Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_14-cv-05308/USCOURTS-cand-3_14-cv-05308-5/pdf.json

Nature of Suit Code: 555
Nature of Suit: Prisoner - Prison Condition
Cause of Action: 42:1983 Prisoner Civil Rights

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United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

MICHAEL ANGELO POWELL,

Plaintiff,

v.

RICHARD L. MARLAIS, et al.,

Defendants.

Case No. 14-cv-05308-JST 

ORDER GRANTING SUMMARY 

JUDGMENT IN FAVOR OF

DEFENDANTS, DENYING AS MOOT 

PLAINTIFF’S SECOND AMENDED 

PRELIMINARY INJUNCTION 

MOTION, DENYING PLAINTIFF’S 

MOTION TO SUPPRESS FEBRUARY 

22, 2016 DEPOSITION TRANSCRIPT

Re: Dkt. Nos. 48, 51, 68, 69

I. INTRODUCTION

Plaintiff filed this pro se civil rights action under 42 U.S.C. § 1983 against prison officials 

at Correctional Training Facility – Soledad (―CTF‖), where he is currently housed. Plaintiff 

alleges that defendants Dr. Marlais and Dr. Calderon failed to properly treat his abscessed tooth in 

2012 and 2013 and that defendant Dr. Uy failed to order proper follow-up treatment since that 

time. 

Now before the Court are the following motions: a second amended preliminary 

injunction motion filed by Plaintiff (Docket No. 48); summary judgment motions filed by Drs. 

Marlais and Uy (Docket No. 51) and by Dr. Calderon (Docket No. 68); and Plaintiff‘s motion to 

suppress the February 22, 2016 deposition transcript (Docket No. 69). For the reasons set forth 

below the Court GRANTS the summary judgment motion filed by Drs. Marlais and Uy; GRANTS 

the summary judgment motion filed by Dr. Calderon; DENIES Plaintiff‘s second amended 

preliminary injunction motion; and DENIES Plaintiff‘s request to suppress the February 22, 2016 

deposition transcript.

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II. BACKGROUND

The following facts are undisputed unless otherwise noted.

Prior to Plaintiff‘s incarceration, Plaintiff had a porcelain-fused bridge applied between 

lower anterior teeth 23 and 26 to replace two missing lower front teeth, teeth 24 and 25. Docket 

No. 52 (―Marlais Decl.‖) ¶ 8. The bridge was anchored to teeth 23 and 26 with crowns bonded to 

these teeth. Docket No. 68-2 (―Calderon Decl.‖) ¶ 4.

In mid-January 2012, a CTF dentist conducted a dental examination of Plaintiff and 

prepared a dental treatment plan. Docket No. 53 (―Uy Decl.‖) ¶ 6, and Ex D at 41–45. The dental 

examination noted that Plaintiff had an asymptomatic abscess at tooth 23. Uy Decl. ¶ 6 and Ex. D 

at 54. The treatment plan listed the following necessary dental treatments: gross debridement for 

all teeth, extraction of both teeth 23 and 4, an amalgam (filling) for tooth 2, and an occlusal 

amalgam (filling on the biting surface) for tooth 15. Uy Decl., Ex. D at 6 and 43. On January 12, 

2012, Plaintiff refused the recommended extraction of tooth 23 by signing a Form 7362, Refusal 

of Examination and/or Treatment, wherein he acknowledged that he had been informed that the 

abscess detected at tooth 23 could cause pain and infection. Uy Decl., Ex. D at 6. Plaintiff 

refused the entire dental treatment plan on a Form 7362 dated January 20, 2012, and 

acknowledged that he had been informed that the failure to follow the treatment plan could result 

in future pain, swelling, and infection. Uy Decl., Ex. D at 6 and 55. 

On January 25, 2012, Plaintiff had a teeth cleaning and he agreed to have the 

recommended fillings done. Uy Decl., Ex. D at 56. 

On February 7, 2012, Plaintiff was seen in response to his complaint of a sore gum around 

tooth 26. Uy Decl., Ex. D at 57. X-rays showed that there was no abscess at tooth 26, but again 

showed an abscess at tooth 23. Uy Decl., Ex. D at 57. 

During March 2012, Plaintiff was seen by the CTF dental office four times, during which 

tooth 4 was extracted and fillings were done on tooth 2 and tooth 15. Uy Decl., Ex. D at 17–18 

and 58–61. Plaintiff continued to refuse to allow the extraction of tooth 23. 

On August 7, 2012, Plaintiff submitted an emergency request for dental treatment, stating: 

I‘m in a great deal of  ̳pain‘ with my lower front 4 teeth. The pain is waking me up at 

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night. I need antibiotics. Will you  ̳please‘ call me in as soon as possible. Please! Thank 

you!

Uy Decl., Ex. D at 88. 

A. August 13, 2012 Dental Examination by Dr. Marlais

On August 13, 2012, Plaintiff was examined by Dr. Marlais in response to his healthcare 

request submitted August 7, 2012. Marlais Decl., Ex. A at 63. In the pain profile that Plaintiff 

completed at the dental examination, Plaintiff reported waking at night with pain in his lower jaw, 

especially at tooth 26. Marlais Decl., Ex. A at 93. He reported that cold water worsened the pain, 

but acetaminophen helped. Marlais Decl., Ex. A at 93. 

Dr. Marlais examined tooth 23 and noticed that a large portion of the biting edge of tooth 

23 was missing and appeared to have been fractured prior to the placement of the bridge. Marlais 

Decl. ¶ 8. Dr. Marlais took an x-ray of tooth 23 which showed a chronic apical abscess and pulp 

necrosis (death of the material within a tooth). Marlais Decl. ¶ 4. Bacterial infection cannot be 

seen in x-rays. Marlais Decl. ¶ 6. 

Dr. Marlais concluded that the abscess at tooth 23 was sterile and not infected for the 

following reasons. First, an acute abscess caused by bacterial infection is usually accompanied by 

pain, fever and swelling, but Plaintiff exhibited neither fever nor swelling. Marlais Decl. ¶ 6. 

Second, Plaintiff reported that cold water worsened the pain but it is generally heat that causes an 

abscess to hurt, because heat causes the pus in an abscess to expand and put hydraulic pressure on 

the bone. Marlais Decl. ¶ 7. A tooth with a dental abscess does not have vital tissue in the pulp 

and will not be sensitive to cold. Marlais Decl. ¶ 5. Third, generally hydraulic pressure causes the 

tooth to become sensitive to percussion but Plaintiff did not exhibit sensitivity to palpitation or 

percussion of tooth 23. Marlais Decl. ¶¶ 6–7. Dr. Marlais concluded that the pain reported by 

Plaintiff at tooth 26 was ―referred pain‖ caused by night-time teeth grinding, and was not caused 

by pressure in, or infection of, the abscess at tooth 23. Marlais Decl. ¶ 7 and Ex. A at 63. 

Plaintiff disputes Dr. Marlais‘ assessment of the origin of his pain, of the existence of his 

pain, and of the severity of his pain. Plaintiff alleges that his abscess was infected and had been 

causing him severe pain since August 7, 2012. The pain included physical discomfort, debilitating 

headaches, and fatigue. The pain interfered with his ability to sleep and to eat solid food. The 

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pain caused Plaintiff to suffer from isolation, depression, and emotional distress because he was 

too fatigued and uncomfortable to leave his cell. Docket No. 48 at 4. 

The parties provide differing accounts of which treatment options were discussed with 

Plaintiff at this appointment. 

According to Plaintiff, Dr. Marlais told him the following. Dr. Marlais stated that the only 

treatment available at CTF for Plaintiff‘s abscess was extraction of tooth 23, which would also 

require removal of the four-tooth bridge (spanning teeth 23–26) and extraction of tooth 26. 

Docket No. 13 at 5 and Docket No. 48 at 3. Dr. Marlais informed Plaintiff that there was a 

surgery that could save his tooth, but none of the CTF dentists were capable of performing this 

surgery, and this surgery could only be done by an outside surgeon ―specialist‖ and could 

therefore be expensive. Docket No. 13 at 5. Dr. Marlais told Plaintiff: ―You have to remember 

where you‘re at.‖ Id. Dr. Marlais then informed Plaintiff that he would schedule Plaintiff for the 

extraction of tooth 23 in a couple weeks. Id. Plaintiff questioned Dr. Marlais ―about the dangers 

of not treating the infection / abscess for a  ̳few more weeks‘ and asked if the abscess shouldn‘t be 

cleared up first before he pulled his teeth.‖ Id. Dr. Marlais told Plaintiff that it was not necessary 

for the infection to clear up prior to the extraction. Id. Plaintiff refused the extraction and 

informed Dr. Marlais that Plaintiff thought it was dangerous to pull the abscessed tooth while an 

infection was festering, that the proposed treatment plan was not in Plaintiff‘s best long-term 

medical interests, and that the proposed treatment plan was clearly based solely on monetary 

incentives. Id. 

