Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_16-cv-02601/USCOURTS-casd-3_16-cv-02601-1/pdf.json

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

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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

JOSE INIGUEZ,

Plaintiff,

v.

PATRICIA NEWTON,

Defendant.

3:16-cv-2601-LAB-PCL

REPORT AND 

RECOMMENDATION RE: 

DEFENDANT’S MOTION TO 

DISMISS [Doc. 6-1]

I. INTRODUCTION

Plaintiff Jose Iniguez (“Plaintiff”), an inmate currently housed at Calipatria State 

Prison, has filed a civil rights Complaint pursuant to 42 U.S.C. § 1983, and California state 

law under the California Torts Claims Act, Government Code §§ 810 and 844.6(d). 

Plaintiff alleges violations resulting from medical care given by Dr. Patricia Newton

(“Defendant”). Presently before this Court is a Motion to Dismiss the Complaint pursuant 

to Federal Rule of Civil Procedure 12(b)(6). The Honorable Larry Alan Burns referred the 

matter to the undersigned Judge for Report and Recommendation pursuant to 28 U.S.C. § 

636(b)(1)(B) and Local Civil Rule 72.1(c)(d). After a thorough review of the pleadings and 

supporting documents, this Court recommends the Motion to Dismiss be GRANTED.

///

///

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II. FACTUAL BACKGROUND

Plaintiff underwent several orthopedic surgeries to remove “bony tumors” in his 

feet.1(Doc. 1 at 3.) Plaintiff’s last surgery, on May 28, 2015, was successful on his right 

foot but left his left foot “deformed.” (Id.) Plaintiff does not describe his exact medical 

diagnosis, symptoms, previous treatment, or provide detail on the resulting deformity. On 

June 2, 2015, Plaintiff met with Defendant, Dr. Patricia Newton, for “severe” pain he was 

experiencing in his left foot. (Id. at 4.) Plaintiff had difficulty walking on crutches to the 

dining hall, and requested to be “cell fed” for the five days of his approved recovery period.

(Id.) In response, Defendant told him he needed to “man up” and that often shortly after 

foot surgery people “walk around with no problem.” (Id.) On June 19, 2015, Plaintiff

requested “adequate” pain medication and a disability vest from Defendant, who refused

to provide these items. (Id.) On June 30, 2015, Plaintiff filed a Reasonable Accommodation 

Request for stronger medication, a mobility vest, orthopedic shoes, and a walking cane to 

“help take pressure of his foot.” The Appeals Coordinator’s Office denied Plaintiff’s 

request, and advised him to file an administrative appeal. (Id.) 

On July 10, 2015, Plaintiff was seen by Nurse Alvarez regarding pain in his left foot. 

(Doc. 1 at 4.) Defendant instructed Alvarez to not make changes to Plaintiff’s treatment 

plan. On July 15, 2015, Defendant “confiscated” Plaintiff’s crutches and once again denied 

his request for a walking cane and additional pain medication. (Id.) On July 28, 2015, 

Plaintiff met with Dr. Ben Wehrli, the surgeon who operated on him on May 28, 2015. (Id.

at 3.) Dr. Wehrli recommended another surgery. Plaintiff feared further deformity, pain, 

 

1 Plaintiff does not state in his Complaint what bony tumors are or how many surgeries he has had. 

According to the American College of Foot and Ankle Surgeons, bony tumors are “caused by an abnormal 

growth of cells. They may be benign (noncancerous) or malignant (cancerous). Although rare, bone 

tumors can occur in the foot and ankle. They can be primary (originating in the bone) or secondary 

(originating in another part of the body). Symptoms of a bone tumor may include: [f]racture from slight 

injury, [b]one pain, often at night, [and] [o]ccasionally a mass or swelling in the area.” Bone Tumors in 

the Foot, FOOT HEALTH FACTS https://www.foothealthfacts.org/conditions/bone-tumors-in-the-foot. (last 

visited July 28, 2017).

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and difficulty with mobility, so he declined the surgery. On August 4, 2015, Dr. Wehrli

again recommended a second surgery. However, Plaintiff again declined the surgery 

because there was no promise of correcting the deformity. (Id.)

On October 16, 2015, Plaintiff filed his first administrative appeal, again requesting

pain medication beyond Ibuprofen, a mobility vest, orthopedic shoes, and a walking cane. 

(Doc. 1 at 4.) On November 17, 2015, Plaintiff spoke with Defendant regarding the appeal. 

(Id.) Plaintiff alleges Defendant was “very angry” toward him and said the appeal was 

“totally unnecessary.” (Id.) Defendant also said she was going to refer him for orthopedic 

shoes and antidepressants for the pain, but that was “all [he was] getting.” (Id. at 4–5.) 

Defendant further said she would not give him any other pain medication and that she was 

going to remove his medical accommodations. (Id. at 5.) On November 23, 2015, Plaintiff 

filed another administrative appeal against Defendant for Reasonable Comprehensive 

Accommodation and for retaliation. (Id.)

