Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_16-cv-00426/USCOURTS-casd-3_16-cv-00426-0/pdf.json

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

---

1

16-cv-0426-JAH-AGS

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

Eugene M. Remund,

Plaintiff,

v.

Fernando Zamudio, M.D., et al.,

Defendants.

Case No.: 16-cv-0426-JAH-AGS

REPORT AND RECOMMENDATION 

ON DEFENDANT ZAMUDIO’S 

MOTION TO DISMISS [Doc. 16]

An inmate with an ironclad medical malpractice case against prison doctors does not 

necessarily have a winning civil rights lawsuit. A civil rights violation requires criminal 

recklessness—the doctors must disregard an excessive health risk of which they are aware.

Because the inmate here alleges nothing approaching thisstandard, his civil rights suit fails.

I. BACKGROUND

For this report only, the following facts alleged in the second amended complaint

are presumed to be true:

Pro se plaintiff Eugene Remund is a state prisoner who suffered medical problems

after adjustments to his pacemaker. When defendant Fernando Zamudio, M.D., first 

changed the pacemaker’s settings—“for no reason at all”—Remund told him that he “felt 

sort of dizzy and naus[e]ated.” (ECF No. 10, at 2-3.) But the doctor told Remund “not to 

worry[,] that the pacemake[r] had to settle down” and get used to his body. (Id. at 3.) Later, 

Dr. Zamudio made other settings modifications, but Remund continued to complain about 

Case 3:16-cv-00426-JAH-AGS Document 24 Filed 05/31/17 PageID.<pageID> Page 1 of 5
2

16-cv-0426-JAH-AGS

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

dizziness, nausea, fainting, and fatigue. Each time he “got the same response . . . ‘give it 

time to adjust and you will feel better.[’]” (Id.)

Remund sued Dr. Zamudio and others under 42 U.S.C. § 1983 for violating his civil 

rights. He alleges that the doctor “acted with total disregard for [Remund’s] well being”

and that his deliberate indifference to a serious medical need infringed Remund’s right 

against cruel and unusual punishment. (ECF No. 10, at 2-3.) Dr. Zamudio now moves to 

dismiss the action for failure to state a claim.

II. LEGAL STANDARDS

A. Motion to Dismiss Standard

To survive a motion to dismiss, a complaint must contain sufficient facts to “state a 

claim to relief that is plausible on its face.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) 

(citation omitted); see also Fed. R. Civ. P. 12(b)(6). The reviewing court must accept “all 

factual allegations in the complaint as true and constru[e] them in the light most favorable 

to the nonmoving party.” Ebner v. Fresh, Inc., 838 F.3d 958, 962 (9th Cir. 2016) (citation 

omitted). But “‘naked assertions’ devoid of ‘further factual enhancement’” will not suffice. 

Iqbal, 556 U.S. at 678 (citation omitted).

Pro se pleadings demand an especially charitable interpretation, but the court “may 

not supply essential elements of the claim that were not initially pled. Vague and 

conclusory allegations of official participation in civil rights violations are not sufficient to 

withstand a motion to dismiss.” Ivey v. Bd. of Regents of the Univ. of Alaska, 673 F.2d 266, 

268 (9th Cir. 1982) (citations omitted).

B. Constitutionally Inadequate Medical Care

For inadequate medical care to reach constitutional dimensions, the prisoner must 

prove two elements: (1) “the existence of a serious medical need,” that is, a condition that 

left untreated “‘could result in further significant injury’ or cause ‘the unnecessary and 

wanton infliction of pain’”; and (2) the prison official’s “deliberate indifference” to that 

need. Colwell v. Bannister, 763 F.3d 1060, 1066 (9th Cir. 2014) (citations omitted).

Case 3:16-cv-00426-JAH-AGS Document 24 Filed 05/31/17 PageID.<pageID> Page 2 of 5
3

16-cv-0426-JAH-AGS

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

Deliberate indifference is a formidable standard. “[I]solated occurrences of neglect,”

as well as “mere malpractice, or even gross negligence,” may be inexcusable, but they do 

not amount to deliberate indifference. Wood v. Housewright, 900 F.2d 1332, 1334 (9th Cir. 

1990) (citation omitted); see also Estelle v. Gamble, 429 U.S. 97, 106 (1976) (“Medical 

malpractice does not become a constitutional violation merely because the victim is a 

prisoner.”). Rather, deliberate indifference requires at least criminal recklessness; the 

prison official must “know[] of and disregard[] an excessive risk to inmate health or 

safety. . . .” Farmer v. Brennan, 511 U.S. 825, 837, 839-40 (1994). The plaintiff “‘must 

show that the course of treatment the doctors chose was medically unacceptable under the 

circumstances’ and that the defendants ‘chose this course in conscious disregard of an 

excessive risk to the plaintiff’s health.’” Hamby v. Hammond, 821 F.3d 1085, 1092 

(9th Cir. 2016) (citations omitted). “[A] difference of opinion between a physician and the 

prisoner—or between medical professionals—concerning what medical care is appropriate

does not amount to deliberate indifference.” Id. (citation omitted).