Dr. Marlais alleges that he informed Plaintiff that root canal treatment on tooth 23 was not 

possible. Marlais Decl. ¶ 13. In a root canal, a dental surgeon would drill through a tooth canal to 

the root of the tooth, remove the nerve and the pulp in the tooth, and clean and re-seal the 

hollowed-out chambers of the tooth. Calderon Decl. ¶ 4. Dr. Marlais reports that the following 

factors made a root canal treatment ―not medically necessary.‖ The root canal of tooth 23 was 

very difficult to see indicating that it had calcified closed and would be difficult to access, leading 

to a negative outcome of any root canal treatment. Marlais Decl. ¶ 13. Root canal treatment 

would fracture the abutment crown covering tooth 23, which would render tooth 23 unrestorable. 

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Marlais Decl. ¶ 13. Tooth 23 was dead and chronically abscessed, and therefore susceptible to 

infection. Marlais Decl. ¶ 14. 

Dr. Marlais states that he is unaware of any oral surgery available to Plaintiff in August 

2012 that would have ―saved‖ tooth 23, whether available at CTF or any outside facility. Marlais 

Decl. ¶ 15. Dr. Marlais informed Plaintiff that he recommended extraction of tooth 23, which 

would involve sectioning the bridge and replacing the anterior teeth with a partial lower denture. 

Marlais Decl. ¶ 14 and Ex. A at 63. In his declaration supporting his summary judgment motion, 

Dr. Marlais alleges that Plaintiff agreed to the recommended treatment plan. Marlais Decl. ¶ 14. 

Dr. Marlais‘ progress notes for this appointment are silent as to whether Plaintiff rejected or 

consented to the recommended treatment plan. Marlais Decl., Ex. A at 63.

The parties agree that Plaintiff requested antibiotics and pain medications to treat the 

abscess and that Dr. Marlais refused the request. However, the parties provide differing accounts 

as to why Dr. Marlais refused.

Plaintiff alleges that Dr. Marlais stated that his personal policy was to not prescribe 

antibiotics at this facility because inmates became tolerant to antibiotics if they were prescribed 

too often and unnecessarily. Docket No. 13 at 4 and Docket No. 48 at 3. In response, Plaintiff 

informed Dr. Marlais that he had never received antibiotics in the nine years that he had been in 

custody, and again requested antibiotics. Docket No. 13 at 4 and Docket No. 48 at 3. Dr. Marlais 

refused to check Plaintiff‘s medical records to verify Plaintiff‘s claim and continued to refuse to 

prescribe antibiotics. Docket No. 13 at 4 and Docket No. 48 at 3. Plaintiff also alleges that Dr.

Marlais refused to prescribe pain medications ―because all inmates are drug addicts and lie about 

dental pain.‖ Docket No. 13 at 4. Plaintiff informed Dr. Marlais that he was not lying about his 

pain, and that the pain could be confirmed the x-rays showing an abscess and by the visible 

swelling of Plaintiff‘s lower jaw that had been caused by the abscess. Docket No. 13 at 4–5. 

Plaintiff 

Dr. Marlais stated that he refused to provide antibiotics because the dental examination did 

not show signs of either an acute abscess or infection. Marlais Decl. ¶ 11. Dr. Marlais stated that 

while antibiotics can be an effective and appropriate treatment for bacterial infection, antibiotics 

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are contraindicated, have side effects, and breed antibiotic-resistant bacteria if prescribed 

indiscriminately. Marlais Decl. ¶ 11. Dr. Marlais further stated that if there had been an infection, 

he would have prescribed an antibiotic to treat it prior to performing other dental services because 

an infection makes it difficult to numb a patient which in turn makes the patient more difficult to 

treat. Marlais Decl. ¶ 11. 

Dr. Marlais does not recall Plaintiff requesting pain medication at the August 13, 2013 

dental examination. Marlais Decl. ¶ 10. At that time, Plaintiff had an active prescription for 650 

mg acetaminophen three times daily and was unable to take non-steroidal anti-inflammatories such 

as Motrin because he had been treated for hepatitis C. Marlais Decl. ¶ 10 and Ex. B at 110–12. 

Plaintiff‘s medical records also indicated a codeine allergy. Marlais Decl. ¶ 10 and Ex. B at 110–

12. Dr. Marlais concluded that no additional prescription for pain medications was necessary. Dr. 

Marlais also concluded that Plaintiff was not in pain, because Plaintiff did not report pain in 

response to palpitation or percussion of his abscessed tooth and because Plaintiff confirmed that 

he was not suffering sharp dental pain; that he had filled out a form exaggerating his pain to get a 

prescription for pain medication; and that he was seeking prescription pain medication in case the 

abscess became infected in the future and caused him pain in the future. Marlais Decl. ¶¶ 9, 11.

The following day, Plaintiff submitted a healthcare grievance complaining about Dr. 

Marlais‘ recommended treatment plan, requesting that tooth 26 be ―treated and not pulled,‖ a 

prescription for a seven-to-ten day course of antibiotics to treat his abscess, and a prescription for 

pain medication stronger than acetaminophen. Docket No. 54-2 at 4 and 6. 

B. August 22, 2012 Dental Examination by Dr. Marlais

On August 22, 2012, Plaintiff was called to the dental office where he was seen by Dr. 

Marlais. Plaintiff alleges that he was informed that the appointment was for the extractions of 

tooth numbers 23 and 26. Docket No. 48 at 4. Plaintiff further alleges that he informed Dr. 

Marlais that he was still in a great deal of pain and requested both pain medication and antibiotics. 

Docket No. 48 at 4. Dr. Marlais alleges that the appointment was only for the extraction of tooth 

23 and sectioning of the bridge, that Plaintiff did not report any pain at this appointment, and that 

Dr. Marlais did not observe any signs of infection at this appointment. Marlais Decl. ¶ 16 and Ex. 

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A at 64. The progress notes for this appointment and the related refusal of treatment executed by 

Plaintiff at this appointment only refer to the extraction of tooth 23. Marlais Decl., Ex. A at 22 

and 64. The parties agree that Plaintiff refused to have tooth 23 extracted and that no dental 

services were performed that day. Docket No. 48 at 4 and Marlais Decl. ¶ 16.

C. September 7, 2012 Dental Examination by Dr. Nares

On September 7, 2012, Plaintiff was interviewed by Dr. Nares in response to his 

resubmitted healthcare appeal. Docket No. 48 at 4. Plaintiff informed Dr. Nares that the abscess 

continued to cause him pain, and requested antibiotics to treat the abscess and pain medication to 

address his pain. Docket No. 48 at 4. 

Plaintiff informed Dr. Nares that he opposed extraction of tooth 23 for the following 

reasons. First, extraction of tooth 23 and the related four tooth bridge would require the extraction 

of tooth 26, a healthy tooth, because tooth 26 could not stand on its own without the support of the 

bridge. Docket No. 13 at 7. Second, without the bridge, Plaintiff would have difficulty eating 

food because he would be missing four of his lower front teeth. Finally, the removal of these 

lower teeth would destabilize Plaintiff‘s remaining lower teeth, resulting in the teeth becoming 

―crooked over time and unproductive.‖ Docket No. 13 at 7. Plaintiff also informed Dr. Nares that 

he was aware of a surgery that could be done to treat his abscess and save both tooth 23 and the 

related bridge. Docket No. 13 at 7. 

Dr. Nares informed Plaintiff that this surgery could only be performed by an oral surgeon 

specialist because it required drilling the porcelain bridge. Docket No. 13 at 7. Dr. Nares 

examined Plaintiff and prescribed him antibiotics. Docket No. 13 at 7 and Marlais Decl., Ex. A at 

65.

Plaintiff started the course of antibiotics on September 9, 2012, and by September 12, 

2012, Plaintiff‘s pain had subsided. Docket No. 48 at 4. 

D. Dental Treatment from October 2012 to August 2013

Between October 2012 and August 2013, Plaintiff received dental services unrelated to 

tooth 23 on October 4, 2012, December 4, 2012, December 6, 2012, December 11, 2012, and 

February 26, 2013. Uy Decl. ¶ 7 and Ex D at 66–70. During this time period, Plaintiff did not 

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report any pain caused by tooth 23. Uy Decl., Ex. D at 66–70; Marlais Decl. ¶¶ 17–18. After 

December 6, 2012, Dr. Marlais had no further involvement in Plaintiff‘s dental treatment and had 

no further contact with Plaintiff. Uy Decl., Ex. D at 66–70; Marlais Decl. ¶ 19. 

