Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_19-cv-00004/USCOURTS-caed-1_19-cv-00004-15/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

After Cyrus Ayers killed himself while in custody, his child, E.M. and his mother, Dana 

Smithee, filed this lawsuit. They allege Ayers was not provided proper medical care during his 

incarceration at the California Correctional Institution in Tehachapi and this resulted in his death. In 

their fourth amended complaint, Plaintiffs claim that Defendant Litt-Stoner, Chief Executive Officer

for Health Care Services at CCI, Defendant Narayan, Chief Psychiatrist at CCI, and Defendants 

Seymour and Celosse, psychologists at CCI, are liable for Ayers’ death.

Defendants Litt-Stoner, Seymour, Nesson and Celosse previously moved the Court to dismiss 

the action. Because the second amended complaint failed to state a federal cause of action, the Court

dismissed it with leave to amend. (Doc. 47.) On August 29, 2019, Plaintiffs filed a third amended 

complaint, which only included the following defendants: Narayan, Seymour and Celosse. (Doc. 45.) 

On September 20, 2019, Defendants Narayan, Seymour and Celosse moved the Court to dismiss the 

action. (Docs. 48, 49.) Because the third amended complaint still failed to state a federal cause of 

DANA SMITHEE, et al.,

 Plaintiffs,

v.

CALIFORNIA CORRECTIONAL 

INSTITUTION, et al.,

Defendants.

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Case No.: 1:19-cv-00004-NONE-JLT

FINDINGS AND RECOMMENDATIONS 

GRANTING DEFENDANTS’ MOTIONS TO 

DISMISS

(Docs. 66, 67)

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action, the Court dismissed it with leave to amend. (Doc. 59.) On January 16, 2020, Plaintiffs filed a 

fourth amended complaint, including Defendants Litt-Stoner, Narayan, Seymour, and Celosse. (Doc. 

65.) 

On January 30, 2020, Defendants Litt-Stoner, Narayan, Seymour, and Celosse moved the 

Court to dismiss the action. (Docs. 66, 67.) Because the fourth amended complaint still fails to state a 

federal cause of action, the Court recommends it be DISMISSED and the Court decline to exercise 

supplemental jurisdiction.

I. Factual Allegations

On or about February 2, 2018, Ayers died by hanging while in custody at CCI. (Doc. 65 at 4-5; 

13.) According to Plaintiffs, Ayers was incarcerated within the California Corrections system around 

May 2015. (Doc. 65 at 5.)

Plaintiffs report that since 1999, the federal district court has had a special master overseeing

the inadequate mental health services, and the suicide prevention efforts of the California Department 

of Corrections and Rehabilitation. (Doc. 65 at 5-6.) Plaintiffs contend that the special master, referred 

to as the Coleman court, noted a pattern of inadequacies in suicide prevention at CDCR. (Doc. 65 at 

6.) Plaintiffs report that on January 14, 2014, an auditor and expert appointed by the Coleman court, 

Lindsay M. Hayes, M.S., issued the results of an audit of all 34 Corrections prisons from November 

12, 2013 to July 24, 2014, which identified certain ongoing deficiencies. (Doc. 65 at 6-7.) According 

to Plaintiffs, on April 17, 2017, the California State Auditor issued a report (2016-131) on and to 

Corrections identifying the deficiencies previously identified that continued to exist in its facilities. 

(Doc. 65 at 8-9.) Plaintiffs report that from May 23, 2017 to February 15, 2018, Hayes conducted 

another audit of 23 prisons including CCI at the direction of the Coleman court and found that even 

though inmates were being referred for reported suicidal ideation and self-injurious behavior, 

completion of suicide risk evaluations and suicide risk and self-harm evaluations were still not being 

performed. (Doc. 65 at 13.) Plaintiffs assert that Hayes also found that safety planning for those with 

suicide risk, and the coordination between it and the suicidal and self-risk evaluations was nearly nonexistent. (Doc. 65 at 13.) Plaintiffs also state that Hayes found that compliance rates for annual suicide 

prevention block training of both medical and mental health staff remained very problematic, and 

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those trainings that were provided and attended were truncated, presented inadequately and too 

quickly, post-test reviews were not performed, and workshop workbooks were rarely distributed. 

(Doc. 65 at 13.)

The Plaintiffs claim that during the entirety of his incarceration at multiple prisons within the 

State of California, Ayers was receiving mental health care. (Doc. 65 at 7.) They allege that around

July 2016, Ayers expressed suicidal ideations while an inmate at Kern Valley State Prison. (Doc. 65 at 

7.) Plaintiffs contend that, at this point, Ayers should have been placed under direct observation until a 

clinician trained to perform a suicide risk assessment conducts a face-to-face evaluation, and a formal 

risk assessment should have been completed, a plan developed and follow-up care identified. (Doc. 65 

at 7.) Plaintiffs also contend that this suicidal history, evaluation and plan should have been tracked on 

the Corrections-wide Mental Health Tracking System (MHTS) and Mental Health Identifier System 

(MHIS), and this information on both systems should have been updated daily. (Doc. 65 at 7.) 

Additionally, Plaintiffs allege that this information should also have been used to produce an Inmate 

Profile for Ayers that documented his suicide risk, assessment and plan, and accompanied him when 

he transferred to provide the receiving institution with suicide risk data. (Doc. 65 at 8.) Particularly, 

Plaintiffs contend that a Suicide Risk Assessment Checklist (SRAC) should have been conducted, as 

well as a 5-day clinical follow-up treatment plan, and included in the MHTS and MHIS. (Doc. 65 at 

8.) 

According to Plaintiffs, in or about July 2017, while an inmate at Kern Valley State Prison, 

Ayers overdosed on prescription medications, which required him to be hospitalized. (Doc. 65 at 9.)

Plaintiffs contend that this overdose should have been tracked on the Corrections-wide MHTS and 

MHIS, his status should have been updated daily and it should have been included with his Inmate 

Profile. (Doc. 65 at 9.) According to Plaintiffs, throughout 2017, Ayers reported having made multiple 

suicide attempts, and this should have been tracked on the Corrections-wide MHTS and MHIS, his 

status should have been updated daily and it should have been included with his Inmate profile. (Doc. 

