Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_13-cv-00416/USCOURTS-caed-2_13-cv-00416-8/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

FOR THE EASTERN DISTRICT OF CALIFORNIA

NOEL KEITH WATKINS,

Plaintiff,

v.

VAMIL SINGH, et al.,

Defendants.

No. 2:13-cv-0416 KJM CKD P

FINDINGS AND RECOMMENDATIONS

Plaintiff is a California prisoner proceeding pro se with an action for violation of civil 

rights under 42 U.S.C. § 1983. His remaining claims arise under the Eighth Amendment against 

defendants Dr. Bick and Dr. Dhillon1and concern medical treatment. Defendants Bick and 

Dhillon have filed a motion for summary judgment. 

I. Plaintiff’s Claims

In his complaint, which is signed under the penalty of perjury, plaintiff asserts that 

between January and April, 2005 he suffered from intermittent symptoms including severe chest 

pain and difficulty breathing which he believes resulted from heart problems. On April 25, 2005, 

plaintiff suffered from chest pain and was taken by gurney to the emergency room at the 

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1

 In his complaint, plaintiff refers to this defendant as Dr. Dillon. This defendant answered 

plaintiff’s complaint as Dr. Balraj Dhillon. ECF No. 19.

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California Medical Facility (CMF). When he arrived at the emergency room, he was given 

nitroglycerin and placed on oxygen.

After plaintiff stabilized, plaintiff was approached by a Dr. Francis who asked plaintiff 

about his condition. After plaintiff explained his condition to Dr. Francis, Dr. Francis indicated to 

plaintiff that she would like to have plaintiff sent to an outside hospital for an angiogram. Dr. 

Francis asked plaintiff if he would consent to the outside visit and plaintiff indicated that he 

would.

Minutes before Dr. Francis approached plaintiff, plaintiff heard Francis argue with 

defendant Dr. Dhillon as to why he would not have plaintiff sent to an outside hospital for an 

angiogram. Defendant Dhillon stated to Francis that it was not necessary. As they argued, 

defendant Dhillon called cardiologist Dr. Dassah. After Dhillon hung up, Dhillon told Francis 

that Dr. Dassah stated it was not necessary to send plaintiff to an outside hospital. At that point, 

Dr. Francis told Dr. Dhillon that it was her opinion that plaintiff should be sent to an outside 

facility and that his normal electrocardiogram results should not dictate whether an outside visit 

should occur. As plaintiff’s treating physician, it was up to defendant Dr. Dhillon whether to 

send plaintiff to an outside facility for an angiogram and he elected not to.

Also on April 25, 2005, defendant Dr. Bick, the Chief Medical Officer at CMF, looked 

over plaintiff and was aware of his situation as plaintiff had made requests to Bick that he be sent 

to an outside hospital for an angiogram or heart scan. Dr. Bick denied plaintiff’s request. 

Plaintiff was seen by cardiologist Dr. Dassah on April 27, 2005 and was given a treadmill 

test.

On June 22, 2010, plaintiff received the results of an ultrasound of his heart. The heart 

specialist indicated to plaintiff that he has mild mitral regurgitation of the small heart valve; a 

leaky heart valve. Plaintiff asserts that had he received better treatment through the years, he 

would not have this condition. 

II. Summary Judgment Standard

Summary judgment is appropriate when it is demonstrated that there “is no genuine 

dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. 

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Civ. P. 56(a). A party asserting that a fact cannot be disputed must support the assertion by 

“citing to particular parts of materials in the record, including depositions, documents, 

electronically stored information, affidavits or declarations, stipulations (including those made for 

purposes of the motion only), admissions, interrogatory answers, or other materials. . .” Fed. R. 

Civ. P. 56(c)(1)(A). 

Summary judgment should be entered, after adequate time for discovery and upon motion, 

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. See

Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986). “[A] complete failure of proof concerning an 

essential element of the nonmoving party’s case necessarily renders all other facts immaterial.” 

Id. 

If the moving party meets its initial responsibility, the burden then shifts to the opposing 

party to establish that a genuine issue as to any material fact actually does exist. See Matsushita 

Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986). In attempting to establish the 

existence of this factual dispute, the opposing party may not rely upon the allegations or denials 

of their pleadings but is required to tender evidence of specific facts in the form of affidavits, 

and/or admissible discovery material, in support of its contention that the dispute exists or show 

that the materials cited by the movant do not establish the absence of a genuine dispute. See Fed. 

R. Civ. P. 56(c); Matsushita, 475 U.S. at 586 n.11. The opposing party must demonstrate that the 

fact in contention is material, i.e., a fact that might affect the outcome of the suit under the 

governing law, see Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986); T.W. Elec. Serv., 

Inc. v. Pacific Elec. Contractors Ass’n, 809 F.2d 626, 630 (9th Cir. 1987), and that the dispute is 

genuine, i.e., the evidence is such that a reasonable jury could return a verdict for the nonmoving 

party, see Wool v. Tandem Computers, Inc., 818 F.2d 1433, 1436 (9th Cir. 1987).

In the endeavor to establish the existence of a factual dispute, the opposing party need not 

establish a material issue of fact conclusively in its favor. It is sufficient that “the claimed factual 

dispute be shown to require a jury or judge to resolve the parties’ differing versions of the truth at 

trial.” T.W. Elec. Serv., 809 F.2d at 631. Thus, the “purpose of summary judgment is to ‘pierce 

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the pleadings and to assess the proof in order to see whether there is a genuine need for trial.’” 

