Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_08-cv-01183/USCOURTS-caed-1_08-cv-01183-2/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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MDR

IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

Arthur L. Johnson,

Plaintiff,

vs.

Dr. Ortiz, et al.,

Defendants.

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No. CV 1-08-1183-DCB P

ORDER

I. Background

Plaintiff Arthur L. Johnson is confined in the Correctional Training Facility in

Soledad, California. In an October 8, 2009 Order, the Court screened Plaintiff’s First

Amended Complaint and dismissed without prejudice Defendants Ortiz, Salazar, Kushner,

Emler, Castillo,Vilaysane, Diep, and Doehring because Plaintiff had failed to state a claim

against them. The Court stated that Plaintiff had stated a claim against members of the

medical review committee or against the individual at the California Department of

Corrections and Rehabilitation (CDCR) who allegedly created or implemented a policy of

permitting the committee to arbitrarily deny prescribed treatments. However, because

Plaintiff had identified these individuals only as “Doe” Defendants, the Court gave Plaintiff

30 days to file a Response to the Order, that included

either (1) the name of at least one member of the medical review

committee or the individual who implemented the CDCR policy

or (2) an explanation of what Plaintiff has done to try to learn

their names, a description of what discovery he would undertake

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to learn their names, and the identity of at least one person who

could be served with discovery.

In a December 8, 2009 Order, the Court granted Plaintiff’s November 25, 2009

Motion for Extension of Time and gave Plaintiff until December 28, 2009 to file the names

of the Doe Defendants.

On December 9, 2009, Plaintiff filed a “Notice to File Third Amended Complaint.”

In that document, Plaintiff requested leave to file a third amended complaint, noting that he

had determined the name of one of the Doe Defendants and stating that a amended complaint

would rectify his failure to “adequately reference [Defendants] Ortiz, Emler, Kushner,

Doehring, Vilaysane and Diep with the cause of action.” Plaintiff sought an extension of

time until February 3, 2010 to file his amended complaint. On December 24, 2009, Plaintiff

filed a “Response” in which he identified three of the Doe Defendants, asserted that he had

failed to “adequately reference [Defendants] Ortiz, Kushner, Vilaysane, Diep, Salazar,

Castillo, and Nurse Practitioners Doehering, and Emler,” and indicated that he was currently

creating a third amended complaint that he intended to file in late January or mid-February

2010.

In a January 21, 2010 Order, the Court gave Plaintiff until February 3, 2010 to file an

amended complaint. On January 25, 2010, Plaintiff filed a “Notice of Third Amended

Complaint” (Doc. #20) and attached his Third Amended Complaint to the Notice. Although

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the Third Amended Complaint was unsigned, Plaintiff submitted a January 29, 2010 Notice

(Doc. #21), noting that he had inadvertently failed to sign the Third Amended Complaint and

attaching a signed final page of the Third Amended Complaint. The signed final page shall

serve as an original signature on Plaintiff’s Third Amended Complaint for the purposes of

Rule 11 of the Federal Rules of Civil Procedure.

. . . .

. . . .

The January 25th document is, in actuality, Plaintiff’s “second” amended complaint.

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Nevertheless, because Plaintiff refers to the January 25th document as the “Third” Amended

Complaint, the Court, for purposes of clarity, will do the same.

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II. Statutory Screening of Prisoner Complaints

The Court is required to screen complaints brought by prisoners seeking relief against

a governmental entity or an officer or an employee of a governmental entity. 28 U.S.C.

§ 1915A(a). The Court must dismiss a complaint or portion thereof if a plaintiff has raised

claims that are legally frivolous or malicious, that fail to state a claim upon which relief may

be granted, or that seek monetary relief from a defendant who is immune from such relief.

28 U.S.C. § 1915A(b)(1), (2).

A pleading must contain a “short and plain statement of the claim showing that the

pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2) (emphasis added). While Rule 8 does not

demand detailed factual allegations, “it demands more than an unadorned, the-defendantunlawfully-harmed-me accusation.” Ashcroft v. Iqbal, 129 S. Ct. 1937, 1949 (2009).

“Threadbare recitals of the elements of a cause of action, supported by mere conclusory

statements, do not suffice.” Id.