On December 10, 2015, Plaintiff sought mental health services for stress and 

insomnia “as a result of Defendant’s actions.” (Doc. 1 at 5.) “It is extremely difficult for 

Plaintiff to understand why [D]efendant Newton does not believe or does not want to 

believe that [P]laintiff . . . continues to suffer physical pain as a result of the botched foot 

surgery. The stress is so unable [sic] at times that [P]laintiff cannot sleep.” (Id.) On 

December 22, 2015, Dr. Wehrli recommended Plaintiff receive the pain medication 

Neurontin, a walking cane, and orthopedic shoes. (Id. at 3, 5.) On January 5, 2016, 

Defendant spoke with Plaintiff about Dr. Wehrli’s recommendation. Defendant told 

Plaintiff she would not follow the recommendation, with the exception of the orthopedic 

shoes. (Id. at 5.) Defendant went on to “scold” Plaintiff about his attitude and persistence 

in seeking additional pain medication and a cane. On September 26, 2016, Plaintiff again 

went to see Defendant regarding the pain in his left foot. (Id.) Plaintiff told Defendant the 

pain was “so unbearable” he felt he had no choice but to have surgery. Defendant replied

“[g]et out of here. You had your opportunity for another surgery.” (Id.) On February 12, 

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2016, Plaintiff filed a Government Claims board petition (#G62941), and as of this date 

has not received a response. (Id. at 5.)

Plaintiff filed this Complaint on October 17, 2016, suing Defendant in both her 

individual and official capacities. (Doc. 1 at 1–2.) Plaintiff alleges 1) Defendant denied 

him adequate medical care in retaliation for filing an administrative appeal, in violation of 

the First Amendment; 2) that Defendant denied his right to medical care in violation of the 

Eighth Amendment, and; 3) Defendant’s failure and refusal to provide adequate medical 

care constituted negligence under state law. (Id. at 3–7.) Plaintiff requests an injunction, 

damages, punitive damages, and an order for Defendant to satisfy his medical request. (Id.

at 9.) Defendant moves to dismiss Plaintiff’s Complaint for failure to state a claim, failure 

to exhaust administrative remedies, and failure to comply with the California Tort Claims 

Act. (Doc. 6-1.)

III. STANDARD OF REVIEW

A. Motion to Dismiss 

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

sufficiency of a claim. Navarro v. Block, 250 F.3d 729, 732 (9th Cir. 2001). Because Rule 

12(b)(6) focuses on the sufficiency of a claim rather than the claim's substantive merits, "a 

court may [ordinarily] look only at the face of the complaint to decide a motion to dismiss." 

Van Buskirk v. Cable News Network, Inc., 284 F.3d 977, 980 (9th Cir. 2002). However, 

courts may consider materials of which the court may take judicial notice, and exhibits that 

are attached to the complaint. See Fed. R. Civ. P. 10(c) ("A copy of a written instrument 

that is an exhibit to a pleading is a part of the pleading for all purposes."); Hal Roach 

Studios, Inc. v. Richard Feiner & Co., Inc., 896 F.2d 1542, 1555 n.19 (9th Cir. 1990); 

Barron v. Reich, 13 F.3d 1370, 1377 (9th Cir. 1994). Exhibits that contradict the allegations 

of a complaint may fatally undermine the complaint's allegations. See Sprewell v. Golden 

State Warriors, 266 F.3d 979, 988 (9th Cir. 2001) (a plaintiff can "plead himself out of a 

claim by including . . . details contrary to his claims." (citing Steckman v. Hart Brewing, 

Inc., 143 F.3d 1293, 1295-96 (9th Cir. 1998) ("[W]e are not required to accept as true 

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conclusory allegations which are contradicted by documents referred to in the 

complaint."))).

A motion to dismiss should be granted if a plaintiff fails to proffer "enough facts to 

state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 

544, 570 (2007). "To survive a motion to dismiss, a complaint must contain sufficient 

factual matter, accepted as true, to 'state a claim to relief that is plausible on its face.' 

[Citation omitted.] 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) (quoting Twombly, 550 

U.S. at 556, 570).

"All allegations of material fact are taken as true and construed in the light most 

favorable to the nonmoving party." Cahill v. Liberty Mut. Ins. Co., 80 F.3d 336, 337-38 

(9th Cir. 1996) (citing Nat'l Wildlife Fed. v. Espy, 45 F.3d 1337, 1340 (9th Cir. 1995)). 

