must prove the subjective element; that the

defendant had a culpable state of mind—was deliberately indifferent—in allowing the

deprivation to occur. Id. at 298-99. A prison official has a sufficiently culpable mind

only if he “knows of and disregards an excessive risk to inmate health or safety; the

official must both be aware of facts from which the inference could be drawn that a

substantial risk of serious harm exists, and [the official] must also draw the inference.” 

Farmer, 511 U.S. at 837; Gibson v. County of Washoe, 290 F.3d 1175, 1187-88 (9th Cir.

2002). 

Where an inmate’s claim is based on the alleged failure to protect, she must show

that prison officials were deliberately indifferent to serious threats to her safety. See

Farmer, 511 U.S. at 834. The inmate may satisfy the “sufficiently serious” requirement

by showing the existence of “conditions posing a substantial risk of serious harm” to her. 

Id. To prove knowledge of the risk, the prisoner may rely on circumstantial evidence; in

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fact, the very obviousness of the risk may be sufficient to establish knowledge. See id. at

842; Wallis v. Baldwin, 70 F.3d 1074, 1077 (9th Cir. 1995). 

C. Analysis

1. Plaintiff’s Motion

Plaintiff asserts that on October 8, 2008, she made requests to Renault and

Valenzuela that she be housed separately from Rowland because Valenzuela told her that

Rowland “knew Plaintiff was snitching on him.” She further asserts that on October 16,

2008, she wrote Renault and Valenzuela inmate letters quoting threats made by Rowland

earlier in the day and requesting again that she be housed separately from Rowland. 

Plaintiff claims that Renault and Valenzuela disregarded that threat in deliberate

indifference to her safety and on October 20, 2008, she was assaulted by Rowland during

which she suffered numerous injuries (Doc. 97-1 at 6-7, Pl. Decl. ¶ 9).

Plaintiff must prove that conditions existed that posed a substantial risk of serious

harm to her and that Renault and/or Valenzuela knew of and disregarded the excessive

risk. Plaintiff’s evidence includes her declaration and copies of inmate letters (Doc. 97-1

at 4-5, Pl. Decl. ¶¶ 6-7; Doc. 97-1 at 25-26, 28 (Oct. 8 and 16, 2008 inmate letters)). 

Defendants assert that Plaintiff’s summary judgment motion must be denied because they

deny that any of the conversations alleged by Plaintiff took place and they deny that they

ever saw any of the inmate letters that Plaintiff claims to have submitted prior to the

alleged assault (Doc. 111 at 15-16). 

On Plaintiff’s motion, Defendants’ evidence is to be believed, and all reasonable

inferences that may be drawn from the facts must be drawn in their favor. See Anderson,

477 U.S. at 255; Matsushita, 475 U.S. at 587. Renault and Valenzuela submit their sworn

statements directly refuting Plaintiff’s claims on every material fact related to Plaintiff’s

failure-to-protect claim (Doc. 112, Ex. A, Renault Decl. ¶¶ 4-7; Ex. B, Valenzuela Decl.

¶¶ 2-5). Therefore, summary judgment for Plaintiff on Count I is not warranted.

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2. Defendants’ Motion

On Defendants’ motion, Plaintiff’s evidence must be assumed to be true, and all

reasonable inferences that may be drawn from the facts must be drawn in her favor. See

Anderson, 477 U.S. at 255; Matsushita, 475 U.S. at 587. But where the record, taken as a

whole, could not lead a rational trier of fact to find for Plaintiff, there is no genuine issue

of material fact for trial. See Matsushita, 475 U.S. at 586. Moreover, “if the factual

context makes the non-moving party’s claim implausible, that party must come forward

with more persuasive evidence than would otherwise be necessary to show that there is a

genuine issue for trial.” Cal. Architectural Bldg. Prods., Inc. v. Franciscan Ceramics,

Inc., 818 F.2d 1466, 1468 (9th Cir. 1987) (citing Matsushita, 475 U.S. at 587). 

A district court should not ordinarily assess the parties’ credibility to resolve a

motion for summary judgment. See, e.g., Berry v. Baca, 379 F.3d 764, 769 (9th Cir.

2004); Hayes v. New York City Dep’t of Corr., 84 F.3d 614, 619 (2d Cir. 1996). 

