Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_16-cv-00689/USCOURTS-casd-3_16-cv-00689-3/pdf.json

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

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UNITED STATES DISTRICT COURT 

SOUTHERN DISTRICT OF CALIFORNIA 

DOYLE WAYNE DAVIS, CDCR 

#34318, 

Plaintiff,

v. 

DANIEL PARAMO, Warden, et al., 

Defendants.

 Case No.: 16cv689 BEN (JMA) 

REPORT AND 

RECOMMENDATION RE 

DEFENDANTS’ MOTIONS TO 

DISMISS PLAINTIFF’S 

COMPLAINT 

[ECF Nos. 22, 24, 46, 61] 

Plaintiff Doyle Wayne Davis is a state prisoner proceeding pro se and in 

forma pauperis in this civil rights action filed pursuant to 42 U.S.C. § 1983. 

Plaintiff contends fourteen correctional and medical care officials at Richard J. 

Donovan Correctional Facility (“RJD”) and two doctors from Alvarado Hospital 

acted with deliberate indifference to his serious medical needs and retaliated 

against him after he filed a San Diego Superior Court case and various inmate 

grievances challenging his medical care. 

Presently before the Court are motions to dismiss filed by Defendant 

Zamudio (ECF No. 22), Defendant Butcher (ECF No. 24), Defendants Silva, 

Jackson, Pasha, Walker, Rodriguez, Self, Pool, Glynn, Sosa, Paramo, Roberts 

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and Stout (ECF No. 46), and Defendant Bedane (ECF No. 61).1

 

I. PLAINTIFF’S COMPLAINT2

 Plaintiff was transferred to RJD from the Substance Abuse Treatment 

Facility in August 2013. (Compl., ECF No. 1 at 13.) He alleges that upon his 

arrival at RJD, Defendant S. Pasha, Registered Nurse Practitioner, told him it 

was RJD policy to discontinue all narcotic medications regardless of inmate 

medical need. (Id.) In December 2013, prison physician Tamara Robinson, M.D. 

noted that Plaintiff had been taking methadone, a narcotic used for pain relief 

and drug addiction detoxification, since at least May 2013. (ECF No. 1-1 at 8.) 

Dr. Robinson preliminarily determined that long term narcotic treatment was not 

medically necessary, but planned to conduct a full pain assessment because 

Plaintiff’s previous medical providers had conflicting opinions regarding his need 

for pain relief. (Id. at 8-9.) In early 2014, Plaintiff saw Defendant D. Clifton, a 

physical therapist, for low back, left leg, and neck pain. (ECF No. 1-1 at 12-15.) 

 In April 2014, Defendant D. Paramo, the Warden of RJD, allegedly ordered 

Defendant M. Stout, Correctional Captain, to house Plaintiff on B Facility, allow 

Plaintiff to work in Prison Industry Authority, and to ensure that all stolen personal 

property was returned to him. (ECF No. 1 at 14.) Defendant Stout allegedly 

refused to allow Plaintiff to work even though he met all the California 

Department of Corrections and Rehabilitation (“CDCR”) guidelines. (Id.) 

 In July 2014, Plaintiff filed a Petition for Writ of Habeas Corpus in the 

Superior Court of California, County of San Diego, in which he alleged he was 

                                               

1 The sixteenth defendant, David Clifton, Physical Therapist, has not been served in this 

matter. See ECF No. 20 (summons returned unexecuted). 

2 Plaintiff’s Complaint consists of a 39 page form complaint and attachments, docketed at ECF 

No. 1, as well as 231 pages of exhibits, docketed at ECF Nos. 1-1 and 1-2. For ease of 

reference, the Court will refer to the document and page numbers affixed by the Court’s 

Electronic Case Filing (ECF) system when citing to Plaintiff’s Complaint. 

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being denied adequate pain mediation as well as the opportunity to consult with a 

neurosurgeon for spinal injuries and/or degeneration. (Id. at 31-34.) In August 

2014, the court found Plaintiff failed to make a prima facie showing that health 

care officials were deliberately indifferent to his condition, and that Plaintiff had 

failed to exhaust his administrative remedies on his claim that he was being 

denied a consultation with a neurosurgeon. (Id.) 

 On August 14, 2014, Plaintiff had his first visit with Defendant J. Silva, 

prison physician. (Id. at 14.) He complained of increasing exertional dyspnea 

(shortness of breath) over the previous six months. (ECF No. 1-1 at 36.) After 

listening to Plaintiff’s heart and obtaining an EKG, Dr. Silva diagnosed Plaintiff 

with atrial fibrillation (irregular heartbeat). Dr. Silva noted that while Plaintiff did 

not have a history of atrial fibrillation, he did have a history of hypertension. (Id.) 

Plaintiff admitted he never took his hypertensive medication, and would continue 

to refuse to take any form of such medication because “he felt he was not being 

treated completely from a medical standpoint and felt that if he was not going to 

be treated completely then he does not want to be treated at all.” (Id.) After 

advising Plaintiff of the risks of refusing hypertensive medication, including the 

possibility of death, Dr. Silva sent Plaintiff to the Triage and Treatment Area 

(“TTA”) to be transferred to the emergency room. (Id.) 

 Plaintiff was initially taken to Sharp Chula Vista, where a Cardizem 

(calcium channel blocker used to treat hypertension) drip was started due to 

atrial fibrillation, and was then transferred and admitted into Alvarado Hospital. 

(ECF No. 1-1 at 39.) There, Plaintiff alleges that Defendant Richard O. Butcher, 

M.D. told him he had spoken with RJD medical staff and “they told him what they 

wanted him to do for me.” (ECF No. 1 at 14.) Dr. Butcher confirmed the 

diagnosis of atrial fibrillation, new onset, admitted Plaintiff to the telemetry floor, 

and continued the drip started at Sharp. (ECF No. 1-1 at 40.) Defendant 

Fernando A. Zamudio, M.D., cardiologist, examined Plaintiff at Alvarado on 

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August 15, 2014, the day after his admission. According to Plaintiff, Dr. Zamudio 

told him his atrial fibrillation was mostly caused by the exercise program that 

RJD’s physical therapist, Defendant Clifton, had placed him on, combined with 

methadone use, which medical staff at the CDCR had initiated. (ECF No. 1 at 

14-15.) Plaintiff alleges that Dr. Zamudio told him that RJD medical staff had 

been in contact with the hospital and wanted Plaintiff off methadone and all 

narcotic medications. (Id. at 15.) Dr. Zamudio’s consultation records indicate 

that Plaintiff’s cardiac history dated back to 2011, when he experienced chest 

pain while incarcerated. (ECF No. 1-1 at 42.) He received a cardiac workup, 

which came out well, and had no further problems until May 2014. (Id.) Around 

that time, he noticed he was getting short of breath and his heart pounded with 

exertion. (Id.) Dr. Zamudio’s impression consisted of: (1) Probable congestive 

cardiomyopathy with atrial fibrillation and severe impairment of left ventricular 

systolic function with acute on chronic congestive heart failure, mild mitral 

regurgitation, mild tricuspid regurgitation, and mild pulmonary hypertension; 

(2) history of cigarette abuse (2 packs daily for 34 years, until 2005), history of 

methamphetamines (10 months per year for 20 years, until 1991), and chronic 

obstructive pulmonary disease; (3) history of hypertension; and (4) abnormal 

prostate-specific antigen (PSA) test. (Id. at 42-43.) 

 Dr. Butcher prepared the following summary of Plaintiff’s hospital course 

upon his discharge on August 19, 2014: 

The patient was placed on telemetry and did show atrial fibrillation, 

which was controlled. The patient was seen by Dr. Zamudio and was 

taken off Cardizem drip, placed on [oral] Cardizem, Coreg (beta 

blocker used to treat heart failure and hypertension), and 

Hydrochlorothiazide (diuretic). The patient seemed to improve; 

however, felt that a Lexiscan was indicated, if it were positive, the 

patient should have catheterization. The patient had the Lexiscan by 

Dr. Camacho, read as negative. The patient then started on Lovenox 

(blood thinner) as well as Coumadin (blood thinner) because of the 

atrial fibrillation. The patient is stable otherwise . . . . It was felt that 

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the patient could be discharged back with cardiac workup being 

negative . . . . The patient should lie in for the next week with no work 

detail. He is ambulatory. He is on regular diet. The patient should 

follow up in the med clinic in one to two days and have a repeat of his 

INR [International Normalized Ratio, used to provide information 

about the blood’s tendency to clot] to keep it therapeutic between 2 

and 3. The patient understands his illness, did request to be on DNR 

[do not resuscitate] status, which was done. The patient was okay for 

the general population. He should follow his medication reconciliation 

list, which has him on [C]arvedilol (beta blocker) 3,125 mg twice a 

day and Coumadin 60 mg total 120 mg every eight hours. He is on 

HydroDIURIL (diuretic) 25 mg. He is on chlorpheniramine 

(antihistamine) 4 mg four times a day [as needed for] allergies, he is 

on methadone 10 mg. He was not given that during his stay here, 

may be able to be discontinued. He is on one tablet two times a day. 