The Court need not, however, "accept as true allegations that are merely conclusory, 

unwarranted deductions of fact, or unreasonable inferences." Sprewell, 266 F.3d at 988 

(citing Clegg v. Cult Awareness Network, 18 F.3d 752, 754-55 (9th Cir. 1994)); see also

Iqbal, 556 U.S. at 678 ("Threadbare recitals of the elements of a cause of action, supported 

by mere conclusory statements, do not suffice."); Papasan v. Allain, 478 U.S. 265, 286 

(1986) (on motion to dismiss, court is "not bound to accept as true a legal conclusion 

couched as a factual allegation."). "[T]he pleading standard Rule 8 does not require 

'detailed factual allegations,' but it demands more than an unadorned, the defendantunlawfully-harmed-me accusation." Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 

555).

Thus, "[w]hile legal conclusions can provide the framework of a complaint, they 

must be supported by factual allegations. When there are well-pleaded factual allegations, 

a court should assume their veracity and then determine whether they plausibly give rise 

to an entitlement to relief." Id. at 679. "The plausibility standard is not akin to a 'probability 

requirement,' but it asks for more than a sheer possibility that a defendant has acted 

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unlawfully." Id. at 678. "Where a complaint pleads facts that are 'merely consistent with' a 

defendant's liability, it 'stops short of the line between possibility and plausibility of 

'entitlement to relief.''" Id. (quoting Twombly, 550 U.S. at 570 (when plaintiffs have not 

"nudged their claims across the line from conceivable to plausible, their complaint must be 

dismissed.")).

"In sum, for a complaint to survive a motion to dismiss, the non-conclusory 'factual 

content,' and reasonable inferences [drawn] from that content, must be plausibly suggestive 

of a claim entitling the plaintiff to relief." Moss v. United States Secret Serv., 572 F.3d 

962, 969 (9th Cir. 2009) (quoting Iqbal, 556 U.S. at 678).

IV. DISCUSSION

A. Request for Judicial Notice2

 Defendant asks the Court take judicial notice on the following records and search:

Ex. 1: Certified Records of the Claims Board for Jose Iniguez

(CDCR # J-36853) related to his claim number G629421. (Doc. 6-2 

at 2.)

Record Search: Search was conducted regarding all claims 

submitted by Jose Iniguez to the Claims Board from March 28, 2015 

to February 8, 2017, and no claims other than claim number 

G629421 were located. (Id.)

A court may take judicial notice of a fact that is not reasonably disputed if it “can be 

accurately and readily determined from sources whose accuracy cannot reasonably be 

questioned.” Fed. R. Evid. 201(b)(2). On a motion to dismiss, courts may consider “matters 

of public record.” Northstar Fin. Advisors Inc. v. Schwab Inv., 779 F.3d 1036, 1042 (9th 

Cir. 2015) (quoting Coto Settlement v. Eisenberg, 593 F.3d 1031, 1038 (9th Cir. 2010)). 

“Matters of public record” include records and reports of administrative agencies. Enciso 

 

2 A court may take judicial notice of what attached documents contain, but not the truth of those 

contents. Lee v. City of Los Angeles, 250 F.3d 668, 689–690 (9th Cir.2001).

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v. Moon, 2015 WL 673269, at *6 n.6 (E.D. Cal. Feb. 17, 2015) (citing United States v. 

14.02 Acres of Land More or Less in Fresno Cty., 547 F.3d 943, 955 (9th Cir. 2008)). A 

court may also take judicial notice “that an authorized custodian of records for [CDCR] 

conducted a search of the [CDCR] records” and of the results of that search. Martin v. 

Hedgpeth, 2014 WL 3884287, at *6 (N.D. Cal. Aug. 7, 2014).

Here, Defendant requests the Court take judicial notice of Plaintiff’s Government 

Claims Board petition. (Doc. 6-2 at 2.) Whether Plaintiff filed a Government Claims 

petition is not in dispute. Plaintiff states in his Complaint that he filed the petition. (Doc. 1 

at 5.) Furthermore, public records that are authorized to be judicially noticed include 

records and reports of administrative agencies such as the CDCR. Therefore, judicial 

notice is proper.

Defendant also requests the Court judicially notice that a search was conducted 

regarding all claims submitted by Plaintiff to the Claims Board from March 28, 2015, to 

February 8, 2017, and that no claims other than claim number G629421 were located. (Doc. 

6-2 at 2.) Whether Plaintiff filed one or more Government Claim petitions is not in dispute. 

Plaintiff states in his Complaint he filed only one petition, claim number G629421. (Doc. 

1 at 5.) Furthermore, a court is allowed to take judicial notice that an authorized custodian 

of a public agency conducted a search of the records. Thus, judicial notice is proper.

Therefore, this Court recommends Defendant’s judicial notice request be GRANTED.

B. Motion to Dismiss

Plaintiff alleges Defendant failed to provide adequate medical care as retaliation for 

filing an administrative appeal, in violation of the First Amendment. Further, Plaintiff 

alleges Defendant denied Plaintiff his right to medical care under the Eighth Amendment. 

Lastly, Plaintiff alleges negligence under the California Torts Claims Act. (Doc. 1 at 3–7.)