65 at 9.) Plaintiffs also contend that a Suicide Risk Assessment Checklist (SRAC) should have been 

conducted, as well as a 5-day clinical follow-up treatment plan, and included in the MHTS and MHIS 

after the overdose and after each report of multiple suicide attempts. (Doc. 65 at 9.) 

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According to Plaintiffs, around November 2017, Ayers was transferred from Kern Valley State 

Prison to CCI. (Doc. 65 at 9.) Plaintiffs report that Ayers’ Inmate Profile, which should have included

detailed records of his suicidal ideation, overdose and reports of suicide attempts should have also 

been transferred, as well as a treatment and follow-up plan.1(Doc. 65 at 10.) 

Plaintiffs claim that in November 2017, upon being transferred to CCI, Celosse conducted a 

suicide risk and self-harm evaluation, in which she noted that Ayers reported he wished to be dead, 

had an intensity ideation score of “10,” and “had collected pills in preparation for suicide.”2(Doc. 65 

at 10.) They allege that Celosse reviewed Ayers’ previous medical records and noted that Ayers’ 

condition had significantly worsened over the previous few months and Ayers had a history of selfharm and suicide. (Doc. 65 at 10.) Plaintiffs contend that, at that point, Ayers should have been placed 

under direct observation, had a formal suicide risk assessment, including the SRAC, which should 

have been followed by a treatment plan and wellness check within 5 days, and all of this should have 

been documented on the automated systems. (Doc. 65 at 10.) However, according to Plaintiffs, Ayers

was not placed under direct observation, no formal SRAC was performed, no treatment plan was 

prepared, no wellness check was conducted, and none of it was documented in the MHTS and MHIS. 

(Doc. 65 at 10.) 

According to Plaintiffs, in or about December 2017, Ayers told Narayan that since transferring 

to CCI, he was not doing well, and Ayers told Narayan that he wished he had a higher level of care, 

including group therapy and one-on-one sessions with a clinician. (Doc. 65 at 11.) Plaintiffs contend 

that Narayan should have reviewed Ayers’ Inmate Profile, which would have revealed Ayers’ suicide 

risk. (Doc. 65 at 11.) Plaintiffs allege that given Ayers’ history of suicidality, Narayan should have 

conducted a suicide risk assessment using the SRAC and documented this on the MHTS and MHIS. 

(Doc. 65 at 11.) 

Plaintiffs report that in December 2017, Celosse noted that Ayers had “unremitting symptoms 

of a serious mental disorder” and had initiated self-injurious behavior. (Doc. 65 at 11.) Plaintiffs argue 

1 The allegations do not demonstrate that such an Inmate Profile was ever actually created but also allege that it should 

have been transferred to CCI. 

2 The allegations do not clarify whether Ayers’ statement referred to the July 2017 event or whether he was asserting that 

he currently was stockpiling medications.

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that Celosse should have reviewed Ayers’ Inmate Profile, which would have revealed Ayers’ suicide 

risk. (Doc. 65 at 11.) Plaintiffs argue that given Ayers’ history of suicidality, Celosse should have 

placed Ayers under direct observation, performed a formal risk assessment using SRAC, developed a 

treatment plan, arranged for a timely wellness check and documented this on the MHTS and MHIS. 

(Doc. 65 at 11.) 

Plaintiffs report that during a period of approximately six weeks before his death, on more than 

four occasions, Ayers asked Seymour that he be permitted to see his other clinician regarding his 

mental health. (Doc. 65 at 12.) Plaintiffs contend that Seymour should have reviewed Ayers’ Inmate 

Profile, which would have revealed Ayers’ suicide risk. (Doc. 65 at 12.) Plaintiffs argue that given 

Ayers’ history of suicidality, Seymour should have performed a formal risk assessment using SRAC 

and documented this on the MHTS and MHIS. (Doc. 65 at 12.) 

According to Plaintiffs, on or about January 8, 2018, CCI staff noted Ayers’ history of 

“cheeking” medications in an attempt to overdose, and such information would have been included in 

his Inmate Profile and on the MHTS and MHIS. (Doc. 65 at 12.) Plaintiffs argue that Narayan, 

Celosse and Seymour should have reviewed Ayers’ Inmate Profile and the MHTS and MHIS, which 

would have revealed Ayers’ suicide risk. (Doc. 65 at 12.) Plaintiffs contend that given Ayers’ history 

of suicidality, Narayan, Celosse and Seymour should have performed a formal risk assessment using 

SRAC and documented this on the MHTS and MHIS. (Doc. 65 at 12.) 

Plaintiffs contend that throughout her tenure, and at all times pertinent, Litt-Stoner, as Chief 

Executive Officer, had the duty to ensure implementation of a robust, constitutionally sufficient 

suicide prevention program at CCI. (Doc. 65 at 14.) According to Plaintiffs, CDCR adopted a formal 

policy, as ordered by the Coleman court, that provided for a comprehensive and constitutionallyadequate suicide prevention policy. (Doc. 65 at 14.) However, Plaintiffs argue, Litt-Stoner allowed an 

informal policy of lax suicide prevention to languish during the entire time Ayers was incarcerated, 

while she failed to ensure the court-ordered policy was followed by CDCR personnel. (Doc. 65 at 14.) 

II. Legal Standard

A motion to dismiss under Rule 12(b)(6) “tests the legal sufficiency of a claim.” Navarro v. 

Block, 250 F.3d 729, 732 (9th Cir. 2001). Dismissal under Rule 12(b)(6) is appropriate when “the 

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complaint lacks a cognizable legal theory or sufficient facts to support a cognizable legal theory.” 

Mendiondo v. Centinela Hosp. Med. Ctr., 521 F.3d 1097, 1104 (9th Cir. 2008). On a motion filed 

pursuant to Rule 12(b)(6), “review is limited to the complaint alone.” Cervantes v. City of San Diego, 5 

F.3d 1273, 1274 (9th Cir. 1993). 

Allegations of a complaint must be accepted as true when the Court considers a motion to 

dismiss for failure to state a claim. Hospital Bldg. Co. v. Rex Hospital Trustees, 425 U.S. 738, 740 

(1976). The Supreme Court explained, “[t]o 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.’” 

Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 

(2007)). The Supreme Court explained:

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. The plausibility standard is not akin to a “probability requirement,” but it asks 

for more than a sheer possibility that a defendant has acted unlawfully. 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.’

Iqbal, 556 U.S. at 678 (internal citations, quotation marks omitted). 

A court must construe the pleading in the light most favorable to the plaintiff and resolve all 

doubts in favor of the plaintiff. Jenkins v. McKeithen, 395 U.S. 411, 421 (1969). “The issue is not 

whether a plaintiff will ultimately prevail, but whether the claimant is entitled to offer evidence to 

support the claims. Indeed, it may appear on the face of the pleadings that a recovery is very remote and 

unlikely but that is not the test.” Scheuer v. Rhodes, 416 U.S. 232, 236 (1974). However, the Court 

“will dismiss any claim that, even when construed in the light most favorable to plaintiff, fails to plead 

sufficiently all required elements of a cause of action.” Student Loan Marketing Assoc. v. Hanes, 181 

F.R.D. 629, 634 (S.D. Cal. 1998). Leave to amend should not be granted if “it is clear that the 

complaint could not be saved by any amendment.” Livid Holdings Ltd. v. Salomon Smith Barney, Inc., 

416 F.3d 940, 946 (9th Cir. 2005).

III. Discussion and Analysis

A. Deliberate Indifference 

Defendants allege that Plaintiffs failed to plead sufficient facts to state a federal cause of action 

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for deliberate indifference. (Doc. 66-1 at 5-10; Doc. 67-1 at 13-19.)

1. Serious medical need

A serious medical need exists "if the failure to treat the prisoner's condition could result in 

further significant injury or the 'unnecessary and wanton infliction of pain.'" McGuckin v. Smith, 974 

F.2d 1050, 1059 (9th Cir. 1991), overruled on other grounds by WMX Techs., Inc. v. Miller, 104 F.3d 

1133, 1136 (9th Cir. 1997) (quoting Estelle v. Gamble, 429 U.S. 97, 104 (1976)). Indications of a 

serious medical need include "[t]he existence of an injury that a reasonable doctor or patient would 

find important and worthy of comment or treatment; the presence of a medical condition that 

significantly affects an individual's daily activities; or the existence of chronic and substantial 

pain." Id. at 1059-60 (citing Wood v. Housewright, 900 F.2d 1332, 1337-41 (9th Cir. 1990)).

The Ninth Circuit has held heightened suicide risk to be a serious medical need. Simmons v. 

Navajo County, 609 F.3d 1011, 1018 (9th Cir. 2010). Although Plaintiffs have not established that 

Ayers’ was an imminent suicide risk, because the Defendants do not challenge whether Ayers suffered 

a serious medical need, the Court accepts that he did so for purposes of these motions.

2. Deliberate indifference 

If a plaintiff establishes the existence of a serious medical need, he must then show that 

officials responded to that need with deliberate indifference. Farmer v. Brennan, 511 U.S. 825, 834

(1994). In clarifying the culpability required for "deliberate indifference," the Supreme Court held:

[A] prison official cannot be found liable under the Eighth Amendment for denying an 

inmate humane conditions of confinement unless the official knows of and disregards 

an excessive risk to inmate health or safety; 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 that inference.

Farmer, 511 U.S. at 837. Therefore, a defendant must be "subjectively aware that serious harm is 

likely to result from a failure to provide medical care." Gibson v. County of Washoe, 290 F.3d 1175, 

1193 (9th Cir. 2002) (emphasis omitted). When a defendant should have been aware of the risk of 

substantial harm but, indeed, was not, "then the person has not violated the Eighth Amendment, no 

matter how severe the risk." Id. at 1188.

Where deliberate indifference relates to medical care, "[t]he requirement of deliberate 

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indifference is less stringent . . . than in other Eighth Amendment contexts because the responsibility 

to provide inmates with medical care does not generally conflict with competing penological 

concerns." Holliday v. Naku, 2009 U.S. Dist. LEXIS 55757, at *12 (E.D. Cal. June 26, 2009) (citing 

McGuckin v. Smith, 974 F.2d 1050, 1060 (9th Cir. 1991)). Generally, deliberate indifference to 

serious medical needs may be manifested in two ways: "when prison officials deny, delay, or 

intentionally interfere with medical treatment, or . . . by the way in which prison physicians provide 

medical care." Hutchinson v. United States, 838 F.2d 390, 393-94 (9th Cir. 1988). A claimant seeking 

to establish deliberate indifference must show "both (a) a purposeful act or failure to respond to a 

prisoner's pain or possible medical need and (b) harm caused by the indifference." Conn v. City of 

Reno, 591 F.3d 1081 (9th Cir. 2010) (emphasis added).

Deliberate indifference is a high legal standard. Toguchi v. Chung, 391 F.3d 1051, 1060 (9th 

Cir. 2004). "Under this standard, the prison official must not only 'be aware of the facts from which 

the inference could be drawn that a substantial risk of serious harm exists,' but that person 'must also 

draw the inference.'" Id. at 1057 (quoting Farmer, 511 U.S. at 837). "'If a prison official should have 

been aware of the risk, but was not, then the official has not violated the Eighth Amendment, no 

matter how severe the risk.'" Id. (quoting Gibson v. County of Washoe, Nevada, 290 F.3d 1175, 1188 

(9th Cir. 2002)).

a. Defendant Pratap Narayan 

Narayan argues that the fourth amended complaint did not correct or cure the deficiencies in 

their Eighth Amendment claim. (Doc. 66-1 at 7.) Narayan contends that Plaintiffs “added general

references to various special masters’ reports about inmate medical care, various audit reports, and 

mental health program guidelines.” (Doc. 66-1 at 7.) As Defendant correctly points out, “Plaintiffs’ 

generalized references to various special masters' reports, audit reports, and mental health program 

guidelines were mostly to time periods predating Ayers' CDCR incarceration, periods before his 

incarceration at CCI or relate to other CDCR institutions.” (Doc. 76 at 2; see also Doc. 66-1 at 7-8.) 

