Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_15-cv-00681/USCOURTS-cand-3_15-cv-00681-5/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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United States District Court 

Northern District of Californi

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UNITED STATES DISTRICT COURT 

NORTHERN DISTRICT OF CALIFORNIA 

MICHAEL WALTER BERGER,

Plaintiff, 

v. 

JEFFREY BEARD, 

Defendant. 

Case No. 15-cv-0681-TEH 

ORDER GRANTING DEFENDANT’S 

MOTION FOR SUMMARY JUDGMENT 

Dkt. Nos. 21, 32 

Plaintiff Michael Berger, a former state prisoner, filed 

this pro se action under 42 U.S.C. § 1983. This case proceeds 

against Defendant Dr. Palmer who is a surgeon employed by 

Monterey County at Natividad Medical Center. Plaintiff alleges 

that Defendant provided inadequate medical care for the treatment 

of Plaintiff’s bowel obstruction. Defendant has filed a motion 

for summary judgment. Despite being provided several extensions, 

Plaintiff has not filed an opposition, though he did file a 

three-page declaration that the Court has reviewed in addition to 

the allegations in the complaint.1

 The Court has looked to the 

 

1

 Plaintiff was paroled from prison on June 27, 2015. Docket No. 

16. This motion for summary judgment was filed on November 20, 

2015. Docket No. 21. Plaintiff became detained in Sacramento 

County Jail around March 2016. Docket No. 37. When Plaintiff 

was incarcerated in prison another inmate was aiding with the 

litigation. After Plaintiff’s release the Court denied requests 

for the inmate to be granted “next fried” status and litigate the 

case on Plaintiff’s behalf. Docket No. 28. The Court has still 

reviewed the motion to compel filed by that inmate but denies it 

because it contains no specific requests. Moreover, the motion 

for summary judgment contains more than 300 pages of Plaintiff’s 

medical records covering his time at several hospitals. 

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merits of the motion for summary judgment and for the reasons 

that follow, Defendant’s motion is GRANTED. 

I 

 Plaintiff was incarcerated at Correctional Training Facility 

during the relevant time.2 Complaint at 10. Defendant was a 

surgeon at Natividad Medical Center (“NMC”) during the relevant 

time. Motion for Summary Judgment (“MSJ”) at Ex. 1 at 1. 

Defendant treated Plaintiff at NMC on many occasions from October 

5, 2011, to November 18, 2013, for a bowel obstruction and 

related issues. MSJ, Ex. 1 at 1, 10.3 

 On October 5, 2011, Plaintiff was transported to NMC where 

he complained of nausea, vomiting, and abdominal pain. MSJ, Ex. 

F at 3-5. A CT scan was performed that revealed a severe 

stenosis of his prior anastomosis, along the staple line. 

Defendant performed surgery on Plaintiff that same day to address 

a bowel obstruction. Defendant observed a near complete bowel 

obstruction at the previous anastomotic site so he performed a 

small bowel resection and colostomy. Id. at 6-9, 299-301. 

 On October 7, 2011, Defendant again operated on Plaintiff 

for post-operative bleeding and resected an additional section of 

the bowel. Id. Defendant continued to treat Plaintiff until he 

was discharged. MSJ, Ex. 1 at 3. 

 

2

 The following facts, unless otherwise noted, are undisputed. 

3 Plaintiff received other bowel treatment prior to his arrival at 

NMC. In January 2010 he underwent a laparoscopic sigmoidectomy 

at Community Regional Medical Center in Fresno. MSJ, Ex. G at 

654-58. In March 2010, Plaintiff was taken to the emergency room 

at Mercy Hospital in Bakersfield where he underwent a laparotomy 

involving a partial rectosigmoid colectomy. Id. at 9-10. 

Another bowel surgery was performed on Plaintiff at Mercy 

Hospital in January 2011. Id. at 684-88.