He is being followed by pain management. He is also on Prilosec 

(used to decrease stomach acid) 20 mg daily. The patient is 

stabilized to talk with the physician at Donovan. 

(Id. at 46-47.) 

 On August 20, 2014, Plaintiff completed a Health Care Services Request 

Form (CDC 7362) in which he stated: “I returned from Alvarado Hosp. yesterday 

with heart and blood pressure meds with printed instructions. Transport staff and 

TTA staff refused to give me those specific medication instructions SO I REFUSE 

TO TAKE THOSE MEDS.” (ECF No. 1-1 at 53 [emphasis in original].) In 

response, the triage registered nurse advised Plaintiff the pharmacy had been 

notified and Plaintiff’s new medications would be processed “stat” and delivered 

that day. Plaintiff informed the nurse he had a “Merck” book and had an 

understanding of his new “A-fib” diagnosis. (Id.) On August 22, 2014, Plaintiff’s 

INR was subtherapeutic, most likely due to missing three days of warfarin (blood 

thinner) as it was not available. (Id. at 55.) Plaintiff’s INR was to be remeasured 

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in three days. (Id.)3

 

 On August 26, 2014, Plaintiff was seen by Dr. Silva, who Plaintiff alleges 

told him that his court case had been denied, that he could expect no outside 

help in his medical care and treatment, and that he should not be on any pain 

medication due to cost. (ECF No. 1 at 15.) Dr. Silva’s treatment records indicate 

that while Plaintiff was willing to take Coumadin, he refused Coreg and diltiazem 

(calcium channel blocker used to treat hypertension) because “he was sent here 

for issues with his prostate and kidneys and did not get the followup that he 

wanted so he feels he is not getting the type of treatment that he needs and is 

refusing to take the mediation because of that.” (ECF No. 1-1 at 58.) Dr. Silva 

reviewed Plaintiff’s urologic history, ordered another PSA, and requested a CT 

urogram, referral to Urology for cystoscopy, and a urinalysis to evaluate for 

hematuria. (Id.) With respect to Plaintiff’s atrial fibrillation, Dr. Silva noted: 

Atrial fibrillation appears now to be rate controlled; however, he 

refuses to take his Coreg, diltiazem, hydrochlorothiazide, and any 

other cardiac medication or blood pressure medication. I had a long 

discussion with the patient about this and I discussed the risks of 

noncompliance including the risk of possible [myocardial ischemia], 

possible blood clot formation causing pulmonary embolism, possible 

stroke, and even death. He is also at risk for worsening medical 

condition which can increase pain and suffering. He stated he was 

aware of this and signed a refusal for any form of cardiac medication. 

He agrees to take the Coumadin, however. 

(Id.) With respect to Plaintiff’s chronic pain: 

He has been on methadone 10 mg twice a day for chronic low back 

pain and severe degenerative disk disease at L5/S1. We did not 

                                               

3 The INR of patients using Warfarin is regularly monitored in order to balance the risk of 

excessive bleeding against the risk of clotting or thrombosis. When the INR is too high (over 

4.5), the blood is too thin, whereas when the INR is too low (less than 2), the blood is too thick 

and there is risk of thromboembolism and associated conditions such as heart attack and 

stroke. See https://www.myvmc.com/investigations/blood-clotting-international-normalisedratio-inr/#C3 (as visited June 7, 2017). 

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have sufficient time to thoroughly review this; however, because of 

his atrial fibrillation and the possibility that methadone can exacerbate 

arrhythmias, risks of continued methadone use outweigh the benefits 

and, therefore, this will be [dis]continued. He will be switched over to 

morphine ER 15 mg [twice per day]. Therapeutic interchange as 

calculated via opioid calculator calculated the morphine equivalent 

dose to be 25 mg daily dose; therefore, 15 mg [twice per day] should 

be sufficient. A pain contract was signed and the patient was given a 

copy of the pain contract. The patient stated that he was 

recommended to have some form of back surgery in the past. Will 

plan to review his condition on the follow-up appointment regarding 

this. He will be tested randomly and regularly. 

(Id. at 59.) Two days later, after Plaintiff complained that Dr. Silva had lied to him 

about his morphine dosage, Dr. Silva saw Plaintiff again and explained he had 

checked the calculation through the opioid calculator after Plaintiff had left his 

last appointment, and had determined the appropriate dose of morphine was 15 

mg twice daily rather than 30 mg twice daily. (Id. at 61, 63.) Dr. Silva noted that 

Plaintiff wanted to go back to methadone, but because of the risks, he would 

refrain from prescribing this. (Id. at 63.) Plaintiff alleges Dr. Silva told him that if 

Plaintiff wanted to file more grievances against medical staff, they would 

discontinue all pain medication immediately. (ECF No. 1 at 16.) Plaintiff also 

alleges that contrary to Dr. Silva’s calculations, the CDCR’s conversion chart 

shows that methadone is four times stronger than morphine, and therefore Dr. 

Silva had not prescribed a high enough dosage of morphine for Plaintiff. (Id.; 

ECF No. 1-1 at 69.) 

 On September 3, 2014, Plaintiff had a telemedicine custody consultation 

(“telemed”) with Defendant Zamudio, the Alvarado cardiologist. (ECF No. 1-1 at 

71-73.) Dr. Zamudio explained the importance of taking his medications, 

including the risks of acute congestive heart failure or stroke, but Plaintiff 

remained undecided at the end of the evaluation whether he would take them. 

(Id. at 72-73.) Plaintiff reported feeling tired all the time, being short of breath 

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without exertion, and awakening due to shortness of breath. (Id. at 72.) Dr. 

Zamudio felt Plaintiff should be taken to the clinic right away, but also explained 

there was little value in him coming to the hospital unless he took his 

medications. (Id. at 73.) Dr. Zamudio also explained the cardioversion 

procedure (performed to restore a normal heart rhythm), and advised that an INR 

of more than two was needed before the procedure could be considered. (Id.) 

Plaintiff states this was the first time he was made aware that he was being 

prepared for the procedure. (ECF No. 1 at 16.) RJD doctor Darryl Bates, M.D. 

noted after the telemed that he spent 20-25 minutes discussing Plaintiff’s 

frustrations regarding his treatment, and that Plaintiff signed a refusal for his 

cardiac mediations despite Dr. Zamudio’s recommendation to restart. Dr. Bates 

reordered the medicines and explained to Plaintiff that he could restart at any 

time. (ECF No. 1-1 at 74-75.) 

 Plaintiff saw Dr. Silva again on September 8, 2014. (ECF No. 1-1 at 79-

80.) The medical record reflects Plaintiff was upset that he had not been told 

sooner that he was being prepared for defibrillation (cardioversion), and he 

stated he did not want it done because he had looked up the risks and benefits of 

the procedure in his Merck manual. (Id. at 79.) His INR on September 2, 2014 

was 1.6, and 1.1 on August 21, 2014. (Id.) Plaintiff continued to refuse all 

cardiac medication with the exception of Coumadin, and stated the only things he 

wanted were to remain a DNR (do not resuscitate) and receive comfort care in 

the form of pain medication. (Id.) In his Complaint, Plaintiff claims he refused 

treatment due to reprisals by medical and custody staff and the mishandling of 

his life-sustaining medications. (ECF No. 1 at 16.) Dr. Silva referred Plaintiff to 

Mental Health for an evaluation to rule out a psychiatric condition contributing to 

his decision-making. (ECF No. 1-1 at 79.) 