Specifically, the fourth amended complaint alleges that Ayers’ “suicidal history, evaluation 

and plan should have been tracked on the Corrections-wide Mental Health Tracking System (MHTS) 

and Mental Health Identifier System (MHIS),” that this information on both systems should have been 

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updated daily, and should also have been used to produce an “Inmate Profile for AYERS that 

documented his suicide risk, assessment and plan, and accompanied him when he transferred.” (Doc. 

65 at 7-8.) Related to Narayan, Plaintiffs claim that Narayan “should have reviewed Mr. AYERS’ 

Inmate Profile, which would have revealed Mr. AYERS’ suicide risk,” and that Narayan “should have 

conducted, but did not, a suicide risk assessment using the SRAC and document this on the MHTS and 

MHIS.” (Doc. 65 at 11.) However, as Plaintiffs allege, the information from the MHTS and MHIS was

supposed to be used to produce the “Inmate Profile;” Narayan cannot have failed to review such an 

“Inmate Profile” that was never produced and did not exist. Even if the records Plaintiffs allege 

Narayan should have reviewed existed, it is pure speculation that such records would reveal sufficient 

information to provide knowledge to Narayan that there was an imminent substantial risk of serious 

harm to Ayers’ health and then disregarded it. As Defendant argues in his reply, the allegations against 

Narayan “consist of arguments, speculation, conjecture or conclusory statements about what he should 

have known, should have been aware [of], should have done or should have been in a position to do.” 

(Doc. 76 at 2-3, emphasis in original.) Similarly, if Plaintiffs are alleging that doctors, prior to 

Defendants, were not using the Corrections-wide Mental Health Tracking System and Mental Health 

Identifier System, Defendants cannot be held liable for deficiencies of other medical providers and 

institutions (i.e., prior to Ayers’ incarceration at CCI). Moreover, Defendant argues that there was also 

no allegation that Narayan was responsible for any historical system-wide deficiency in inmate mental 

health care or suicide prevention referenced throughout the fourth amended complaint. (Doc. 66-1 at 

8; Doc. 76 at 2.) 

Defendant contends that “Plaintiffs do not claim a failure to respond or a failure to provide 

medical care; but rather allege a disagreement or differing opinion about the medical care that was 

admittedly provided.” (Doc. 66-1 at 8.) As Defendant points out, the Plaintiffs state in their fourth

amended complaint that during the entirety of his incarceration at multiple prisons within the State of 

California, Ayers was receiving mental health care. (Doc. 65 at 7; Doc. 66-1 at 8.) The Court 

addressed this point in its last Findings and Recommendations. (Doc. 54 at 6-7.) Specifically, 

Plaintiffs continue to claim in the fourth amended complaint, as previously alleged, that Ayers told 

Narayan that since transferring to CCI, Ayers was not doing well, and he told Narayan “that he wished 

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he had a higher level of care, including group therapy and one-on-one sessions with a clinician.” (Doc. 

65 at 11; Doc. 45 at 5.) As Narayan points out, it remains the same in the fourth amended complaint 

that there are no factual allegations that Narayan knew that Ayers’ self-report and his history required 

him to take a different approach and to place Ayers on a suicide watch or to provide different or 

additional medical care. (Doc. 54 at 6; Doc. 66-1 at 9.) A defendant must be "subjectively aware that 

serious harm is likely to result from a failure to provide medical care." Gibson, 290 F.3d at 1193. The 

Court accepts that Narayan did not provide Ayers with the higher level of care Ayers’ requested and 

did not place him on suicide watch. However, the allegations admit that Narayan did not fail to 

provide medical care, only that he did not provide the medical care that Ayers’ wanted. (See Doc. 65 

at 7; Doc. 54 at 7; Doc. 66-1 at 9.) Mere differences of opinion as to the proper course of treatment for 

a medical condition do not give rise to a medical indifference claim. Additionally, no facts were 

alleged whether group therapy was available at the prison for an inmate with Ayers’ custody and 

security level or if it was medically appropriate for Ayers. Plaintiffs fail to plead facts showing 

Narayan was subjectively aware and actually drew the inference that there was an imminent substantial 

risk of serious harm to Ayers’ health. When a defendant should have been aware of the risk of 

substantial harm but, indeed, was not, "then the person has not violated the Eighth Amendment, no 

matter how severe the risk." See id. at 1188.

Of most significance, Plaintiffs have failed to plead facts showing a causal connection between 

Narayan’s conduct and Ayers’ subsequent suicide, even with considering the newly alleged facts. As 

Defendant argues, “Plaintiffs made no specific factual allegations that tie or link the various references 

to special masters’ reports or audit reports to any specific Narayan action that had anything to do with 

Ayers’ February 2018 suicide.” (Doc. 66-1 at 8; see also Doc. 76 at 2.) Defendant alleges in his reply 

that Narayan was not the Chief Psychiatrist at CCI, that Narayan was not based or stationed at CCI, 

and had a single communication with Ayers, via a video conference. (Doc. 76 at 2.) Plaintiffs continue

to allege in their fourth amended complaint that Narayan saw Ayers on just one occasion in December 

2017 and have not alleged facts about any information brought to Narayan’s attention about Ayers’ 

condition or any medical treatment after this visit and before Ayers’ death in February 2018. (See Doc. 

65.) Accordingly, as Narayan argues, “[t]here are no other particular or specific factual allegations 

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about any other Narayan communication, interaction or dealing with Ayers or any other Narayan 

involvement in, or knowledge about, Ayer[s’] medical care or custody arrangements between 

December 7, 2017 and Ayer[s’] February 2, 2018 suicide.” (Doc. 76 at 2.) Thus, Plaintiffs fail to 

demonstrate that Narayan was aware that a substantial risk of harm existed. Accordingly, Plaintiffs fail 

to state a cognizable claim for violation of the Eighth Amendment against Narayan.

b. Defendant Celosse

As Defendant points out, the allegations in the fourth amended complaint with respect to 

Celosse are the same allegations that Plaintiffs made in the third amended complaint. (Doc. 67-1 at 

15.) Defendant contends that Plaintiffs have changed their allegations slightly, to add more detail as to

what they believe Celosse should have done. (Doc. 67-1 at 15.) Specifically, Plaintiffs continue to 

allege that in November 2017, upon Ayers being transferred to CCI, Celosse conducted a suicide risk 

and self-harm evaluation on Ayers, in which she reported he wished to be dead, had an intensity of 

ideation score of “10”, and had collected pills in preparation of suicide. (Doc. 65 at 10; Doc. 45 at 5.) 