Plaintiff seeks (1) an injunction preventing Defendant from retaliating against him, (2) 

damages, (3) punitive damages, and (4) an order requiring Defendant to provide adequate 

pain management. (Id. at 9.)

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1. Retaliation Claim (First Amendment)

Plaintiff alleges Defendant violated his First Amendment right to freedom of speech 

when she denied him adequate medical care, in retaliation for Plaintiff filing an 

administrative appeal. (Id. at 3.) Defendant contends Plaintiff fails to plead facts that show

Defendant made an adverse or a retaliatory action that denied him his freedom of speech. 

(Doc. 6-1 at 8–9.) 

“Incarceration does not divest prisoners of all constitutional protections.” Shaw v. 

Murphy, 532 U.S. 223, 228 (2001). There is no statute or case law to suggest that prisoners 

do not have a right to speak to correctional officers. See, e.g., Clark v. Woodford, 36 Fed. 

Appx. 240, 241 (9th Cir. 2002). In particular, “[p]risoners have a First Amendment right 

to file grievances against prison officials and to be free from retaliation for doing so.” 

Watison v. Carter, 668 F.3d 1108, 1114 (9th Cir. 2012) (citing Brodheim v. Cry, 584 F.3d 

1262, 1269 (9th Cir. 2009)). Retaliation claims have five elements. Watison, 668 F.3d at 

1114.

First, a plaintiff must claim that “the retaliated-against conduct is protected.” Id.

Filing a grievance against a correctional officer or other individual within the prison's 

administration is protected conduct. Id. Second, Plaintiff must allege that the “defendant 

took adverse action against the plaintiff,” though “the adverse action need not be an 

independent constitutional violation.” Id. Thus, the mere threat of harm can be an adverse 

action, regardless of whether it is carried out because the threat itself can have a chilling 

effect. Brodheim, 584 F.3d at 1270. However, not every allegedly adverse action is 

sufficient to support a claim for retaliation under § 1983. Watison v. Carter, 668 F.3d 1108, 

1114 (9th Cir. 2012) (harm must be “more than minimal” (quoting Rhodes, 408 F.3d at 

568 n.11)); Bell v. Johnson, 308 F.3d 594, 603 (6th Cir. 2002) (“[S]ome adverse actions 

are so de minimis that they do not give rise to constitutionally cognizable injuries.” (citing 

Thaddeus–X v. Blatter, 175 F.3d 378, 396 (6th Cir. 1999))).

Third, the plaintiff must claim that a causal connection exists between the adverse 

action and the plaintiff's protected conduct. Watison, 668 F.2d at 1114. In other words, “a 

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plaintiff must show that his protected conduct was ‘the “substantial” or “motivating” factor 

behind the defendant's conduct.’ ” Brodheim, 584 F.3d at 1271 (quoting Soranno's Gasco, 

Inc. v. Morgan, 874 F.2d 1310, 1314 (9th Cir. 1989)). Owing to the fact that a plaintiff 

rarely can produce direct evidence of a defendant's retaliatory intent, a plaintiff may plead 

circumstantial evidence that permits the inference of retaliation, such as the chronology of 

events. See Watison, 668 F.2d at 1114; see also Pratt v. Rowland, 65 F.3d 802, 808 (9th 

Cir. 1995). Fourth, “the plaintiff must allege that the ‘official's acts would chill or silence 

a person of ordinary firmness from future First Amendment activities.’ ” Watison, 668 F.3d 

at 1114 (quoting Rhodes v. Robinson, 408 F.3d 559, 568 (9th Cir. 2005)). An otherwise 

permitted action can be the basis for a retaliation claim if performed with a retaliatory 

motive and lacking a legitimate correctional goal. See id. at 1115. Even if a plaintiff fails 

to allege a chilling effect, he may still state a claim by alleging that he suffered some other 

“more than minimal” harm. Id. Last, the plaintiff must allege that the defendant's retaliatory 

conduct did not advance legitimate penological interests. Id. “A plaintiff successfully 

pleads this element by alleging, in addition to a retaliatory motive, that the defendant's 

actions were arbitrary and capricious ... or that they were ‘unnecessary to the maintenance 

of order in the institution.’” Id. at 1114–15 (quoting Franklin v. Murphy, 745 F.2d 1221, 

1230 (9th Cir. 1984)) (internal citations omitted).

Stated plainly, in order to state a retaliation claim, Plaintiff must assert facts showing 

that (1) Defendant took adverse action against him (2) because of (3) Plaintiff’s protected 

conduct (filing administrative appeal), and that such action (4) chilled the exercise of 

Plaintiff’s First Amendment rights, and (5) the action did not reasonably advance a 

legitimate correctional goal. Plaintiff fails to satisfy this requirement.