E. Dental Treatment from September 2013 to April 2015

1. September 5, 2013 Dental Examination by Dr. Calderon

On September 5, 2013, Plaintiff was summoned to the CTF dental office for an 

examination by CTF dentist Dr. Calderon. Plaintiff had not scheduled this dental appointment and 

alleges that the dental appointment was scheduled in response to a court order for an informal 

response issued in his state habeas petition challenging his dental treatment. Docket No. 13 at 10. 

During this visit, Dr. Calderon examined tooth 23 and the related bridge, and reviewed recent xrays of Plaintiff‘s teeth. Docket No. 13 at 10; Calderon Decl. ¶ 4. Dr. Calderon concluded that 

Plaintiff had chronic apical periodontitis — long-tern breakdown or decay of the nerve tissue — in 

tooth 23 which rendered tooth 23 non-vital, abscessed, and susceptible to infection. Calderon 

Decl. ¶ 4. Dr. Calderon opined that there were two medically acceptable dental treatments for 

tooth 23, either an extraction or a root canal. Calderon Decl. ¶ 4. 

Dr. Calderon discussed the treatment options with Plaintiff, who expressed his desire to 

preserve tooth 23. Calderon Decl. ¶ 4; Docket No. 13 at 10. Dr. Calderon informed Plaintiff that 

it would be difficult to access the root canal because the x-rays indicated that the canal had shrunk 

and calcified. Calderon Decl. ¶ 5. Dr. Calderon stated that x-rays do not show whether a canal is 

so calcified that the root canal can no longer be accessed. Calderon Decl. ¶ 5. Dr. Calderon also 

informed Plaintiff that drilling through the porcelain crown on tooth 23 could fracture the bridge. 

Calderon Decl. ¶ 5. Dr. Calderon explained that the root canal could ultimately lead to more 

damage to tooth 23 that would render removal of tooth 23 imperative. Calderon Decl. ¶ 5. 

Plaintiff alleges, and Dr. Calderon does not dispute, that Dr. Calderon also informed Plaintiff that 

the root canal was ―medically necessary to save the tooth‖ and that with the root canal, the 

prognosis for the tooth was very good. Docket No. 13 at 10. 

Plaintiff verbalized his understanding of the risks and difficulties of the root canal 

treatment and asked to proceed with the root canal treatment. Calderon Decl. ¶ 5. Dr. Calderon 

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therefore scheduled Plaintiff for a root canal treatment for tooth 23. Calderon Decl. ¶ 5. 

2. September 11, 2013 Root Canal Treatment by Dr. Razavi

On September 11, 2013, Dr. Razavi attempted to perform the root canal on tooth 23. After 

drilling on Plaintiff‘s abscessed tooth for approximately forty-five minutes, Dr. Razavi informed 

Plaintiff that he could not complete the root canal because he could not find the tooth canal. 

Docket No. 13 at 10. Dr. Razavi put a temporary filling in the hole drilled into tooth 23 so that 

another dentist could finish the root canal. Docket No. 13 at 10.

Defendants allege that Dr. Razavi was unable to complete the root canal because the canal 

was excessively calcified. Calderon Decl. ¶ 6 and Ex. B. Plaintiff alleges that Dr. Razavi 

informed Plaintiff that he was unable to complete the root canal because there were limited 

materials available at CTF. Docket No. 13 at 10. Specifically, Dr. Razavi stated that CTF lacked 

a chemical that could be used to dissolve the build-up in the tooth canal. Docket No. 13 at 10. Dr. 

Razavi also informed Plaintiff he had not taken ―Root Canal Surgery‖ courses in dental school 

although he was supposed to have done so, and that perhaps a more experienced dentist such as 

Dr. Calderon could find the canal and finish the root canal. Docket No. 13 at 10–11. 

Plaintiff alleges, and Defendants do not dispute, that Dr. Razavi stated that he would 

prescribe Plaintiff antibiotics and pain medication because Plaintiff was likely to experience pain 

and discomfort following the attempted surgery. Docket No. 13 at 11. While Plaintiff received 

antibiotics the following day, he did not receive any pain medication. Docket No. 13 at 11. 

Plaintiff alleges that because he did not receive pain medication, he suffered severe pain from the 

partially drilled hole until the pain subsided on its own on September 13, 2013, two days after the 

attempted root canal. 

3. September 17, 2013 Root Canal Treatment by Dr. Razavi

On September 17, 2013, Plaintiff was called to the dental office again and informed that 

Dr. Calderon would attempt the root canal treatment. The parties dispute the details of this 

attempted root canal.

Dr. Calderon states that after drilling for approximately ten to fifteen minutes on tooth 23, 

Dr. Calderon discovered that the canal was so excessively calcified and dense that he was only 

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able to access the top one-fourth of the canal. Calderon Decl. ¶ 7. Dr. Calderon alleges that he 

informed Plaintiff that the canal was so excessively calcified that it would not be possible to 

complete the root canal treatment. Calderon Decl. ¶ 7. 

Plaintiff claims that Dr. Calderon drilled on the tooth for approximately thirty to forty 

minutes before determining that it was not possible to complete the root canal treatment. Docket 

No. 13 at 11. Plaintiff alleges that Dr. Calderon informed Plaintiff that he could not find the tooth 

canal and therefore could not complete the root canal. Docket No. 13 at 11.

The parties agree that following this root canal, Dr. Calderon informed Plaintiff that he had 

changed his treatment recommendation from a root canal to extraction. Docket No. 13 at 11 and 

Calderon Decl. ¶ 7. Plaintiff refused to consent to extraction of tooth 23 and informed Dr. 

Calderon that he wished to have an oral surgeon specialist complete the surgery. Docket No. 13 at 

11. Dr. Calderon concluded that referral to an outside medical facility was not medically 

necessary because, after attempting the root canal treatment, Dr. Calderon now agreed with Dr. 

Razavi‘s conclusion that tooth 23 could not be treated in a way that would preserve what was left 

of the tooth. Calderon Decl. ¶ 8. 

Plaintiff then requested prescription pain medication for the pain that he anticipated would 

be caused by the incomplete root canal. Docket No. 13 at 11. Dr. Calderon stated that he would 

not prescribe any pain medication for Plaintiff because the pharmacy stated that Plaintiff had an 

allergy to codeine. Plaintiff responded that this was factually inaccurate and could be confirmed 

by reviewing Plaintiff‘s medical records which indicated that he had been prescribed codeine in 

August 2005 following a knee surgery. Docket No. 13 at 11. Dr. Calderon refused to prescribe 

any pain medication. Docket No. 13 at 12. Later that day, Plaintiff was seen by his medical 

doctor who reviewed Plaintiff‘s prescription information and called the pharmacy. Docket No. 13 

at 12. According to the medical doctor, neither the prescription information nor Plaintiff‘s 

medical history indicated any allergy to codeine. Docket No. 13 at 12. Defendants do not dispute 

or otherwise address Plaintiff‘s allegations regarding this particular request for prescription pain 

medications. 

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4. December 27, 2013 Dental Examination by Dr. Nguyen1

On December 27, 2013, Plaintiff was examined by CTF dentist Dr. Nguyen in response to 

a request for dental treatment marked urgent and submitted on December 22, 2013. Docket No. 

13 at 13. Plaintiff informed Dr. Nguyen that his front lower jaw, around tooth 23, continued to 

cause him pain. He requested pain medication for his pain and antibiotics to treat the abscess. 

After examining Plaintiff, Dr. Nguyen prescribed him antibiotics and ibuprofen. Plaintiff 

requested that Dr. Nguyen refer him to an oral surgeon specialist for treatment and preservation of 

tooth 23 and the related bridge. Dr. Nguyen informed Plaintiff that, because of the ongoing

litigation, she was prohibited him from referring Plaintiff an oral surgeon and from discussing 

other treatment options. Docket No. 13 at 13.

5. Dental Treatment from January 2014 through April 2015

After December 2013, Plaintiff did not request dental services again until June 2015, seven 

months after he filed the instant action and six weeks prior to filing the amended complaint. 

Docket Nos. 53-4 at 79 and 53-5 at 2. The dental treatment requested and received in June 2015 

are not referenced in Plaintiff‘s amended complaint. 

