Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_19-cv-01054/USCOURTS-caed-1_19-cv-01054-3/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

EASTERN DISTRICT OF CALIFORNIA

REBIO RONNIE TOWNSEND,

Plaintiff,

v.

HEMELA, et al.,

Defendants.

Case No. 1:19-cv-01054-NONE-BAM (PC)

ORDER ADOPTING FINDINGS AND 

RECOMMENDATIONS IN PART, 

DISMISSING CERTAIN CLAIMS, AND 

ALLOWING ONE CLAIM TO PROCEED

(ECF No. 10)

Plaintiff Rebio Ronnie Townsend (“Plaintiff”) is a civil detainee proceeding pro se and in 

forma pauperis in this civil rights action brought under 42 U.S.C. § 1983. (Doc. No. 1.) Plaintiff

is being detained pursuant to California’s Mentally Disordered Offender (MDO) law, California

Penal Code §§ 2970, et seq.1 Individuals detained under the MDO law are considered civil 

detainees, rather than prisoners within the meaning of the Prisoner Litigation Reform Act. Page 

v. Torrey, 201 F.3d 1136, 1140 (9th Cir. 2000). This matter was referred to a United States 

 

1 Under the MDO law, a state prisoner who is about to be released may be found to represent a 

substantial danger of physical harm to others, on account of a mental disease or defect, and on 

this basis committed to a state hospital for a term of one year. The determination of MDO status 

is made at a court proceeding where the person facing commitment is represented by counsel and, 

unless waived, is entitled to a jury trial. See Cal. Penal Code § 2972. Prior to the expiration of 

the one-year commitment, if it is deemed that remission either has not occurred or cannot be 

maintained without treatment, a further proceeding may be held to determine whether 

recommitment for another one year period is warranted. Id.

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Magistrate Judge pursuant to 28 U.S.C. § 636(b)(1)(B) and Local Rule 302.

On January 24, 2020, the assigned magistrate judge issued findings and recommendations 

recommending that this action be dismissed for failure to state a cognizable § 1983 claim. (Doc. 

No. 10.) Those findings and recommendations were served on plaintiff and contained notice that 

any objections thereto were to be filed within fourteen (14) days after service. (Id. at 5.) Plaintiff 

filed objections on February 10, 2020. (ECF No. 12.)

In accordance with the provisions of 28 U.S.C. § 636 (b)(1)(C), this court has conducted a 

de novo review of the case. Having carefully reviewed the entire file, the court adopts the 

magistrate judge’s findings and recommendations in part, but declines to do so in one respect, as 

explained below. 

In his complaint, plaintiff alleges that he is being forced to take psychiatric medication 

based upon a state court order and that these medications are causing side effects that plaintiff 

finds intolerable, including incontinence, vomiting, dizziness, constant abdominal pain and 

constipation, and excessive drowsiness. (Doc. No. 1 at 3.) Plaintiff further alleges that he has 

brought his concerns to the attention of the three medical professional defendants, but that no one 

will listen to him. (Id. at 4-5.) 

The pending findings and recommendations correctly conclude that to the extent plaintiff 

is challenging his designation under the MDO law2and/or the fact that he is being forcibly 

medicated, he fails to state a cognizable claim under § 1983 because the circumstances of 

plaintiff’s commitment indicate he has no expectation to be free from unwanted psychotropic 

medication. (Doc. No. 10 at 4.) 

However, a liberal reading of plaintiff’s complaint suggests that he is not only challenging 

the fact of his forced medication, but also the exact drugs and dosages of those drugs being 

administered to him, as well as the inattentiveness of defendants to the serious side effects he is 

suffering as a result of the forced medications. The Supreme Court has recognized that inmates 

 

2 The findings and recommendations incorrectly indicate that plaintiff is a civil detainee held 

pursuant to California’s Sexually Violent Predators Act (SVPA). Cal. Welf. & Inst. Code § 6600 

et seq. However, this distinction does not change the applicable legal standard or alter the 

analysis set forth in this order.

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possess a liberty interest in freedom from unwanted antipsychotic drugs requiring that “certain 

essential procedural protections” and “factual circumstances” be in place in any system seeking to 

forcibly administer such medications. Washington v. Harper, 494 U.S. 210, 221–22, 36 (1990). 

Detainees who are not confined due to a criminal conviction possess “at least” as much protection 

as convicted criminals. Riggins v. Nevada, 504 U.S. 127, 135 (1992). Courts have extended 

Riggins to civil detainees. See Jurasek v. Utah State Hosp., 158 F.3d 506, 511 (10th Cir. 1998); 

see also Miller v. Allenby, No. 1:15-CV-01207-MJS PC, 2015 WL 5255444, at *3 (E.D. Cal. 

Sept. 9, 2015) (permitting leave to amend to allege claims challenging forced psychotropic 

medication). Notably, as the Ninth Circuit has recognized, “[w]hile the therapeutic benefits of 

antipsychotic drugs are well documented, it is also true that the drugs can have serious, even fatal, 

side effects . . ..” United States v. Williams, 356 F.3d 1045, 1055 (9th Cir. 2004) (quoting 

Harper, 494 U.S at 229-30). As a result, an order compelling administration of antipsychotic 

drugs is “an unusually serious infringement of liberty that calls for . . . thorough consideration and 

justification.” Id. at 1056 (discussing compelled administration of antipsychotics in the context of 

supervised release). Courts have found that the statutory procedure set forth in California’s

Lanterman-Petris-Short Act (“LPS Act”), California Welfare & Institutions Code §§ 5000, et 

seq., under which a person qualified under California law as a “mentally disordered offender can 

be compelled to be treated with antipsychotic medication under certain circumstances, “clearly 

satisfies the minimum requirements of the Due Process Clause.” Simpson v. State Dep't of 

Mental Health, No. 1:11-CV-01559-RRB, 2013 WL 1811817, at *2 (E.D. Cal. Apr. 29, 2013). 

