Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_10-cv-02226/USCOURTS-casd-3_10-cv-02226-6/pdf.json

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

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

PETER ROMERO LOMAX,

Plaintiff,

CASE NO. 10cv2226-WQH

(WMc)

REPORT AND

RECOMMENDATION ON

DEFENDANT LEHV’S

MOTION TO DISMISS

PLAINTIFF’S COMPLAINT 

(ECF No. 73)

vs.

DR. CANLAS, et al.,

Defendants.

Introduction

Plaintiff, formerly incarcerated at Richard J. Donovan Correctional Facility

(“RJD”) in San Diego, California, and proceeding pro se, filed a civil rights

complaint pursuant to 42 U.S.C. § 1983.1

 Plaintiff alleges various prison and

medical officials at RJD and Alvarado Hospital have violated his Eighth

Amendment right to adequate medical care.2

 (Plaintiff’s Complaint at 9; ECF No.

1).3

 Plaintiff seeks injunctive relief as well as general and punitive damages. (Id. at

60-61).

1

 Plaintiff now lives in Tennessee. See (ECF No. 37).

2

 Plaintiff’s underlying condition was a tumor located near his perineum. 

3

 The Court will refer to the pleadings by the number assigned by CM/ECF, i.e., ECF No. 1.

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On October 19, 2012, defendant Dr. Lehv brought a motion to dismiss

plaintiff’s complaint. (ECF No. 73). Dr. Lehv contends the Court should dismiss

plaintiff’s complaint because: (1) plaintiff failed to state a claim against Dr. Lehv for

deliberate indifference to his medical needs under the Eighth Amendment, and (2) to

the extent plaintiff alleges Dr. Lehv was a state actor, plaintiff cannot recover

monetary damages from Dr. Lehv in his official capacity. Dr. Lehv contends

amendment of the complaint would be futile because plaintiff’s claims sound in

negligence. 

On November 30, 2012, plaintiff filed an opposition to Dr. Lehv’s motion to

dismiss. (ECF No. 84). In the opposition, plaintiff only addressed Dr. Lehv’s

deliberate indifference argument, claiming Dr. Lehv examined him, knew plaintiff

had trouble walking, was in pain, had been waiting on an ultrasound for months, and

that the tumor was growing, but marked his examination report as “ROUTINE”

instead of “EMERGENT” or “URGENT,” refused to help him and passed him on to

the next doctor. (ECF No. 84 at 4). 

Dr. Lehv replied to plaintiff’s opposition on December 14, 2012. (ECF No.

87). 

This Report and Recommendation is submitted to United States District Judge

William Q. Hayes pursuant to 28 U.S.C. § 636(b)(1) and Local Rule 72.3 of the

United States District Court for the Southern District of California. After reviewing

the pleadings and Dr. Lehv’s motion, and for the reasons set forth below, the Court

recommends that the Motion to Dismiss be GRANTED.

Plaintiff’s Claims Against Dr. Lehv

Plaintiff contends Dr. Lehv was employed as a medical doctor at RJD and

acted under color of state law when he denied medical care and treatment to

plaintiff. Plaintiff contends “on 9-6-07 Dr. Lehv defendant 2.4 submitted another

CDC 7243 form for the same kind of request that was submitted on 7-26-07. On the

form there is a section to indicate initial or follow-up, Dr. Lehv marked initial on the

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CDC 7243 he filled out when he knew one had already been submitted on 7-26-07

for an ultrasound request where he was required as a physician to have marked

follow-up instead of initial.” (ECF No. 1 at 9-10). Plaintiff confirms an ultrasound

was performed on September 26, 2007. Id. at 10. Nevertheless, plaintiff contends Dr.

Lehv intentionally disregarded the growth and size of plaintiff’s tumor, and

plaintiff’s pain and difficulty walking. Id. at 11. Plaintiff attached to the complaint

what appears to be a request for an ultrasound report completed by Dr. Lehv. (Id. at

Exhibit C, pg. 6). 