F. Dr. Uy’s employment with the California Department of Corrections and 

Rehabilitation

Dr. Uy has been employed with the California Department of Corrections and 

Rehabilitation (―CDCR‖) since 2009. In January 2014, Dr. Uy began working at CTF as the 

supervising dentist. Docket No. 53 (―Uy Decl.‖), ¶ 1. Prior to January 2014, Dr. Uy worked as 

staff dentist and supervising dentist at other CDCR locations. Id. As the CTF supervising dentist, 

Dr. Uy does not have a regular patient schedule, but treats inmate-patients on occasion when a 

staff dentist is unexpectedly absent. Id. 

G. Grievance and Litigation History

On August 14, 2012, Plaintiff submitted an emergency healthcare grievance, CTF-HC12037770, stating that the abscess continued to cause him significant pain that prevented him from 

 

1

Plaintiff misspells Dr. Nguyen‘s name as Nugyne in his pleadings. Docket No. 13 at 13. 

Plaintiff‘s dental records indicate that he is referring to Dr. Chi Nguyen. Docket No. 53-5 at 16. 

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sleeping. Docket Nos. 13 at 5 and 54-2 at 4–7. Plaintiff requested that his tooth be treated not 

pulled, and also requested antibiotics and pain medication ―stronger than acetaminophen.‖ Docket 

Nos. 13 at 5 and 54-2 at 6. 

On September 12, 2012, Plaintiff received a first-level response to his grievance which 

granted in part his grienvace, in that Plaintiff received antibiotics, and denied in part his grievance, 

in that Plaintiff‘s requests for referral to an oral surgeon and for his tooth to be treated were 

denied. Docket Nos. 13 at 5 and 54-2 at 6, 9–10. Plaintiff unsuccessfully appealed his healthcare 

grievance through the prison grievance system. Docket No. 54-2 at 2–11. Plaintiff‘s healthcare 

grievance was denied at the third and final level on April 23, 2013. Docket No. 54-2 at 2–3.

On December 3, 2014, Plaintiff filed the instant action and named Drs. Calderon and 

Marlais as defendants. Docket No. 1. On April 29, 2015, Plaintiff filed an amended complaint 

and named Dr. Uy as an additional defendant. Docket No. 13. Plaintiff identified Dr. Uy as ―Dr. 

Calderon‘s  ̳successor‘ per Federal Rules of Civil Procedure, Rule 25(d)(1).‖ Docket No. 13 at 2. 

III. DISCUSSION

A. Standard of Review

Summary judgment is proper where the pleadings, discovery and affidavits show there is 

―no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of 

law.‖ See Fed. R. Civ. P. 56(a) (2014). Material facts are those that may affect the outcome of the 

case. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A dispute as to a material 

fact is genuine if the evidence is such that a reasonable jury could return a verdict for the 

nonmoving party. See id.

A court shall grant summary judgment ―against a party who fails to make a showing 

sufficient to establish the existence of an element essential to that party‘s case, and on which that 

party will bear the burden of proof at trial [,] . . . since a complete failure of proof concerning an 

essential element of the nonmoving party‘s case necessarily renders all other facts immaterial.‖ 

See Celotex Corp. v. Catrett, 477 U.S. 317, 322–23 (1986). The moving party bears the initial 

burden of identifying those portions of the record that demonstrate the absence of a genuine issue 

of material fact. Id. The burden then shifts to the nonmoving party to ―go beyond the pleadings 

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and by [his] own affidavits, or by the  ̳depositions, answers to interrogatories, and admissions on 

file,  ̳designate  ̳specific facts showing that there is a genuine issue for trial.‘‖ See id. at 324 

(citing Fed. R. Civ. P. 56(e)).

For purposes of summary judgment, the court must view the evidence in the light most 

favorable to the nonmoving party; if the evidence produced by the moving party conflicts with 

evidence produced by the nonmoving party, the court must assume the truth of the evidence 

submitted by the nonmoving party. See Leslie v. Grupo ICA, 198 F.3d 1152, 1158 (9th Cir. 

1999). The court‘s function on a summary judgment motion is not to make credibility 

determinations or weigh conflicting evidence with respect to a disputed material fact. See T.W. 

Elec. Serv., Inc., v. Pac. Elec. Contractors Ass‘n, 809 F.2d 626, 630 (9th Cir. 1987).

B. Deliberate Indifference to Serious Medical Needs

Deliberate indifference to a serious medical need violates the Eighth Amendment‘s 

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

(1976); McGuckin v. Smith, 974 F.2d 1050, 1060 (9th Cir. 1992) overruled on other grounds by

WMX Technologies, Inc. v. Miller, 104 F.3d 1133, 1136 (9th Cir. 1997). A determination of 

―deliberate indifference‖ involves an examination of two elements: the seriousness of the 

prisoner‘s medical need and the nature of the defendant‘s response to that need. See McGuckin, 

974 F.2d at 1059.

A prison official is deliberately indifferent if he knows that a prisoner faces a substantial 

risk of serious harm and disregards that risk by failing to take reasonable steps to abate it. Farmer 

v. Brennan, 511 U.S. 825, 837 (1994). The prison official 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 a prison official should have been aware of the risk but was not, 

then the official has not violated the Eighth Amendment, no matter how severe the risk. Gibson v. 

County of Washoe, 290 F.3d 1175, 1188 (9th Cir. 2002). Mere negligence, or even gross

negligence, is not enough. Farmer, 511 U.S. at 835–36 & n.4.

C. Dr. Uy

Dr. Uy contends that he is entitled to summary judgment because Plaintiff failed to exhaust 

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his administrative remedies against Dr. Uy, and because Dr. Uy was not involved in, and did not 

supervise, Plaintiff‘s dental treatment during the relevant time period. 

1. Exhaustion of Administrative Remedies

a. Standard

―No action shall be brought with respect to prison conditions under [42 U.S.C. § 1983], or 

any other Federal law, by a prisoner confined in any jail, prison, or other correctional facility until 

such administrative remedies as are available are exhausted.‖ 42 U.S.C. § 1997e(a). Exhaustion 

in prisoner cases covered by § 1997e(a) is mandatory. Porter v. Nussle, 534 U.S. 516, 524 (2002). 

All available remedies must be exhausted; those remedies ―need not meet federal standards, nor 

must they be  ̳plain, speedy, and effective.‘‖ Id. Section 1997e(a) requires ―proper exhaustion‖ of 

available administrative remedies. Woodford v. Ngo, 548 U.S. 81, 93 (2006). Proper exhaustion 

requires using all steps of an administrative process and complying with ―deadlines and other 

critical procedural rules.‖ Id. at 90. The level of detail in an administrative grievance necessary to 

properly exhaust a claim is determined by the prison‘s applicable grievance procedures. Jones v. 

Bock, 549 U.S. 199, 218 (2007); see also Sapp v. Kimbrell, 623 F.3d 813, 824 (9th Cir. 2010) 

(―To provide adequate notice, the prisoner need only provide the level of detail required by the 

prison‘s regulations.‖).

The CDCR provides its inmates and parolees the right to appeal administratively ―any 

policy, decision, action, condition, or omission by the department or its staff that the inmate or 

parolee can demonstrate as having a material adverse effect upon his or her health, safety, or 

welfare.‖ Cal. Code Regs. tit. 15, § 3084.1(a). In order to exhaust available administrative 

remedies within this system, a prisoner must submit his complaint on CDCR Form 602 and 

proceed through several levels of appeal: (1) first formal-level appeal filed with one of the 

institution‘s appeal coordinators, (2) second formal-level appeal filed with the institution head or 

designee, and (3) third formal-level appeal filed with the CDCR director or designee. Cal. Code 

Regs. tit. 15, § 3084.7. This satisfies the administrative remedies exhaustion requirement under § 

1997e(a). Id. §§ 3084.1(b); 3084.7(c)(3); Barry v. Ratelle, 985 F. Supp. 1235, 1237–38 (S.D. Cal. 

1997). If an inmate‘s grievance does not comply with a procedural rule but prison officials decide 

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it on the merits anyway at all available levels of administrative review, it is exhausted. Reyes v. 

Smith, 810 F.3d 654, 656, 658 (9th Cir. 2016) (agreeing with all ―sister‖ circuits in so holding).

b. Analysis

Dr. Uy argues that Plaintiff‘s grievance number CTF-HC-12037770, filed on August 14, 

2012, failed to exhaust Plaintiff‘s claim that Dr. Uy was deliberately indifferent to his serious 

medical needs because the grievance only grieved Dr. Marlais‘ conduct at the August 13, 2012 

appointment ‒ specifically, Dr. Marlais‘ failure to prescribe antibiotics and adequate pain 

medication, Dr. Marlais‘ recommendation that tooth 26 be extracted, and Dr. Marlais refusal to 

refer Plaintiff to an outside surgeon for treatment of his tooth root ‒ and did not grieve Dr. Uy‘s 

involvement in Plaintiff‘s dental care or grieve the dental treatment of tooth 23. 