The LPS Act’s procedures, as interpreted by California’s courts, are implemented through 

hearings bearing the name of a seminal case on the subject: In re Qawi, 32 Cal. 4th 1, 27-28 

(2004). However, mere non-compliance with California’s procedures does not make out a

constitutional violation cognizable under § 1983. See Simpson, 2013 WL 1811817, at *2. 

Here, the question is whether plaintiff has plausibly alleged a separate constitutional 

violation. The Fourteenth Amendment provides the general standard for evaluating the 

constitutionally protected interests of individuals who have been involuntarily committed to a 

state facility. See Youngberg v. Romeo, 457 U.S. 307, 312 (1982). Such individuals are “entitled 

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to more considerate treatment and conditions of confinement than criminals whose conditions of 

confinement are designed to punish.” Id. In determining whether the constitutional rights of an 

involuntarily committed individual have been violated, the court must balance the individual’s 

liberty interests against the relevant state interests, with deference shown to the judgment 

exercised by qualified professionals. Id. at 320-22. A “decision, if made by a professional, is 

presumptively valid; liability may be imposed only when the decision by the professional is such 

a substantial departure from accepted professional judgment, practice, or standards as to 

demonstrate that the person responsible actually did not base the decision on such a judgment.” 

Id. at 322–23. The professional judgment standard is an objective standard and it equates “to that 

required in ordinary tort cases for a finding of conscious indifference amounting to gross 

negligence.” Ammons v. Wash. Dep’t of Soc. & Health Servs., 648 F.3d 1020, 1029 (9th Cir. 

2011) (citations and emphasis omitted).

The mere “existence of side-effects is not enough in itself to show that professional 

judgment was not exercised,” given the medical determination (implied by plaintiff’s own 

allegations related to the Qawi hearing) that the medication was appropriately administered to 

treat plaintiff’s condition. See Tilley v. Tracy, No. C 03-5701 PJH(PR), 2006 WL 822174, at *2 

(N.D. Cal. Mar. 28, 2006). But the extent and severity of the side effects plaintiff alleges here at 

least give rise to the inference that the specific dosages (or combination of dosages) being 

administered to him may not have been medically appropriate and, relatedly, may not have 

represented the exercise of professional judgment. That said, plaintiff acknowledges that one of 

the treating physician defendants did decrease the dosage of one of his medications in response to 

plaintiff’s complaints regarding side effects. (Doc. No. 1 at 4.) Plaintiff was then provided a 

Qawi hearing in the Fresno County Superior Court on September 17, 2019. (Id.) After that 

hearing, his treating physician reinstated the original dosage. (Id.) Plaintiff’s allegations related 

to the Qawi hearing suggest that the Fresno County Superior Court determined that the 

medications plaintiff was being given were appropriate given his condition. Obviously, if the 

dosages and side effects were discussed at the Qawi hearing or were otherwise considered and/or 

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addressed by medical professionals responsible for plaintiff’s care, that might be relevant or even 

possibly dispositive of plaintiff’s claims. 

Because this case is at the screening stage, however, which requires only that the claims 

asserted be “facially plausible,” the court concludes that plaintiff has adequately alleged a 

violation of the professional judgment standard set forth in Youngberg. If it is true, as plaintiff’s 

allegations suggests, that he described to the defendants the serious side effects of the medications

being administered to him and they ignored him, a finder of fact could conclude that this 

amounted to conscious indifference. It is, of course, quite possible that the record and other 

evidence will ultimately reveal that the complained of side effects were fully considered by the 

defendants but that professional judgment was exercised to continue to medicate plaintiff in the 

same manner in light of his condition. However, this determination cannot be made as a matter of 

law at the screening stage of the litigation. Accordingly, the court will allow plaintiffs to proceed 

on his claim that the manner by which his forced medication has been carried out violates the 

professional judgment standard set forth in Youngberg, most notably based on plaintiff’s 

allegation that all three defendant medical providers were made aware of and ignored his

complaints of the serious side effects of the medication being administered. Defendants will be 

required to answer to these allegations. 

Accordingly, IT IS HEREBY ORDERED that:

1. The findings and recommendations issued on January 24, 2020, (ECF No. 10), are 

adopted in part;

2. To the extent plaintiff is challenging his designation under the MDO law and/or 

the fact that he is being forcibly medicated, such claims are dismissed with 

prejudice because those allegations fail to state a cognizable claim under 42 U.S.C. 

§ 1983;

3. However, plaintiff may proceed on his claim to the extent it is based on his 

allegation that the manner by which his forced medication has been carried out 

violates the professional judgment standard set forth in Youngberg, including the 

allegation that all three defendant medical providers were made aware of and 

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ignored plaintiff’s complaints of serious side effects resulting therefrom; and

4. This action is referred back to the assigned magistrate judge for further 

proceedings consistent with this order.

IT IS SO ORDERED.

Dated: March 2, 2020 

UNITED STATES DISTRICT JUDGE

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