Standard of Review

Rule 12(b)(6) Motion to Dismiss

A motion to dismiss for failure to state a claim pursuant to Federal Rule of

Civil Procedure 12(b)(6) tests the legal sufficiency of the claims in the complaint.

See Davis v. Monroe County Bd. of Educ., 526 U.S. 629, 633 (1999). The old

formula—that the complaint must not be dismissed unless it is beyond doubt without

merit—was discarded by Bell Atl. Corp. v. Twombly, 550 U.S. 544, 563 n.8 (2007).

A complaint must be dismissed if it does not contain “enough facts to state a

claim to relief that is plausible on its face.” Bell Atl. Corp., 550 U.S. at 570. “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 misconduct

alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). The court must accept as true

all material allegations in the complaint, as well as reasonable inferences to be

drawn from them, and must construe the complaint in the light most favorable to the

plaintiff. Cholla Ready Mix, Inc. v. Civish, 382 F.3d 969, 973 (9th Cir. 2004) (citing

Karam v. City of Burbank, 352 F.3d 1188, 1192 (9th Cir. 2003)); Parks Sch. of Bus.,

Inc. v. Symington, 51 F.3d 1480, 1484 (9th Cir.1995); N.L. Indus., Inc. v. Kaplan,

792 F.2d 896, 898 (9th Cir.1986).

The court looks at whether the plaintiff fulfilled his obligation to provide the

“grounds of his entitle[ment] to relief.” See Bell Atl. Corp. v. Twombly, 550 U.S. at

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555 (quoting Papasan v. Allain, 478 U.S. 265, 286 (1986) (internal quotation

omitted)). A dismissal under Rule 12(b)(6) is generally proper only where there “is

no cognizable legal theory or an absence of sufficient facts alleged to support a

cognizable legal theory.” Navarro v. Block, 250 F.3d 729, 732 (9th Cir. 2001) (citing

Balistreri v. Pacifica Police Dep't, 901 F.2d 696, 699 (9th Cir. 1988)).

The court need not accept conclusory allegations in the complaint as true;

rather, it must “examine whether [they] follow from the description of facts as

alleged by the plaintiff.” Holden v. Hagopian, 978 F.2d 1115, 1121 (9th Cir. 1992)

(citation omitted); see Halkin v. VeriFone, Inc., 11 F.3d 865, 868 (9th Cir. 1993);

see also Cholla Ready Mix, 382 F.3d at 973 (citing Clegg v. Cult Awareness

Network, 18 F.3d 752, 754–55 (9th Cir. 1994)) (stating that on Rule 12(b)(6)

motion, a court “is not required to accept legal conclusions cast in the form of

factual allegations if those conclusions cannot reasonably be drawn from the facts

alleged”). “Nor is the court required to accept as true allegations that are merely

conclusory, unwarranted deductions of fact, or unreasonable inferences.” Sprewell v.

Golden State Warriors, 266 F.3d 979, 988 (9th Cir. 2001).

When analyzing the sufficiency of a complaint, courts may consider the

exhibits attached to the complaint. See Parks Sch. of Bus., 51 F.3d at 1484 (citing

Cooper v. Bell, 628 F.2d 1208, 1210 n.2 (9th Cir. 1980)). The court may also

consider “documents whose contents are alleged in a complaint and whose

authenticity no party questions, but which are not physically attached to the pleading

. . . . ” Branch v. Tunnell, 14 F.3d 449, 454 (9th Cir. 1994), overruled on other

grounds by Galbraith v. County of Santa Clara, 307 F.3d 1119 (9th Cir. 2002);

Knieval v. ESPN, 393 F.3d 1068, 1076 (9th Cir. 2005); Stone v. Writer’s Guild of

Am. W., Inc., 101 F.3d 1312, 1313–14 (9th Cir. 1996). Here, plaintiff attached a

medical request form to his complaint. (ECF No. 1, Exh. C at p. 6). The Court will

consider this exhibit in addressing Dr. Lehv’s motion.