Plaintiff contends that the reference to tooth 26 in his grievance was a typographical error 

and that Dr. Nares and other CDCR officials understood that he was grieving the treatment of 

tooth 23. Docket No. 63 at 3. He also argues that this grievance concerned proper dental 

treatment for his painful abscess, which was an ongoing issue, and not solely Dr. Marlais‘ actions 

on August 13, 2012. Id. at 6. Plaintiff further argues that because dental treatment of his abscess 

was an ongoing issue, prison regulations precluded him from filing a separate grievance 

challenging other dentists‘ treatment of this issue. Id. (citing 15 Cal. Code Regs. § 3084.6(c((4)).

Having carefully reviewed the grievance, the Court finds that Plaintiff has exhausted his 

administrative remedies for the claims raised in his instant action. 

First, the failure to identify Dr. Uy in the grievance, as required by the California Code of 

Regulations, title 15, section 3084.2(a)(3)-(4), was waived by Defendants when Defendants 

addressed the grievance on the merits. Reyes, 810 F.3d at 656, 658. In the responses to the 

grievance, the CDCR addressed whether Plaintiff was entitled to a referral to an outside specialist 

for treatment of the root of tooth 23. See Docket No. 54-2 at 2-3 and 10; see also discussion infra.

Second, Dr. Uy reads Plaintiff‘s grievance too narrowly. Plaintiff accurately characterizes 

his grievance as seeking proper dental treatment for tooth 23, rather than complaining solely about 

Dr. Marlais‘ treatment during August 2013. While Plaintiff‘s grievance complains about Dr. 

Marlais‘ refusal to treat and save tooth 23, and refusal to provide antibiotics and pain medication, 

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the relief sought is independent of Dr. Marlais and requests that tooth 23 ―be treated and not 

pulled, that [Plaintiff] receive a 7 to 10 day prescription for antibiotics for the abscess and that 

[Plaintiff] receive something stronger than acetaminophin (sic) for the pain.‖ Docket No. 54-2 at 

6. 

Finally, Plaintiff‘s grievance complied with the specificity requirements set forth in the 

prison regulations. The CDCR grievance procedure only requires that the prison ―state all facts 

known and available to him/her regarding the issue being appealed at the time of submitting the 

[grievance].‖ Cal. Code Regs. tit. 15, § 3084.2(a)(4). Plaintiff was not required to specify 

concerns that he would have regarding future refusals to treat tooth 23 with a root treatment, 

antibiotics, and pain medication.2 Jones, 549 U.S. at 218. Not only did Plaintiff‘s grievance 

comply with the CDCR‘s specificity requirements, but a review of the CDCR‘s response to 

Plaintiff‘s grievance indicates that prison officials also understood that the grievance was 

generally grieving the proposed treatment for tooth 23, rather than solely and specifically grieving 

Dr. Marlais‘ treatment in August 2013. In both the first and second level response to the 

grievance, the responses identified the grievance‘s issues and requested action as follows:

Issue Type Action Requested

Issue 1: Dental Services (Examination) Tooth Root be treated

Issue 2: Medication (Med Specific Type / Antibiotic

Dose)

Docket No. 54-2 at 9. In the director‘s level response, the response acknowledged that the 

institution decision correctly focused on the recommended extraction of tooth 23. Docket No. 54-

2 at 2. The first-level response granted in part and denied in part the grievance as follows: 

Your request to receive antibiotics was GRANTED. The recommendation of the 

dentist is extraction of tooth #23. You refused the extraction on January 20 and 

 

2 Moreover, as Plaintiff points out, CDCR grievance procedures prohibited him from filing 

additional grievances regarding prison‘s refusal to consider treatment options outside of extraction 

for tooth 23. See Cal. Code Regs. tit. 15 § 3084.6(c)(2), (4) (grievance may be cancelled if the 

grievance ―duplicates an inmate‘s . . . previous [grievance] upon which a decision has been 

rendered or is pending‖; ―If the issue is ongoing . . . the inmate . . . may appeal any time during the 

duration of the event; however, the inmate . . . is precluded from filing another appeal on the same 

issue unless a change in circumstances creates a new issue.‖). 

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August 22, 2012 (copies attached). There was no indication by your dentist to refer 

you to the oral surgeon and your request for the tooth root to be treated is DENIED.

Id. at 10 (emphasis in original). Similarly, the third level response to the grievance concluded: 

Though you may not have received the [dental] treatment of your choice, [i.e. the 

treatment of the root of tooth 23,] there is no indication you were denied necessary 

dental services in an attempt to reduce costs.]

. . . 

After review, there is no compelling evidence that warrants intervention at the 

[Director‘s Level Review] as your dental condition has been evaluated and you are 

receiving treatment deemed medically necessary.

Docket No. 54-2 at 3.

After reviewing the evidence in the record, the Court finds that Plaintiff‘s grievance CTFHC-12037770 exhausted his administrative remedies for the claims asserted in the instant action. 

See Griffin v. Arpaio, 557 F.3d 1117, 1120 (9th Cir. 2009) (―A grievance also need not contain 

every fact necessary to prove each element of an eventual legal claim. The primary purpose of a 

grievance is to alert the prison to a problem and facilitate its resolution, not to lay the groundwork 

for litigation.‖).

2. Eighth Amendment Claim

Dr. Uy alleges that he was not deliberately indifferent to Plaintiff‘s serious medical needs 

because he was not the supervising dentist during 2012 through 2013, when the alleged 

indifference took place. Docket No. 51 at 13. Plaintiff contends that there is a ― ̳De 

Facto‘/underground‖ policy at CTF prohibiting treating oral abscesses with oral surgery, 

regardless of an inmate‘s serious medical needs, and that Dr. Uy has applied this policy to Plaintiff 

despite Plaintiff‘s serious medical needs. Docket No. 63 at 7. Plaintiff also alleges that because 

he is seeking injunctive relief, Dr. Uy is properly named as a defendant, pursuant to Pouncil v. 

Tilton, 704 F.3d 568, 576 (9th Cir. 2012). Id. Dr. Uy argues that Pouncil only apples to actions 

seeking injunctive relief related to unconstitutional laws or policies. Docket No. 65 at 4.

a. Dr. Uy’s alleged involvement 

It is undisputed that Plaintiff filed his amended complaint on April 29, 2015, and that the 

amended complaint alleges that Drs. Marlais and Calderon violated Plaintiff‘s Eighth Amendment 

rights in 2012 and 2013. See Docket No. 13. It is also undisputed that Dr. Uy did not start

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working at CTF until January 2014, after the constitutional violations alleged in the amended 

complaint. It is further undisputed that Plaintiff did not seek dental treatment between January 

2014 and June 2015. 

Assuming arguendo that there is a de facto policy of denying oral surgery treatment for 

oral abscesses and that Dr. Uy applied such a policy to Plaintiff, any such action or inaction by Dr. 

Uy took place in 2015, which is outside the scope of the complaint.3 There is therefore no genuine 

dispute as to whether Dr. Uy is liable under section 1983 for his direct participation in, or 

supervisory liability for, the alleged constitutional violations. See Taylor v. List, 880 F.3d 1040, 

1045 (9th Cir. 1989) (―Liability under section 1983 arises only upon a showing of personal 

participation by the defendant. A supervisor is only liable for constitutional violations of his 

subordinates if the supervisor participated in or directed the violations, or knew of the violations 

and failed to act to prevent them.‖) (internal citations omitted). 

However, these after-occurring claims would be properly brought in a supplemental 

complaint. A supplemental complaint adds to the complaint allegations of events occurring after 

the original complaint was filed. Fed. R. Civ. P. 15(d). Under Rule 15(d), the Court may, ―on just 

terms, permit a party to serve a supplemental pleading setting out any transaction, occurrence, or 

event that happened after the date of the pleading to be supplemented.‖ Id. A party may only file 

a supplemental complaint with leave of court. Id. When considering whether to allow a 

supplemental complaint, the Court considers factors such as whether allowing supplementation 

would serve the interests of judicial economy; whether there is evidence of delay, bad faith or 

dilatory motive on the part of the movant; whether amendment would impose undue prejudice 

upon the opposing party; and whether amendment would be futile. See San Luis & Delta–

Mendota Water Authority v. United States Dep‘t of the Interior, 236 F.R.D. 491, 497 (E.D. Cal.