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Defendant continued to treat Plaintiff on an outpatient 

basis after he was discharged. Id. Defendant treated Plaintiff 

on November 29, 2011, and performed a colonoscopy on Plaintiff on 

December 14, 2011. Id. On December 29, 2011, Defendant again 

performed surgery on Plaintiff, taking down his colostomy and 

reconnecting the colon to the rectum. Id. Plaintiff remained at 

the hospital following the surgery until he was discharged on 

January 20, 2011. Id. at 4. 

Defendant treated Plaintiff again on January 27, 2011, and 

on February 5, 2012, when Plaintiff returned with drainage from 

the incision site. Id. It was determined that Plaintiff was 

suffering from an enterocultaneous fistula, which is a recognized 

risk of bowel surgery and allows the contents of the bowel to 

leak through the opening in the skin. Id. After Plaintiff was 

observed for several days, he was released for the fistula to 

heal on its own, if possible. Id. 

Defendant saw and treated Plaintiff four more times between 

February 21 and May 22, 2012. During this time Defendant noted 

that the drainage had reduced markedly and Plaintiff indicated 

that he was having normal bowel movements and denied nausea or 

vomiting. Id. at 5-6. On May 22, 2012, Defendant treated the 

fistula and recommended a CT scan. Id. At a different hospital, 

Plaintiff received a fistulogram, which showed only a sinus tract 

connecting with a localized small cavity and no communication 

with the bowel. MSJ, Ex. I at 101. Defendant treated Plaintiff 

on August 24, 2012, and after reviewing the fistulogram 

cauterized the fistula opening. MSJ, Ex. 1 at 6. 

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Defendant treated Plaintiff again on September 7 and 

November 20, 2012. Id. at 6-7. On December 6, 2012, Defendant 

performed a wound exploration and debridement in the operating 

room and excised the fistula tract. Id. at 7. Defendant saw 

Plaintiff six more times between December 21, 2012, and June 7, 

2013. Id. at 7-9. On June 7, 2013, Defendant placed a Penrose 

drain in the wound to facilitate drainage and healing. Id. at 9. 

Another doctor removed the Penrose drain but Plaintiff saw 

Defendant again on July 9, 2013, when Defendant inspected the 

wound and observed that the fistula tract extended about 4 cm 

deep. Id. Defendant also discussed treatment options with 

Plaintiff, who was reluctant to undergo further surgery. Id. 

Another CT scan was performed and more options were discussed 

with Plaintiff, who then agreed with further surgery. Id. When 

Defendant saw Plaintiff again on September 3, 2013, he was doing 

well, but surgery was still the recommendation. Id. at 10. 

Defendant saw Plaintiff for the last time on November 18, 

2013. Id. Prior to that visit, Plaintiff was seen by a doctor 

at the University of California San Francisco who planned to 

perform two abdominal surgeries, but first a pre-surgery 

colonoscopy was ordered. Id. Defendant performed the presurgery colonoscopy on Plaintiff. Id. This was the last 

interaction between the parties. Id. 

 Plaintiff underwent the first surgery at the University of 

California San Francisco on March 28, 2014, and the second 

surgery on February 13, 2015. MSJ, Ex. H at 2-20, 536-53. A 

third surgery was performed on June 23, 2015. Id. at 1431-42. 

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 Defendant has also included a declaration from Dr. Barry 

Gardiner, a board certified surgeon, who reviewed Plaintiff’s 

medical records and Defendant’s treatment. MSJ, Ex. 3. Dr. 

Gardiner declared that Defendant’s care was appropriate and 

conformed with the professional standard of care and that 

Defendant was not indifferent to Plaintiff’s medical needs. Id. 

at 3. 

 Plaintiff does dispute the facts set forth above. Plaintiff 

has not filed an opposition, but he did file a three-page 

declaration stating that Defendant was negligent in his care. 

Docket No. 31 at 9. In the complaint, Plaintiff argues that 

Defendant denied needed medical treatment and did not properly 

treat him. Complaint at 10-13. He states that Defendant did not 

properly treat the fistula which caused further bowel problems. 

Id. at 13. 

