Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_14-cv-04686/USCOURTS-cand-3_14-cv-04686-6/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 California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

San Francisco Division

KARLTON MCGARY,

Plaintiff,

v.

LINA MANGLICMOT, et al.,

Defendants.

Case No. 14-cv-04686-LB

ORDER GRANTING THE DEFENDANT 

PALOMERO’S MOTION FOR 

SUMMARY JUDGMENT

[Re: ECF No. 58 ]

INTRODUCTION

Karlton McGary filed this pro se prisoner‟s civil rights action under 42 U.S.C. § 1983 to 

complain about the conditions at the Correctional Training Facility in Soledad. The parties have 

consented to proceed before a magistrate judge. (ECF No. 1 at 4; ECF Nos. 20-23.1) The court 

earlier granted the defendants‟ motion for summary judgment on most of the claims due to Mr. 

McGary‟s failure to exhaust administrative remedies for those claims. The lone remaining claim is 

a medical-care claim against Dr. G. Palomero, who now moves for summary judgment on that 

claim. Mr. McGary does not oppose the motion. For the reasons discussed below, the court grants 

Dr. Palomero‟s motion for summary judgment and will enter judgment against Mr. McGary.

 

1 Citations are to material in the Electronic Case File (“ECF”); pinpoint cites are to the ECFgenerated page numbers at the top of the documents.

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STATEMENT

The claim remaining for adjudication is an Eighth Amendment claim that Dr. G. Palomero was 

deliberately indifferent to Mr. McGary‟s medication needs. Mr. McGary alleges in his unverified 

amended complaint that he had “advanced lower lumbar degen[e]rative disc disease,” which 

caused him acute and occasionally disabling pain. (ECF No. 8 at 2.) He further alleges that Dr. 

Palomero was deliberately indifferent to his medical needs in that Dr. Palomero “refus[ed] to 

discuss long-term pain management medications alread[y] approved” for Mr. McGary, and this 

refusal caused Mr. McGary to be without pain medications for extended periods of time. (ECF No. 

8 at 6.) The events giving rise to the claim against Dr. Palomero occurred at the Correctional 

Treatment Center in Soledad (CTF-Soledad), where Mr. McGary was housed in or about 2013-

2014. After filing this action, Mr. McGary was released from prison. (See ECF No. 42-1.)

The following facts are undisputed unless otherwise noted.

G. Palomero, M.D., is a doctor who has worked at CTF-Soledad since July 2012. (ECF No. 59 

at 1.)

Mr. McGary suffers from severe and chronic lower-back pain. This condition can be treated, 

but not cured. Typically, treatment consists of pain medication and physical therapy to manage the 

patient‟s pain level and help improve his daily living activities. “Severe chronic pain is usually 

treated using long term time release opiates such as morphine or methadone.” (Id. at 2.)

Dr. Palomero examined and treated Mr. McGary on only four occasions at CTF-Soledad, i.e., 

on June 17, 2013, November 25, 2013, January 14, 2014, and March 6, 2014.

On June 17, 2013, Dr. Palomero treated Mr. McGary for complaints of chronic lower-back 

pain. At the time, Mr. McGary was receiving Tylenol III, a short-term opiate, to treat his pain. Mr. 

McGary claimed the Tylenol III was causing him to twitch. Dr. Palomero offered to prescribe 

morphine for pain management, but Mr. McGary declined. Dr. Palomero instead prescribed 

amitriptyline and sent Mr. McGary to physical therapy. Amitriptyline is an antidepressant, but also 

can be used for pain relief, as it was here. (Id.)

At a visit to Dr. Palomero on November 25, 2013, Mr. McGary again complained of lowerback pain and said he no longer wanted to take amitriptyline because of his perception that it was a 

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“psych drug.” (Id.) Dr. Palomero again suggested Mr. McGary try either morphine or methadone, 

and Mr. McGary again declined. Mr. McGary was prescribed oxcarbazepine (also known as 

Trileptal) for pain management. (Id.)

Dr. Palomero next saw Mr. McGary on January 14, 2014, at which time Mr. McGary 

complained of lower-back pain and reported that he had run out of his medication two days earlier.

Mr. McGary‟s pain was worse due to the lack of medication and he appeared to be limping.