 

3

In his opposition to Dr. Calderon‘s summary judgment motion, Plaintiff alleges that Dr. Uy 

directly violated his Eighth Amendment rights when, in 2015, he interfered with treatment of 

Plaintiff‘s jawbone fracture by scheduling Plaintiff for a tooth extraction instead of for a treatment, 

of the fracture, Docket No. 73 at 9–10, and when in March 2016, Dr. Uy denied Dr. Razavi‘s 

recommendation that Plaintiff be treated by an outside oral surgeon, id. at 8. As discussed supra, 

while these after-occurring claims may be properly brought in a supplemental complaint, the Court 

DENIES leave to file a supplemental complaint in this case because amendment would be futile. 

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2006). As set forth later in this order, the Court finds that Plaintiff‘s Eighth Amendment rights 

were not violated by the failure to treat the root of tooth 23, which is the crux of Plaintiff‘s afteroccurring claims, so supplementation would be futile. Accordingly, the Court denies Plaintiff 

leave to file a supplemental complaint. 

Drawing all reasonable inferences in favor of Plaintiff, the Court finds that, to the extent 

that Plaintiff‘s complaint seeks to hold Dr. Uy liable under section 1983 for Dr. Uy‘s personal 

participation in, or supervisory liability for, the alleged constitutional violations, Dr. Uy is entitled 

to summary judgment. 

b. Properly named defendant

The Court agrees that Plaintiff has correctly named Dr. Uy as a defendant in this action 

because he seeks affirmative injunctive relief that Dr. Uy can execute. The Ninth Circuit has 

recognized that the proper state defendant in a § 1983 action seeking prospective injunctive relief 

is the one who ―would be responsible for ensuring that injunctive relief was carried out, even if he 

was not personally involved in the decision giving rise to [the plaintiff‘s] claims.‖ Pouncil, 704 

F.3d at 576 (citing Gonzalez v. Feinerman, 663 F.3d 311, 315 (7th Cir. 2011) (the prison warden 

was the proper defendant for a claim of injunctive relief, notwithstanding his lack of personal 

involvement in the challenged conduct, because he would be responsible for ensuring that the 

injunctive relief was carried out)); see also Hartmann v. Cal. Dep‘t of Corr. & Rehab., 707 F.3d 

1114, 1127 (9th Cir. 2013) (holding that official who was ―the  ̳most appropriate‘ defendant to 

execute court-ordered injunctive relief‖ and the official who ―would have the authority to ensure 

execution of any order issued‖ were ―proper official-capacity defendants for Plaintiffs‘ 

Establishment Clause claim‖) (internal citations omitted). Although both Pouncil and Hartmann

involved motions to dismiss, Pouncil, 704 F.3d at 570; Hartmann, 707 F.3d at 1120–21, the legal 

principles articulated in those cases are still applicable at summary judgment. Dr. Uy does not 

dispute that he would be responsible for carrying out the requested injunctive relief. Instead, he 

argues that Pouncil and Hartmann should be narrowly read to apply only to claims of injunctive 

relief challenging a law or policy. Docket No. 65. 

The Court finds that Dr. Uy‘s reading of Pouncil and Hartmann is unfounded. In Pouncil, 

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the Ninth Circuit held that in seeking relief from a prison regulation, Pouncil had properly named 

the CDCR Director as a defendant ―because [the CDCR director] would be responsible for 

ensuring that injunctive relief was carried out, even if he was not personally involved in the 

decision giving rise to Pouncil‘s claims.‖ Id. at 576 (emphasis added). In other words, the reason 

the CDCR director was properly named as a defendant was because he would ensure the execution 

of the injunctive relief, and not because the injunctive relief involved a prison regulation. 

In Hartmann, the Ninth Circuit held that two prison officials were properly named as

official–capacity defendants in prisoners‘ § 1983 claim for violation of First Amendment's 

Establishment Clause, where prisoners sought affirmative injunctive relief requiring the prison 

administration to adopt and apply neutral criteria in determining chaplain hiring needs, and the 

officials named were the most appropriate defendants to execute any court-ordered injunctive 

relief. Hartmann, 707 F.3d at 1127. The Ninth Circuit analysis in Hartmann also focused on 

whether the official-capacity defendants were capable of executing the injunctive relief, and not on 

whether the injunctive relief involved a prison regulation. Id.

The Court therefore denies Dr. Uy‘s motion for summary judgment to the extent that Dr. 

Uy argues that he has been improperly named as a defendant. However, as discussed infra in 

section F, the Court finds that Plaintiff is not entitled to affirmative injunctive relief. Summary 

judgment is therefore granted in favor of Dr. Uy. 

D. Dr. Marlais

Dr. Marlais alleges that he was not deliberately indifferent to Plaintiff‘s serious medical 

needs because there was no bacterial infection in tooth 23 in August 2012, and because Plaintiff‘s 

requested dental treatment (pain medication, root treatment for tooth 23, and antibiotics) merely 

constitute a difference of opinion. Docket No. 51 at 16–17. In response, Plaintiff alleges that Dr. 

Marlais‘ refusal to prescribe antibiotics has been established as medically unreasonable by other 

prison dental professionals; that over-the-counter acetaminophen would not be the pain medication 

prescribe to Plaintiff if he were not incarcerated; and Dr. Marlais provided no medical treatment 

on August 13, 2012, for Plaintiff‘s festering abscess, knowingly causing Plaintiff to suffer severe 

pain for a prolonged time period. Docket No. 63 at 8. 

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Viewing the evidence in the light most favorable to Plaintiff, the Court concludes that, at 

best, Plaintiff‘s claim against Dr. Marlais amounts to either a difference of opinion as to his 

medical treatment or a negligence claim, neither of which rise to the level of a constitutional 

violation. ―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.‖ Snow v. McDaniel, 681 F.3d 978, 987 (9th Cir. 2012), overruled in part on other 

grounds, Peralta v. Dillard, 744 F.3d 1076, 1082–83 (9th Cir. 2014). Rather, ―[t]o show deliberate 

indifference, 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 plaintiff‘s health.‘‖ Id. at 988 (quoting Jackson v. McIntosh, 90 

F.3d 330, 332 (9th Cir. 1996)). A claim of medical malpractice or negligence insufficient to make 

out an Eighth Amendment violation. Toguchi v. Chung, 391 F.3d 1051, 1060–61 (9th Cir. 2004).

In the instant case, there is no evidence that Plaintiff‘s medical needs were treated with 

deliberate indifference by Dr. Marlais. The record indicates that although Plaintiff did not receive 

his requested dental treatment ‒ root canal treatment of tooth 23, antibiotics, and prescription pain 

medication ‒ at the August 13, 2012 dental appointment, Dr. Marlais was responsive to Plaintiff‘s 

complaint of pain caused by the abscess at tooth 23 and proposed a treatment plan which Plaintiff 

found unacceptable. At the August 13, 2012 appointment, Dr. Marlais examined Plaintiff‘s teeth, 

took an x-ray, and interviewed Plaintiff regarding his pain and his teeth‘s reaction to cold and hot 

water. Marlais Decl. ¶¶ 4–6. Dr. Marlais proposed the following dental treatment: extracting 

tooth 23, sectioning the bridge, and replacing the anterior teeth with a partial lower denture. 

Marlais Decl., Ex. A at 63. Plaintiff refused the treatment and stated that he wished to treat tooth 

23 with a course of antibiotics and oral surgery to treat the root of tooth 23, and requested pain 

medication stronger than acetaminophen. Docket No. 13 at 5. Dr. Marlais refused to prescribe the 

antibiotics, either because he believed them to be medically unnecessary or because he had a 

policy against prescribing antibiotics to inmates because he believed that they would become 

tolerant to the antibiotics. Dr. Marlais claims that he does not recall any request for pain 

medication while Plaintiff alleges that Dr. Marlais refused to prescribe pain medication because he 

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believed that all inmates are drug addicts and lie about their pain. 

Evidence in the record supports Dr. Marlais‘ allegation that the extraction of tooth 23 is a 

medically acceptable course of treatment. Extraction of tooth 23 had been recommended as 

medically necessary earlier that year, in January 2012, by CTF dentist Dr. Nguyen, who is not a 

named defendant. Uy Decl., Ex. D at 41–45. When Dr. Nguyen examined Plaintiff again in 

December 2013, she reiterated her recommendation that tooth 23 be extracted. Extraction of tooth 

23 has also been recommended again by another CTF dentist, Dr. Nares. Uy Decl. ¶ 12. 

Although Plaintiff alleges that the extraction of tooth 23 is medically unacceptable, he 

points to no evidence in the record that supports this allegation. Plaintiff‘s allegation that there are 

other surgeries available that will save tooth 23, see Docket No. 66,4does not establish that the 

extraction of tooth 23 is a medically unacceptable course of treatment. In determining whether Dr. 