II 

A 

Summary judgment is properly granted when no genuine 

disputes of material fact remain and when, viewing the evidence 

most favorably to the nonmoving party, the movant is clearly 

entitled to prevail as a matter of law. Fed. R. Civ. P. 56(c); 

Celotex v.Catrett, 477 U.S. 317, 322-23 (1986); Eisenberg v. Ins. 

Co. of N. Am., 815 F.2d 1285, 1288-89 (9th Cir. 1987). The 

moving party bears the burden of showing there is no material 

factual dispute. Celotex, 477 U.S. at 331. Therefore, the Court 

must regard as true the opposing party's evidence, if supported 

by affidavits or other evidentiary material. Id. at 324; 

Eisenberg, 815 F.2d at 1289. The Court must draw all reasonable 

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inferences in favor of the party against whom summary judgment is 

sought. Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 

U.S. 574, 587 (1986); Intel Corp. v. Hartford Accident & Indem. 

Co., 952 F.2d 1551, 1559 (9th Cir. 1991). 

The moving party bears the initial burden of identifying 

those portions of the pleadings, discovery and affidavits which 

demonstrate the absence of a genuine issue of material fact. 

Celotex, 477 U.S. at 323. If the moving party meets its burden 

of production, the burden then shifts to the opposing party to 

produce “specific evidence, through affidavits or admissible 

discovery material, to show that the dispute exists.” Bhan v. 

NME Hosps., Inc., 929 F.2d 1404, 1409 (9th Cir.) cert. denied, 

502 U.S. 994 (1991); Nissan Fire & Marine Ins. Co. v. Fritz Cos., 

210 F.3d 1099, 1105 (9th Cir. 2000). 

Material facts that would preclude entry of summary judgment 

are those which, under applicable substantive law, may affect the 

outcome of the case. The substantive law will identify which 

facts are material. Anderson v. Liberty Lobby, Inc., 477 U.S. 

242, 248 (1986). Questions of fact regarding immaterial issues 

cannot defeat a motion for summary judgment. Reynolds v. County 

of San Diego, 84 F.3d 1162, 1168-70 (9th Cir. 1996), rev'd on 

other grounds by Acri v. Varian Associates, Inc., 114 F.3d 999 

(9th Cir. 1997). A dispute as to a material fact is genuine if 

there is sufficient evidence for a reasonable jury to return a 

verdict for the nonmoving party. Anderson, 477 U.S. at 248. 

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B 

Deliberate indifference to serious medical needs violates 

the Eighth Amendment’s proscription against cruel and unusual 

punishment. Estelle v. Gamble, 429 U.S. 97, 104 (1976); McGuckin 

v. Smith, 974 F.2d 1050, 1059 (9th Cir. 1992), overruled on other 

grounds, WMX Technologies, Inc. v. Miller, 104 F.3d 1133, 1136 

(9th Cir. 1997) (en banc). A determination of “deliberate 

indifference” involves an examination of two elements: the 

seriousness of the prisoner’s medical need and the nature of the 

defendant’s response to that need. Id. at 1059. 

A “serious” medical need exists if the failure to treat a 

prisoner’s condition could result in further significant injury 

or the “unnecessary and wanton infliction of pain.” Id. The 

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 are examples of indications that a prisoner has a “serious” 

need for medical treatment. Id. at 1059-60. 

A defendant is deliberately indifferent if he or she knows 

that a prisoner faces a substantial risk of serious harm and 

disregards that risk by failing to take reasonable steps to abate 

it. Farmer v. Brennan, 511 U.S. 825, 837 (1994). Deliberate 

indifference describes a state of mind more blameworthy than 

negligence and requires “more than ordinary lack of due care for 

the prisoner’s interests or safety.” Id. at 835. Thus, if a 

defendant should have been aware of the substantial risk of 

serious harm, but was not, then the defendant has not violated 

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the Eighth Amendment, no matter how severe the risk. Gibson v. 

County of Washoe, 290 F.3d 1175, 1188 (9th Cir. 2002). 

Consequently, in order for deliberate indifference to be 

established, there must exist both a purposeful act or failure to 

act on the part of the defendant and harm resulting therefrom. 

