Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_19-cv-02095/USCOURTS-caed-2_19-cv-02095-7/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 

BRIAN BEINLICK, 

Plaintiff, 

v. 

SANDAR AUNG, et al., 

Defendants. 

No. 2:19-cv-02095 DAD AC 

FINDINGS & RECOMMENDATIONS 

Plaintiff is a state prisoner proceeding through counsel in this civil rights action filed 

pursuant to 42 U.S.C. § 1983. Currently before the court are defendants’ separately filed motions 

for summary judgment. ECF Nos. 49, 50. The motions have been fully briefed. ECF Nos. 56-

58. For the reasons explained in further detail below, the undersigned recommends that 

defendant Aung be granted summary judgment and that defendant Liu’s motion for summary 

judgment be granted in part and denied in part. 

I. Procedural History 

Plaintiff initiated this action on October 16, 2019, and the case now proceeds on plaintiff's 

Second Amended Complaint, filed July 11, 2021. ECF No. 7. At all relevant times, plaintiff was 

incarcerated in the California Department of Corrections and Rehabilitation (“CDCR”), at Mule 

Creek State Prison (“MCSP”). On December 5, 2022, the court granted in part, and denied in 

part, defendants’ motion to dismiss. ECF No. 30. The court dismissed defendants Dr. Monivirin 

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Son, San Joaquin County, and the California Department of Corrections and Rehabilitation 

(“CDCR”) without leave to amend. The action therefore proceeds against defendants Dr. Aung 

and Dr. Liu for deliberate indifference to plaintiff’s serious medical needs in violation of the 

Eighth Amendment, and professional negligence under state law. 

II. Plaintiff’s Allegations 

Plaintiff began to experience pain in his right testicles and was seen by defendant Dr. 

Aung, his primary care physician at MCSP, on August 16, 2018. ECF No. 7 at 2-3. He was 

transported to San Joaquin General Hospital (“SJGH”) for urgent treatment on the same day. 

ECF No. 7 at 4. After an ultrasound, he was diagnosed with multiple epididymal cysts on both 

testicles with his right side being more severe than his left. Id. Hospital staff consulted with 

defendant Dr. Liu, a urologist at SJGH, who recommended that plaintiff return for follow-up in 2 

to 3 days. Id. at 2,4. 

When plaintiff returned to Mule Creek, he was seen by Dr. Aung again on August 20, 

2018. Id. at 4. Instead of submitting a request for treatment on an urgent basis in light of Dr. 

Liu’s recommendation, Dr. Aung submitted a routine request for consultation at SJGH for 

plaintiff’s continued testicular pain and swelling. Id. Dr. Aung also failed to treat plaintiff’s 

worsening pain and only prescribed him an antibiotic during this visit. Id. 

Plaintiff submitted additional requests to see his doctor on August 31 and September 4, 

2018 based on his worsening testicular pain. Id. at 5. On September 11, 2018, plaintiff was seen 

in the prison’s clinic for his pain where he was only given numbing cream. Id. Dr. Aung saw 

plaintiff on September 12, 2018 and ignored his worsening testicular pain. Id. 

Finally, on October 11, 2018, plaintiff was sent out for his consultation with Dr. Liu at 

SJGH. Id. Dr. Liu prescribed a Non-Steroidal Anti-Inflammatory Drug (“NSAID”) to reduce 

plaintiff’s swelling and indicated that if this was unsuccessful, plaintiff would need surgery. Id. 

However, plaintiff’s medical records indicated that plaintiff was allergic to NSAIDs and should 

not be prescribed any. Id. 

Plaintiff was seen by Dr. Aung on October 12, 2018 and November 6, 2018 for a different 

medication since he was allergic to NSAIDs and his pain was still not managed. ECF No.7 at 5-

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6. Dr. Aung submitted another routine request for a urology consult rather than an urgent request. 

Id. at 6. 

On December 13, 2018, plaintiff returned to see Dr. Liu for his treatment options and was 

told that aspirating the cysts was not an option. Id. at 6. Dr. Liu told plaintiff that surgery was his 

only option. Id. Plaintiff requested another ultrasound before the surgery was performed, but that 

request was ignored. Id. Dr. Liu performed the surgery on December 21, 2018 and, in the course 

thereof, severed plaintiff’s right testicular artery requiring the removal of the whole right testicle. 

Id. 

Following surgery, plaintiff had ongoing pain in his left testicle. In appointments with Dr. 

Aung on January 3, February 1 and 28, 2019, plaintiff was once against prescribed an ineffective 

NSAID for his pain. ECF No. 7 at 7. 