III. DISCUSSION

A. Dr. Zamudio’s Motion to Dismiss

Dr. Zamudio does not dispute the first element of this inadequate medical care 

claim—that Remund had a serious medical condition—so the only question is whether 

Remund sufficiently pleads deliberate indifference.

Remund charges that Dr. Zamudio adjusted the pacemaker “for no reason at all” 

(ECF No. 10, at 2), but not that the doctor intended or knew that those adjustments might 

cause harm. In fact, after making each adjustment, Dr. Zamudio said, “[Y]ou will feel 

better.” (Id. at 3.) “An act or omission unaccompanied by knowledge of a significant risk 

of harm” is not deliberate indifference. Farmer, 511 U.S. at 837-38. The only other 

allegation touching on Dr. Zamudio’s mental state is that he “acted with total disregard for 

[Remund’s] well being.” (ECF No. 10, at 3.) But this is exactly the type of “naked 

assertion” lacking “further factual enhancement” decried by the Supreme Court. See Iqbal,

556 U.S. at 678 (citation omitted). Remund, therefore, fails to state a claim.

Case 3:16-cv-00426-JAH-AGS Document 24 Filed 05/31/17 PageID.<pageID> Page 3 of 5
4

16-cv-0426-JAH-AGS

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

B. Dismissal as to All Defendants

This same reasoning applies equally to dismissing the case against the remaining 

codefendants: Dr. R. Holt and ten John Does. The second amended complaint does not 

mention any supporting facts about the John Does. And the only allegations against 

Dr. Holt are that he “in[s]erted the pacemaker into my chest and it worked just fine,” but 

thereafter Dr. Holt and Dr. Zamudio worked together making the pacemaker adjustments 

described earlier, “with total disregard” to Remund’s well-being. (ECF No. 10, at 3.) In 

other words, the only additional facts alleged against Dr. Holt are that he did a satisfactory 

job implanting Remund’s pacemaker. This does not make out deliberate indifference.

Even if Remund had adequately stated a claim, he has not served Dr. Holt in the nine 

months since filing his second amended complaint. (ECF No. 13.) Unless Remund can 

show good cause, this failure would provide an independent basis for dismissing the case 

against Dr. Holt. See Fed. R. Civ. P. 4(m); Civ. LR 41.1(a).

C. Opportunity to Amend

A self-represented prisoner plaintiff is entitled to an “opportunity to amend the 

complaint to overcome [any] deficiency unless it clearly appears from the complaint that 

the deficiency cannot be overcome by amendment.” James v. Giles, 221 F.3d 1074, 1077 

(9th Cir. 2000) (citations omitted). Remund has had that opportunity. He has now drafted 

three versions of this civil rights complaint against these same defendants. Judge Houston 

dismissed the first two complaints for failing to state a claim against anyone, but granted 

leave to amend both times. (ECF No. 6, at 7-8; ECF No. 9, at 7-8.) On both occasions, 

Judge Houston explained that the dismissal grounds were that Remund failed to set forth 

specific allegations supporting deliberate indifference. Because Remund tried and failed to 

correct this exact same flaw twice before, the Court need not give him a third bite at the 

complaint-drafting apple.

1

 

1 Although not considered in this Court’s analysis, other information also suggests 

that another leave to amend would be unavailing. According to a medical record attached 

Case 3:16-cv-00426-JAH-AGS Document 24 Filed 05/31/17 PageID.<pageID> Page 4 of 5
5

16-cv-0426-JAH-AGS

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

IV. CONCLUSION

Because Remund fails to state an inadequate medical care claim, this Court 

RECOMMENDS that his second amended complaint be DISMISSED.

Upon being served with a copy of this report, the parties have 14 days to file any 

objections. Upon being served with any objections, the party receiving such objections has 

14 days to file any response. See Fed. R. Civ. P. 72(b)(2).

Dated: May 31, 2017

 

to the previous complaint, Dr. Zamudio was genuinely worried about Remund’s health, not 

callously indifferent to it. In that record, Dr. Zamudio wrote, “I am obviously concerned 

because of the arrhythmia that Mr. Redmond [sic] is experiencing. . . . I feel it is imperative 

that we proceed with coronary angiography as soon as possible.” (ECF No. 7, at 16.)

Case 3:16-cv-00426-JAH-AGS Document 24 Filed 05/31/17 PageID.<pageID> Page 5 of 5