Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_09-cv-00892/USCOURTS-casd-3_09-cv-00892-9/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

FLOYD MOODY, 

CDCR #G-26035,

Plaintiff,

CASE NO. 09CV0892-LAB (JMA)

ORDER ADOPTING REPORTS

AND RECOMMENDATIONS;

AND ORDER GRANTING

DEFENDANTS’ MOTIONS FOR

SUMMARY JUDGMENT

[Docket numbers 88, 103, 105,

138, 140, 141, and 142.]

vs.

PAULETTE FINANDER, et al.

Defendants.

Plaintiff, a prisoner in state custody, brought this action under 42 U.S.C. § 1983

against prison medical personnel for violation of his Eighth Amendment rights. Specifically,

he argued they were deliberately indifferent to his serious medical needs. This matter was

referred first to Magistrate Judge Jan Adler, and later to Magistrate Judge Bernard Skomal

for report and recommendation (“R&R”). 

Defendant Dr. Richard Butcher filed a motion for summary judgment (Docket no. 88),

as did Defendants Drs. Finander and Ball (Docket no. 105). Defendant Dr. Reddy moved

to dismiss under Fed. R. Civ. P. 12(b)(5) (for improper service) and (6) (for failure to state

a claim) (Docket no. 103). Judge Adler issued his three reports and recommendations (the

“R&Rs”) (Docket nos. 140 through 142), recommending granting both motions for summary

judgment, granting Dr. Reddy’s motion to quash service, and denying as moot Dr. Reddy’s

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motion to dismiss for failure to state a claim. The R&Rs set deadlines for objections.

Plaintiff Moody has objected to the two R&Rs that recommend granting the motions for

summary judgment, but has not objected to the R&R that recommends quashing service on

Dr. Reddy.

On June 23, 2011, Moody also filed a motion (Docket no. 138) objecting to various

tactics and actions by Defendants, especially Defendants’ counsel’s failure to send him a

proposed pretrial order for review. More generally, the motion objects that Defendants are

engaging in stalling tactics in this litigation.

While the motions were pending, Judge Skomal issued a warning pursuant to Klingele

v. Eikenberry, 849 F.2d 409 (9th Cir. 1988), and Rand v. Rowland, 154 F.3d 952 (9th Cir.

1998) (en banc). (Docket no. 139.) This warning cautioned Moody about the effect of a

summary judgment motion, and invited him to submit additional briefing or evidence. Moody

failed to do so within the time permitted and, in his objections to the R&Rs, acknowledged

he was not submitting supplemental documents. (Docket no. 143, ¶ 4.)

I. Moody’s Motion

To the extent Moody’s motion deals with matters concerning the pretrial conference,

it is premature. No pretrial conference is imminent, and no proposed pretrial order is due

yet. This request is therefore unripe. To the extent Moody is objecting to Defendants’ tactics

as inappropriate, this is mainly an argument about the merits of his claims. Because the

merits are being ruled on, this request is moot. 

II. Legal Standards

A district court has jurisdiction to review a Magistrate Judge's report and

recommendation on dispositive matters. Fed. R. Civ. P. 72(b). "The district judge must

determine de novo any part of the magistrate judge's disposition that has been properly

objected to." Id. "A judge of the court may accept, reject, or modify, in whole or in part, the

findings or recommendations made by the magistrate judge." 28 U.S.C. § 636(b)(1). The

Court reviews de novo those portions of the R&R to which specific written objection is made.

United States v. Reyna-Tapia, 328 F.3d 1114, 1121 (9th Cir. 2003) (en banc). "The statute

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makes it clear that the district judge must review the magistrate judge's findings and

recommendations de novo if objection is made, but not otherwise." Id. When no objections

are filed, the Court need not review de novo the Report and Recommendation. Wang v.

Masaitis, 416 F.3d 992, 1000 n.13 (9th Cir. 2005). Objections that would not alter the

outcome are moot, and can be overruled on that basis. See, e.g., Ammons v. Walker, 2011

WL 844965, slip op. at *2 (C.D.Cal., March 3, 2011) (overruling as moot objections that,

even if sustained, would not alter the outcome)).