Plaintiff had a consultation with a different urologist, Dr. Sorbera, on March 14, 2019 due 

to ongoing pain and increased swelling in his testicles. ECF No. 7 at 8. Back at Mule Creek. Dr. 

Aung ignored this specialist’s recommendations. Id. at 8. 

Based on these facts, plaintiff alleges in claim one that defendants Dr. Aung and Liu were 

deliberately indifferent to his serious medical needs in violation of the Eighth Amendment. ECF 

No. 7 at 9. In his second cause of action, plaintiff alleges that that defendants were professionally 

negligent. ECF No. 7 at 9-10. 

 Plaintiff was released from CDCR custody on December 11, 2019. ECF No. 7 at 1. 

III. Motions for Summary Judgment 

A. Defendant Aung 

Plaintiff filed a Statement of Non-Opposition to Dr. Aung’s motion. ECF No. 57. 

Because plaintiff, through counsel, does not oppose the granting of summary judgment to Dr. 

Aung, that will be the recommendation. 

B. Defendant Liu’s Arguments 

The briefing has also narrowed the issues in dispute regarding Dr. Liu’s motion. At the 

outset, the court notes that the parties’ briefs have narrowed the issues in dispute. Defendant Liu 

acknowledges, “for purposes of this motion only, that Mr. Beinlick has articulated facts sufficient 

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to create a factual dispute precluding summary judgment of his state law medical malpractice 

claim.” ECF No. 58 at 9 (reply). Therefore, the court’s discussion of defendant Liu’s motion for 

summary judgment is limited to plaintiff’s Eighth Amendment deliberate indifference claim and 

the request for punitive damages. ECF No. 50. 

In his motion, Dr. Liu submits that the undisputed material facts demonstrate that: (1) he 

did not prescribe medications to which plaintiff was allergic; (2) the epididymectomy procedure 

performed by Dr. Liu was medically indicated and a less invasive procedure was not appropriate; 

(3) the surgery was competently performed by Dr. Liu despite the complication that occurred; (4) 

plaintiff received appropriate pain medications from Dr. Liu after surgery; (5) Dr. Liu’s treatment 

was not negligent and was within the medical standard of care at all times. ECF No. 50-2 at 10-

14. In support thereof, defendant Liu submitted a declaration from Edward J. Yun, M.D., a 

board-certified urologist, stating that the treatment and surgical intervention provided to plaintiff 

by Dr. Liu was proper and well within the standard of care for physicians practicing in the same 

or similar circumstances. ECF No. 50-3. In addition, defendant Liu asserts that plaintiff is not 

entitled to punitive damages because there is no evidence of any evil motive or reckless and 

callous indifference towards plaintiff. ECF No. 50-2 at 14-15. 

C. Plaintiff’s Response 

With regard to the Eighth Amendment deliberate indifference claim, plaintiff points out 

that there is no dispute that plaintiff had a serious medical need. ECF No. 56 at 13. Plaintiff 

submits that the declaration of his medical expert, Dr. Karlovsky, demonstrates that defendant Dr. 

Liu followed a course that was medically unacceptable under the circumstances thus establishing 

the subjective state of mind required to establish deliberate indifference. ECF No. 56 at 13-14. 

This is also established based upon plaintiff’s subsequent diagnosis and treatment by Dr. Sorbera 

as well as the ineffectual use of NSAID’s to treat plaintiff’s pain for months before 

recommending surgery. Id. 

Lastly, plaintiff argues that defendant Dr Liu’s conduct rises to the level of callous and 

reckless indifference to plaintiff’s federally protected rights, even though he does not point to any 

evidence that establishes this. ECF No. 56 at 14. 

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D. Defendant’s Reply 

By way of reply, defendant Liu emphasizes that an Eighth Amendment violation is not 

established by just pointing to evidence that a doctor’s chosen course of treatment was medically 

unacceptable under the circumstances. ECF No. 58 at 2 (citing Hamby v. Hammond, 821 F.3d 

1085, 1092 (9th Cir. 2016)). In this regard, plaintiff must do more than simply demonstrate that 

defendant was negligent or committed medical malpractice. ECF No. 58 at 2-3. The undisputed 

medical evidence establishes that “Dr. Liu provided Mr. Beinlick with extensive medical care, 

diagnosis and treatment for his medical condition as well as prescribing medication to address it.” 

Id. at 3. Plaintiff’s evidence merely establishes a difference of opinion between Dr. Liu and Dr. 