Matsushita, 475 U.S. at 587 (quoting Fed. R. Civ. P. 56(e) advisory committee’s note on 1963 

amendments).

In resolving the summary judgment motion, the evidence of the opposing party is to be 

believed. See Anderson, 477 U.S. at 255. All reasonable inferences that may be drawn from the 

facts placed before the court must be drawn in favor of the opposing party. See Matsushita, 475 

U.S. at 587. Nevertheless, inferences are not drawn out of the air, and it is the opposing party’s 

obligation to produce a factual predicate from which the inference may be drawn. See Richards 

v. Nielsen Freight Lines, 602 F. Supp. 1224, 1244-45 (E.D. Cal. 1985), aff’d, 810 F.2d 898, 902 

(9th Cir. 1987). Finally, to demonstrate a genuine issue, the opposing party “must do more than 

simply show that there is some metaphysical doubt as to the material facts . . . . Where the record 

taken as a whole could not lead a rational trier of fact to find for the nonmoving party, there is no 

‘genuine issue for trial.’” Matsushita, 475 U.S. at 587 (citation omitted).

III. Defendants’ Argument And Analysis

The Eighth Amendment’s prohibition of cruel and unusual punishment extends to 

medical care of prison inmates. Estelle v. Gamble, 429 U.S. 97, 104-05 (1976). In order to 

overcome a motion for summary judgment with respect to a § 1983 claim for violation of the 

Eighth Amendment based on inadequate medical care, a prison inmate must point to “acts or 

omissions sufficiently harmful to evidence deliberate indifference to serious medical needs.” See

id. at 106. The nature of a defendant’s responses must be such that the defendant purposefully 

ignores or fails to respond to a prisoner’s pain or possible medical need in order for “deliberate 

indifference” to be established. McGuckin v. Smith, 974 F.2d 1050, 1060 (9th Cir. 1992). A

showing of merely inadvertent or even negligent medical care is not enough to establish a 

constitutional violation. Estelle, 429 U.S. at 105-06; Frost v. Agnos, 152 F.3d 1124, 1130 (9th 

Cir. 1998). A difference of opinion about the proper course of treatment is not deliberate

indifference, nor does a dispute between a prisoner and prison officials over the necessity for or 

extent of medical treatment amount to a constitutional violation. See, e.g., Toguchi v. Chung, 

391 F.3d 1051, 1058 (9th Cir. 2004).

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Defendants Bick and Dhillon assert there is no evidence before the court tending to show 

they were deliberately indifferent to plaintiff’s serious medical needs on April 25, 2005. The 

court agrees. First, there is no admissible evidence that the failure by any physician at CMF to 

send plaintiff to a facility outside the prison for an angiogram or for other tests on or around April 

25, 2005 amounted to deliberate indifference to plaintiff’s condition,

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or that plaintiff suffered 

any actionable injury as a result. Second, at worst, the evidence before the court indicates that 

defendants Dhillon and Bick deferred to cardiologist Dr. Dassah with respect to questions 

concerning the health of plaintiff’s heart.3 It is generally not deliberate indifference to defer to a 

specialist. See Butler v. Jong Yeoung Moon, No. 1:09-cv-2074 MJS P, 2011 WL 4591072, at *5 

(E.D. Cal. Sept. 30, 2011). 

For these reasons, defendants Dr. Bick and Dr. Dhillon should be granted summary 

judgment and this case should be closed.

Accordingly, IT IS HEREBY RECCOMMENDED that:

1. Defendants’ July 11, 2014 motion for summary judgment (ECF No. 31) be granted; 

and

2. This case be closed.

These findings and recommendations are submitted to the United States District Judge 

assigned to the case, pursuant to the provisions of 28 U.S.C. § 636(b)(l). Within fourteen days 

after being served with these findings and recommendations, any party may file written 

objections with the court and serve a copy on all parties. Such a document should be captioned 

“Objections to Magistrate Judge’s Findings and Recommendations.” Any response to the 

 

2

 As indicated above, plaintiff reports in his complaint that Dr. Francis believed plaintiff should 

be sent to an outside facility for an angiogram. However, plaintiff’s statement in this respect 

constitutes inadmissible hearsay, see Fed. R. Evid. 801 et. seq. Furthermore, as indicated above, 

a mere difference of opinion is not deliberate indifference.

3

 In his affidavit, Dr. Bick indicates that he is essentially an administrator and not a heart 

specialist. He also indicates that if a patient presented potential heart problems to Dr. Bick, he 

would refer them to “an appropriate physician for care and treatment.” In fact, medical records 

show that on April 25, 2005, Dr. Bick approved a request by Dr. Dhillon that plaintiff be referred 

to cardiologist Dr. Dassah for tests and evaluation. ECF No. 31-4 at 21.

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objections shall be served and filed within fourteen days after service of the objections. The 

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

appeal the District Court’s order. Martinez v. Ylst, 951 F.2d 1153 (9th Cir. 1991). 

Dated: January 9, 2015

1

watk0416.57

_____________________________________

CAROLYN K. DELANEY

UNITED STATES MAGISTRATE JUDGE

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