Here, Plaintiff fails to allege sufficient facts that show Defendant took an adverse 

action against him. Plaintiff states that after he filed his first administrative appeal, 

Defendant met with him and said she would refer him for orthopedic shoes and 

antidepressants. It seems counterintuitive to say Defendant acted adversely against Plaintiff 

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when she said she was going to refer him for two of four things he requested in his 

administrative appeal.

Furthermore, Plaintiff also fails to explain how Defendant’s refusal to provide a 

second surgery was an adverse action. Plaintiff states he requested a second surgery, and 

Defendant denied his request, saying “...get out of here. You had your opportunity for 

another surgery.” There are legitimate reasons why such a statement would be made and 

the statement alone does not establish that Defendant took adverse action against Plaintiff 

because he filed an administrative appeal. Plaintiff does not show how denying surgery

chilled Plaintiff's exercise of his First Amendment rights. Defendant may have denied the 

additional surgery request because Plaintiff had, on his own, twice denied this surgery 

fearing additional pain without additional relief. Plaintiff’s allegations do not satisfy the 

requirement for an adverse action.

Plaintiff also fails to state facts that show a causal connection between Defendant’s

actions and the protected conduct. Plaintiff states that after he filed the first administrative 

appeal, Defendant met with him, seemed angry, and said the appeal was totally 

unnecessary. Defendant also agreed to refer him for orthopedic shoes and antidepressants. 

Subsequently, Defendant told him she was removing his medical accommodations. 

However, Plaintiff fails to state sufficient facts that show the substantial or motivating

factor behind removing the medical accommodations was his protected conduct. Defendant 

could have said she was going to remove Plaintiff’s accommodations because they were 

no longer medically necessary or because she was changing his course of treatment. In 

addition, Plaintiff’s first administrative appeal was a Reasonable Comprehensive 

Accommodation request, not a grievance specifically against Defendant. Therefore, it is 

unlikely Defendant was motivated to remove Plaintiff’s accommodations because she was 

retaliating.

Additionally, Plaintiff fails to state facts that show Defendant’s actions chilled his 

First Amendment right to freedom of speech. Plaintiff must be able to show Defendant’s 

actions would silence a person of ordinary firmness from future First Amendment 

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activities. On November 17, 2015, Defendant allegedly threatened to remove Plaintiff’s

medical accommodations. Six days later, Plaintiff filed another administrative appeal for 

Reasonable Comprehensive Accommodation and for retaliation. Additionally, he filed a 

Government Claims board petition. This shows Plaintiff was, at the very least, not silenced 

from future First Amendment right activities. 

Therefore, Defendant’s Motion to Dismiss based on First Amendment retaliation

should be GRANTED.

2. Deliberate Indifference to Medical Care (Eighth Amendment)

Plaintiff alleges Defendant violated his Eighth Amendment right when Defendant 

showed deliberate indifference to his medical needs by refusing to follow Dr. Wehrli’s

recommendations of providing the pain medication Neurontin, a walking cane, and 

orthopedic shoes. (Doc. 1 at 6.) Defendant argues that Plaintiff merely disagreed with her

treatment plan, and this fact alone does not amount to deliberate indifference. (Doc. 6-1 at 

10–11.) Plaintiff arguesthat Dr. Wehrli’s recommendation for additional surgery was made 

by a “medically advanced specialist hired by the prison” and that that Defendant did not 

offer any reasonable explanation for not following the recommendation. (Doc. 8 at 2.) 

Defendant argues Dr. Wehrli’s treatment plan constituted nothing more than a difference 

in medical opinion, which does not rise to deliberate indifference. (Doc. 9 at 2.)

The Eighth Amendment proscription against cruel and unusual punishment 

encompasses the government's obligation to provide adequate medical care to those whom 

it is punishing by incarceration. See Estelle v. Gamble, 429 U.S. 97, 103 (1976). In order 

to establish an Eighth Amendment claim based on inadequate medical care, plaintiff must 

show that the defendants were deliberately indifferent to his serious medical needs. See

Helling v. McKinney, 509 U.S. 25, 32, 113 (1993); Gamble, 429 U.S. at 106; McGuckin

v. Smith, 974 F.2d 1050, 1059 (9th Cir.1992), overruled on other grounds, WMX 

Technologies v. Miller, 104 F.3d 1133 (9th Cir.1997). 

Deliberate indifference to the serious medical needs of a prisoner constitutes the 

“unnecessary and wanton infliction of pain” proscribed by the Eighth Amendment. See

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McKinney, 509 U.S. at 32; Gamble, 429 U.S. at 104; McGuckin, 974 F.2d at 1059. A 

“serious” medical need arises if the failure to treat the plaintiff could result in further 

significant injury or the “unnecessary and wanton infliction of pain.” Gamble, 429 U.S. at 

104; McGuckin, 974 F.2d at 1059.