Karlovsky which is not sufficient to meet the Eighth Amendment standard of deliberate 

indifference. Id. at 4. “Dr. Karlovsky’s speculation about the viability of, or even the superiority 

of, alternate courses of medical care or treatment do not supply a sufficient basis for an Eighth 

Amendment constitutional violation claim under 42 U.S.C. §1983 as a matter of law.” Id. at 6. 

Because there is no record evidence that defendant Dr. Liu consciously disregarded any excessive 

risk to plaintiff’s health, he is entitled to summary judgment. Id. at 7. 

With regard to punitive damages, plaintiff’s “failure to provide a substantive response 

articulating facts showing “evil motive or intent or reckless and callous indifference to federally 

protected rights” is a concession that his claims regarding his alleged entitlement to punitive 

damages are inadequately pled.” ECF No. 56 at 9-10. 

IV. Legal Standards for Summary Judgment 

Summary judgment is appropriate when the moving party “shows 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. 

Civ. P. 56(a). Under summary judgment practice, “[t]he moving party initially bears the burden 

of proving the absence of a genuine issue of material fact.” In re Oracle Corp. Sec. Litig., 627 

F.3d 376, 387 (9th Cir. 2010) (citing Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986)). The 

moving party may accomplish this 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 

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answers, or other materials” or by showing that such materials “do not establish the absence or 

presence of a genuine dispute, or that an adverse party cannot produce admissible evidence to 

support the fact.” Fed. R. Civ. P. 56(c)(1). 

“Where the non-moving party bears the burden of proof at trial, the moving party need 

only prove that there is an absence of evidence to support the non-moving party’s case.” Oracle 

Corp., 627 F.3d at 387 (citing Celotex, 477 U.S. at 325); see also Fed. R. Civ. P. 56(c)(1)(B). 

Indeed, 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.” Celotex, 477 U.S. at 322. “[A] complete failure of proof concerning an essential element 

of the nonmoving party’s case necessarily renders all other facts immaterial.” Id. at 323. In such 

a circumstance, summary judgment should “be granted so long as whatever is before the district 

court demonstrates that the standard for the entry of summary judgment, as set forth in Rule 

56(c), is satisfied.” 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. Matsushita Elec. 

Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586-87 (1986). In attempting to establish the 

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

of its 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. See Fed. R. 

Civ. P. 56(c). 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,” and that the dispute is 

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

party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). 

 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., Inc. v. Pac. Elec. Contractors Ass’n, 809 F.2d 626, 630 (9th Cir. 1987) 

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(quoting First Nat’l Bank of Ariz. v. Cities Serv. Co., 391 U.S. 253, 288-89 (1968). Thus, the 

“purpose of summary judgment is to pierce 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 (citation and internal 

quotation marks omitted). 

 “In evaluating the evidence to determine whether there is a genuine issue of fact, [the 

court] draw[s] all inferences supported by the evidence in favor of the non-moving party.” Walls 

v. Cent. Contra Costa Transit Auth., 653 F.3d 963, 966 (9th Cir. 2011) (citation omitted). 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, 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.” Matsushita, 475 U.S. at 586 (citations 

omitted). “Where the record taken as a whole could not lead a rational trier of fact to find for the 

non-moving party, there is no ‘genuine issue for trial.’” Id. at 587 (quoting First Nat’l Bank, 391 

U.S. at 289). 

V. Eighth Amendment Deliberate Indifference Legal Standard 

Denial or delay of medical care for a prisoner’s serious medical needs may constitute a 

violation of the prisoner’s Eighth and Fourteenth Amendment rights. Estelle v. Gamble, 429 U.S. 

97, 104-05 (1976). An individual is liable for such a violation only when the individual is 

deliberately indifferent to a prisoner’s serious medical needs. Id.; see Jett v. Penner, 439 F.3d 

1091, 1096 (9th Cir. 2006); Hallett v. Morgan, 296 F.3d 732, 744 (9th Cir. 2002); Lopez v. 

Smith, 203 F.3d 1122, 1131-32 (9th Cir. 2000). A physician need not fail to treat an inmate 

altogether in order to violate that inmate’s Eighth Amendment rights. Estelle v. Gamble, 429 

U.S. 97, 106 (1976) (emphasizing that acts of omission as well as commission may rise to the 

level of deliberate indifference); Ortiz v. City of Imperial, 884 F.2d 1312, 1314 (9th Cir. 1989) 

(per curiam). A failure to competently treat a serious medical condition, even if some treatment 

is prescribed, may constitute deliberate indifference in a particular case. Id. 