 Plaintiff alleges that Defendant Dr. K. Rodriguez, psychologist, told him 

“she had gone out and purchased her own malpractice insurance because of her 

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fear of liability due to the situations such as mine where she knew illegal actions 

were being taken.” (ECF No. 1 at 16.) He also alleges Dr. Rodriguez told him 

that funds from inmates’ care were being diverted to construction so RJD could 

receive American Correctional Association (ACA) accreditation in order to obtain 

$89 million in funding. (Id.; see also ECF No. 1-1 at 82-83.) 

 On September 22, 2014, Plaintiff had a follow-up visit for Warfarin 

monitoring, including his INR measurement. (ECF No. 1-1 at 85.) The medical 

record reflects that Plaintiff also underwent drug testing, which showed morphine 

undetected in serum, notwithstanding Plaintiff’s claim that he complied with his 

morphine dosage daily and did not skip doses, and his urine was positive for 

opiates. (Id. at 87.) Plaintiff, in his Complaint, alleges he was ordered to the 

TTA for a blood serum draw, instead of the B Facility Clinic area as had been 

done in the past, and that a male lab technician, known to him only as Defendant 

John Doe “Jose”, told him he could not draw blood samples as his license was 

not valid, but that he supervised a female trainee who took the lab sample from 

Plaintiff’s arm. The female allegedly questioned whether the amount of the 

sample was sufficient, but “Jose” told her the worst that could happen was a 

negative test result, in which case Plaintiff would be retested. (ECF No. 1 at 17.) 

On October 2, 2014, Dr. Silva noted the following in Plaintiff’s medical records: 

He claims to have pain and need for narcotics however serum testing 

reveals no morphine in blood. Urine testing is positive for opiates. 

This is strongly suggestive of diversion and a breach of the pain 

contract. His reports of pain is not consistent with drug monitoring. . . 

. Currently, there is no medical indication for continuation of narcotic 

medication. . . . Presently, the risks of continued prescribing of 

narcotics outweigh benefits due to the concern for diversion. I offered 

to prescribe non-narcotic alternative medication for his pain such as 

APAP, NSAIDS, SSRI and anticonvulsants[,] however[,] he stated 

“don’t even bother because I won’t take them.” . . . . [H]e will be 

referred to Mental Health to assess for suicide risk prior to weaning 

off morphine, and also for behavioral modalities for pain 

management. 

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(ECF No. 1-1 at 87.) Plaintiff alleges Dr. Silva told him that had he not filed 

grievances, perhaps he would still be receiving opioid medication. (ECF No. 1 at 

17.) Plaintiff further alleges that notwithstanding Dr. Silva’s statement to the 

contrary, Plaintiff had undergone drug testing previously. (See id. at 17; ECF No. 

1-1 at 89.) Plaintiff claims that each prior drug test was within the required range. 

(ECF No. 1 at 17; ECF No. 1-1 at 91-93.) Plaintiff alleges he attempted to obtain 

“Jose’s” last name, but Defendants Bedane, Walker, Roberts, and Glynn refused 

to provide it to him “in order to hide . . . illegal activity from myself in legal 

redress.” (ECF No. 1 at 22.) 

 On October 22, 2014, Plaintiff again signed a refusal for all medications. 

(ECF No. 1 at 18; ECF No. 1-1 at 95.) He told the prison pharmacist that RJD 

had an incompetent medical department and that he had had “enough” of the 

medical system at the prison. (ECF No. 1-1 at 95.) The following day, Plaintiff 

refused to leave his cell and come to a medical appointment, despite being 

warned that continued refusal would result in the issuance of a CDC 115 rules 

violations report. (ECF No. 1 at 18; ECF No. 1-1 at 97, 99-101.) Plaintiff alleges 

that Defendant Rodriguez, the psychologist, came to his cell on multiple dates 

and told him that medical and custody staff were attempting to make him seem 

disruptive to avoid liability for their unlawful acts, and were trying to push him into 

attempting suicide in order to rid themselves of the problems he had caused. 

(ECF No. 1 at 18.) 

 On November 12, 2014, Dr. Silva presented Plaintiff’s case in a “Mega 

Huddle Multidisciplinary Patient Care Conference” due to his concerns about 

Plaintiff’s non-compliance with medications, refusal to attend medical 

appointments, and cardiac risks. (ECF No. 1-1 at 103.) Dr. Rodriguez reported 

that Plaintiff had refused to see her despite her efforts to see him weekly, but that 

he had come in for a mental health appointment that day. (Id.) Plaintiff 

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reportedly told her that he blamed the phlebotomist for his negative serum 

testing, in which no morphine was detected, blamed the CDCR for his cardiac 

condition which he felt was caused by medication the CDCR had prescribed, and 

planned to sue the CDCR. (Id.) Plaintiff had declined to be psychologically 

assessed by a graduate student, but Dr. Rodriguez stated that based on her 

observations, she did not believe Plaintiff was cognitively impaired or psychotic, 

and that he understood the risks and consequences of his refusals. (Id.) The 

Mega Huddle resulted in the following care plan: Plaintiff had a follow-up 

scheduled with his Primary Care Provider (“PCP”) on November 24, 2014; 

nursing would provide patient education regarding adherence; ongoing 

collaboration between mental health, nursing, and the PCP; pharmacy would 

attempt to follow up with Plaintiff for further counseling and education regarding 

the risks and benefits of medication; and the Mega Huddle would reconvene in 

one month’s time. (Id. at 103-04.) Plaintiff states he declined mental health 

testing with the graduate student as he considered it Dr. Silva’s attempt at cost 

saving and another example of RJD’s “inept” medical care. (ECF No. 1 at 18-

19.) 

 On November 24, 2014, custody staff, allegedly upon the orders of 

Defendant Stout, brought Plaintiff to the clinic for his scheduled medical 

appointment. (ECF No. 1 at 19; ECF No. 1-1 at 106.) Plaintiff refused treatment, 

refused to sign the refusal form, cursed at Sgt. Strickland, Defendant Silva, and 

Defendant Pool, a licensed vocational nurse, and stated he did not want to be 

called for any medical appointments. (Id.) 

 The Mega Huddle reconvened on December 10, 2014. (ECF No. 1 at 19; 

ECF No. 1-1 at 108.) Dr. Walker recommended that Plaintiff be scheduled with 

his PCP every thirty days, even if Plaintiff refused these appointments. (ECF No. 

1-1 at 108.) Despite the pharmacist having spoken with Plaintiff about the 

importance of adhering to Coumadin, Plaintiff continued to refuse to take it, and 

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thus the medication was discontinued. (Id.) Dr. Rodriguez reported that she had 

been seeing Plaintiff more frequently, but he told her this was causing him more 

stress; therefore, the team decided that Plaintiff would be seen only for routine 

mental health follow-up appointments every two or three months. (Id.) The team 

also decided that a nursing wellness visit would be scheduled with Plaintiff to 

discuss the outcome of the Mega Huddle and to ensure he understood that he 

could request health care services by using the CDC 7362 form, and that mental 

health, nursing, and the PCP would continue ongoing communication and 

collaboration regarding Plaintiff. (Id. at 108-09.) 

 On January 26, 2015, Defendant Pasha, the nurse practitioner, noted in 

Plaintiff’s medical file that he had seen his PCP and was still refusing medication. 

(Id. at 114.) Plaintiff makes two allegations regarding this appointment: first, that 

only qualified high-risk providers, such as a PCP, can attend to high-risk medical 

inmates such as himself, and second, that Nurse Pasha saw him at Dr. Silva’s 

behest, and falsified his medical record by stating treatment had been rendered 

when there was no such treatment. (ECF No. 1 at 20; ECF No. 1-1 at 111-12.) 

Plaintiff further alleges that Pasha falsified his records again the following day. 

(ECF No. 1 at 20.) The progress note dated January 27, 2015, however, 

indicates that it is a late entry for the prior day’s appointment, and also clearly 

notes that treatment was not rendered due to Plaintiff’s refusal. (ECF No. 1-1 at 

116.) Plaintiff was next seen on February 9, 2015, at which time it was noted 

that Plaintiff continued to decline all medications and understood the risk of 

stroke and death. (ECF No. 1-2 at 3.) Plaintiff points out that the progress note 

includes a reference to his having suffered from low back pain for thirty years, for 

which he alleges he received little to no treatment. (ECF No. 1 at 20.) 