Marlais provided unconstitutional medical care when he proposed extracting tooth 23 and refused 

to authorize root canal treatment, the dispositive question is whether the proposed treatment was 

medically unacceptable, and not whether there were alternative acceptable medical treatments 

available. See, e.g., Dixon v. Bannister, 845 F. Supp. 2d 1136, 1144 (D. Nev. 2012) (because 

extraction of four teeth and placing a partial denture not medically unacceptable under the 

circumstances, prison dentist-defendants had not violated prisoner‘s Eighth Amendment rights 

even though outside dentist had agreed to provide an alternative treatment – replacement of 

 

4

Plaintiff requests the Court take judicial notice of documents describing an apicectomy, a root 

end resectioning, which he alleges is the surgery he needs for tooth 23. Docket No. 66 at 2. He 

alleges that an apicectomy is a ―common / standard MINOR surgical procedure with a very high 

success rate, that can be performed by a trained Endodontist.‖ Id. Federal Rule of Evidence 

201(b) provides that a ―court may judicially notice a[n adjudicative] fact that is not subject to 

reasonable dispute because it: (1) is generally known within the trial court's territorial jurisdiction; 

or (2) can be accurately and readily determined from sources whose accuracy cannot reasonably 

be questioned.‖ Fed. R. Evid. 201(a)-(b). Although the Court ―may take judicial notice of the 

existence of unrelated court documents . . . it will not take judicial notice of such documents for 

the truth of the matter asserted therein.‖ In re Bare Escentuals, Inc. Sec. Lit., 745 F. Supp. 2d 

1052, 1067 (N.D. Cal. 2010) (in considering defendant's motion to dismiss, the court took judicial 

notice of the existence of unrelated court documents, but declined to take judicial notice of truth of 

the matters set forth in these unrelated court documents). In asking the Court to take judicial 

notice of the documents attached to Docket No. 66, Plaintiff is, in essence, requesting that it take 

judicial notice of these documents for the truth of the matters asserted therein. Accordingly, the 

Court DENIES the request for judicial notice. After all, whether an apicectomy is the surgery 

needed or is the sole medically acceptable treatment is not only subject to reasonable dispute ‒ it is 

the disputed issue in this case. 

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crowns and veneers – free of charge); Wood v. Idaho Dep‘t of Corr., 391 F. Supp. 2d 852, 863 (D. 

Idaho 2005) (prisoner‘s allegation that his eye condition required prescription sunglasses and 

tinted lenses on his regular glasses amounted only to a difference of opinion as to treatment 

provided where treating physician gave prisoner a different type of eye drops and referred him to 

an ophthalmologist). 

Nor is it dispositive that in September 2013, Drs. Calderon and Razavi agreed to the root 

canal treatment which Dr. Marlais declined to prescribe. Differing opinions between medical 

professionals as to appropriate medical treatment does not constitute a constitutional violation. 

See Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir. 1989) (prisoner alleged a mere difference in 

medical opinion where prison doctor advised surgery and subsequent medical personnel treated 

him but did not recommend surgery). Moreover, Dr. Calderon specified that there were two

medically acceptable treatments, and that one of them was extraction. Calderon Decl.¶ 4. 

Similarly, Plaintiff‘s claim that he should have received prescription pain medication is the 

type of difference in medical opinion between a lay prisoner and medical personnel that is 

insufficient to establish a constitutional violation. See Alford v. Gyaami, No. 2:13-CV-2143 DAD 

P, 2015 WL 3488301, at *10 n.3 (E.D. Cal. June 2, 2015) (noting that ―in other contexts, courts 

within this circuit have consistently rejected a prisoner‘s attempt to dictate the terms of their pain 

medication‖) (citing cases). 

Plaintiff has also failed to designate facts that show there is a genuine dispute as to whether 

Dr. Marlais‘ refusal to prescribe antibiotics to treat the infection in Plaintiff‘s abscess violated 

Plaintiff‘s Eighth Amendment rights. Plaintiff claims that his abscess was infected because he 

was suffering pain from that area and because his jaw was swollen. Dr. Marlais found no 

evidence of infection and diagnosed Plaintiff as having referred pain from nighttime tooth 

grinding, and concluded that antibiotics were not necessary to treat pain from tooth grinding. 

Marlais Decl. ¶ 7 and Ex. A at 63. Plaintiff counters that because Dr. Nares prescribed antibiotics 

a month later, Dr. Marlais‘ refusal to provide antibiotics was medically unacceptable. Assuming 

arguendo that Plaintiff had an infection at the abscess at tooth 23, Dr. Marlais‘ misdiagnosis was, 

at worst, negligence, which does not state a constitutional violation. See McGuckin, 974 F.2d at 

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1059 (mere negligence in diagnosing or treating a medical condition, without more, does not 

violate a prisoner‘s Eighth Amendment rights). The fact that Dr. Nares prescribed Plaintiff the 

antibiotics which Dr. Marlais denied only shows a difference of opinion between medical 

professionals as to appropriate medical treatment. Plaintiff has failed to show a genuine dispute as 

to whether Dr. Marais‘ refusal to provide antibiotics constituted an Eighth Amendment violation. 

See Sanchez, 891 F.2d at 242.

Based on the record before this Court, the Court finds that Dr. Marlais established a course 

of treatment that was medically acceptable. Accordingly, the Court concludes that Dr. Marlais is

entitled to summary judgment in his favor.

E. Dr. Calderon

Dr. Calderon alleges that he was not deliberately indifferent to Plaintiff‘s serious medical 

needs because he provided Plaintiff with medically acceptable treatment, and that Plaintiff‘s claim 

is simply a difference of opinion as to the appropriate dental treatment. Docket No. 68-1 at 7–9. 

Plaintiff alleges that Dr. Calderon‘s medical treatment was medically unacceptable because 

he allowed Dr. Marlais, who was under his supervision, to deny Plaintiff antibiotics and pain 

medication for his abscess, and allowed Dr. Marlais to provide ― ̳NO‘ actual dental treatment‖ on 

August 13, 2012. Docket No. 73 at 12 (emphasis in original). As the Court has already found that 

Dr. Marlais established a medically acceptable course of treatment, the Court finds that Dr. 

Calderon‘s supervision of Dr. Marlais did not violated Plaintiff‘s Eighth Amendment rights.

Plaintiff also alleges that Dr. Calderon‘s medical treatment was medically unacceptable 

because Dr. Calderon acknowledged that the root canal was medically necessary and knew that 

CDCR dentists were not qualified to perform this root canal, but failed to refer Plaintiff to a 

dentist capable of executing the surgery — either a root canal specialist or an endodontist —

thereby violating CDCR regulations and Plaintiff‘s Eighth Amendment rights. Id. at 5–6. In 

support of his allegation that a root canal specialist or endodontist can complete this root canal, 

Plaintiff alleges that on March 15, 2016, Dr. Razavi, his current dentist, submitted a 

recommendation for an outside oral surgeon to treat Plaintiff‘s abscess. Id. at 8. However, as 

discussed supra, a difference of opinion between Dr. Razavi and Dr. Calderon as to whether a root 

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canal specialist or endodontist can complete the root canal does not, by itself, establish that Dr. 

Calderon chose a medically unacceptable course of treatment in recommending that tooth 23 be 

extracted, especially where other CDCR dentists have recommended the extraction of tooth 23. 

See Sanchez, 891 F.2d at 242. Also, there is no liability under § 1983 for violating prison policies. 

Cousins v. Lockyer, 568 F.3d 1063, 1070 (9th Cir. 2009). Finally, contrary to Plaintiff‘s 

allegations, neither the CDCR regulations nor Dr. Razavi‘s March 15, 2016 dental progress notes 

support his allegations. The CDCR regulations distinguish between oral surgery and root canal 

treatment, also known as endodontics. Uy Decl. ¶ 9. The CDCR regulations governing 

endodontics are set forth in Chapter 2.9 of the CDCR‘s Dental Services Policies & Procedures 

Manual (―P&P Manual‖) (available at http://www.cdcr.ca.gov/DHCS/docs/2010-August-PP.pdf). 

The P&P Manual does not require referral to an outside surgeon for medically necessary 

procedures, as Plaintiff alleges. See P&P Manual, Chapter 2.9. The P&P Manual also indicates 

that, subject to the criteria set forth in Chapter 2.9(E)(IV), endodontics are generally within the 

scope of practice of CDCR‘s staff dentists. Id., see also Uy Decl. ¶ 9. The failure to refer Plaintiff 

to an endodontist did not violate CDCR regulations. Dr. Razavi‘s dental progress notes indicate 

that he did not independently recommend that Plaintiff receive treatment from an endodontist. 