In the Ninth Circuit, the test for deliberate indifference consists of two parts. Jett, 439 

F.3d at 1096, citing McGuckin v. Smith, 974 F.2d 1050 (9th Cir. 1991), overruled on other 

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grounds by WMX Techs., Inc. v. Miller, 104 F.3d 1133 (9th Cir. 1997) (en banc). First, the 

plaintiff must show a “serious medical need” by demonstrating that “failure to treat a prisoner’s 

condition could result in further significant injury or the ‘unnecessary and wanton infliction of 

pain.’” Id., citing Estelle, 429 U.S. at 104. “Examples of serious medical needs 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.’” Lopez, 203 F. 3d 

at 1131-1132, citing McGuckin, 974 F.2d at 1059-60. 

Second, the plaintiff must show the defendant’s response to the need was deliberately 

indifferent. Jett, 439 F.3d at 1096. This second prong is satisfied by showing (a) a purposeful act 

or failure to respond to a prisoner’s pain or possible medical need and (b) harm caused by the 

indifference. Id. Under this standard, the prison official must not only “be aware of facts from 

which the inference could be drawn that a substantial risk of serious harm exists,” but that person 

“must also draw the inference.” Farmer v. Brennan, 511 U.S. 825, 837 (1994). This “subjective 

approach” focuses only “on what a defendant’s mental attitude actually was.” Id. at 839. A 

showing of merely negligent medical care is not enough to establish a constitutional violation. 

Frost v. Agnos, 152 F.3d 1124, 1130 (9th Cir. 1998), citing Estelle, 429 U.S. at 105-106. 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); Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir. 1989). Furthermore, mere delay of 

medical treatment, “without more, is insufficient to state a claim of deliberate medical 

indifference.” Shapley v. Nev. Bd. of State Prison Comm’rs, 766 F.2d 404, 407 (9th Cir. 1985). 

Where a prisoner alleges that delay of medical treatment evinces deliberate indifference, the 

prisoner must show that the delay caused “significant harm and that Defendants should have 

known this to be the case.” Hallett, 296 F.3d at 745-46; see McGuckin, 974 F.2d at 1060. 

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VI. Legal Standards Governing Punitive Damages 

In a § 1983 case, punitive damages are proper where a defendant’s conduct was driven by 

evil motive or intent, or when it involved a reckless or callous indifference to the constitutional 

rights of others. Smith v. Wade, 461 U.S. 30, 56 (1982). 

VII. Undisputed Material Facts1

A. Pre-Surgical Medical Treatment 

On August 16, 2018, the CDCR transported Mr. Beinlick to the emergency room of San 

Joaquin General Hospital (“SJGH”) with complaints of right testicular pain. ECF No. 56-1 at No. 

46 (Plaintiff’s Response to Defendant Liu’s Statement of Undisputed Facts) (hereinafter referred 

to as “PSUF”); ECF No. 58-1 at No. 46 (Defendant Liu’s Response to Plaintiff’s Additional 

Undisputed Facts). The SJGH emergency department consulted with urologist/defendant Dr. Liu, 

via telephone. PSUF at No. 46. Dr. Liu recommended that Mr. Beinlick present to the urology 

clinic in 2-3 days for outpatient management. ECF No. 50-1 at No. 5 (Defendant Liu’s Separate 

Statement of Undisputed Material Facts) (hereinafter referred to as “DSSUMF”). The SJGH 

emergency department advised a physician at Mule Creek State Prison of Dr. Liu’s 

recommendations. DSSUMF at No. 5. 

Plaintiff was subsequently examined and received additional medical treatment by CDCR 

physicians and medical staff, including the prescription of pain medications, for testicular pain 

and/or discomfort on August 17, 2018; August 20, 2018; September 11, 2018; September 12, 

2018; and, October 1, 2018. DSSUMF at No. 6. 

On October 11, 2018, Mr. Beinlick was seen by Dr. Liu and reported swelling and pain in 

his right testicle. PSUF at No 47. On examination, Dr. Liu determined that plaintiff had bilateral 

epididymal cysts. PSUF at No. 47. Dr. Liu discussed treatment options with Mr. Beinlick 

including conservative treatment with nonsteroidal anti-inflammatory medications and surgical 

intervention. PSUF at No. 47. Dr. Liu recommended that Mr. Beinlick try the conservative 

treatment with medication for a few months and if the pain persisted, Dr. Liu would see him again 

1

 Unless otherwise noted, these facts are undisputed by the parties or are deemed undisputed by 

the court upon review of the record evidence. 