Deliberate indifference may be manifested by the intentional denial, delay or 

interference with the plaintiff's medical care, or by the manner in which the medical care 

was provided. See Gamble, 429 U.S. at 104–05; McGuckin, 974 F.2d at 1059. However, 

the defendant must purposefully ignore or fail to respond to the plaintiff's pain or medical 

needs. See McGuckin, 974 F.2d at 1060. Thus, neither an inadvertent failure to provide 

adequate medical care, nor mere negligence or medical malpractice, nor a mere delay in 

medical care (without more), nor a difference of opinion over proper medical treatment, is 

sufficient to constitute an Eighth Amendment violation. See, e.g., Gamble, 429 U.S. at 

105–06; Toguchi v. Chung, 391 F.3d 1051, 1058–60 (9th Cir.2004); Jackson v. Mcintosh,

90 F.3d 330, 332 (9th Cir.1996); Sanchez v.Vild, 891 F.2d 240, 242 (9th Cir.1989); 

Shapley v. Nevada Bd. of State Prison Commissioners, 766 F.2d 404, 407 (9th Cir.1984).

Moreover, the Eighth Amendment does not require optimal medical care or even 

medical care that comports with the community standard of medical care. “[A] complaint 

that a physician has been negligent in diagnosing or treating a medical condition does not 

state a valid claim of medical mistreatment under the Eighth Amendment. Medical 

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

prisoner.” See Gamble, 429 U.S. at 106: see also, e.g., Anderson v. County of Kern, 45 

F.3d 1310, 1316 (9th Cir.1995); McGuckin, 974 F.2d at 1050; Broughton v. Cutter 

Laboratories, 622 F.2d 458, 460 (9th Cir.1980). Even gross negligence is insufficient to

establish deliberate indifference to serious medical needs. See Wood v. Housewright, 900 

F.2d 1332, 1334 (9th Cir.1990).

Here, construing the facts in the light most favorable to Plaintiff, this Court finds

Plaintiff fails to allege a cognizable Eighth Amendment violation. Specifically, Plaintiff 

fails to show Defendant’s actions could result in further significant injury or increased pain. 

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Plaintiff states he was harmed by his last surgery, not from Defendant’s actions. (Doc. 1 at 

3.) Furthermore, Plaintiff does not state how being denied a second surgery or the 

accommodations he requested led to further harm. Plaintiff states he was in “severe” pain 

and was forced to walk with crutches to the dining hall because he was not allowed to eat 

in his cell. Plaintiff, however, does not argue this caused his condition to deteriorate. 

Plaintiff states he sought mental health services for stress and insomnia because of 

Defendant’s actions. However, Plaintiff’s statement merely shows that what has caused 

him stress and insomnia was his disagreement with Defendant’s treatment plan, not her

actions.

Plaintiff also fails to show Defendant was deliberately indifferent to his medical 

need. According to Plaintiff, Defendant met with him five times. Furthermore, Defendant

referred him for orthopedic shoes and antidepressants. (Id. at 4.) Plaintiff states Nurse 

Alvarez called Defendant regarding Plaintiff’s treatment plan, and that Defendant refused 

to allow changes. (Id.) However, Plaintiff fails to state how Defendant’s refusal to change 

his treatment plan constituted deliberate indifference. It is clear from the Complaint that 

Plaintiff disagrees with Defendant’s treatment plan and believes her refusal to follow Dr. 

Wehrli’s recommendation shows deliberate indifference. However, Defendant is not the 

only one that disagrees with the accommodations Plaintiff requested. The Appeals 

Coordinator’s Office denied Plaintiff’s initial request (Id.) In addition, Dr. Wehrli did not 

recommend a mobility vest (Id. at 5.) As such, Defendant’s treatment plan was reasonable 

and medically acceptable under the circumstances. 

Therefore, Defendant’s Motion to Dismiss the Eighth Amendment claim should be 

GRANTED.

3. Plaintiff’s Claims Against Defendant in her Official Capacity

Plaintiff sues Defendant in her official capacity. (Doc. 1 at 2.) Defendant argues all 

claims seeking monetary relief against her in her official capacity should be dismissed. 

(Doc. 6-1 at 16.)

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The Eleventh Amendment grants the states immunity from private civil suits. U.S. 

Const. amend. XI; Savage v. Glendale Union High Sch. Dist. No. 205, 343 F.3d 1036, 1040 

(9th Cir. 2003). It also provides immunity for state officials sued in their official capacities. 

“[A] suit against a state official in his or her official capacity is not a suit against the official 

but rather is a suit against the official's office.” Will v. Michigan Dept. of State Police, 491 

U.S. 58, 71 (citing Brandon v. Holt, 469 U.S. 464, 471 (1985)). “As such, it is no different 

from a suit against the State itself.” Id. (citing Kentucky v. Graham, 473 U.S. 159, 165-66 

(1985); Monell v. Dep't of Soc. Servs. of City of N.Y., 436 U.S. 658, 690 n.55 (1978)). 