“However, when evidence is so contradictory and fanciful that it cannot be believed by a

reasonable person, it may be disregarded.” Jeffreys v. Rossi, 275 F. Supp. 2d 463, 476-

477 (S.D.N.Y. 2003) (“[The Plaintiff’s] own testimony is so replete with inconsistencies

and improbabilities that a reasonable jury could not find that excessive force was used

against him.”); see also Villiarimo v. Aloha Island Air, Inc., 281 F.3d 1054, 1061 (9th

Cir. 2002) (stating that uncorroborated allegations and “self-serving testimony” are

insufficient to create a genuine issue of material fact); Riley v. City of Montgomery, Ala.,

104 F.3d 1247, 1251 (11th Cir. 1997) (finding the plaintiff’s “theory of the incident is

inherently incredible and could not support reasonable inferences sufficient to create an

issue of fact.”). 

On October 24, 2008, four days after Plaintiff was assaulted by Rowland, Plaintiff

submitted an inmate letter regarding the assault that did not request to be housed

separately from Rowland and did not state that she had previously requested separate

housing. A month later, on November 24, 2008, Plaintiff submitted an Inmate Grievance

that did not request to be housed separately from Rowland and did not state that she had

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previously submitted written requests for separate housing. Both Plaintiff’s Original

Complaint and her First Amended Complaint allege that on October 8, 2008, she

requested that she be separated from Rowland, but do not allege that she made any

written requests for separate housing. The probability that Plaintiff wrote and submitted

requests for separate housing on October 8, 2008, and October 16, 2008, but failed to

mention them on October 24, 2008, November 24, 2008, and in either of her complaints

approaches zero. Because Plaintiff’s declaration that she made multiple requests in

writing to be housed separately from Rowland before the October 20, 2008 assault is

implausible, and Renault and Valenzuela deny having received any request from Plaintiff

for separate housing, Plaintiff is left with her uncorroborated and inconsistent accounts of

having made oral requests for separate housing before October 20, 2008. Plaintiff has not

produced more persuasive evidence that Renault and Valenzuela knew of and disregarded

an excessive risk to Plaintiff’s safety. 

Thus, Defendants are entitled to summary judgment on Count I because the record,

taking Plaintiff’s evidence to be true, could not lead a rational trier of fact to find that

either Renault or Valenzuela knew of and disregarded conditions that posed a substantial

risk of serious harm to Plaintiff. 

IV. Count II–Dental Care

A. Facts

Plaintiff states that on October 20, 2008, following the assault, she was examined

by Nurse Daley (PSOF ¶ 14; DSOF ¶ 27). Plaintiff states that on October 22, 2008,

Nurse Browning examined Plaintiff’s right pinky finger and noted that it was purple and

swollen with edema; her finger was x-rayed (PSOF ¶ 15; DSCF ¶ 15). Dr. Grant also

examined Plaintiff on October 22; he noted a fractured mandible and red and swollen

tissue (PSOF ¶ 16: DSCF ¶ 16; DSOF ¶ 28). Dr. Grant requested that Plaintiff be seen by

an oral surgeon, ordered a liquid diet, and provided Acetaminophen for pain (DSOF

¶ 28). 

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7

Reduction is restoration of a part to its normal anatomic relation, and open reduction

is defined as “reduction by manipulation of bone, after surgical exposure of the site of the

fracture.” Stedman’s Medical Dictionary reduction (27th ed. 2000).

8

Defendants’ objections to PSOF ¶¶ 20-21 are overruled (DSCF ¶¶ 20-21); the

documents support Plaintiff’s assertions.

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On October 27, 2008, Plaintiff underwent oral surgery with Dr. Thorpe in Gilbert,

Arizona (PSOF ¶ 17; DSCF ¶ 17). Dr. Thorp inserted a bone plate and four screws and

extracted a tooth (id.). During surgery, Plaintiff was administered various sedatives and

pain medications (DSOF ¶ 29). Following surgery, Dr. Thorpe proposed the following

treatment plan: open reduction concerning bone plate and screws, a liquid diet, and 100

mg Darvocet-N as needed (PSOF ¶ 17; DSCF ¶ 17; DSOF ¶ 43).7

 That same day, when

she returned to prison, Plaintiff was given two Ibuprofen tablets by a dental assistant with

authorization by Dr. Vinluan (DSOF ¶ 30; PSCF ¶ 30). 

On October 28, 2008, Plaintiff submitted a health needs request (HNR) in which

she complained about pain and four loose teeth (PSOF ¶ 18; DSCF ¶ 18). That same day,

she saw Dr. Ricard, who noted Plaintiff’s inability to open her mouth to maximum

opening (id.). The next day, Plaintiff was at the Lewis dental clinic again complaining to

Dr. Grant of pain and loose teeth (PSOF ¶ 19; DSCF ¶ 19). On November 7, 2008, Dr.