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to discuss excision of the epididymal cysts via surgical intervention. DSSUMF at No. 7. 

Plaintiff received additional treatment and pain medications by non-party medical staff at 

MCSP on October 12, 2018; October 17, 2018; and, November 6, 2018. DSSUMF at No. 8. 

B. Surgery 

On December 13, 2018, plaintiff had a follow-up appointment with Dr. Liu. DSSUMF at 

No. 9. Dr. Liu examined plaintiff, discussed the nature of his pain, once again diagnosed him 

with epididymal cyst, and discussed treatment options which included the option of a right 

epididymectomy to remove the cyst. DSSUMF at No. 9. Dr. Liu discussed the risks and benefits 

of the procedure, but plaintiff disputes that he was informed that testicular loss is an 

uncommon, but known risk of an epididymectomy. DSSUMF at No. 9; PSDF at No. 48. 

Plaintiff signed a written consent form in which he agreed to accept the risks of the 

epididymectomy. ECF No. 50-4 at 29-30. 

On December 21, 2018 Dr. Liu performed the scheduled right epididymectomy. PSUF at 

No. 49. Dr. Liu’s operative report noted inflammation with cystic changes in the right 

epididymis. PSUF at No. 49. Dr. Liu’s operative report also states “[w]hile trying to dissect the 

epididymis away, we inadvertently in[j]ured the right testicular artery. Since the testicle will not 

survive without the artery, we have to remove the testicle as well...” PSUF at No. 49. The 

testicle and epididymis were then removed and sent for pathologic examination. DSSUMF at No. 

10. 

According to defendant’s medical expert, Dr. Yun, the occurrence of testicular loss or 

injury is a known but uncommon complication for all intrascrotal operations (including 

epididymectomy). DSSUMF at No. 34. He further is of the opinion that “when procedural 

intervention is indicated, such as in this case, surgical excision via epididymectomy is the best 

treatment because aspiration (placing a needle into the cysts) confers an increased risk of cyst 

recurrence, as well as increased risks of bleeding or infection.” DSSUMF at No. 24. According 

to Dr. Yun, the epididymectomy operation was performed with all standard risk-reduction 

strategies and techniques, and due to the inflammation encountered, a known but uncommon 

complication occurred. Dr. Liu managed this complication appropriately and at all times acted 

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completely within the standard of urologic care. ECF No. 50-3 at 21 (Declaration of Edward J. 

Yun, M.D.). 

According to plaintiff’s medical expert, Dr. Liu performed an unnecessary surgery rather 

than conducting a less invasive procedure and failed to perform the surgery competently when he 

injured the testicular artery leading to the loss of plaintiff’s right testicle. ECF No. 56-3 at 18 

(Declaration of Matthew E. Karlovsky, M.D.). Plaintiff’s expert is also of the opinion that Dr. 

Liu did not take all standard surgical precautions and techniques to minimize the risk of injury to 

plaintiff. PSUF at No. 75. 

C. Post-Surgical Medical Treatment 

Mr. Beinlick was examined and received post-surgical follow-up care and treatment by 

CDCR physicians and other prison medical professionals on: December 21, 2018; December 24, 

2018; December 27, 2018; and January 3, 2019. DSSUMF at No. 11. 

Mr. Beinlick returned to Dr. Liu on January 31, 2019, reporting that his right sided pain 

was much better, but still had residual pain on his left side. PSUF at No. 51. Dr. Liu’s note 

states: “[T]his man has already lost his right testicle. I do not think we should be overly 

aggressive about his pain on the left side. I told him we should try to manage his pain with using 

NSAID medicines. He should not consider any surgical intervention unless it is the last resort 

because we do not want him to lose his left testicle as well.” DSSUMF at No. 12. Dr. Liu had no 

further contact and/or involvement in Mr. Beinlick’s care and treatment after January 31, 2019. 

DSSUMF at No. 13. 

Mr. Beinlick received additional care and treatment for his left testicle (including, but not 

limited to, examination, evaluation, and medications) from CDCR physicians (and other CDCR 

medical professionals) on the following dates: February 1, 2019; February 27, 2019; February 28, 

2019; March 12, 2019; March 15, 2019; June 10, 2019; July 2, 2019; July 24, 2019; August 8, 

2019; August 23, 2019; September 3, 2019; September 12, 2019; October 18, 2019; October 19, 

2019; October 20, 2019; October 21, 2019; October 24, 2019; and, December 3, 2019. DSSUMF 

at No. 14. 