“The proponent of a claim to absolute immunity bears the burden of establishing the 

justification for such immunity.” Antoine v. Byers & Anderson, 508 U.S. 429, 432 (1993) 

(footnote omitted).

In Will, the Supreme Court recognized one vital exception to the general rule that 

states, state agencies, and state officials sued in their official capacities are not persons 

subject to civil rights suits under 42 U.S.C. § 1983. When sued for prospective injunctive 

relief, a state official in his official capacity is considered a “person” for § 1983 purposes. 

See Will, 491 U.S. at 71 n. 10 (“Of course a state official in his or her official capacity, 

when sued for injunctive relief, would be a person under § 1983 because ‘official-capacity

actions for prospective relief are not treated as actions against the State.’ ” This exception 

recognizes the doctrine of Ex Parte Young, 209 U.S. 123 (1908), that a suit for prospective 

injunctive relief provides a narrow, but well-established, exception to Eleventh 

Amendment immunity. See Rounds v. Or. State Bd. of Higher Educ., 166 F.3d 1032, 1036 

(9th Cir.1999) (“Ex Parte Young provided a narrow exception to Eleventh Amendment 

immunity for certain suits seeking declaratory and injunctive relief against unconstitutional 

actions taken by state officers in their official capacities.”); Flint v. Dennison, 488 F.3d 

816, 825 (9th Cir. 2007); Doe v. Lawrence Livermore Nat'l Lab., 131 F.3d 836, 840 (9th 

Cir. 1997).

Here, Plaintiff sues Defendant in her individual and official capacities, and seeks 

monetary damages and injunctive relief. (Doc. 1 at 9.) Defendant has justified immunity to 

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monetary damages in her motion to dismiss by citing the Eleventh Amendment. (Doc. 6-1 

at 16.) Under the Eleventh Amendment, Defendant is immune from suit in her official

capacity for money damages. However, Defendant is not immune from being sued for 

injunctive relief.

Accordingly, Defendant’s Motion to Dismiss the official capacity claims seeking 

monetary relief should be GRANTED.

4. State Tort Negligence 

Plaintiff sues Defendant under a state law claim of negligence. (Doc. 1 at 7.)

Defendant argues the negligence claim is subject to dismissal because Plaintiff failed to 

allege compliance with the California Tort Claims Act. (Doc. 6-1 at 16–17.)

Failure to comply with claim-filing requirements imposed by the California Torts 

Claims Act bars pendent state claims. Karim-Panahi v. Los Angeles Police Dept., 839 F.2d 

621, 627 (9th Cir. 1988). When a personal injury claim against the State is presented to the 

Claims Board, the claimant is required to pay a filing fee of $25. Cal. Gov’t Code § 905.2(c)

(West 2016). A claimant who requests a waiver of the filing fee shall attach to the 

application (1) a signed affidavit requesting the waiver and (2) verification of benefits or 

income and any other required financial information in support of the requests for the 

waiver. Cal. Gov’t Code § 905.2(c)(2) (West 2016). For inmates, the required financial 

information is a certified copy of their trust account balance that has a balance of $100 or 

less. Cal. Gov’t Code § 905.2(c)(1)(C) (West 2016).

Here, Defendant has submitted certified records from the Claims Board showing

Plaintiff did not submit a certified copy of his trust account balance. (Doc. 6-2 at 3–25.)

Plaintiff asserts he attached a certified copy of his trust account. (Doc. 8 at 3.) However, a 

review of his files does not reveal a copy of the document. (Id.) Therefore, Plaintiff 

concedes he is unable to show he attached a certified copy of his trust account and agrees 

his negligence claim can be dismissed. (Id.) 

Therefore, Defendant’s Motion to Dismiss based on state tort negligence should be 

GRANTED.

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B. Failure to Exhaust Administrative Remedies 

Plaintiff claims he exhausted all administrative remedies before filing his Complaint.

(Doc. 1 at 4–5.) Defendant argues Plaintiff’s failure to exhaust is clear on the face of the 

Complaint regarding the September 26, 2016 refusal of Plaintiff’s request for surgery.

(Doc. 6-1 at 13.) Defendant argues that Plaintiff filed his suit eleven days after this refusal, 

making it impossible to have exhausted his administrative remedies. (Id.)

A prisoner must exhaust all administrative remedies before filing a suit under the 

Prison Litigation Reform Act (“PLRA”). 42 U.S.C. § 1997e(a); Porter v. Nussle, 534 U.S. 

516, 524 (2002); Lira v. Herrera, 427 F.3d 1164, 1169 (9th Cir. 2005). In a non-enumerated 

Rule 12(b) motion to dismiss for failure to exhaust administrative remedies, defendants 

“have the burden of raising and proving exhaustion.” Wyatt v. Terhune, 315 F.3d 1108, 

1119 (9th Cir. 2003). The defendant, and not the plaintiff, bears the burden of proving the

plaintiff had available administrative remedies that he or she did not utilize. Id. To show 

failure to exhaust, defendants may go outside the pleadings and submit supporting

affidavits or declarations. Id. The plaintiff, however, must be provided an opportunity to 

develop a record to refute defendants’ prima facie showing of non-exhaustion. Id. at 1120 

n.14.