 On March 29, 2015, Plaintiff submitted a CDCR 22 form to request a copy 

of the CDCR 128 form that Sgt. Strickland indicated Plaintiff would receive if 

Plaintiff refused to write the word “forever” on his refusal of medical treatment 

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form on November 24, 2014, when Strickland accompanied Plaintiff to the B 

Facility Clinic. (ECF No. 1 at 20.) Sgt. Strickland denied Plaintiff’s version of 

events and responded that he did not prepare a 128 form. (ECF No. 1-2 at 6.) 

Plaintiff submitted another CDCR 22 form on April 3, 2015 to find out who had 

incorrectly summoned him to B Clinic the prior day, and alleged prison staff had 

been harassing him by falsely paging him for medical appointments. (ECF No. 1 

at 20; ECF No. 1-2 at 8.) Correctional Officer Ponce replied that Correctional 

Officer Hampton had received a call to send Plaintiff to the clinic, but could not 

remember who called, and Ponce was unable to find out who had summoned 

Plaintiff. (ECF No. 1-2 at 8.) 

 On March 29, 2015, Plaintiff completed a Patient-Inmate Health Care 

Appeal Form (CDCR 602). (ECF No. 1 at 20; ECF No. 1-2 at 13.) He alleged 

unlawful conspiracy, ongoing retaliation, deliberate indifference to a severe 

condition, and falsification of documents. (ECF No. 1-2 at 13.) From his 

perspective, in 2013/2014, prison staff had attempted to discontinue his pain 

medication, methadone, by falsely alleging abuse of medications, so he promptly 

filed a court case (presumably, his habeas petition in July 2014). (Id.) 

Thereafter, he suffered a heart condition due to being forced to take methadone. 

(Id.) Plaintiff was then placed on morphine due to his atrial fibrillation (in August 

2014). (ECF No. 1-2 at 15.) All of Plaintiff’s drug testing showed his drug levels 

were appropriate, except when an undertrained phlebotomist did not draw 

sufficient blood for testing (in September 2014). (Id.) Plaintiff alleges his 

morphine was discontinued in retaliation for having filed a court action, and he 

“likewise refused all further meds. & medical treatment.” (Id.) The action sought 

by Plaintiff included: immediate removal of Defendants Silva, Pasha, and Pool 

from the B Clinic; immediate reinstatement of all previous medication, including 

morphine at the “appropriate” level of 30 milligrams three times per day for 

treatment of his severe back pain and chronic health issues; immediate transfer 

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to Tri-City Medical Center to be examined by Dr. Matthews; permanent housing 

in a single cell due to the risk of him “bleeding out” if he restarted medication for 

atrial defibrillation; immediate investigation into the custody and medical staffs’ 

illegal conspiracy to deprive him of adequate medical care; compensatory 

damages from all named parties of $1.00 each; punitive damages as determined 

by a jury; and the full names and titles of the phlebotomists referred to in his 

appeal. (Id.) Plaintiff’s appeal culminated in a Director’s Level Decision on 

October 12, 2015 in which Plaintiff’s appeal was denied and his administrative 

remedies were exhausted. (ECF No. 1-2 at 10-12.) 

 On July 24, 2015, Defendant Sosa issued a CDC 128-A counseling chrono 

to document the following language contained in an appeal filed by Plaintiff on 

June 30, 2015: “Fire these incompetent medical and custody staff. Or in the 

alternative, place each and every one of them into a job where they cannot 

violate inmate rights, namely in a supply closet.” (Id. at 28.) Plaintiff alleges 

Sosa issued the chrono in order to “chill redress” and “thwart exhaustion” of his 

grievances. (ECF No. 1 at 21.) 

 On August 6, 2015, Plaintiff engaged in a hunger strike to protest not being 

placed on an appropriate workers list, the loss of $546.08 worth of property, and 

not being treated for all of his medical ailments. (ECF No. 1 at 21; ECF No. 1-2 

at 49.) Defendant Paramo, the Warden, ordered Defendant J. Jackson to 

intervene. (ECF No. 1 at 21.) On August 28, 2015, the Victims Compensation 

and Government Claims Board denied Plaintiff’s application for leave to present 

a late claim and rejected the claim itself. (ECF No. 1-2 at 51.) Plaintiff alleges 

this occurred because appeals staff at RJD refused to allow the timely filing of his 

CDCR Form 602 grievances. (ECF No. 1 at 22.) On September 3, 2015, 

Plaintiff presented a CDCR Form 22 to complain that RJD staff−specifically, 

Defendant Sosa−were incompetent because another inmate’s confidential 

paperwork was attached to a Screen Out form responding to his Form CDCR 

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602 appeal. (ECF No. 1-2 at 53-54.) 

 On September 3, 2015, Plaintiff received x-rays of his lumbar spine, 

referred by Dr. Silva, which showed mild to moderate lumbar arthrosis. (Id. at 

101.) Plaintiff alleges on November 25 and 28, 2015, he was given unlawful 

direct orders via Defendants Paramo and Jackson to perform work that he should 

not have undertaken due to his medical restrictions. (ECF No. 1 at 22; ECF No. 

1-2 at 57, 58.) On November 25 and December 10, 2015, Plaintiff filled out 

health care services request forms to report injuries he had sustained while 

working. (ECF No. 1 at 23; ECF Nos. 1-2 at 61, 62.) Plaintiff alleges he was told 

by an unnamed nurse that “medical” could not and would not do anything for him 

because he had filed previous grievances. (ECF No. 1 at 23.) 

 Plaintiff alleges his CDC 602 Inmate/Parolee Appeal Forms were unlawfully 

screened out by Defendants Sosa and/or Self, Appeals Coordinators, on five 

occasions. (Id. at 23; ECF No. 1-2 at 65-69.) On December 15, 2015, Plaintiff 

submitted a request for mental health services, stating, “I am having an 

extremely difficult time dealing with staff which is causing me a great deal of 

depression.” (ECF No. 1-2 at 81.) Plaintiff alleges that his assigned mental 

health clinician told him to “just stop filing paperwork and kiss some ass by doing 

whatever staff wanted [him] to do.” (ECF No. 1 at 23.) 

 On December 1, 2015, Plaintiff underwent MRIs of his spine. (ECF No. 1-2 

at 103, 105, 107.) On December 24, 2015, he saw Dr. Peyman Shakiba and 

complained of chronic neck and back pain. (Id. at 84-84.) Dr. Shakiba advised 

Plaintiff that his cervical MRI showed degenerative changes at T3 to C5 and C6 

to C7, mild central canal narrowing at C3 to C4 and C4 to C5, and bilateral neural 

foraminal narrowing at C3 to C5; his thoracic MRI showed mild degenerative 

changes, and mild central canal narrowing at T11 to T12; and his lumbar MRI 

showed moderate central canal narrowing at L4 to L5 and mild narrowing at L2 to 

L4. (Id.) Dr. Shikiba noted: 

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After I reviewed these results with the patient, he became very upset, 

feeling that these images are showing that he is better than his 

previous imaging and he feels this is because these MRIs did not 

have contrast. So he insists that these MRI readings are inaccurate 

because he should be worse, not better, than his previous MRI. I 

tried to explain to him that, if they were [not] good visualizations of the 

nerves and the spine, the radiologist would have requested an MRI 

with contrast. The patient again repeated his demand to have fusion 

of his lumbar spine because he feels this will control his pain. I 

[asked] him if he would be interested in trying physical therapy; he 

said he has had physical therapy in the past and epidural and they 

have never helped him. The patient then stood up and walked out of 

the examination room. 

(Id.) Plaintiff alleges RJD “dummied” his MRI results and that images taken 

inside prison vary from images taken outside prison; prior MRI and x-ray results 

from 1998, 2004, 2006, and 2013 are attached to his Complaint. (ECF No. 1 at 

24; ECF No. 1-2 at 86-99.) Plaintiff alleges, “[I]t is clear that RJD fraudulently 

had these [test] results prepared and that CDCR/RJD were involved in an illegal, 

unconstitutional “shopping around” of medical tests until they could 

obtain/fabricate test results that mirrored [their] desire to prove cost-effective 

(none) medical care to my severe known medical conditions.” (ECF No. 1 at 25.) 