According to Dr. Palomero, patients have the option to make a direct request to the pharmacy for 

prescription refills or can make a doctor‟s appointment to obtain prescription refills; the former is 

quicker and easier. Dr. Palomero advised Mr. McGary that he should seek a refill as soon as 

possible and not wait for a doctor‟s appointment. Mr. McGary was again offered stronger pain 

medications such as morphine or methadone, and again declined. Mr. McGary‟s prescription for 

oxcarbazepine was refilled, and acetaminophen was prescribed to assist with pain management.

(Id.)

At a visit to Dr. Palomero on March 6, 2014, Mr. McGary complained of lower-back pain and 

stated he had difficulty walking as a result of the pain. Mr. McGary was able to perform his job as 

a barber, but his pain was not well managed. Dr. Palomero explained that chronic lower-back pain

such as Mr. McGary was suffering from, usually is treated with long-lasting time-release opiates 

such as morphine or methadone. This time, Mr. McGary agreed to try a small dosage of morphine 

and acetaminophen while tapering off the oxcarbazepine. Mr. McGary was scheduled for a followup appointment in 60-90 days, but was transferred to another facility before that appointment

occurred. (Id.)

Dr. Palomero summarized Mr. McGary‟s pain medication thusly: Mr. McGary “was initially 

unwilling to take the long lasting opiates to treat his condition and instead chose a series of less 

effective pain medications with less than satisfactory results. After a period of poorly managed 

pain, he agreed to try morphine, but he was transferred to another facility before [Dr. Palomero] 

could examine him again” to determine the effectiveness of the treatment. (ECF No. 59 at 3-4.) In 

Dr. Palomero‟s medical opinion, Mr. McGary “received the most effective pain management 

treatment available that he was willing to accept.” (Id. at 4.)

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SUMMARY-JUDGMENT STANDARD

The court must grant a motion for summary judgment if the movant shows that there is no 

genuine dispute as to any material fact and the moving party is entitled to judgment as a matter of 

law. Fed. R. Civ. P. 56(a); Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48 (1986). Material 

facts are those that may affect the outcome of the case. Anderson, 477 U.S. at 248. A dispute about 

a material fact is genuine if there is sufficient evidence for a reasonable jury to return a verdict for 

the non-moving party. Id. at 248-49.

The party moving for summary judgment bears the initial burden of informing the court of the 

basis for the motion, and identifying portions of the pleadings, depositions, answers to 

interrogatories, admissions, or affidavits which demonstrate the absence of a triable issue of 

material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). To meet its burden, “the moving 

party must either produce evidence negating an essential element of the nonmoving party's claim 

or defense or show that the nonmoving party does not have enough evidence of an essential 

element to carry its ultimate burden of persuasion at trial.” Nissan Fire & Marine Ins. Co., Ltd. v. 

Fritz Cos., Inc., 210 F.3d 1099, 1102 (9th Cir. 2000); see Devereaux v. Abbey, 263 F.3d 1070, 

1076 (9th Cir. 2001) (“When the nonmoving party has the burden of proof at trial, the moving 

party need only point out „that there is an absence of evidence to support the nonmoving party's 

case.‟”) (quoting Celotex, 477 U.S. at 325).

If the moving party meets its initial burden, the burden shifts to the non-moving party to 

produce evidence supporting its claims or defenses. Nissan Fire & Marine Ins. Co., Ltd., 210 F.3d 

at 1103. The non-moving party may not rest upon mere allegations or denials of the adverse 

party's evidence, but instead must produce admissible evidence that shows there is a genuine issue 

of material fact for trial. See Devereaux, 263 F.3d at 1076. If the non-moving party does not 

produce evidence to show a genuine issue of material fact, the moving party is entitled to 

summary judgment. See Celotex, 477 U.S. at 323.

In ruling on a motion for summary judgment, inferences drawn from the underlying facts are 

viewed in the light most favorable to the non-moving party. Matsushita Elec. Indus. Co. v. Zenith 

Radio Corp., 475 U.S. 574, 587 (1986).

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

on personal knowledge and sets forth specific facts admissible in evidence. See Schroeder v. 

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

opposing affidavit where, even though verification not in conformity with 28 U.S.C. § 1746, 

plaintiff stated under penalty of perjury that contents were true and correct, and allegations were 

not based purely on his belief but on his personal knowledge). Mr. McGary‟s complaint (but not 

his amended complaint) is signed under penalty of perjury, so the facts in the complaint (but not 

the amended complaint) are evidence for purposes of evaluating the defendant‟s motion for 

summary judgment.