///

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Standards Applicable to Pro Se Litigants

Where a plaintiff appears in propria persona in a civil rights case, the court

must construe the pleadings liberally and afford the plaintiff any benefit of the

doubt. Karim-Panahi v. L.A. Police Dep’t, 839 F.2d 621, 623 (9th Cir. 1988). The

rule of liberal construction is “particularly important in civil rights cases.” Ferdik v.

Bonzelet, 963 F.2d 1258, 1261 (9th Cir. 1992). In giving liberal interpretation to a

pro se civil rights complaint, courts may not “supply essential elements of the claim

that were not initially pled.” Ivey v. Bd. of Regents of the Univ. of Alaska, 673 F.2d

266, 268 (9th Cir. 1982). “Vague and conclusory allegations of official participation

in civil rights violations are not sufficient to withstand a motion to dismiss.” Id.; see

also Jones v. Cmty. Redev. Agency, 733 F.2d 646, 649 (9th Cir. 1984) (finding

conclusory allegations unsupported by facts insufficient to state a claim under

section 1983). “The plaintiff must allege with at least some degree of particularity

overt acts which defendants engaged in that support the plaintiff’s claim.” Jones,

733 F.2d at 649 (internal quotation omitted).

Nevertheless, the court must give a pro se litigant leave to amend his

complaint “unless it determines that the pleading could not possibly be cured by the

allegation of other facts.” Lopez v. Smith, 203 F.3d 1122, 1127 (9th Cir. 2000) (en

banc) (internal quotation omitted). Thus, before a pro se civil rights complaint may

be dismissed, the court must provide the plaintiff with a statement of the complaint’s

deficiencies. Karim-Panahi, 839 F.2d at 623–24. But where amendment of a pro se

litigant’s complaint would be futile, denial of leave to amend is appropriate. See

James v. Giles, 221 F.3d 1074, 1077 (9th Cir. 2000).

Stating a Claim Under 42 U.S.C. § 1983

To state a claim under section 1983, the plaintiff must allege facts sufficient to

show (1) a person acting under color of state law committed the conduct at issue,

and (2) the conduct deprived the plaintiff of some right, privilege, or immunity

protected by the Constitution or laws of the United States. 42 U.S.C.A. § 1983 (West

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2003); Shah v. County of Los Angeles, 797 F.2d 743, 746 (9th Cir. 1986).

Discussion

Plaintiff’s Eighth Amendment Claim Against Dr. Lehv

Not every prisoner claim of inadequate medical treatment states a violation of

the Eighth Amendment. To state a section 1983 medical claim, a plaintiff must show

that the defendants acted with “deliberate indifference to serious medical needs.” Jett

v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) (quoting Estelle v. Gamble, 429 U.S.

97, 104 (1976)). A plaintiff must show: (1) a “‘serious medical need’ by

demonstrating that ‘failure to treat a prisoner’s condition could result in further

significant injury or the ‘unnecessary and wanton infliction of pain,’” and (2) the

defendant’s response “was deliberately indifferent.” Jett, 439 F.3d at 1096 (quoting

McGuckin v. Smith, 974 F.2d 1050, 1059–60 (9th Cir. 1991)).

To act with deliberate indifference, a prison official must both know of and

disregard an excessive risk to inmate health; the official must both be aware of facts

from which the inference could be drawn that a substantial risk of serious harm

exists and he must also draw the inference. Farmer v. Brennan, 511 U.S. 825, 837

(1994). Deliberate indifference in the medical context may be shown by a purposeful

act or failure to respond to a prisoner’s pain or possible medical need and harm

caused by the indifference. Jett, 439 F.3d at 1096. Deliberate indifference may also

be shown when a prison official intentionally denies, delays, or interferes with

medical treatment or by the way prison doctors respond to the prisoner’s medical

needs. Estelle, 429 U.S. at 104–05; Jett, 439 F.3d at 1096.