 Plaintiff saw Dr. Silva on January 12, 2016 and complained of severe, 

chronic pain. (ECF No. 1-2 at 108-09.) Dr. Silva noted that Plaintiff continued to 

refuse treatment for his atrial fibrillation, but appeared well notwithstanding his 

complaints of severe pain. (Id.) Plaintiff refused neuropathic pain medication 

other than narcotics, which Dr. Silva indicated were not medically indicated 

because narcotics were not the best form of treatment for chronic back pain, and 

because of Plaintiff’s prior inconsistent drug testing. (Id. at 109.) Dr. Silva also 

wrote, “Dr. Matthews has recommended that [Plaintiff] be kept in atrial fibrillation 

rather than rate control for cost-effective [treatment].” (Id. at 108). Plaintiff points 

to this as evidence of the CDCR’s opinion that it was better for him to “suffer in 

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pain and die” of his medical conditions because appropriate treatment was not 

cost-effective. (ECF No. 1 at 25.) Dr. Silva continued in his note, “Dr. Matthews 

thinks that [Plaintiff’s] condition is worsening due to the development of 

cardiomyopathy and feels his condition will only get worse without [treatment]. I 

relayed this to [Plaintiff] who stated he understood but still refused any 

treatment.” (ECF No. 1-2 at 108.) 

 Plaintiff asserts the following claims: (1) retaliation in violation of the First 

Amendment; (2) conspiracy under 42 U.S.C. § 1986 in violation of the First 

Amendment; (3) deliberate indifference to severe medical condition in violation of 

the Eighth Amendment; and (4) deliberate indifference to severe medical 

condition and falsification of medical reports due to cost considerations in 

violation of the Eighth Amendment. (ECF No. 1 at 26-27.) 

II. LEGAL STANDARDS 

 A motion to dismiss under Federal Rule of Civil Procedure 12(b)(6) “tests 

the legal sufficiency of a claim.” Navarro v. Block, 250 F.3d 729, 732 (9th Cir. 

2001). Because Rule 12(b)(6) focuses on the “sufficiency” of a claim rather than 

the claim’s substantive merits, “a court may [ordinarily] look only at the face of 

the complaint to decide a motion to dismiss.” Van Buskirk v. Cable News 

Network, Inc., 284 F.3d 977, 980 (9th Cir. 2002). However, courts may consider 

exhibits that are attached to the complaint. See Fed. R. Civ. P. 10(c) (“A copy of 

a written instrument that is an exhibit to a pleading is a part of the pleading for all 

purposes.”); Hal Roach Studios, Inc. v. Richard Feiner & Co., Inc., 896 F.2d 

1542, 1555 n.19 (9th Cir. 1990) (citing Amfac Mortg. Corp. v. Ariz. Mall of 

Tempe, Inc., 583 F.2d 426 (9th Cir. 1978) (“[M]aterial which is properly submitted 

as part of the complaint may be considered” in ruling on a Rule 12(b)(6) motion 

to dismiss.) Exhibits that contradict the allegations of a complaint may fatally 

undermine the complaint’s allegations. See Sprewell v. Golden State Warriors, 

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266 F.3d 979, 988 (9th Cir. 2001) (a plaintiff can “plead himself out of a claim by 

including . . . details contrary to his claims” (citing Steckman v. Hart Brewing, 

Inc., 143 F.3d 1293, 1295-96 (9th Cir. 1998) (courts “are not required to accept 

as true conclusory allegations which are contradicted by documents referred to in 

the complaint.”))); see also Nat’l Assoc. for the Advancement of Psychoanalysis 

v. Cal. Bd. of Psychology, 228 F.3d 1043, 1049 (9th Cir. 2000) (courts “may 

consider facts contained in documents attached to the complaint” to determine 

whether the complaint states a claim for relief). 

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

matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’ A 

claim has facial plausibility when the plaintiff pleads factual content that allows 

the court to draw the reasonable inference that the defendant is liable for the 

conduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. 

Corp. v. Twombly, 550 U.S. 544, 556, 570 (2007)). “All allegations of material 

fact are taken as true and construed in the light most favorable to the nonmoving 

party.” Cahill v. Liberty Mut. Ins. Co., 80 F.3d 336, 337-38 (9th Cir. 1996) 

(citation omitted). The court need not, however, “accept as true allegations that 

are merely conclusory, unwarranted deductions of fact, or unreasonable 

inferences.” Sprewell, 266 F.3d at 988; see also Iqbal, 556 U.S. at 678 

(“Threadbare recitals of the elements of a cause of action, supported by mere 

conclusory statements, do not suffice.”). “[T]he pleading standard Rule 8 

announces does not require ‘detailed factual allegations,’ but it demands more 

than an unadorned, the defendant-unlawfully-harmed me accusation.” Iqbal, 556 

U.S. at 678 (quoting Twombly, 550 U.S. at 555). For a complaint to survive a 

motion to dismiss, “the non-conclusory ‘factual content,’ and reasonable 

inferences [drawn] from that content, must be plausibly suggestive of a claim 

entitling the plaintiff to relief.” Moss v. United States Secret Serv., 572 F.3d 962, 

969 (9th Cir. 2009) (quoting Iqbal, 556 U.S. at 678). “Vague and conclusory 

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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). 

III. DEFENDANTS’ MOTIONS 

A. Claim Preclusion (CDCR Defendants) 

 Defendants Silva, Jackson, Pasha, Walker, Rodriguez, Self, Pool, Glynn, 

Sosa, Paramo, Roberts, Stout, and Bedane (hereafter collectively the “CDCR 

Defendants”), relying on Furnace v. Giurbino, 838 F.3d 1019 (9th Cir. 2016), 

move to dismiss all of Plaintiff’s claims as barred by claim preclusion. In 

Furnace, the Ninth Circuit held that a petition for writ of habeas corpus filed in 

California state court can have a claim preclusive effect on a subsequent § 1983 

action if the second suit involves: (1) the same cause of action (2) between the 

same parties or parties in privity with them (3) after a final judgment on the merits 

in the first suit. Furnace, 838 F.3d at 1023. 

 Under the Full Faith and Credit Statute, 28 U.S.C. § 1738, federal courts 

must give the same preclusive effect to state court judgments, including 

“reasoned” habeas judgments, as the rendering state court would. Id. Under 

California law, two suits will be found to involve the same cause of action when 

they involve the same “primary right.” Id. at 1024 (citing Brodheim v. Cry, 584 

F.3d 1262, 1268 (9th Cir. 2009)). Under the primary rights theory, “a cause of 

action is (1) a primary right possessed by the plaintiff, (2) a corresponding 

primary duty devolving upon the defendant, and (3) a harm done by the 

defendant which consists in a breach of such primary right and duty.” Brodheim, 

584 F.3d at 1268. 

 The causes of action in the instant case and the state habeas petition are 

distinct. In his state habeas petition, filed on July 21, 2014, Plaintiff complained, 

among other things, that he was being denied adequate pain medication as his 

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request that his medication be increased to three doses per day had been denied 

by prison medical staff. (ECF No. 1 at 31-34.) The allegations in this case are 

much more expansive than those in his habeas petition, and go beyond Plaintiff’s 

allegation of not being provided opiate medication. Plaintiff’s Complaint in the 

instant case includes allegations that Defendants caused Plaintiff’s atrial 

fibrillation heart condition, improperly diagnosed and treated him (including by not 

providing him adequate pain medication), and conspired to retaliate, and 

retaliated, against him for filing grievances and a previous lawsuit. Moreover, 

Plaintiff’s federal complaint largely relates to events occurring after the filing of 

Plaintiff’s state habeas petition, and the majority of the defendants named in this 

action were not named as respondents in his habeas petition, nor did they have 

any connection to the inadequate pain medication allegation raised therein.4

 

“The critical focus of primary rights analysis is the harm suffered.” Brodheim, 584 

F.3d at 1268. The alleged harms in Plaintiff’s state habeas petition and this 

federal case are distinct, and “were caused at different times, by different acts, 

and by different actors.” See id. at 1268-69. Although Plaintiff’s current 

allegation that he was denied adequate pain medication bears some similarity to 

the contentions in his habeas petition, Plaintiff’s habeas petition is based upon a 

different set of circumstances and a different time frame than those set forth in 

his § 1983 complaint. Accordingly, the Court recommends that this action not be 

found to be barred by the state court’s decision on Plaintiff’s state habeas 

                                               

4 The CDCR Defendants’ request for judicial notice of Plaintiff’s July 21, 2014 state habeas 

petition is granted. See Rosales-Martinez v. Palmer, 753 F.3d 890, 891 (9th Cir. 2014) (court 

may take judicial notice of the records and filings of other courts); Knievel v. ESPN, 393 F.3d 

1068, 1076 (9th Cir. 2005) (court may consider any documents attached to the complaint or 

incorporated by reference into the complaint). Plaintiff named the following parties as 

respondents in his state habeas petition: Edmund G. Brown, Jr., Governor; M.D. Stainer; J. 