“In deciding a motion to dismiss for a failure to exhaust nonjudicial remedies, the court

may look beyond the pleadings and decide disputed issues of fact.” Wyatt v. Terhune, 315

F.3d 1108, 1120 (9th Cir. 2003). In ruling on a motion to dismiss for failure to state a claim,

however, the Court accepts factual allegations as true and construes the pleadings in the

light most favorable to the nonmoving party. Outdoor Media Group, Inc. v. City of Beaumont,

506 F.3d 895, 900 (9th Cir. 2007).

Prison conditions involving “the wanton and unnecessary infliction of pain” constitute

cruel and unusual punishment in violation of the Eighth Amendment. Rhodes v. Chapman,

452 U.S. 337, 347 (1981). A prisoner's claim of inadequate medical care does not rise to the

level of an Eighth Amendment violation, however, unless (1) the prison official deprived the

prisoner of the “minimal civilized measure of life's necessities,“ and (2) the official “acted with

deliberate indifference in doing so.’“ Toguchi v. Chung, 391 F.3d 1051, 1057 (9th Cir.2004)

(citations omitted). “[T]he indifference to his medical needs must be substantial. Mere

‘indifference,’ ‘negligence,’ or ‘medical malpractice’ will not support this cause of action.”

Broughton v. Cutter Laboratories, 622 F.2d 458, 460 (9th Cir. 1980) (citing Estelle v.

Gamble, 429 U.S. 97, 105–06 (1976)). “[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.” Estelle, 429 U.S. at 106; see

also Anderson v. County of Kern, 45 F.3d 1310, 1316 (9th Cir. 1995).

/ / /

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A prison official does not act in a deliberately indifferent manner unless the official

“knows of and disregards an excessive risk to inmate health or safety.” Farmer v. Brennan,

511 U.S. 825, 834 (1994). Deliberate indifference may be manifested “when prison officials

deny, delay or intentionally interfere with medical treatment,” or in the manner “in which

prison physicians provide medical care.” McGuckin v. Smith, 974 F.2d 1050, 1059 (9th

Cir.1992), overruled on other grounds by WMX Techs., Inc. v. Miller, 104 F.3d 1133, 1136

(9th Cir. 1997) (en banc). To succeed on a § 1983 “deliberate indifference” claim, a plaintiff

must show, among other things, that a defendant's deliberate indifference caused harm. Jett

v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) (citing McGuckin at 1060).

III. Discussion

A. Dr. Reddy’s Motion to Dismiss

On January 4, 2011, the Court denied Moody’s motion for default judgement against

Dr. Reddy, finding Dr. Reddy had not been properly served. Two days later, Dr. Reddy

moved to dismiss for lack of personal jurisdiction, and also for failure to state a claim. On

August 26, Judge Skomal issued his R&R (Docket no. 142), recommending that service on

Dr. Reddy be quashed, that Moody be given additional time in which to serve Dr. Reddy, and

that Dr. Reddy’s motion to dismiss for failure to state a claim be denied as moot. Neither

party has objected to this R&R, which the Court therefore ADOPTS.

B. Motions for Summary Judgment by Drs. Butcher, Ball, and Finander

Dr. Butcher filed a motion to dismiss, and Drs. Ball and Finander jointly filed another

motion to dismiss. Judge Skomal’s R&Rs (Docket nos. 140 and 141) recommend granting

these motions.

Moody suffers from numerous significant health problems, including serious liver

problems. The R&Rs set forth the details of the lengthy treatment of Moody’s liver problems.

Without repeating all of the details, the salient points are that Moody suffers from hepatitis

C and cirrhosis of the liver, and a variety of painful symptoms. He also had a lesion on the

right lobe of his liver. Initially, it was unclear whether this was benign, a malignant tumor, or

fatty infiltration. After a good deal of evaluation, testing, and consultation it became clear the

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lesion was not cancerous. It is undisputed that Moody does not have liver cancer, and never

did. Moody even takes pains to distance himself from any suggestion that he ever said he

had liver cancer. (See, e.g., Obj. to R&R (Docket no. 143), ¶ 6 (“Not once on ‘any document’

has or can the Defend[a]nts show Plaintiff has at any time ‘thought’ or said ‘I have cancer.’

Those are statements of Defendants.”)) Moody does repeatedly dangle the possibility of

cancer before the Court, but only for the purpose of arguing that the doctors had no basis

for delaying cancer screening; he never says he had it, only that it was possible he had it and

that testing for it was “very urgent.” (Obj. to R&R (Docket no. 144), at 8.)

Moody’s essential medical claim is that, when some doctors suspected he had, or

might have, liver cancer, he should have been properly biopsied and screened for cancer,

but wasn’t. He also argues that the doctors should have treated his other liver problems

(hepatitis C and cirrhosis). He also emphasizes the pain he was in, and the terrible

symptoms of his liver problems. 

In his opposition to Dr. Butcher’s motion for summary judgment, Moody also identified

gastro-intestinal problems he says Dr. Butcher failed to treat. He says this caused the liver

lesion to get worse. But there is no evidence to support this. He also accuses Dr. Butcher

of forging documents and falsely denying the existence of liver masses. He faults Dr.