McGuckin, 974 F.2d at 1060. 

A difference of opinion between a prisoner-patient and 

prison medical authorities regarding treatment does not give rise 

to a § 1983 claim. Franklin v. Oregon, 662 F.2d 1337, 1344 (9th 

Cir. 1981). Similarly, a showing of nothing more than a 

difference of medical opinion as to the need to pursue one course 

of treatment over another is insufficient, as a matter of law, to 

establish deliberate indifference. Toguchi v. Chung, 391 F.3d 

1051, 1058-60 (9th Cir. 2004). 

III 

It is undisputed that Defendant saw Plaintiff on 

approximately 19 outpatient visits over 25 months and treated 

Plaintiff during three hospitalizations, during which time he 

performed four separate surgical procedures. Defendant has 

presented a great deal of evidence demonstrating that he provided 

appropriate medical care. Defendant has also included a medical 

expert opinion from another doctor stating that he provided 

proper care. 

Defendant, the moving party, has met his burden in 

demonstrating the absence of a genuine issue of material fact. 

Plaintiff has failed to meet his burden to show the existence of 

any disputed fact to oppose summary judgment. Plaintiff has 

failed to file an opposition or discuss any of the arguments or 

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evidence presented by Defendant. Plaintiff argues in his 

complaint and brief declaration that Defendant was negligent and 

reckless in his care and did not properly treat the fistula, 

causing further bowel problems. Other than these conclusory 

statements, Plaintiff provides no other evidence in support. 

This is insufficient to defeat summary judgment. See Soremekun 

v. Thrifty Payless, Inc., 509 F.3d 978, 984 (9th Cir. 2007) 

(“Conclusory, speculative testimony in affidavits and moving 

papers is insufficient to raise genuine issues of fact and defeat 

summary judgment.”) 

The undisputed facts described above demonstrate that each 

time Plaintiff was admitted to the hospital he received 

comprehensive treatment and care by Defendant. Plaintiff was 

also properly treated during his outpatient visits. It is also 

undisputed that Plaintiff was suffering from bowel problems and 

underwent multiple surgical procedures prior to any involvement 

by Defendant. 

Plaintiff states that another surgeon at the University 

California San Francisco stated that Defendant performed faulty 

and negligent stitching in the abdominal wall when treating the 

fistula. Docket No. 31 at 9. Plaintiff states that this caused 

a large hernia. However, Plaintiff does not provide a 

declaration from this surgeon, nor does Plaintiff identify where 

this is stated in the medical records from the University 

California San Francisco. A review of the records does not 

reflect this allegation. 

Assuming arguendo that Plaintiff’s condition worsened due to 

an error caused by Defendant in treating the fistula, Plaintiff 

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provides no evidence to support negligence let alone the higher 

standard for deliberate indifference. There is no evidence to 

support a deliberately indifferent state of mind, which is more 

blameworthy than negligence and requires “more than ordinary lack 

of due care for the prisoner’s interests or safety.” Farmer, 511 

U.S. at 835. Plaintiff has not identified a purposeful act or 

failure to act on the part of Defendant that resulted in harm. 

See McGuckin, 974 F.2d at 1060. 

The Court has not found a constitutional violation, yet even 

if there was such a violation Defendant is entitled to qualified 

immunity. It would not be clear to a reasonable official that 

providing all the medical care and surgery which was provided 

would be unlawful. See Saucier v. Katz, 533 U.S. 194, 202 (2001) 

For all these reasons, summary judgment is granted. 

IV 

For the foregoing reasons, the Court hereby orders as 

follows: 

1. Plaintiff’s motion to compel filed by a third party 

(Docket No. 32) is DENIED for the reasons set forth above. 

2. Defendant’s motion for summary judgment (Docket No. 21) 

is GRANTED. 

2. The Clerk shall close the file. This order terminates 

Docket Nos. 21, 32. 

IT IS SO ORDERED. 

Dated: 04/08/2016 

________________________ 

THELTON E. HENDERSON 

United States District Judge 

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