Deliberate indifference requires a higher standard than negligence or lack of

ordinary due care for the prisoner’s safety. Farmer, 511 U.S. at 835. Indeed, “neither

negligence nor gross negligence will constitute deliberate indifference.” Clement v.

Cal. Dep’t Corrs., 220 F.Supp.2d 1098, 1105 (N.D. Cal. 2002) (citing Farmer, 511

U.S. at 835–36); see also Broughton v. Cutter Labs., 622 F.2d 458, 460 (9th Cir.

1980) (mere claims of “indifference,” “negligence,” or “medical malpractice” do not

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support a claim under section 1983). “[A] mere ‘difference of medical opinion . . .

[is] insufficient, as a matter of law, to establish deliberate indifference.’” Toguchi v.

Chung, 391 F.3d 1051, 1058 (9th Cir. 2004); Sanchez v. Vild, 891 F.2d 240, 242 (9th

Cir. 1989). A mere delay in medical care, without more, is insufficient to state a

claim against prison officials for deliberate indifference. See Shapley v. Nev. Bd.

State Prison Comm’rs, 766 F.2d 404, 407 (9th Cir. 1985). Also, the indifference

must be substantial. The action must rise to a level of “unnecessary and wanton

infliction of pain.” Estelle, 429 U.S. at 105–06. 

Here, plaintiff has successfully established a serious medical need. Plaintiff

alleges the presence of a serious tumor intertwined with his internal parts in a private

and sensitive area. (ECF No. 1 at 9-10). Furthermore, plaintiff’s complaint and

attached exhibits show plaintiff’s post-surgery recovery process involved the

removal of fifteen surgical staples recovered from plaintiff’s surgical site on three

separate occasions. (ECF No. 1 at 14-17). The Court finds these allegations and

supporting factual descriptions establish a serious medical need.

However, plaintiff failed to establish Dr. Lehv acted with a deliberate

indifference to plaintiff’s medical needs by indicating on the physician request for

services form that the requested service (an ultrasound) was “routine” instead of

“emergent” or “urgent,” or that Dr. Lehv’s consultation was “initial” instead of a

“follow-up.” Indeed, according to plaintiff’s complaint, when plaintiff saw Dr. Lehv

on September 6, 2007, Dr. Lehv filled out the request form that same day, and

plaintiff received an ultrasound twenty days later on September 26, 2007. Plaintiff

failed to allege any facts or argument as to how this twenty day delay in receiving

the ultrasound constituted an excessive risk of harm to plaintiff, or that Dr. Lehv

knew this delay would cause harm and intended for plaintiff to be harmed by the

delay. Similarly, plaintiff failed to allege any facts or argument as to how Dr. Lehv

ignored his pain and the growth of his tumor or that Dr. Lehv had any knowledge or

involvement in plaintiff’s subsequent surgery or consultations. 

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Importantly, plaintiff failed to allege any facts or argument regarding Dr.

Lehv’s intent with regard to the treatment of plaintiff’s medical condition. Rather, it

appears plaintiff disagrees with the medical opinion of Dr. Lehv with regard to

whether the ultrasound request was routine or urgent, and whether plaintiff’s visit

with Dr. Lehv was an initial visit or a follow-up visit. However, a difference of

medical opinion or a mere delay in medical care, without more, is not sufficient to

sustain an Eighth Amendment cause of action. See Toguchi, 391 F.3d at 1058;

Shapley, 766 F.2d at 407. Plaintiff’s allegations against Dr. Lehv fall well short of

establishing Dr. Lehv’s actions or omissions led to an “unnecessary and wanton

infliction of pain” or that Dr. Lehv knew or intended for plaintiff to be harmed by his

actions. Estelle, 429 U.S. at 105–06. 