Finander for failing to intervene to stop his transfer to another institution, but admitted he had

not filed a grievance about this.

Moody’s objections to these two R&R’s (Docket nos. 143 and 144) overlap a good

deal. A good deal of his objections deal with legal standards about which there is no

dispute, with Moody’s belief about what the Court’s rulings on earlier motions have been,

with bare assertions that the doctors were deliberately indifferent, and with generalized

complaints that the R&R overlooks or misquotes the record. He also repeatedly emphasizes

that his case is strong, that any jury would find in his favor, and that summary judgment

ought not to be granted. Moody also raises numerous factual objections that make no

difference to the outcome of his dispute, such as the date of his incarceration, (see Docket

no. 144 at 6), and that his cirrhosis was not caused by alcohol use. (See id. at 9, 12.) To

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the extent any of those objections are relevant, they are not “specific” as required under

Reyna-Tapia, 328 F.3d at 1121. See also Palmisano v. Yates, 2007 WL 2505565, slip op.

at *2 (S.D.Cal., Aug. 31, 2007) (citing authority holding that generalized objections to a

magistrate judge’s R&R do not invoke de novo review of the entire R&R). September 20,

2011

Moody’s actual objections are contained mostly in his first set of Objections (Docket

no. 143, objecting to Docket no. 140, the R&R on Dr. Butcher’s motion), at pages 3–4, 6,

8–9, and 10; and in his second set of Objections (Docket no. 144, objecting to Docket no.

141, the R&R on Drs. Ball and Finander’s motion), at pages 2 (¶¶ 4, 6), 3 (¶¶ 7, 9, 10), and

4–14. The last section is primarily an overview of the evidence from Moody’s point of view,

and his expressed dissatisfaction with the medical treatment. 

Both R&Rs contain factual findings based on the record. While he believes the R&Rs

reached the wrong conclusion and objects to their reasoning, he does not generally disagree

with their recital of facts. The Court therefore adopts the unobjected-to factual findings; the

few potentially material facts he does object to are discussed below. 

Moody has objected to the R&R’s acceptance of medical records as evidence. He

argues these records are inherently unreliable, because Defendants can say “anything they

want” in their reports. For this principle, he cites Bracey v. Herringa, 466 F.2d 702 (7th Cir.

1972). Bracey, however, deals with reports where a party had motives to misrepresent the

facts. See Wheeler v. Sims, 951 F.2d 796, 802 (7th Cir. 1992) (distinguishing Bracey

because the records at issue there contained self-serving statements, whereas the ones at

issue in Wheeler were ordinary records made in the ordinary course of prison business).

Medical records made by doctors and other medical personnel either at the prison or at

outside medical institutions during the course of treatment cannot be said to fall within the

reasoning of Bracey. These records are admissible under Fed. R. Evid. 803(6). See United

States v. Hall, 419 F.3d 980, 987 (9th Cir. 2005).

/ / /

/ / /

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1. Deliberate Indifference

Moody’s objections repeatedly assert deliberate indifference and mention a medical

report on September 19, 2008. That report concerned a CT scan, and recommended a

biopsy of both the right and left sides of his liver, the former being mentioned as likely

malignant and therefore urgent. (Docket no. 141 at 3:16–26.) The left side was successfully

biopsied, but the right could not be. (Id. at 4:6–16.) The follow-up report urgently

recommended the right liver biopsy be again attempted, id. at 4:9–13, but in spite of the

recommendation, this never took place.

Defendants have presented evidence they did not intentionally ignore the urgent

recommendation. Dr. Finander, the chief medical officer at Lancaster State Prison, where

Moody was initially held, submitted evidence she mistakenly believed the follow-up biopsy

had been ordered, and that failure to order it was an oversight. (See Docket no. 141 at

16:7–22.) Moody, for his part, believed she did not read the reports carefully enough and

failed to notice that the right liver biopsy had not been completed. (Id. at 16:I5–19.) 

In early December, 2008, Moody was transferred to Calipatria State Prison. Dr. Ball,

the chief medical officer at Calipatria, presented evidence that he responded to Moody’s

concerns promptly by directing another doctor to review records concerning the biopsy, and

by transferring Moody to Alvarado Hospital for testing to rule out cancer. (Id. at 23:18–24:3.)

Dr. Butcher first encountered Moody at Alvarado Hospital in January, 2009, after which he

consulted with a gastrointestinal specialist, ordered a triple-phase CT scan, and discovered

no evidence of cancer. (Docket no. 140 at 11:6–14, 11:19–12:22.) This uncontroverted

evidence shows a liver cancer screening has taken place, and that liver cancer has been

ruled out. After that, no biopsy of the right side of the liver was performed. (Id. at 12:22–27.)