In a nonenumerated Rule 12(b) motion to dismiss, the court may look at both 

parties’ submissions outside the pleadings to resolve factual issues regarding exhaustion. 

Id. The PLRA requires that a plaintiff exhaust only “available” administrative remedies. 

42 U.S.C. § 1997(e)(a). For example, if an inmate’s appeal is granted at a lower level, the 

inmate need not appeal to the next level because there is nothing left to exhaust. See Brady 

v. Attygala, 196 F.Supp.2d 1016, 1022-23 (C.D. Cal. 2002) (finding further exhaustion not 

required where appeal was granted at the second level); Gomez v. Winslow, 177 F.Supp.2d 

977, 985 (N.D. Cal. 2001) (allowing an inmate to file suit where he had “won” his inmate 

appeal by receiving a “partial grant” at the second level). 

Further, refusing to give an inmate grievance forms could raise the inference the 

prisoner “exhausted” his administrative remedies. See Mitchell v. Horn, 318 F.3d 523, 529 

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(3rd Cir. 2003) (reversing a district court’s dismissal of a section 1983 case because it did 

not consider Plaintiff’s allegation that prison officials refused to provide him with the 

grievance forms); Miller v. Norris, 247 F.3d 736, 740 (8th Cir. 2001) (concluding that any 

remedy prison officials prevent a prisoner from utilizing is not an “available” remedy as 

section 1997(e)(a) defines that term).

“Any inmate . . . may appeal any departmental decision, action, condition, or policy 

perceived by those individuals as adversely affecting their welfare.” Cal. Code Regs. tit. 

15 § 3084.1(a) (2016). An inmate must complete the following steps to exhaust at the 

administrative level: (1) attempt to informally resolve the problem with the staff member 

involved, id. at § 3084.5(a); (2) submit a grievance on the CDCR inmate 602 form, id. at § 

3084.5(b); (3) appeal to the institution head or his/her designee for a second level of review, 

id. at § 3084.5(c); and (4) appeal to the Director of CDCR or his/her designee for a third 

and final level of review. Cal. Dept. of Corr. Operations Manual § 54100.11; Nichols v.

Logan, 355 F.Supp. 2d 1155, 1161 (S.D.Cal. 2004). 

Prisoners must submit their appeal within fifteen working days of the event or lower 

decision being appealed. Cal. Code Regs. tit. 15 § 3084.6(c) (2016). To properly exhaust, 

a prisoner must complete the administrative review process according to the applicable 

rules, including meeting deadlines and complying with other critical procedural rules.

Woodford v. Ngo, 548 U.S. 81, 90 (2006). If a prisoner concedes that he or she did not 

exhaust, that concession is a valid ground for dismissal so long as no exception to 

exhaustion applies. Wyatt, 315 F.3d at 1120.

Here, based on the facts outlined in his Complaint, Plaintiff has not exhausted all 

administrative remedies regarding, at least, the September 26, 2016 incident. Plaintiff 

alleges he submitted two administrative appeals, filed on October 16, and November 23, 

2015. (Doc. 1 at 4–5.) Plaintiff did not include copies of any of his appeals as attachments 

to his Complaint. As such, it is impossible to know which of his allegations included in the 

Complaint have been brought to the attention of prison officials or addressed through the 

three administrative levels. According to the complaint, Plaintiff states that the last incident 

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for which he sues happened on September 26, 2016 and then filed this lawsuit less than a 

month later. Plaintiff does not indicate if he filed a second or third-level appeal for the 

September 26 event. Further, as Defendant argues, it is likely impossible that Plaintiff 

could have gone through all of the required levels of administrative remedies required as a 

threshold for a § 1983 case in such a limited amount of time. Plaintiff has also not argued 

that he has access to any of the available exceptions for exhausting his administrative 

remedies. Plaintiff may be able to establish exhaustion should he amend his Complaint to 

address its deficiencies, however it is clear on the face of the Complaint as it currently 

stands that Plaintiff has not exhausted all of his administrative remedies.

Thus, this Court recommends the motion to dismiss for failure to exhaust should be

GRANTED.

V. CONCLUSION

For the foregoing reasons, the Court RECOMMENDS the District Court issue an 

order: (1) approving and adopting this Report and Recommendation, (2) granting 

Defendant’s motion to dismiss.

IT IS ORDERED that no later than August 23, 2017, 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 be filed with the 

Court and served on all parties no later than September 6, 2017. 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. See Turner v. Duncan, 158 F.3d 449, 455 (9th 

Cir. 1998); Martinez v. Ylst, 951 F.2d 1153, 1156 (9th Cir. 1991).

Dated: August 9, 2017

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