Lewis; Daniel Paramo, Warden; S. Roberts, M.D.; M. Glynn; Tamara S. Robinson, M.D.; and 

K. Dean, M.D. (ECF No. 46-2 at 10-11.) 

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petition. 

B. State Actor (Defendant Butcher)

 Defendant Butcher argues that Plaintiff’s Complaint fails to plead sufficient 

facts showing he is a state actor. “Section 1983 creates a private right of action 

against individuals who, acting under color of state law, violate federal 

constitutional or statutory rights.” Devereaux v. Abbey, 263 F.3d 1070, 1074 (9th 

Cir. 2001). To establish § 1983 liability, a plaintiff must show both (1) deprivation 

of a right secured by the Constitution and laws of the United States, and (2) that 

the deprivation was committed by a person acting under color of state law. Tsao 

v. Desert Palace, Inc., 698 F.2d 1128, 1138 (9th Cir. 2012). As a general matter, 

private hospitals and doctors are not state actors and therefore cannot be sued 

under § 1983. See Briley v. California, 564 F.2d 849, 855-56 (9th Cir. 1977). 

However, an inmate plaintiff may be able to hold a private hospital or doctor 

liable if either contracted directly with the state to provide medical services to 

inmates. West v. Atkins, 487 U.S. 42, 54 (1988); see also McIlwain v. Prince 

William Hosp., 774 F. Supp. 986, 989-90 (E.D. Va. 1991). 

 Plaintiff alleges that Defendant Butcher is or was “a contract medical doctor 

with CDC-R/RJD.” See ECF No. 1 at 6. The Court finds Plaintiff has sufficiently 

alleged that Defendant Butcher is a state actor. 

C. Statute of Limitations (Defendant Butcher) 

 Defendant Butcher contends Plaintiff’s first, third, and fourth claims are 

time-barred based on California’s one-year statute of limitations for actions 

involving professional negligence against a healthcare provider, set forth in 

California Code of Civil Procedure § 340.5. Plaintiff contends a two-year statute 

of limitations applies. Opp’n to Butcher Mot., ECF No. 39 at 21. 

 Dismissal pursuant to Fed. R. Civ. P. 12(b)(6) based on a statute of 

limitations defense is only appropriate where the running of the statute of 

limitations is apparent “on the face of a complaint.” Von Saher v. Norton Simon 

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Museum of Art at Pasadena, 592 F.3d 954, 969 (9th Cir. 2010). However, Rule 

12(b)(6) permits consideration of any matters of which judicial notice may be 

taken, and any exhibits attached to the complaint. United States v. Ritchie, 342 

F.3d 903, 908 (9th Cir. 2003). As § 1983 contains no specific statute of 

limitations, federal courts borrow state statutes of limitations for personal injury 

actions in suits brought pursuant to § 1983. See Wallace v. Kato, 549 U.S. 684, 

387 (2007); Lukovsky v. City of San Francisco, 535 F.3d 1044, 1048 (9th Cir. 

2008). In California, the statute of limitations for an action for a personal injury 

caused by the wrongful or negligence act of another is two years from the date of 

accrual. See Cal. Code Civ. Proc. § 335.1; see also McGee v. Chamberlain, 

2014 WL 1028695, *2 (S.D. Cal. Mar. 13, 2014) (applying two-year statute of 

limitations pursuant to § 335.1 to California prisoner’s allegations that he was 

denied adequate medical care); Bradley v. Jameson, 2013 WL 6504800, *2 (S.D. 

Cal. Dec. 10, 2013) (same); Calloway v. Scribner, 2013 WL 943229, *2 (E.D. Cal. 

Mar. 11, 2013) (applying two-year statute of limitations pursuant to § 335.1 to 

California prisoner’s allegations of deliberate indifference to a serious medical 

need in violation of the Eighth Amendment). Therefore, Defendant Butcher’s 

reliance on California Code of Civil Procedure § 340.5 is misplaced. 

 Federal law determines when a cause of action accrues and begins to run 

for a § 1983 claim. Lukovsky, 535 F.3d at 1048. A federal claim accrues when 

the plaintiff knows or has reason to know of the injury which is the basis of the 

action. Id. at 1051. Here, Plaintiff alleges he was seen by Defendant Butcher on 

or between August 14, 2014 and August 19, 2014. (ECF No. 1 at 14-15; ECF 

No. 1-1 at 39-40, 46-47.) Assuming for the sake of argument that his cause of 

action against Defendant Butcher accrued upon these visits, the two-year statute 

of limitations ran in August 2016. As Plaintiff’s Complaint was filed before this, 

on March 21, 2016, the Court recommends that it not be found to be barred by 

the statute of limitations. 

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D. Plaintiff’s First Claim − Retaliation 

Plaintiff asserts a claim of retaliation against all defendants in violation of 

the First Amendment right to petition the government for redress of grievances. 

All CDCR Defendants, excluding Silva and Pasha, and Defendants Zamudio and 

Butcher seek dismissal of this claim pursuant to Fed. R. Civ. P. 12(b)(6) on 

grounds that Plaintiff fails to state a claim upon which relief can be granted. 

Retaliation against a prisoner for exercising his rights to speech or to 

petition the government may violate the First Amendment. See Rizzo v. Dawson, 

778 F.2d 527, 532 (9th Cir. 1985); see also Rhodes v. Robinson, 408 F.3d 559, 

597 (9th Cir. 2005) (providing that prisoners have a First Amendment right to file 

prison grievances and to pursue civil litigation in court and to be free from 

retaliation from doing so). A claim of First Amendment retaliation requires: 

(1) “the retaliated-against conduct is protected,” (2) the “defendant took adverse 

action against the plaintiff,” (3) there is a “causal connection between the adverse 

action and the protected conduct,” (4) the act “would chill or silence a person of 

ordinary firmness,” and (5) the conduct does not further a legitimate penological 

interest. See Watison v. Carter, 668 F.3d 1108, 1114 (9th Cir. 2012). A plaintiff 

can allege retaliatory intent (factor three) with a time line of events from which 

retaliation can be inferred. Id. If the plaintiff’s exercise of his constitutional rights 

was not chilled (factor four), he must allege the defendant’s actions caused him 

to suffer more than minimal harm. Rhodes, 408 F.3d at 567-68 n.11. Retaliation 

claims are reviewed with particular care as they are prone to abuse by prisoners. 

Graham v. Henderson, 89 F.3d 75, 79 (2d Cir. 1996). 

 Plaintiff alleges he engaged in protected conduct–the filing of his state 

habeas petition and prison grievances. He claims he was retaliated against after 

engaging in his protected activity by being deemed a “troublemaker,” and 

contends prison staff threatened him, fired him from his assigned job, moved his 

housing, made false statements about him, directed other inmates to beat him, 

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placed false documents into his medical file stating he was diverting medication, 

stole his personal property, placed him in Administrative Segregation, and 

threatened him with transfer to a higher security prison if he did not cease filing 

grievances. (ECF No. 1 at 14.) He also alleges his pain medication was 

discontinued in retaliation for having filed a court action. (ECF No. 1-2 at 15.) 

Notwithstanding Plaintiff’s extensive list of alleged adverse actions, Plaintiff 

makes very few specific allegations of such actions against any moving 

defendant; rather, he alleges only generally that “staff” took adverse action 

against him. See ECF No. 1 at 13-14. This, by itself, is insufficient to state a 

claim against any defendant. See Taylor v. List, 880 F.2d 1040 (9th Cir. 1989) 

(“Liability under section 1983 arises only upon a showing of personal 

participation by the defendant.”). 