Dr. Butcher’s conclusion that Moody did not have liver cancer was confirmed by a second

doctor. (Id. at 12:11–22.) 

Moody has presented no evidence to support his allegations that Dr. Butcher forged

documents, deliberately ignored test results or intentionally misinterpreted tests. Nor has

he pointed to any evidence that any of the three intentionally ignored evidence he might

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have liver cancer, or intentionally delayed cancer screening. In particular, it is clear Drs. Ball

and Butcher acted quickly and appropriately to rule out cancer. As for Dr. Finander, both

sides agree anything she did wrong was a mistake, not deliberate.

2. Objection: May 21, 2009 CT-scan Report Showed Delay Caused

Harm

Moody attempts to overcome the R&R’s finding that no harm resulted from a delay

in screening him for liver cancer by citing to a May 21, 2009 CT-scan report from Mercy

Hospital, which he says shows that the delay was harmful. (Docket no. 143, ¶ 2; see also

id. at 10 (alleging harm).) This report by Arthur Fontaine, with Moody’s own annotations, is

Docket no. 119-16, Ex. K at 8. This report notes his general condition, including a lesion on

his liver, with the remarks that the lesion “appears larger” and also “[t]his is not a benign

hemangioma.” Moody appears to be seizing on these observations as a way of showing

harm. (See Docket no. 144 at 10–11 (alleging harm because the mass was “larger” and “not

benign”)). But the report doesn’t show that failure to screen for liver cancer earlier caused

the lesion to get larger, or delayed appropriate treatment. And the observation that it was

“not a benign hemangioma” does not indicate it was malignant. Furthermore, the report

doesn’t say cancer screening would have alleviated Moody’s suffering, or that it should have

been performed earlier, or even that it was necessary as of May, 2009. Instead, its sole

recommendation is “Fine needle aspiration biopsy may be of use for this patient.” Nothing

in this document suggests a delay in testing Moody for liver cancer caused him any harm.

Moody’s theory, essentially, is that his symptoms, which appear to be severe, were

somehow caused by a failure to test him for liver cancer. (See, e.g., Docket no. 144 at 10

(“The delay was harmful . . . since it is accompanied with daily severe, chronic pain and

swelling seen with the eye, such pain the Plaintiff cannot some days ambulate . . . . “)) But

there is no evidence any delay in testing Moody for liver cancer caused his other symptoms.

Even assuming, arguendo, that the doctors were deliberately withholding liver cancer

screening, there is no evidence of any harm this caused. Moody doesn’t have liver cancer,

and never did. This is not a case where a doctor acting out of deliberate indifference didn’t

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treat a prisoner’s cancer, or where a doctor acting out of deliberate indifference treated a 

prisoner for cancer the prisoner didn’t have. Instead, it’s a case of accidentally delaying

screening a prisoner for a malady it turns out he didn’t have anyway.

3. Objection: Delay in Screening for Liver Cancer Caused Emotional

Harm

Moody also attempted to pursue an emotional harm theory, i.e., that by delaying his

liver cancer screening, Defendants left him fearfully wondering whether he had cancer, and

caused emotional injury. But as the R&R points out, the Prison Litigation Reform Act

prevents recovery for emotional injury in the absence of physical injury. See 42 U.S.C.

§ 1997e(e). Because Moody can’t show any physical injury as a result of the delay, he can’t

recover for any emotional harm.

4. Objection: Failure to Treat Other Liver Maladies

Moody does have other problems (which are apparently the source of his symptoms),

but Defendants were treating those to extent they could. Defendants presented evidence

there is no treatment that will reverse cirrhosis of the liver; instead, sufferers must avoid

further harming the liver Moody has no evidence of his own, and admitted he doesn’t know

how cirrhosis is treated. (Docket no. 141, 22:2–15.) 

Defendants offered evidence hepatitis C can be treated with Interferon and Ribivarin,

that treatment takes approximately 48 weeks, and that it has approximately a 25% to 35%

cure rate. (Id. at 22:19–22.) The drugs used to treat hepatitis C are known to have

troublesome side effects, including acute depression and a danger of suicide. (Id. at

20:25–28.) Defendants also offered evidence that Moody’s other health problems, including

hypertension, cardiac problems, diabetes, and blood in the stool need to be addressed

before treatment could begin. (Id. at 21:1–2, 7–16.) A psychiatrist who is not a Defendant

in this case attempted an evaluation of Moody to clear him for treatment of hepatitis C, but

found him uncooperative and recommended that the interview be rescheduled in one month.