Plaintiffs also allege again that Celosse reviewed Ayers’ previous medical records and noted that 

Ayers’ condition had significantly worsened over the previous few months and Ayers had a history of 

self-harm and suicide. (Doc. 65 at 10; Doc. 45 at 5.) Plaintiffs further contend that in December 2017, 

Celosse noted that Ayers had “unremitting symptoms of a serious mental disorder” and had initiated 

self-injurious behavior. (Doc. 65 at 11; Doc. 45 at 6.)

Significantly, "[m]ere '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, 

429 U.S. at 105-06); see also Toguchi v. Chung, 391 F.3d 1051, 1057 (9th Cir. 2004). Accordingly, 

the Ninth Circuit has determined a prisoner must allege "the chosen course of treatment 'was medically 

unacceptable under the circumstances,' and was chosen 'in conscious disregard of an excessive risk to 

[the prisoner's] health.'" See Toguchi, 391 F.3d at 1058 (quoting Jackson v. McIntosh, 90 F.3d 330, 

332 (9th Cir. 1996)).

Plaintiffs fail to allege facts sufficient to support a conclusion that the treatment Ayers received 

was "medically unacceptable" and that Celosse disregarded a substantial risk to Ayers’ health. 

See Toguchi, 391 F.3d at 1058. To the contrary, the facts fail to allege that Celosse’s decisions were 

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not medically supported. In making this observation, the Court accepts as true that Celosse was aware 

of Ayers’ symptoms and history of self-harm and suicide when Celosse chose not to recommend 

Ayers for suicide watch. As Defendant argues, the facts do not demonstrate that Celosse knew Ayers 

was acutely suicidal or that he required an immediate change to his mental health care. (Doc. 77 at 6-

7.) Without more, the facts suggest only that the Plaintiffs disagree with Celosse’s medical judgment.

Plaintiffs allegations that Celosse did not follow certain protocols similarly fails to show 

deliberate indifference. (See Doc. 65 at 10-11; Doc. 67-1 at 15; Doc. 77 at 6-7.) For instance, Plaintiffs 

claim that Celosse should have placed Ayers under direct observation. (Doc. 65 at 11.) However, as 

Defendant argues, Plaintiffs’ more specific allegations regarding what they believe Celosse should 

have done does not change the deliberate indifference analysis. (Doc. 67-1 at 15.) Such allegations do 

not demonstrate that Celosse knew of a serious risk to Ayers’ health and disregarded it. (Doc. 77 at 7.)

Defendant asserts correctly that “[a] deliberate indifference claim requires more than Celosse drawing 

an incorrect medical conclusion, it requires that she actually know that [Ayers] was acutely suicidal, 

but was indifferent to that fact.” (Doc. 67-1 at 15.) And as Defendant alleges, Plaintiffs make no 

allegation that Celosse had such knowledge. (Doc. 67-1 at 15.) Plaintiffs allegations may show a 

mistake in diagnosis but fall short of showing deliberate indifference. (Doc. 67-1 at 15; Doc. 77 at 7.)

As Defendant asserts, “[m]ere negligence in diagnosing or treating a medical condition, without more, 

does not violate a prisoner's Eighth Amendment rights.” (Doc. 77 at 7.)

Plaintiffs also claim that Celosse should have reviewed Ayers’ Inmate Profile, “which would 

have revealed Mr. AYERS’ suicide risk.” (Doc. 65 at 11.) However, as discussed previously, Plaintiffs 

also claim that such an Inmate Profile should have been produced, and it should have accompanied 

Ayers when he transferred to CCI but neither occurred. (See Doc. 65 at 8.) Plaintiffs assertion that 

Defendant should have reviewed something that didn’t exist doesn’t support deliberate indifference. 

Though it may suggest a systemic failure, there is no showing Defendant had any authority or control 

over the system. As Defendant argues in reply, the alleged system-wide problems do not show 

anything about Celosse’s conduct toward Ayers, and moreover, do not show that Celosse was 

deliberately indifferent. (See Doc. 77 at 7.) Alternatively, even if the records Plaintiffs allege Celosse 

should have reviewed existed, it is pure speculation that such records would reveal sufficient

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information to provide knowledge to Celosse that there was an imminent substantial risk of serious 

harm to Ayers’ health and then disregarded it. 

Plaintiffs also fail to plead facts demonstrating that Celosse’s conduct in November or 

December caused Ayers’ death in February. (See Doc. 77 at 6-7.) Accordingly, Plaintiffs fail to state a 

cognizable claim for violation of the Eighth Amendment against Celosse.

c. Defendant Seymour

As Defendant argues, the allegations in the fourth amended complaint as to Seymour are the 

same as those previously pled in the third amended complaint. (Doc. 67-1 at 17.) Again, as Defendant 

points out, the fourth amended complaint provides more detail about what Plaintiffs believe Seymour 

should have done. (Doc. 67-1 at 17-18.) However, as Defendant contends, the facts pled in the fourth

amended complaint, “even if true, would not show that Seymour knew of, and disregarded, a serious 

risk to [Ayers’] health.” (Doc. 67-1 at 18.) 

Specifically, Plaintiffs allege again in their fourth amended complaint that during a period of 

approximately six weeks before his death, on more than four occasions, Ayers asked Seymour (a 

psychologist) to be allowed to see his mental health “clinician.” (Doc. 65 at 12; Doc. 45 at 6.) They 

still allege no facts indicating that Ayers reported to Seymour why he wanted this consultation and no 

facts that Ayers was acutely suicidal at that time. Also, as the Court previously pointed out, Plaintiffs 

do not explain to whom Ayers was referring when he asked to see his “clinician.” (Doc. 54 at 9.)

Seymour was a practicing and treating psychologist and was, therefore, a “clinician.” Plaintiffs fail to 

demonstrate how the denial of seeing a different mental health clinician is a Constitutional violation; 

indeed, many insureds outside of prison do not get to see a provider of their choice. 