Grant saw Plaintiff and noted healing within normal limits and provided Ibuprofen for

any pain (DSOF ¶ 33).

On November 10, 2008, Plaintiff submitted an HNR in which she asked that the

loose teeth be extracted, and she wrote that she is “enduring daily increasing jolts of pain,

and it hurts to eat and sleep . . . . I’m exhausted from the pain” (PSOF ¶ 20; Doc. 97-3 at

88). On November 15, 2008, Plaintiff submitted another HNR complaining about an

abscess around a fifth loose tooth (PSOF ¶ 21; Doc. 97-3 at 87).8

 On November 17, 2008,

Dr. Ricard examined Plaintiff and noted that the abscess was due to trauma (PSOF ¶ 22;

DSCF ¶ 22). Dr. Ricard evaluated Plaintiff’s pain needs and determined that a

prescription of Ibuprofen was not necessary or warranted (DSOF ¶ 34). 

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9

Defendants’ objection to PSOF ¶ 23 is sustained in part as to specific statements of

Nurse Ende and Hoffman (DSCF ¶ 23); the Court considers Plaintiff’s assertion for the

purpose of showing when she became aware that Dr. Thorp had recommended Darvocet. As

set forth above, there is no dispute that Dr. Thorp’s treatment plan following surgery

included this recommendation (PSOF ¶ 17; DSCF ¶ 17; DSOF ¶ 43).

10Defendants object to PSOF ¶ 25 on the basis that Plaintiff misconstrues the HNR and

“is improperly embellishing the facts” by asserting that her HNR complained of “continuous”

pain because the word “continuous” is not in the document (DSCF ¶ 25). In the HNR,

Plaintiff wrote that she was “still having pain coursing at the gum area near [her] 4 loose

teeth” (Doc. 97-3 at 83). Plaintiff’s reference to this HNR as a complaint about continuous

pain is appropriate. Defendants’ objection is unsupported and not helpful to the Court’s

analysis. See Fed. R. Civ. P. 11(b). The objection is overruled.

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Plaintiff states that on November 20, 2008, Nurse Lawrence Ende and Nurse Pam

Hoffman examined Plaintiff for non-dental issues, but they also noted Plaintiff’s jaw and

abscess condition (PSOF ¶ 23; Doc. 97-2 at 78).9

 Plaintiff states that she was not aware

until this appointment that Dr. Thorp had recommended Darvocet following surgery, and

she had not received any Darvocet after the surgery (PSOF ¶ 23). Nurse Ende prescribed

Darvocet to be taken twice a day for seven days (id.; Doc. 97-2 at 78; see Doc. 97-4 at 82,

Resp. to Interrog. 18).

On November 21, 2008, Dr. Grant extracted the abscessed tooth (tooth 21) and

issued gauze and salt packets to Plaintiff in addition to the already prescribed Ibuprofen

(PSOF ¶ 24; DSCF ¶ 24; DSOF ¶ 35). On November 25, 2008, Plaintiff submitted an

HNR requesting to be seen because she was still experiencing pain in the area of her loose

teeth (PSOF ¶ 25).10 Plaintiff saw Dr. Joseph on December 5, 2008 (PSOF ¶ 26; DSOF

¶ 37). The parties dispute whether Plaintiff complained of pain or declared that she was

better at that time (PSOF ¶ 26; DSCF ¶ 26). The dental record from this appointment

states “[Plaintiff] reported pain and loose teeth 23-24-25; Area 21 that is ‘better

now’—Area 21 healing well. 23–25 have very little mobility” (Doc. 97-4 at 73). No

treatment was done at that time (DSOF ¶ 37). 

On January 28, 2009, Plaintiff submitted an HNR in which she complained of

ongoing pain near the gum line of her jaw fracture and stated that the pain is causing her

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11Defendants’ objection to PSOF ¶ 27 is overruled (DSCF ¶ 27); Plaintiff’s assertion

is supported by the HNR. See n. 10.

12Defendants’ objections to PSOF ¶¶ 31-32 are overruled (DSCF ¶¶ 31-32); the

subject HNRs are in the record and support Plaintiff’s assertions (PSCF ¶¶ 31-32, citing Doc.

13, Ex. S). 