 Additionally, none of Plaintiff’s factual allegations, detailed above, shows 

that any of the moving defendants retaliated against Plaintiff. With respect to 

Defendants Jackson and Paramo, Plaintiff alleges only that Jackson intervened 

in Plaintiff’s hunger strike upon Paramo’s orders, and that both ordered Plaintiff 

to perform work that he should not have undertaken due to his medical 

restrictions. Even if these could be considered adverse actions, Plaintiff makes 

no allegation of a causal connection between these actions and his protected 

conduct, nor does he allege such conduct would chill a person of ordinary 

firmness or that it lacked legitimate penological interests. A similar analysis 

applies to Defendants Walker, Glynn, Roberts, and Bedane, against whom 

Plaintiff alleges only their refusal to provide him with John Doe “Jose’s” last 

name, and to Defendant Stout, whom Plaintiff alleges refused to allow him to 

work, and ordered him brought to the medical clinic. Plaintiff alleges no facts at 

all showing that Defendants Rodriguez or Pool retaliated against him. 

 With respect to Defendants Sosa and Self, Plaintiff alleges Defendant Sosa 

issued a CDC 128-A custodial counseling chrono in retaliation for Plaintiff’s 

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grievances, and that both Sosa and Self unlawfully screened out his appeals. 

Courts have found that administrative chronos, such as CDC 128-A chronos, 

which are informational in nature and do not have any disciplinary ramifications, 

are not a sufficient adverse action to support a retaliation claim. See, e.g., 

Williams v. Woodford, 2009 WL 3823916, *3 (E.D. Cal. 2009). Plaintiff, in his 

opposition, contends the CDC 128-A chrono will impact his opportunity to be 

released on parole. Opp’n to CDCR Mot., ECF No. 56 at 27. However, 

assuming arguendo Plaintiff has adequately pleaded the first four factors of a 

retaliation claim, including the adverse action factor, he has not alleged the 

preparation of the chrono, which Sosa used to document incendiary language 

used by Plaintiff about placing prison staff in a supply closet, was not undertaken 

to advance legitimate penological purposes, and therefore does not sufficiently 

state a claim. As for Sosa’s and Self’s alleged unlawful screening out of 

Plaintiff’s appeals, Plaintiff has not asserted facts establishing a causal 

connection between his protected conduct and the claimed adverse action. The 

exhibits attached to Plaintiff’s complaint indicate his appeals were screened out 

because they were missing documentation, failed to state facts supporting his 

allegations, and raised multiple issues which were required to be appealed 

separately. (ECF No. 1-2 at 65-69.) Having been presented only with the appeal 

screening forms and Plaintiff’s conclusory allegations that the denial of his 

appeals was retaliatory, the Court does not find Plaintiff has pled facts sufficient 

to allow for a plausible inference of retaliatory motive in light of the more likely 

explanations available. See Iqbal, 556 U.S. at 681. 

 Plaintiff also fails to state a retaliation claim against Drs. Butcher and 

Zamudio, the Alvarado Hospital physicians. Plaintiff contends in his opposition 

papers that Butcher and Zamudio, at the behest of RJD medical staff, refused to 

provide him pain medication. See Opp’n to Butcher Mot., ECF No. 39 at 13; 

Opp’n to Zamudio Mot., ECF No. 38 at 10-11. Plaintiff, however, has alleged no 

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facts demonstrating that Drs. Butcher and Zamudio even knew about his 

protected conduct, i.e., the filing of his state habeas petition and prison 

grievances, let alone that their decision to not provide him with pain medication 

was motivated by retaliation for Plaintiff having exercised his First Amendment 

rights. See, e.g., Corales v. Bennett, 567 F.3d 554, 568 (9th Cir. 2009) (stating 

that plaintiff must demonstrate that defendant knew of the protected activity); 

Soranno’s Gasco, Inc. v. Morgan, 874 F.2d 1310, 1314 (9th Cir. 1989) (a plaintiff 

must show that his protected conduct was a “substantial” or “motivating” factor 

behind the defendant’s conduct). Indeed, Plaintiff himself alleges he was denied 

pain medication at Alvarado Hospital “due to the stated risk of further heart 

damage.” See Compl., ECF No. 1 at 15. Plaintiff also makes no allegations that 

the physicians prevented him from filing any grievances. In short, Plaintiff has 

not alleged facts sufficient to allow for a plausible inference of retaliatory motive 

by Drs. Butcher and Zamudio. See Iqbal, 556 U.S. at 681. 

 Plaintiff fails to state a claim for retaliation against any of the moving 

defendants. The Court accordingly recommends the moving defendants’ 

motions to dismiss Plaintiff’s first claim be granted. 

E. Plaintiff’s Second Claim – Conspiracy 

Plaintiff alleges that all defendants unlawfully conspired against him in 

violation of 42 U.S.C. § 1986 in relation to his First Amendment right to petition 

the government for redress of grievance. All CDCR Defendants, excluding Silva 

and Pasha, and Defendants Butcher and Zamudio seek dismissal of this claim 

pursuant to Fed. R. Civ. P. 12(b)(6) on grounds that Plaintiff fails to state a claim 

upon which relief can be granted. 

 Section 1986 “authorizes a remedy against state actors who have 

negligently failed to prevent a conspiracy that would be actionable under [42 

U.S.C.] § 1985.” Cerrato v. San Francisco Cmty Coll. Dist., 26 F.3d 968, 971 n.7 

(9th Cir. 1994). Under section 1985(3), “a complaint must allege (1) a 

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conspiracy, (2) to deprive any person . . . of the equal protection of the laws, or of 

equal privileges and immunities under the laws, (3) an act by one of the 

conspirators in furtherance of the conspiracy, and (4) a personal injury, property 

damage, or deprivation of any right or privilege of a citizen of the United States.” 

Gillespie v. Civiletti, 629 F.2d 637, 641 (9th Cir. 1980); see also Griffin v. 

Breckenridge, 403 U.S. 88, 102-03 (1971). “The language requiring intent to 

deprive of equal protection, or equal privileges and immunities, means that there 

must be some racial, or perhaps otherwise class-based, invidiously 

discriminatory animus behind the conspirators’ action.” Griffin, 403 U.S. at 102. 

 Here, Plaintiff’s Complaint contains no facts that any of the alleged 

constitutional violations were based on any “racial, or perhaps otherwise classbased, invidiously discriminatory animus.” RK Ventures, Inc. v. City of Seattle, 

307 F.3d 1045, 1056 (9th Cir. 2002) (citing Sever v. Alaska Pulp Corp., 978 F.2d 

1529, 1536 (9th Cir. 1992)). Therefore, the Court recommends the moving 

defendants’ motions to dismiss Plaintiff’s second claim be granted due to the 

failure to state a claim pursuant to either 42 U.S.C. § 1985 or § 1986 upon which 

relief can be granted. 

F. Plaintiff’s Third and Fourth Claims − Deliberate Indifference 

Plaintiff’s third and fourth claims assert that Defendants conspired with 

each other to act with deliberate indifference to his severe medical condition and 

falsified medical reports due to cost considerations in violation of the Eighth 

Amendment prohibition against cruel and unusual punishment. All CDCR 

Defendants, excluding Silva and Pasha, and Defendants Zamudio and Butcher 

seek dismissal of this claim pursuant to Fed. R. Civ. P. 12(b)(6) on grounds that 

Plaintiff fails to state a claim upon which relief can be granted. 

 A claim of medical indifference requires (1) a serious medical need and (2) 

a deliberately indifferent response by the defendant. Jett v. Penner, 439 F.3d 

1091. 1096 (9th Cir. 2006). The required showing of deliberate indifference is 

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satisfied when it is established “the official knew of and disregarded a substantial 

risk of serious harm to [the prisoner’s] health or safety.” Johnson v. Meltzer, 134 

F.3d 1393, 1398 (9th Cir. 1998) (citing Farmer v. Brennan, 511 U.S. 825, 837 

(1994)). Negligence, inadvertence, or differences in medical judgment or opinion 

do not rise to the level of a constitutional violation. Jackson v. McIntosh, 90 F.3d 

330, 331 (9th Cir. 1996). “Deliberate indifference is a high legal standard.” 

Toguchi v. Chung, 391 F.3d 1051, 1060 (9th Cir. 2004). The indifference must 

be substantial and must rise to a level of “unnecessary and wanton infliction of 

pain.” Estelle v. Gamble, 429 U.S. 97, 105-06 (1976). 