Additionally, as Defendant argues, Seymour is not alleged to have known of any acute suicide 

risk. (Doc. 67-1 at 18; Doc. 77 at 7.) Plaintiffs do not explain their contention that Seymour should 

have acted on Ayers’ request differently or how her failure to do so caused Ayers’ death. Most 

notably, Plaintiffs do not plead facts showing that Seymour knew Ayers’ requests demonstrated that 

he was at imminent risk of suicide as opposed to an ideation that was not acute.

Plaintiffs also appear to provide more detail than the third amended complaint about what 

treatment Plaintiffs believe Seymour should have prescribed, stating that Seymour should have 

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performed a formal risk assessment using SRAC and documented this on MHTS and MHIS. (Doc. 65 

at 12; Doc. 67-1 at 17-18; Doc. 77 at 8.) However, as Defendant argues, the facts do not demonstrate 

that Seymour knew such an analysis was necessary. (Doc. 77 at 8.) Plaintiffs fail to allege facts 

sufficient to support a conclusion that the treatment Seymour provided was “medically unacceptable”

or that Seymour was aware of and disregarded a significant risk of harm to Ayers’ health. 

See Toguchi, 391 F.3d at 1058. Thus, Plaintiffs fail to state a cognizable claim against Seymour for a 

failure to provide adequate medical care. Accordingly, the Court recommends that the motion to 

dismiss the claim for deliberate indifference be granted as to Seymour.

d. Defendant Litt-Stoner

As an initial matter, Defendant claims that Plaintiffs have abandoned their claims against LittStoner because Plaintiffs alleged claims against Litt-Stoner in the second amended complaint but, after 

the Court dismissed the second amended complaint with leave to amend, did not raise them in the third 

amended complaint. (Doc. 67-1 at 21; Doc. 77 at 12-13.) Defendant cites Chubb Custom Ins. Co. v. 

Space Sys./Loral, Inc., 710 F.3d 946, 973 n.14 (9th Cir 2013), stating that where a party is granted 

leave to amend, but does not replead a claim, that claim is deemed abandoned. (Doc. 67-1 at 21.) 

However, as Plaintiffs argue, the claims are abandoned if they were not included in a subsequent 

amended pleading. (Doc. 74 at 26.) The case cited clearly states that, if not replead, that claim is 

deemed abandoned. Chubb Custom Ins. Co., 710 F.3d at 973 n.14 (emphasis added); see also Lacey v. 

Maricopa County, 693 F.3d 896, 925, 928 (9th Cir. 2012) (“[F]or any claims voluntarily dismissed, we 

will consider those claims to be waived if not repled.”). In this case, the claims against Litt-Stoner 

were in fact repled in the fourth amended complaint. (See Doc. 65.) In the additional case cited by 

Defendant in reply, it was the plaintiffs’ subsequent failure to include claims against certain 

defendants in the amended complaint, without still being added back into the case, that deemed the 

claims against those defendants to be waived or abandoned.(Doc. 77 at 12-13); see Westley v. Oclaro, 

Inc., 2013 U.S. Dist. LEXIS 76258, *31 (N.D. Cal. May 30, 2013). In this case, Plaintiffs have indeed 

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added the claims against Litt-Stoner back into the case in their fourth amended complaint (see Doc. 

65), and such claims have not been abandoned.

3

Regarding Plaintiffs’ claim of deliberate indifference against Litt-Stoner, Defendant claims 

that just as the Court previously found Plaintiffs failed to state a claim because “[n]one of these facts 

are tied to Ayers and, consequently, fail to demonstrate that Litt-Stoner knew of and acted with 

deliberate indifference to Ayers’ medical condition,” the same is true of the allegations of the fourth

amended complaint. (Doc. 67-1 at 19; Doc. 41 at 7.) 

Under Section 1983, Plaintiffs must demonstrate that each defendant personally participated in 

the deprivation of their rights. Jones v. Williams, 297 F.3d 930, 934 (9th Cir. 2002). Thus, liability 

may not be imposed on supervisory personnel under Section 1983 on the theory of respondeat 

superior, as each defendant is only liable for his or her own misconduct. Iqbal, 129 S.Ct. at 1948-49 

(2010); Ewing v. City of Stockton, 588 F.3d 1218, 1235 (9th Cir. 2009). A supervisor may be held 

liable only if he or she "participated in or directed the violations, or knew of the violations and failed 

to act to prevent them." Taylor v. List, 880 F.2d 1040, 1045 (9th Cir. 1989); accord Starr v. Baca, 633 

F.3d 1191 (9th Cir. 2011); Corales v. Bennett, 567 F.3d 554, 570 (9th Cir. 2009); Preschooler II v. 

Clark County School Board of Trustees, 479 F.3d 1175, 1182 (9th Cir. 2007); Harris v. Roderick, 126 

F.3d 1189, 1204 (9th Cir. 1997).

The fourth amended complaint alleges facts regarding system-wide audits of CDCR’s suicide 

prevention program, that found that there were problems with the overall implementation, and that 

CCI was one of the prisons included in the audits. (See Doc. 65.) The fourth amended complaint goes 

on to allege that CDCR adopted a formal policy to prevent suicides, but that Litt-Stoner “allowed an 

informal policy of lax suicide prevention to languish” at CCI. (Doc. 65 at 14.) However, as Defendant 

contends, the fourth amended complaint does not plead facts against Litt-Stoner that reveal failures at 

CCI or with CCI staff, and it does not plead facts showing that Litt-Stoner had any knowledge of any 

failures at CCI. (See Doc. 77 at 10.) Notably, the audits and reports referenced by Plaintiffs were 

mostly to time periods predating Ayers’ CDCR incarceration, periods before his incarceration at CCI 

3

In any event, Plaintiffs are within their statute of limitations for adding claims and defendants.

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or relate to other CDCR institutions. (See Doc. 65.) Plaintiffs’ generic allegations regarding the 

policies Litt-Stoner allowed at CCI are insufficient to show that Litt-Stoner was indifferent to Ayers’ 

medical needs. (Doc. 77 at 10.) The fourth amended complaint does not demonstrate how following 

formal policies or different policies than those implemented by Litt-Stoner would have led to different 

care for Ayers or would have prevented his death.