ANALYSIS

Deliberate indifference to an inmate‟s serious medical need violates the Eighth Amendment‟s 

proscription against cruel and unusual punishment. See Estelle v. Gamble, 429 U.S. 97, 104 

(1976); Toguchi v. Chung, 391 F.3d 1051, 1057 (9th Cir. 2004). To establish an Eighth 

Amendment claim on a condition of confinement, such as medical care, a prisoner-plaintiff must 

show: (1) an objectively, sufficiently serious, deprivation, and (2) the official was, subjectively, 

deliberately indifferent to the inmate‟s health or safety. See Farmer v. Brennan, 511 U.S. 825, 834 

(1994). These two requirements are known as the objective and subjective prongs of an Eighth 

Amendment deliberate indifference claim.

To satisfy the objective prong, there must be a deprivation of a “serious” medical need. A 

serious medical need exists if the failure to treat an inmate‟s condition could result in further 

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

The evidence in the record is that Mr. McGary had severe and chronic lower-back pain that 

was of the sort for which the usual treatment included opiates. This evidence would permit a jury 

to find the existence of an objectively serious medical need. Cf. Lolli v. Cnty. of Orange, 351 F.3d 

410, 419 (9th Cir. 2003) (Type I diabetes is a serious medical need). Dr. Palomero does not 

dispute that Mr. McGary‟s lower-back pain was a serious medical condition.

For the subjective prong of an Eighth Amendment claim, there must be deliberate indifference. 

A defendant is deliberately indifferent if he knows that an inmate faces a substantial risk of serious 

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harm and disregards that risk by failing to take reasonable steps to abate it. Farmer, 511 U.S. at

837. The defendant must not only “be aware of facts from which the inference could be drawn that 

a substantial risk of serious harm exists,” but he “must also draw the inference.” Id. If the 

defendant should have been aware of the risk, but was not, then he has not violated the Eighth 

Amendment, no matter how severe the risk. Gibson v. Cnty. of Washoe, 290 F.3d 1175, 1188 (9th 

Cir. 2002), overruled on other grounds by Castro v. Cnty. of Los Angeles, No. 12-56829, slip op. 

at 31 (9th Cir. Aug. 15, 2016) (en banc). Deliberate indifference may be demonstrated when 

prison officials deny, delay or intentionally interfere with medical treatment, or it may be inferred 

from the way in which prison officials provide medical care. See McGuckin v. Smith, 974 F.2d 

1050, 1062 (9th Cir. 1992) (finding that a delay of seven months in providing medical care during 

which a medical condition was left virtually untreated and plaintiff was forced to endure 

“unnecessary pain” sufficient to present colorable § 1983 claim), overruled on other grounds by 

WMX Techs., Inc. v. Miller, 104 F.3d 1133, 1136 (9th Cir. 1997) (en banc). Negligence does not 

amount to deliberate indifference and does not satisfy the subjective prong of an Eighth 

Amendment claim. See Wilhelm v. Rotman, 680 F.3d 1113, 1122-23 (9th Cir. 2012) (finding no 

deliberate indifference but merely a “negligent misdiagnosis” by defendant-doctor who decided 

not to operate because he thought plaintiff was not suffering from a hernia).

A difference of opinion as to which medically acceptable course of treatment should be 

followed does not establish deliberate indifference. See Toguchi, 391 F.3d at 1058; Sanchez v. 

Vild, 891 F.2d 240 (9th Cir. 1989). “[T]o prevail on a claim involving choices between alternative 

courses of treatment, a prisoner must show that the chosen course of treatment „was medically 

unacceptable under the circumstances,‟ and was chosen „in conscious disregard of an excessive 

risk to [the prisoner‟s] health.‟” Toguchi, 391 F.3d at 1058 (second alteration in original); see

Jackson v. McIntosh, 90 F.3d 330, 332 (9th Cir. 1996) (citing Farmer, 511 U.S. at 837).