Accordingly, the Court concludes plaintiff has failed to state a plausible

Eighth Amendment cause of action against Dr. Lehv. Even assuming plaintiff’s

conclusory allegations suggest Dr. Lehv acted negligently, something more than

negligence, or gross negligence, or medical malpractice is required for a violation of

the Eighth Amendment. Toguchi, 391 F.3d at 1060. Accordingly, IT IS

RECOMMENDED Dr. Lehv’s motion to dismiss plaintiff's Eighth Amended

deliberate indifference claim be GRANTED.

Plaintiff Cannot Recover Monetary Damages from Dr. Lehv

Dr. Lehv seeks dismissal of plaintiff's monetary damages claim to the extent it

is based on acts taken in an official capacity. While the Eleventh Amendment bars a

prisoner's section 1983 claims against state actors sued in their official capacities, it

does not bar damage actions against state officials in their personal capacities. Will v.

Michigan, 491 U.S. 58, 66 (1989); Hafer v. Melo, 502 U.S. 21, 31 (1991). In

addition, it does not bar actions against state officers in their official capacities if the

plaintiff seeks injunctive relief. Chaloux v. Killeen, 886 F.2d 247, 252 (9th

Cir.1989).

Here, plaintiff has sued defendants, including Dr. Lehv, in their official and

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individual capacities. Plaintiff's prayer also seeks compensatory and punitive

damages as well as injunctive relief. Although plaintiff is foreclosed from seeking

money damages against Dr. Lehv in his official capacity, he may still seek injunctive

relief against Dr. Lehv in his official capacity as well as money damages against Dr.

Lehv in his individual capacity. Accordingly, IT IS RECOMMENDED Dr. Lehv’s

motion to dismiss plaintiff's claim for money damages ONLY against Dr. Lehv in

his official capacity be GRANTED with prejudice. Plaintiff's claim for injunctive

relief may not be dismissed on these grounds. See Chaloux, 886 F.2d at 252.

Dismissal with Prejudice

A pro se litigant should be given leave to amend his complaint unless it is

absolutely clear that the deficiencies of the complaint cannot be cured by

amendment. See Karim-Panahi, 839 F.2d at 623. 

Here, revising plaintiff’s Eighth Amendment claims against Dr. Lehv would

prove futile because plaintiff’s claims are entirely premised on a negligence theory

of liability. See Estelle, 429 U.S. at 106. Furthermore, a review of the record

indicates plaintiff did not previously avail himself of an opportunity to file an

amended complaint after the Court ruled on the defendants’ first motion to dismiss

(Dr. Lehv was not included in that motion). In that order, the Court concluded

plaintiff’s claims against certain defendants failed because, like the claims against

Dr, Lehv, plaintiff asserted a negligence theory of liability. See (ECF No. 58 at 3).

Judge Hayes specifically instructed plaintiff to file an amended complaint on or

before April 10, 2012. Id. at 5. Judge Hayes further instructed plaintiff that “any

defendant not named, and all claims not re-alleged, will be deemed waived.” Id.

Plaintiff neither filed an amended motion, nor requested an extension of time to file

an amended motion, nor filed a motion for reconsideration within the sixty day

period granted by Judge Hayes. 

Accordingly, this Court RECOMMENDS plaintiff’s allegations against Dr.

Lehv be DISMISSED without leave to amend.

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Conclusion

For the reasons set forth herein, it is RECOMMENDED that an order be

entered as follows:

Defendant’s Motion to Dismiss plaintiff’s claims against Dr. Lehv be

GRANTED without leave to amend.

IT IS ORDERED that no later than April 15, 2013, any party to this action

may file written objections with the Court and serve a copy on all parties. The

document should be captioned “Objections to Report and Recommendation.”

IT IS FURTHER ORDERED that any reply to the objections shall be filed

with the Court and served on all parties no later than April 22, 2013. The parties are

advised that failure to file objections within the specified time may waive the right to

raise those objections on appeal of the Court’s order. Martinez v. Ylst, 951 F.2d 1153

(9th Cir. 1991).

IT IS SO ORDERED.

DATED: March 28, 2013

Hon. William McCurine, Jr.

U.S. Magistrate Judge

United States District Court

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