13Defendants’ objection to PSOF ¶ 41 is overruled (DSCF ¶ 41). Plaintiff’s factual

assertion is not a legal conclusion, it is supported by her declaration, and she has personal

knowledge to testify as to the pain she suffers.

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to lose sleep (PSOF ¶ 27; Doc. 97-3 at 79).11 Dr. Joseph saw Plaintiff on January 30,

2009 (PSOF ¶ 28; DSOF ¶ 39). Plaintiff states that she complained of unbearable,

chronic pain, and that Dr. Joseph told her to submit another HNR in three months and her

healing will be evaluated (PSOF ¶ 28). Defendants state that Plaintiff did not complain of

unbearable pain and that Dr. Joseph took an x-ray that showed Plaintiff’s bone was

healing properly and there were no significant findings (DSCF ¶ 28). 

Plaintiff submitted HNRs in April and May 2009 complaining about tremendous

pain and concern that two screws were shifting in her jaw (PSOF ¶¶ 31-32).12 Plaintiff

states that she was seen on May 29, 2009 by Drs. Grant and Joseph, and although she was

experiencing pain, she was not provided any pain medication (PSOF ¶ 33). Defendants

state that at this May 29 appointment, Dr. Grant did not prescribe pain medication

because it was not necessary and Plaintiff did not request any (DSOF ¶ 41).

On or about June 18, 2009, Plaintiff saw the oral surgeon for screw removal from

the bone plate (DSOF ¶ 42; PSCF ¶ 42). Plaintiff states that she still suffers electricallike jolts of pain in her gums almost two years after the assault (PSOF ¶ 41).13

B. Legal Standard

To prevail on an Eighth Amendment medical or dental care claim, a prisoner must

demonstrate “deliberate indifference to serious medical needs.” Jett v. Penner, 439 F.3d

1091, 1096 (9th Cir. 2006) (citing Estelle v. Gamble, 429 U.S. 97, 104 (1976)). There are

two prongs to the deliberate-indifference analysis. First, a prisoner must show a “serious

medical need.” Jett, 439 F.3d at 1096 (citations omitted). A “‘serious’ medical need

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exists if the failure to treat a prisoner’s condition could result in further significant injury

or the ‘unnecessary and wanton infliction of pain.’” McGuckin v. Smith, 974 F.2d 1050,

1059 (9th Cir. 1992), overruled on other grounds, WMX Techs., Inc. v. Miller, 104 F.3d

1133, 1136 (9th Cir. 1997) (en banc) (internal citation omitted). Examples of a serious

medical need include “[t]he existence of an injury that a reasonable doctor or patient

would find important and worthy of 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.” McGuckin, 974 F.2d at 1059-60.

Second, a prisoner must show that the defendant’s response to that need was

deliberately indifferent. Jett, 439 F.3d at 1096. This second prong is met if the prisoner

demonstrates (1) a purposeful act or failure to respond to a prisoner’s medical need and

(2) harm caused by the indifference. Id. Prison officials are deliberately indifferent to a

prisoner’s serious medical needs if they deny, delay, or intentionally interfere with

medical treatment. Wood v. Housewright, 900 F.2d 1332, 1334 (9th Cir. 1990). But a

delay in providing medical treatment does not constitute an Eighth Amendment violation

unless the delay was harmful. Hunt v. Dental Dep’t, 865 F.2d 198, 200 (9th Cir. 1989)

(citing Shapley v. Nevada Bd. of State Prison Comm’rs, 766 F.2d 404, 407 (9th Cir.

1985) (per curiam)). 

A mere difference of opinion as to which medically acceptable course of treatment

should be followed does not establish deliberate indifference. See Sanchez v. Vild, 891

F.2d 240, 242 (9th Cir. 1989). Where doctors have chosen one course of action and a

plaintiff contends that they should have chosen another course of action, the plaintiff

“must show that the course of treatment the doctors chose was medically unacceptable

under the circumstances, . . . and the plaintiff must show that they chose this course in

conscious disregard of an excessive risk to plaintiff’s health.” Jackson v. McIntosh, 90

F.3d 330, 332 (9th Cir. 1996) (internal citations omitted).

Defendants make no argument that Plaintiff did not suffer from a serious medical

or dental need. See Jett, 439 F.3d at 1096. The evidence reflects that Plaintiff’s broken

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jaw and dental problems warranted surgery and ongoing treatment, which she received. 

Thus, the deliberate-indifference analysis turns on whether Defendants were deliberately

indifferent to Plaintiff’s pain management needs.