Having carefully reviewed the evidence, the court concludes that no reasonable jury could find 

in Mr. McGary‟s favor on his Eighth Amendment claim against Dr. Palomero. The undisputed 

evidence shows that: (1) Dr. Palomero saw Mr. McGary on four occasions at which Mr. McGary 

complained of lower-back pain; (2) Dr. Palomero and Mr. McGary considered Mr. McGary‟s 

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pain-management medications at each of the visits; (3) Dr. Palomero offered to prescribe longterm time-release opiates such as morphine or methadone for Mr. McGary‟s pain at each visit; (4) 

Mr. McGary declined the offer of a prescription for opiates at the first three appointments, leading 

Dr. Palomero to prescribe other medications for Mr. McGary; and (5) when Mr. McGary agreed to 

try a small dosage of morphine at the fourth appointment, Dr. Palomero prescribed morphine as 

well as acetaminophen to address the lower-back pain. The evidence also is undisputed that Dr. 

Palomero did not treat Mr. McGary after the fourth appointment because Mr. McGary was 

transferred to another prison. The evidence is undisputed that Mr. McGary received the most 

effective pain-management treatment available that he was willing to accept. 

Mr. McGary‟s amended complaint alleges that Dr. Palomero refused to discuss long-term 

pain-management medications already approved for Mr. McGary. Mr. McGary has provided no

evidence as to what those pain-management medications were, or how Dr. Palomero‟s alleged 

refusal to discuss them amounted to deliberate indifference. The only evidence in the record shows 

that there was some back-and-forth between doctor and patient about medications for Mr. 

McGary: Dr. Palomero offered opiates, and Mr. McGary turned them down three times before 

agreeing to try morphine; Mr. McGary complained at one appointment that the Tylenol III was 

causing him to twitch; Mr. McGary complained at another appointment that he no longer wanted 

to take amitriptyline; and they talked at another appointment about the medication-refill 

procedures available to Mr. McGary. Even if Mr. McGary wanted medications that were different 

from those offered by Dr. Palomero, he has failed to show that the course of treatment chosen by 

Dr. Palomero “„was medically unacceptable under the circumstances,‟ and was chosen „in 

conscious disregard of an excessive risk to [the prisoner‟s] health.‟” Toguchi, 391 F.3d at 1058. 

Dr. Palomero has met his burden on summary judgment to show the absence of evidence that 

he acted with the deliberate indifference necessary for an Eighth Amendment violation. When the 

evidence is viewed in the light most favorable to Mr. McGary, and inferences therefrom drawn in 

his favor, no reasonable jury could return a verdict for him on his Eighth Amendment claim that 

Dr. Palomero refused to discuss long-term pain medications. Dr. Palomero therefore is entitled to 

judgment as a matter of law on the Eighth Amendment claim. Dr. Palomero‟s motion for summary 

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judgment is granted because he has presented evidence demonstrating the absence of any genuine 

dispute as to any material fact in support of Mr. McGary‟s claim, and not merely because Mr. 

McGary has failed to file an opposition to the motion. See Cristobal v. Siegel, 26 F.3d 1488, 1494-

95 & n.4 (9th Cir. 1994) (unopposed motion for summary judgment cannot be granted solely 

because the plaintiff has failed to file an opposition; rather, the motion may be granted only after 

the court determines that there are no material issues of fact). 

CONCLUSION

Dr. Palomero‟s motion for summary judgment is GRANTED. (ECF No. 58.) Dr. Palomero is 

entitled to judgment as a matter of law on Mr. McGary‟s Eighth Amendment claim regarding 

medications. All the other claims were dismissed without prejudice in the order granting partial 

summary judgment for the defendants. (ECF No. 53). The clerk shall close the file.

IT IS SO ORDERED.

Dated: October 14, 2016 ___________________________

LAUREL BEELER

United States Magistrate Judge

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United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

KARLTON MCGARY,

Plaintiff,

v.

LINA MANGLICMOT, et al.,

Defendants.

Case No. 3:14-cv-04686-LB 

CERTIFICATE OF SERVICE

I, the undersigned, hereby certify that I am an employee in the Office of the Clerk, U.S. 

District Court, Northern District of California.

That on October 14, 2016, I SERVED a true and correct copy(ies) of the attached, by 

placing said copy(ies) in a postage paid envelope addressed to the person(s) hereinafter listed, by 

depositing said envelope in the U.S. Mail, or by placing said copy(ies) into an inter-office delivery 

receptacle located in the Clerk's office.

Karlton McGary ID: D87345

10465 S. Figueroa #5

Los Angeles, CA 90003 

Dated: October 14, 2016

Susan Y. Soong

Clerk, United States District Court

By:________________________

Lashanda Scott, Deputy Clerk to the 

Honorable LAUREL BEELER

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