 Plaintiff has alleged facts that plausibly show he had serious medical 

needs. Taking the allegations in the Complaint as true, he has alleged serious 

health issues, including atrial fibrillation and neck and back pain. He has not, 

however, alleged facts plausibly demonstrating the moving defendants acted with 

deliberate indifference to his serious medical needs. While Plaintiff indicates in 

his opposition that he successfully controlled his high blood pressure condition 

for over five years, prior to being housed at RJD, and it was not until he allowed 

RJD staff and their “contract” medical doctors to treat him that he experienced 

the “dire” effects that he had been warned of (see Opp’n to CDCR Mot., ECF No. 

56 at 7-8), his pleading lacks factual allegations necessary to show deliberate 

indifference. Plaintiff makes no allegations relating to the denial of medical care 

or deliberate indifference against Defendants Walker, Self, Pool, Glynn, Sosa, 

Roberts, or Bedane. Although Plaintiff argues in his opposition that Roberts, 

Walker and Glynn are medical executives at RJD and that “[n]o medical action is 

taken, nor denied, save by permission . . . of these defendants” (id. at 10), 

Plaintiff does not allege this in his Complaint. See Schneider v. California Dep’t 

of Corr., 151 F.3d 1194, 1197 n.1 (9th Cir. 1998) (providing that new allegations 

contained in an opposition are irrelevant for Rule 12(b)(6) purposes). As to 

Defendants Paramo and Jackson, Plaintiff alleges only that Jackson intervened 

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in Plaintiff’s hunger strike upon Paramo’s orders, and that both ordered Plaintiff 

to perform work that he should not have undertaken due to his medical 

restrictions. These allegations are insufficient to allow for a plausible inference of 

the requisite state of mind required to establish deliberate indifference to 

Plaintiff’s serious medical needs. See Iqbal, 556 U.S. at 681. As to Defendant 

Rodriguez, the psychologist, Plaintiff alleges she told him she had purchased 

malpractice insurance, that funds for inmate care were being diverted to 

construction efforts at the prison, and that prison staff were attempting to push 

Plaintiff into suicide. Even if true, none of these show that Rodriguez was 

deliberately indifferent to Plaintiff’s serious medical needs. The only allegation 

regarding medical care relating to Defendant Stout is that Stout ordered Plaintiff 

to be brought to the medical clinic. This does not lend any factual support to a 

deliberate indifference claim. 

 Plaintiff argues that Defendants denied him adequate medical care in 

retaliation for filing grievances and court actions, and because it was not costeffective to treat his condition. Opp’n to CDCR Mot., ECF No. 56 at 21. He 

contends in his opposition that Defendants knew of his back, heart, kidney, and 

chronic pain, yet refused anything but aspirin for treatment, and although 

Defendants knew of his new onset atrial fibrillation, they failed to treat Plaintiff 

until it became chronic atrial fibrillation requiring multiple painful surgeries to 

treat. He argues Defendants knew of his immediate need for medical treatment, 

but allowed him to suffer in order to allow the contracted doctors, Drs. Butcher 

and Zamudio, to “bilk the State of California” and “earn more medical fees” once 

his condition worsened because he needed multiple procedures, not a single 

procedure. Id. at 22-25. These contentions, however, go beyond the allegations 

in the Complaint (see Schneider, 151 F.3d at 1197 n.1), and are not supported 

by the medical records attached to the Complaint. 

 Plaintiff’s medical records show that although he is a difficult patient who 

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declines to take his prescribed medications and who regularly refuses to 

cooperate with medical staff, which Plaintiff himself acknowledges, he has been 

seen frequently by medical staff at RJD, and was seen on an emergency basis 

by Drs. Butcher and Zamudio upon discovery of his atrial fibrillation. The 

voluminous exhibits and medical records offered by Plaintiff in support of his 

Complaint show that RJD medical staff and Drs. Butcher and Zamudio acted 

promptly, carefully, and responsibly when he was treated at both RJD as well as 

Alvarado Hospital. See Steckman, 143 F.3d at 1295-96 (stating that courts “are 

not required to accept as true conclusory allegations which are contradicted by 

documents referred to in the complaint”). In short, Plaintiff’s exhibits belie any 

plausible claims of deliberate indifference as to any of the moving defendants. 

Iqbal, 662 U.S. at 678; see also Sprewell, 266 F.3d at 988. Moreover, although 

Plaintiff claims falsification of his medical records, he offers no facts supporting 

why and how his medical records were false. Plaintiff does not have an 

independent right to an accurate prison record. See Hernandez v. Johnston, 833 

F.2d 1316, 1319 (9th Cir. 1987). 

 Finally, a claim of conspiracy requires the existence of an agreement or a 

meeting of the minds to violate the plaintiff’s constitutional rights, and an actual 

deprivation of those constitutional rights. Avalos v. Baca, 596 F.3d 583, 592 (9th 

Cir. 2010). Plaintiff alleges no facts suggesting an agreement or common 

objective among Defendants to violate his rights. See Zemsky v. City of New 

York, 821 F.2d 148, 151 (2d Cir. 1987) (pro se complaint containing only 

conclusory, vague, or general allegations of conspiracy to deprive a person of 

constitutional rights will not withstand a motion to dismiss); Franklin v. Fox, 312 

F.3d 423, 441 (9th Cir. 2001) (quoting United Steel Workers of Am. v. Phelps 

Dodge Corp., 865 F.2d 1539, 1541 (9th Cir. 1989)) (“To be liable, each 

participant in the conspiracy need not know the exact details of the plan, but 

each participant must at least share the common objective of the conspiracy.”). 

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A plaintiff must state specific facts, not mere conclusory statements, to support 

the existence of an alleged conspiracy. Burns v. County of King, 883 F.2d 819, 

821 (9th Cir. 1989). Although pro se pleadings are liberally construed, a liberal 

interpretation of a civil rights complaint may not supply essential elements of the 

claim that were not initially pled. Ivey v. Board of Regents of Univ. of Alaska, 673 

F.2d 819, 821 (9th Cir. 1989). While Plaintiff makes a variety of vague and 

conclusory allegations of conspiracy, his Complaint fails to set forth the essential 

facts as to the specific acts of each defendant that support the existence of the 

claimed conspiracy. Burns, 883 F.2d at 821. Claims based on vague and 

conclusory allegations, which fail to specify each defendant’s role in the alleged 

conspiracy, are subject to dismissal. Pena v. Gardner, 976 F.2d 469, 471 (9th 

Cir. 1992). 

 Accordingly, the Court recommends the moving defendants’ motions to 

dismiss the third and fourth claims be granted. 

IV. CONCLUSION 

 For the reasons set forth above, the Court recommends: 

 1. Defendant Zamudio’s motion to dismiss (ECF No. 22) be GRANTED; 

 2. Defendant Butcher’s motion to dismiss (ECF No. 24) be DENIED with 

respect to his arguments that he is not a state actor and that Plaintiff’s first, third, 

and fourth claims are time-barred by the statute of limitations, but GRANTED in 

all other respects; and 

 3. The motions to dismiss filed by CDCR Defendants Silva, Jackson, 

Pasha, Walker, Rodriguez, Self, Pool, Glynn, Sosa, Paramo, Roberts and Stout 

(ECF No. 46), and Defendant Bedane (ECF No. 61) be DENIED as to their 

argument that Plaintiff’s Complaint is barred by claim preclusion; but GRANTED 

in all other respects as to moving CDCR Defendants (Jackson, Walker, 

Rodriguez, Self, Pool, Glynn, Sosa, Paramo, Roberts, Stout, and Bedane). 

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 This report and recommendation will be submitted to the Honorable Roger 

T. Benitez, pursuant to the provisions of 28 U.S.C. § 636(b)(1). Any party may file 

written objections with the Court and serve a copy on all parties on or before July 

5, 2017. The document should be captioned “Objections to Report and 

Recommendation.” Any reply to the Objections shall be served and filed on or 

before July 19, 2017. The parties are advised that failure to file objections within 

the specified time may waive the right to appeal the district court’s order. 

Martinez v. YIst, 951 F.2d 1153 (9th Cir. 1991). 

IT IS SO ORDERED. 

Dated: June 13, 2017 

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