C. Analysis

In Count II of her First Amended Complaint, Plaintiff defines the injury caused by

Drs. Grant, Ricard, and Joseph as “ongoing excruciating pain from deprivation of pain

medication.” (Doc. 7 at 8.) She alleges that these defendants only offered her

“ineffective aspirin and ibuprofen on occasion” and denied her Darvocet, a narcotic pain

medication that she claims was effective in providing her pain relief. (Docs. 7 at 10, 11;

124 at 16.) She further alleges on three occasions after the October 20, 2008 assault she

was given “ineffective over-the-counter aspirin or ibuprofen,” which never alleviated any

of her pain. She also alleges that since late November 2008, these defendants “adamantly

refuse Plaintiff effective pain medication for pain from serious physical injuries.” (Doc. 7

at 10.) In her reply in support of her motion for summary judgment, Plaintiff states,

“Ibuprofen, aspirin, acetaminophen and penicillin have not been adequate pain relievers

for the Plaintiff,” but “Darvocet was effective.” (Doc. 124 at 16.) Thus, Plaintiff’s claim

is that Drs. Grant, Richard, and Joseph were deliberately indifferent to her serious

medical need by prescribing ineffective pain medications, i.e., Acetominophen and

Ibuprofen, rather than Darvocet, which was effective. And she further contends that the

fact that a non-dental nurse prescribed a week’s supply of Darvocet and an oral surgeon

outside the prison proposed treating with Darvocet demonstrates that Drs. Grant, Richard,

and Joseph should have continued to refill her Darvocet prescription for ongoing pain.

But a mere difference of opinion regarding treatment does not establish deliberate

indifference. See Sanchez, 891 F.2d at 242. Whether Drs. Grant, Richard, and Joseph

correctly or incorrectly relied on medical records showing that Plaintiff had previously

abused narcotic drugs is irrelevant to this Eighth Amendment claim. Further, it cannot be

assumed that Darvocet or any other pain medication would have successfully relieved all

of Plaintiff’s pain from a broken jaw, insertion of a bone plate and four screws, tooth

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extraction, loose teeth, a dental abscess, a second tooth extraction, removal of screws

from the bone plate, and related nerve damage. The evidence shows Drs. Grant, Richard,

and Joseph provided Plaintiff with treatment based on their professional judgment and not

in conscious disregard of an excessive risk to Plaintiff’s health. Thus, Defendants are

entitled to summary judgment on Count II because the record, taking Plaintiff’s evidence

to be true, could not lead a rational trier of fact to find that Drs. Grant, Richard, and

Joseph were deliberately indifferent to Plaintiff’s serious medical need. 

In her reply in support of her motion for summary judgment, Plaintiff also asserts

that on numerous occasions she submitted requests for pain evaluation, was examined and

often treated, and on some of those occasions not provided pain medication. (Doc. 124 at

31-32.) She further contends that no pain medication has been given to her since

December 2009. (Id. at 16.) She has not, however, stated that she requested any

medication other than Darvocet. Further, because over-the-counter aspirin or ibuprofen

has been ineffective, Plaintiff cannot have been harmed by not receiving them more

frequently. Moreover, any deliberate indifference to Plaintiff’s serious medical needs

after December 2009 is outside the scope of this lawsuit filed in June 2009 after

concluding administrative proceedings. Thus, to the extent that Plaintiff raises for the

first time in her reply a claim that Drs. Grant, Richard, and Joseph were deliberately

indifferent to Plaintiff’s serious medical need by denying her non-prescription pain

medication, the claim is not properly before the Court. Further, Drs. Grant, Richard, and

Joseph are entitled to summary judgment on that claim as well because, taking Plaintiff’s

evidence to be true, a rational trier of fact could not find that Drs. Grant, Richard, and

Joseph were deliberately indifferent to Plaintiff’s serious medical need by denying her

non-prescription pain medication. 

IT IS ORDERED:

(1) The reference to the Magistrate Judge is withdrawn as to Plaintiff’s Motion

for Summary Judgment (Doc. 96), and Defendants’ Cross-Motion for Summary Judgment

(Doc. 111).

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(2) Plaintiff’s Motion for Summary Judgment (Doc. 96) is denied.

(3) Defendants’ Cross-Motion for Summary Judgment (Doc. 111) is granted.

(4) The Clerk shall enter judgment in favor of Defendants and that the Plaintiff

take nothing. The Clerk shall terminate this action.

DATED this 21st day of September, 2011.

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