 Mr. Beinlick also received care and treatment at SJGH for his left testicle on August 30, 

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2019. DSSUMF at No. 15. Mr. Beinlick received care and treatment for his left testicle from 

Urologist Thomas Sorbera, M.D. on: March 14, 2019; May 30, 2019; October 14, 2019; and, 

October 22, 2019. DSSUMF at No. 16. During the first appointment, Dr. Sorbera diagnosed 

plaintiff with epididymitis and orchialgia, and recommended conservative treatment for the 

testicular pain, including an ultrasound of the testis, an alpha blocker to relax the smooth muscle 

of the prostatic area and smooth muscle of the vas; and, noted the “presence of epididymal cysts 

is not indicative of any significant problem and is not usually the cause of pain”. PSUF at No. 55. 

 Plaintiff was released from prison on December 11, 2019 and had a microdenervation of 

the spermatic cord performed at USC in February 2021. PSDF at No. 84. He has been pain-free 

since that procedure. PSUF at No. 84. 

D. Plaintiff’s Medications 

The parties dispute whether plaintiff ever advised CDCR or SJGH medical staff that he 

was not allergic to Ibuprofen. According to plaintiff’s medical expert, plaintiff’s nonresponsiveness to NSAIDS suggests that the pain was not inflammatory in nature but neuropathic. 

PSUF at No. 61. Plaintiff’s expert specifically faults Dr. Liu for not using any of the widely 

available alternative conservative treatment modalities for chronic epididymal pain such as 

amitriptyline, gabapentin, pregabalin, tamsulosin, local nerve/cord block, BOTOX injection, 

physical therapy, and psychotherapy prior to surgery. PSUF at No. 66. 

Defendant’s medical expert is of the opinion that Dr. Liu never prescribed any medication 

to which plaintiff was known, or claimed to be, allergic. DSSUMF at No. 18. It is also Dr. Yun’s 

opinion that, following his epididymectomy surgery, Dr. Liu appropriately prescribed 

Acetaminophen/Hydrocodone (Norco) and there is no evidence in the medical records that any 

medications prescribed to Mr. Beinlick were inappropriate for the management of his 

postoperative discomfort following his epididymectomy operation. DSSUMF at No. 28. 

VIII. Discussion 

A. Deliberate Indifference and Negligence Claims 

Regarding the Eighth Amendment claim, the medical evidence provided by plaintiff’s 

expert creates a material factual dispute as to whether Dr. Liu was deliberately indifferent by 

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failing to competently treat plaintiff’s medical condition. See Ortiz v. City of Imperial, 884 F.2d 

at 1314. As to the state law medical malpractice claim, the parties agree that there is a triable 

question whether plaintiff received appropriate medical treatment that was within the relevant 

standard of care. Plaintiff has demonstrated triable issues of fact concerning whether Dr. Liu’s 

course of treatment was “medically unacceptable under the circumstances,” and chosen “in 

conscious disregard of an excessive risk to plaintiffs health.” Jackson v. McIntosh, 90 F.3d 330, 

332 (9th Cir. 1996) (citations and internal quotation marks omitted). Accordingly, it is 

recommended that defendant Liu’s motion for summary judgment be denied with respect to the 

Eighth Amendment deliberate indifference and state law medical malpractice claims. 

B. Punitive Damages 

Defendant Liu has met his initial burden of demonstrating the absence of a genuine issue 

regarding the availability of punitive damages. Plaintiff has not come forward with any evidence 

upon which a reasonable jury could find that Dr. Liu’s treatment decisions were driven by an evil 

motive or that he was callously indifferent to plaintiff’s serious medical needs. See Smith v. 

Wade, 461 U.S. at 56. Accordingly, the undersigned recommends granting defendant Liu’s 

motion for summary judgment on punitive damages. 

CONCLUSION 

 For the reasons explained above, IT IS HEREBY RECOMMENDED that: 

 1. Defendant Aung’s motion for summary judgment (ECF No. 49) be granted, as such 

relief is expressly unopposed by plaintiff. 

 2. Defendant Liu’s motion for summary judgment (ECF No. 50) be granted with respect 

to plaintiff’s claim for punitive damages, but denied on plaintiff’s Eighth Amendment deliberate 

indifference and state law medical negligence claims. 

 3. The Clerk of Court be directed to enter judgment in favor of defendant Aung. 

 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 twenty-one 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 

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

objections shall be served and filed within 21 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: September 19, 2024 

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