Plaintiffs do not allege that Litt-Stoner knew of a serious risk to Ayers and does not allege that 

she ignored that risk. (Doc. 67-1 at 19; Doc. 77 at 8-9.) Plaintiffs fail to plead a connection between 

the alleged conduct and Ayers’ suicide, and moreover, fail to plead that Litt-Stoner had any contact 

with Ayers at all. (See Doc. 77 at 10.) Plaintiffs’ allegations fail to demonstrate how any failures on 

Litt-Stoner’s part affected Ayers’ care or caused his death. Defendant can only be liable for her own 

misconduct, and Plaintiffs here have failed to demonstrate that Litt-Stoner personally participated in 

the deprivation of Ayers’ rights. See Iqbal, 129 S.Ct. at 1948-49; Jones, 297 F.3d at 934. None of the 

alleged facts are tied to Ayers and, consequently, fail to demonstrate that Litt-Stoner knew of and 

acted with deliberate indifference to Ayers’ medical condition. See Gibson, 290 F.3d at 1188 (“When 

a defendant should have been aware of the risk of substantial harm but, indeed, was not, ‘then the 

person has not violated the Eighth Amendment, no matter how severe the risk.’”) Thus, Plaintiffs’ 

claim against Litt-Stoner for deliberate indifference to his serious medical needs in violation of the 

Eighth Amendment is not cognizable and should be dismissed.

e. Claims as to all Defendants related to Coleman

Plaintiffs appear to make arguments, as to all Defendants, pursuant to the federal district 

court’s special master’s reports and rulings in Coleman v. Brown, et al., that the defendants have failed 

to comply with the orders issued in that case. Indeed, the fourth amended complaint appears to present 

a historical review and critique of state-wide inmate mental health care. (See generally, Doc. 65; see

Doc. 76 at 1-2.) Plaintiffs quote from various special master’s reports, audit reports, and 

recommendations for mental health guidelines. (See generally, Doc. 65; see Doc. 76 at 1-2.) However, 

as Defendant argues, to the extent Plaintiffs are seeking to litigate CDCR’s compliance with the 

federal district court’s special master’s reports and rulings in Coleman v. Brown, et al., this “complaint 

is the wrong legal vehicle against the wrong defendant for a system-wide challenge to inmate mental 

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health care or suicide prevention procedures.” (Doc. 76 at 2.) Defendants in this case are not parties to 

the ongoing Coleman litigation, and Plaintiffs claims under Coleman are not actionable here but must 

be raised in that action. Frost v. Symington, 197 F.3d 348, 358-59 (9th Cir. 1999).

B. Failure to Train – Defendant Litt-Stoner

4

Plaintiffs allege in the fourth amended complaint that Defendant Litt-Stoner failed to

adequately train CCI staff in suicide prevention and response training. (Doc. 65 at 20-23.) However, 

Defendant argues that the allegations of the fourth amended complaint are limited to lists of 

generalized training failures that allegedly occurred at CCI or systemwide at CDCR. (Doc. 67-1 at 20; 

Doc. 77 at 12.) Defendant contends those allegations are not closely related to the ultimate injury and 

do not show deliberate indifference on Litt-Stoner’s part. (Doc. 67-1 at 20.) Defendant argues that

Plaintiffs’ generic recitations of supposed failures to train fail to connect any alleged constitutional 

violation to conduct undertaken by Litt-Stoner. (Doc. 67-1 at 21; Doc. 77 at 12.) 

A supervisor’s failure to train subordinates may give rise to individual liability under Section 

1983 where the failure amounts to deliberate indifference to the rights of persons with whom the 

subordinates are likely to come into contact. See Canell v. Lightner, 143 F.3d 1210, 1213-14 (9th Cir. 

1998). To impose liability under this theory, a plaintiff must demonstrate the subordinate's training 

was inadequate, the inadequate training was a deliberate choice on the part of the supervisor, and the 

inadequate training caused the constitutional violation. Id. at 1214; see also City of Canton v. Harris, 

489 U.S. 378, 391 (1989); Lee v. City of Los Angeles, 250 F.3d 668, 681 (9th Cir. 2001).

Plaintiffs do not allege facts that show Litt-Stoner was aware of any training, policy or staff 

deficiency for the mental health staff at CCI or, if she was, that Ayers was at risk as a consequence.

Plaintiffs allege that mental health personnel at CCI were untrained on the administration of suicide 

evaluation, that CDCR was noncompliant with suicide prevention training requirements, and CDCR 

mental health staff had problematic or inadequate suicide prevention training. (Doc. 65 at 20.)

Notably, the audits and reports referenced by Plaintiffs were mostly to time periods predating Ayers’

CDCR incarceration, periods before his incarceration at CCI or relate to other CDCR institutions. (See

4 Defendant also claims that Plaintiffs have abandoned this claim against Litt-Stoner (see Doc. 67-1 at 21), which argument 

is addressed above. 

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Doc. 65.) Nevertheless, Plaintiffs fail to allege facts demonstrating that Litt-Stoner was aware of any 

of these issues. (See Doc. 77 at 11-12.) Absent this, the Court can draw no inference that Litt-Stoner 

can be held liable merely because these problems existed at CDCR. As this Court previously observed, 

"[t]he cases in which supervisors have been held liable under a failure to train/supervise theory involve 

conscious choices made with full knowledge that a problem existed." Woodward v. Kokor, 2017 U.S. 

Dist. LEXIS 91777, 2017 WL 2572456 (E.D. Cal. June 13, 2017) (citation omitted); see also Cousin 

v. Small, 325 F.3d 627, 637 (5th Cir. 2003) (explaining that to impose liability for failure to train, "a 

plaintiff must usually demonstrate a pattern of violations and that the inadequacy of the training is 

obvious and obviously likely to result in a constitutional violation"). As such, because Plaintiffs fail to 

demonstrate that Litt-Stoner knew of any violations or deficiencies, Plaintiffs cannot allege that LittStoner failed to act to prevent them. See Taylor, 880 F.2d at 1045. 