(Id. at 21:4–7.) Before the month was over, however, Moody had been transferred.

Following the transfer, another doctor who is not a Defendant in this case found his other

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medical problems absolutely contraindicated treatment. (Id. at 21:9–16.) Moody has

submitted no evidence contradicting any of this. His assertions and allegations, standing

alone, do not constitute evidence. Because the motions under consideration are for

summary judgment, Moody “can no longer rest on such mere allegations, but must set forth

by affidavit or other evidence specific facts” to resist the motion. Lujan v. Defenders of

Wildlife, 504 U.S. 555, 561 (1992).

Moreover, the record is replete with evidence showing Defendants were going to great

lengths to attempt to diagnose and treat Moody’s liver problems. Even if he could show they

were negligent, he cannot show they were deliberately indifferent. The fact that Moody

disagrees with the treatment does not create a triable issue of fact. Jackson v. McIntosh,

90 F.3d 330, 332 (9th Cir. 1996) (difference of opinion between prisoner and his doctors

does not constitute deliberate indifference).

In short, Moody’s pain and other liver symptoms appear to be caused by diseases

Defendants were attempting to treat. They were not caused by liver cancer. Therefore,

even assuming Defendants were deliberately indifferent by failing to screen Moody for liver

cancer earlier, that deliberate indifference didn’t cause any harm. 

5. Court’s Earlier Ruling

Moody cites to an earlier ruling the Court made in this case. In Docket no. 143 at 8,

he cites the Court’s order of April 20, 2010 (Docket no. 38) denying in part and granting in

part Defendants’ motions to dismiss:

Here, Plaintiff claims Defendants Finander, Ball and Butcher all knew about,

but deliberately ignored a 10-page report issued after Plaintiff’s September

19, 2008 biopsy which “urgently” recommended his right liver mass be tested

because it was “most likely hepatoma or hepatocellular carcinoma.” Assuming

this true, the Court finds both that Plaintiff has sufficiently alleged a violation

of the Eighth Amendment and that it would be clear to any reasonable

medical official in Defendant Finander and Ball’s position that to deny Plaintiff

a right-liver mass biopsy under the circumstances would violate clearly

established law.

(Id. at 15:7–15) (citations omitted).

Moody argues that because the R&R departed from this standard, it was in error. The

cited ruling, however, occurred within the qualified immunity analysis, and dealt with whether

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officials in Drs. Finander, Ball, and Butcher’s positions could reasonably believe they were

acting within the law, if they avoided screening Moody for liver cancer under those

circumstances. 

In other words, this is not a complete statement of the standard for recovering on an

Eighth Amendment “deliberate indifference” claim. Among other things, it is missing the

necessary element of causation. The earlier ruling should not be understood as purporting

to overrule Jett, 439 F.3d 1091, 1096 (9th Cir. 2006), which requires a showing that the

deliberate indifference caused harm.

6. Claim Arising From Transfer

Moody does not object to the R&R’s finding that he never exhausted his

administrative remedies concerning Dr. Finander’s failure to intervene to prevent his transfer.

(Docket no. 141 at 18:21–19:15). While he repeatedly points out he is still suffering, he has

not objected that the transfer caused his suffering or made it worse, or that he received

worse health care as a result of the transfer. He also does not point to any evidence he

suffered any harm because of the transfer. As the R&R explains, even if he could show

harm, this claim would be barred because of Moody’s failure to exhaust.

IV. Conclusion and Order

For the reasons set forth above, Moody’s motion concerning pretrial matters (Docket

no. 138) is DENIED. Moody’s objections to the R&Rs (Docket nos. 140 and 142)

recommending that the motions by Drs. Finander, Ball, and Butcher for summary judgment

(Docket nos. 88 and 105) be granted are OVERRULED, and the two motions are

GRANTED. All claims against Drs. Finander, Ball, and Butcher are DISMISSED WITH

PREJUDICE.

Dr. Reddy’s motion to dismiss conspiracy claims pursuant to Fed. R. Civ. P. 12(b)(6)

is DENIED AS MOOT. Dr. Reddy’s motion to dismiss pursuant to Fed. R. Civ. P. 12(b)(5)

is DENIED, but service on Dr. Reddy is QUASHED. Moody is GRANTED an extension of

time under Fed. R. Civ. P. 4(m) to effectuate service on Dr. Reddy. 

/ / /

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The U.S. Marshal shall re-attempt service of the First Amended Complaint and

summons upon Defendant Reddy within 30 days of the date this order is issued.

IT IS SO ORDERED.

DATED: September 23, 2011

HONORABLE LARRY ALAN BURNS

United States District Judge

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