Rather, he followed Plaintiff‘s wishes in sending Plaintiff‘s case to the Dental Authorization 

Review (―DAR‖) Committee. The dental progress notes indicate that Plaintiff informed Dr. 

Razazi that he wanted an outside endodontist to do a root canal and apicoectomy, and sought a 

DAR to obtain the necessary referral. Docket No. 73 at 17 (―Patient wants to be sent to DAR to 

see if he could go to outside endodontist for root canal and/or apicoectomy‖). Dr. Razavi‘s notes 

that that Dr. Razavi 

[i]nformed [Plaintiff] of poor prognosis of tooth [23] due to severely calcified 

canal; informed [Plaintiff] that this is beyond the reach of a general dentist; 

viability of tooth [23] would be decided at DAR.

. . . Informed [Plaintiff] of findings and poor prognosis of this tooth [23]; 

calcification makes navigating and obturating canal difficult, and this is beyond the 

reach of many general dentists; informad [Plaintiff] that leaving the abcess in place 

is risking future swelling and pain; informed [Plaintiff] about CDCR Policy and 

Procedure regarding endo and referral out for certain procedures

Id. Dr. Razavi‘s dental notes confirm Dr. Calderon‘s diagnosis that the root canal was difficult to 

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perform because of the calcification in the canal, and, contrary to Plaintiff‘s assertion, do not 

recommend any particular treatment. 

Finally, Plaintiff alleges that there is evidence that Dr. Calderon deliberately disregarded 

the risk to Plaintiff‘s health. Plaintiff alleges that Dr. Calderon was aware that a root canal of this 

complexity could only be completed by an endodontist, but Dr. Calderon decided to ―go the cheap 

way‖ and have a CDCR dentist attempt the root canal. Plaintiff alleges that 

[i]n the community at large a general dentist would not have attempted a difficult root 

canal like plaintiff‘s, they would have the good sense to send their patient to a trained 

specialist an Endodontist, so they would receive the most efficient treatment for their 

medical problem.

Docket No. 73 at 7. Plaintiff alleges that Drs. Calderon and Razavi were unable to complete the 

root canal, not because the canal was excessively calcified, but because only an endodontist or 

root canal specialist can complete the root canal.5

Plaintiff points to no evidence that Dr. Calderon chose to have CDCR dentists attempt the 

root canal because of cost concerns. More importantly, Plaintiff points to no evidence having 

CDCR dentists attempt the root canal constituted deliberate disregard for his serious medical 

needs, and Plaintiff points to no evidence that having a general dentist, rather than an endodontist, 

perform the root canal treatment was medically unacceptable. Dr. Razavi‘s conclusion that 

treatment of Plaintiff‘s tooth 23 is ―beyond the reach of a general dentist,‖ as set forth in his 

March 15, 2016 dental notes, reaches that conclusion based on the severe calcification of the canal 

in tooth 23, which was unknown to both Dr. Calderon and Dr. Razavi until after they had 

 

5

In support of his allegation that CDCR dentists are deliberately denying him necessary treatment, 

he points to the following circumstantial evidence. Id. at 8. In June 2015, Plaintiff suffered an 

injury to the jaw which knocked out his bridge, which was re-cemented into place. Uy Decl. ¶¶

14–15. Plaintiff was diagnosed with a potential bone fracture between teeth numbers 23 and 26 

due to the injury. Id. Plaintiff consented to Dr. Nares‘ recommendation that he be referred for an 

oral surgeon consultation for his fracture. Docket No. 73 at 9. Plaintiff alleges that instead of 

being seen for a consultation for his jaw fracture, Plaintiff was seen by Dr. McQuirter, who 

Plaintiff alleges identified himself as a ―Sun-Shine Dentist‖ whose specialty was pulling teeth, and 

who told Plaintiff that the only treatment that he would provide was the extraction of teeth 23 and 

26. Id. Plaintiff alleges that extracting teeth in an area of recent fracture could have seriously 

injured him, and that Defendants proposed this course of treatment clearly shows malice and 

forethought and a reckless disregard for his health. Id. at 10. This circumstantial evidence cannot 

serve as evidence of Dr. Calderon‘s ―sufficiently culpable state of mind‖ because these events 

happened in 2015, after Dr. Calderon‘s alleged constitutional violation,s and after Dr. Calderon 

ceased working at CTF.

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attempted to perform the root canal. Although at the summary judgment stage, a court must make 

all reasonable inferences in favor of the non-moving party, Anderson, 477 U.S. at 255 (at 

summary judgment, all reasonable inferences from evidence are to be drawn in favor of nonmoving party), here Plaintiff has provided nothing other than his own assertions, which are 

insufficient to create a genuine dispute as to whether having CDCR dentists attempt the root canal 

was either medically unacceptable or done with deliberate disregard for Plaintiff‘s serious medical 

needs. 

F. Preliminary Injunction Motion

Plaintiff has filed a second amended motion for preliminary injunction (Docket No. 48), 

seeking an order mandating Defendants refer Plaintiff to ―a contracted Oral Surgeon or to an 

outside dental facility to drain and remove his oral abscess as soon as possible.‖ Docket No. 48 at 

14. ―A plaintiff seeking a preliminary injunction must establish that he is likely to succeed on the 

merits, that he is likely to suffer irreparable harm in the absence of preliminary relief, that the 

balance of equities tips in his favor, and that an injunction is in the public interest.‖ Winter v. 

Natural Resources Defense Council, Inc., 555 U.S. 7, 20 (2008). Should a moving party fail to 

demonstrate any chance of success on the merits, a court may disregard the determination of 

potential injury or a balancing of hardships and deny the injunction. Arcamuzi v. Continental Air 

Lines, Inc., 819 F.2d 935, 937 (9th Cir. 1987); Sports Form, Inc. v. United Press International, 

Inc., 686 F.2d 750, 753 (9th Cir. 1982). As detailed above, Plaintiff fails to demonstrate any 

chance of success on the merits of his underlying action. The Court therefore DENIES Plaintiff‘s 

preliminary injunction motion.

G. Motion to Suppress Transcript of February 22, 2016 Deposition 

Plaintiff has filed a motion to suppress the transcript of his February 22, 2016 deposition, 

and also requests that the Court impose the appropriate monetary and other sanctions on 

Defendants to prevent future transgressions. Docket No. 69. In the motion, filed on May 16, 

2016, Plaintiff alleges that Defendants and the court reporter deliberately refused to make the 

deposition transcript available to Plaintiff, in violation of the Civil Discovery Act and Federal 

Rules of Civil Procedure. Docket No. 69 at 4–5. 

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Plaintiff‘s motion to suppress the unapproved deposition transcript is DENIED AS MOOT. 

As of May 24, 2016, Plaintiff had received and reviewed the deposition transcript and made only 

four minor changes. Docket No. 72-1 at 4.

Plaintiff‘s request for sanctions is also DENIED. The record indicates that the failure to 

provide Plaintiff with the deposition transcript was unintentional. See Docket No. 72-1 at 2. In 

addition, the record indicates that Plaintiff was not prejudiced by the delayed receipt of the 

deposition because he had access to the full deposition transcript while preparing his opposition to 

Dr. Calderon‘s summary judgment motion.6 Dr. Calderon‘s summary judgment motion was filed 

on May 4, 2016, and referenced the deposition transcript. Plaintiff received the deposition 

transcript by May 24, 2016. Docket No. 72-1 at 4. On May 27, 2016, Plaintiff was granted an 

extension of time to June 17, 2016, to file his opposition to Dr. Calderon‘s summary judgment 

motion. Sanctions are not warranted under these circumstances.

CONCLUSION

For the foregoing reasons, the Court GRANTS the summary judgment motion filed by Drs. 

Marlais and Uy, Docket No. 51; GRANTS the summary judgment motion filed by Dr. Calderon, 

Docket No. 68; DENIES Plaintiff‘s second amended preliminary injunction motion, Docket No. 

48; and DENIES Plaintiff‘s request to suppress the February 22, 2016 deposition transcript, 

Docket No. 69.

The Clerk shall enter judgment for Defendants and close the file.

This order terminates Docket Nos. 48, 51, 68, and 69.

IT IS SO ORDERED.

Dated: September 28, 2016

______________________________________

JON S. TIGAR

United States District Judge

 

6

Plaintiff‘s deposition was taken on February 22, 2016, after Drs. Uy and Marlais filed their 

summary judgment motion on January 14, 2016. Plaintiff did not require a copy of the deposition 

transcript to file an opposition to the summary judgment motion filed by Drs. Uy and Marlais. 

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