Nevertheless, even if Litt-Stoner was actually aware of these deficiencies, Plaintiffs fail to 

allege facts to demonstrate Litt-Stoner was aware that Ayers was at risk as a consequence of any 

alleged training deficiencies. As stated above, failure to train subordinates gives rise to individual 

liability under Section 1983 where the failure amounts to deliberate indifference to the rights of 

persons with whom the subordinates are likely to come into contact. See Canell, 143 F.3d at 1213-14. 

Plaintiffs have alleged that Litt-Stoner was responsible for implementing and ensuring staff 

participation in training programs and ensuring mental health personnel were properly trained in 

suicide prevention. (Doc. 65 at 20-21.) However, Plaintiffs have failed to allege more than just 

generalized inadequacies of the suicide prevention and response training. As Defendant argues, 

Plaintiffs’ allegations are not closely related to the ultimate injury to Ayers and do not show deliberate 

indifference on Litt-Stoner’s part. (See Doc. 67-1 at 20; Doc. 77 at 12.) Plaintiffs failed to allege that 

Litt-Stoner had any contact with Ayers or was even aware of him or any risk to him. For example, one 

alleged training failure includes the failure to provide training related to “[m]ental health evaluations 

for rules violation reports.” (Doc. 65 at 21.) There is no indication that Ayers was ever charged with a 

rules violation or, if he was, that he suffered a violation report contemporaneous to his death or how 

the failure to evaluate his mental health at the time, caused his death. If this training failure does not 

relate to Ayers’ death, the Court is at a loss as to why this is listed in the complaint. The allegations

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must describe the relevant training that was not provided or was provided inadequately and allege 

facts to demonstrate how this caused Ayers’ death.

Consequently, the Court finds the facts alleged are not sufficient to support Plaintiffs’ claim for 

failure to train against Litt-Stoner and recommends that this claim for relief be dismissed.

C. Recoverable Damages – Federal Law Claim

In Chaudhry v. City of Los Angeles, 751 F.3d 1096, 1103 (9th Cir. May 19, 2014), the Ninth 

Circuit confronted the question of whether pre-death pain and suffering damages were allowed in § 

1983 suits brought in California. The defendants in that case argued that since Cal. Code Civ. Proc. § 

377.34 barred a decedent’s estate to recover for the decedent’s pre-death pain and suffering, these 

damages should similarly be barred under § 1983. The Ninth Circuit disagreed and, in so doing, 

reasoned that "[o]ne of Congress's primary goals in enacting § 1983 was to provide a remedy for 

killings unconstitutionally caused or acquiesced in by state governments." Id. (citing Monroe v. Pape, 

365 U.S. 167, 172-76 (1961)). The court concluded that since the "practical effect of § 377.34 is to 

reduce, and often eliminate, compensatory damage awards for the survivors of people killed by 

violations of federal law, . . . a prohibition against pre-death pain and suffering awards for a 

decedent’s estate has the perverse effect of making it more economically advantageous for a defendant 

to kill rather than injure his victim." Id. at 1103-04. Thus, pre-death pain and suffering awards are 

allowed for § 1983 cases where the victim died from the unconstitutional conduct of the defendant. Id.

Though the successor can seek damages suffered by the decedent before his death, the 

complaint here does not attempt to do that. Rather, the complaint seeks damages suffered by E.M. and 

Ms. Smithee. (Doc. 65 at 17, 19-20, 22-23 [“Plaintiffs DANA SMITHEE and E.M., . . . have suffered 

general and special damages including but not limited to loss of love, companionship, comfort, care

and support . . .”]). Though they allege that the conduct of the defendants caused Ayers’ death, they do 

so only to demonstrate that because the defendants caused Ayers’ death, they indirectly caused the 

plaintiffs’ damages is the source of their damages. Accordingly, because the complaint does not seek 

Mr. Ayers’ pre-death pain and suffering, and, indeed, do not allege facts to support that Ayers suffered 

these damages, these damages sought are not recoverable in this action.

///

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D. Qualified Immunity

Due to the dearth of facts alleged to support the conclusions made by Plaintiffs, the Court 

declines to consider qualified immunity at this time.

E. Supplemental Jurisdiction

The remaining claims in Plaintiffs’ fourth amended complaint arise under state law, including 

negligence and wrongful death. (See generally Doc. 65.) Pursuant to 28 U.S.C. § 1367(c)(3), a district 

court may decline to exercise supplemental jurisdiction over state law claims if "the district court has 

dismissed all claims over which it has original jurisdiction." Significantly, the Ninth Circuit 

determined that "[w]hen federal claims are dismissed before trial . . . pendant state claims also should 

be dismissed." Religious Tech. Ctr. v. Wollersheim, 971 F.2d 364, 367-68 (9th Cir. 1992) (internal 

quotation marks omitted); see also Brown v. Lucky Stores, Inc., 246 F.3d 1182, 1189 (9th Cir. 

2001) (recognizing the propriety of dismissing supplemental state law claims without prejudice when 

the district court has dismissed the federal claims over which it had original jurisdiction). Because the 

Court grants the motions to dismiss as to the federal law claims, the Court declines to exercise 

supplemental jurisdiction over state law claims. 

IV. Findings and Recommendations

Plaintiffs fail to state a cognizable claim under federal law. Based upon the foregoing, the 

Court RECOMMENDS:

1. Defendants’ Motions to Dismiss (Docs. 66, 67) be GRANTED; 

2. Plaintiffs’ Fourth Amended Complaint be DISMISSED without leave to amend;

3. The Court decline to exercise supplemental jurisdiction over the state law claims.

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)(1)(B) and Rule 304 of the Local 

Rules of Practice for the United States District Court, Eastern District of California. Within fourteen 

days after being served with these findings and recommendations, Plaintiffs may file written 

objections with the court. Such a document should be captioned “Objections to Magistrate Judge’s 

Findings and Recommendations.” Plaintiffs 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 

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1153 (9th Cir. 1991); Wilkerson v. Wheeler, 772 F.3d 834, 834 (9th Cir. 2014).

IT IS SO ORDERED.

Dated: March 29, 2020 /s/ Jennifer L. Thurston 

UNITED STATES MAGISTRATE JUDGE

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