“[A] complaint must contain sufficient factual matter, accepted as true, to ‘state a

claim to relief that is plausible on its face.’” Id. (quoting Bell Atlantic Corp. v. Twombly,

550 U.S. 544, 570 (2007)). A claim is plausible “when the plaintiff pleads factual content

that allows the court to draw the reasonable inference that the defendant is liable for the

misconduct alleged.” Id. “Determining whether a complaint states a plausible claim for

relief [is] . . . a context-specific task that requires the reviewing court to draw on its judicial

experience and common sense.” Id. at 1950. Thus, although a plaintiff’s specific factual

allegations may be consistent with a constitutional claim, a court must assess whether there

are other “more likely explanations” for a defendant’s conduct. Id. at 1951.

III. Third Amended Complaint

An amended complaint supersedes the original complaint and prior amended

complaints. Ferdik v. Bonzelet, 963 F.2d 1258, 1262 (9th Cir. 1992); Hal Roach Studios v.

Richard Feiner & Co., 896 F.2d 1542, 1546 (9th Cir. 1990). After amendment, the Court

treats the original Complaint and all prior amended complaints as nonexistent. Ferdik, 963

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F.2d at 1262. Thus, the Court will consider only those claims raised in the Third Amended

Complaint against only those Defendants named in the Third Amended Complaint.

In his Third Amended Complaint, Plaintiff sues the following Defendants: Doctors

Ortiz, Salazar, Kushner, Castillo, Vilaysane, and Diep; Nurse Practioners Emler and

Doehring; and Registered Nurse Corona. Plaintiff alleges that Defendant Corona is a

utilization management nurse “responsible for all [Utilization Management] Review

Processing for health care services for all prisoners at [Pleasant Valley State PrisonCoalinga].”

Plaintiff alleges that the Court has federal question jurisdiction over his claim under

42 U.S.C. § 1983 and invokes the Court’s supplemental jurisdiction over his state court

claims of negligence/malpractice and failure to discharge a mandatory duty.

Plaintiff makes the following allegations:

1. On January 13, 2005, Plaintiff, after complaining about rapid

heartbeat and weight loss, was seen by Defendant Ortiz.

Defendant Ortiz ordered a blood test.

2. On February 1, 2005, Defendant Ortiz informed Plaintiff that the

blood test showed a positive result for hypothyroidism,

prescribed a thyroid medication, and scheduled a follow-up

appointment in a month. On February 25th, Defendant Ortiz

examined Plaintiff, who had twice complained about increased

heart palpitations and other symptoms, and informed Plaintiff

that he would be scheduled to see an “expert” who would

perform a thyroid scan.

3. On April 26, 2005, Plaintiff was taken to a hospital to see an

endocrinologist, but the endocrinologist was unable to conduct

the thyroid scan because prison medical staff had not informed

Plaintiff that he needed to stop his thyroid medication before the

scan. The endocrinologist advised medical staff to stop

Plaintiff’s medication for six weeks.

4. On June 13, 2005, Plaintiff was told that he would be getting a

thyroid scan. On June 15th, Plaintiff informed a nurse that he

was experiencing severe heart palpitations, constantshortness of

breath, and fatigue. The nurse told Plaintiff that his complaints

would be reported to Defendant Ortiz. The nurse also informed

Plaintiff that the thyroid scan appointment had been cancelled

by Defendant Corona. On June 17th, Plaintiff received “lab

work” and was informed that he would be started back on this

thyroid medication. On July 5th, Plaintiff was seen by

Defendant Ortiz, who informed Plaintiff that the results of the

June 17th lab work were not in Plaintiff’s file. Defendant Ortiz

told Plaintiff to “try and relax.”

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5. On August 11, 2005, Plaintiff received a thyroid scan. On

September 8th, Plaintiff complained of severe heart palpitations,

was evaluated by a nurse, was informed that he potentially had

cardiac arrhythmia, and was returned to his cell. On September

9th, Defendant Ortiz saw Plaintiff, informed Plaintiff that he

needed to have his thyroid medication restarted, and stated that

he would review the results of the thyroid scan and would see

Plaintiff “soon.”

6. On September 16, 2005, Defendant Salazar saw Plaintiff.

Plaintiff informed Defendant Salazar of his health problems, but

Defendant Salazar made no diagnosis and simply told Plaintiff

to take care of himself. On October 12th, Plaintiff was

supposed to meet with Defendant Salazar to review the thyroid

scan report, but the report had been misplaced, and Plaintiff’s

appointment was rescheduled.

7. On December 12, 2005, Defendant Kushner reviewed the

thyroid scan report with Plaintiff and informed Plaintiff that he

needed Ablation therapy (Ablation) and that his heart

palpitations and arrhythmia were caused by Plaintiff’s

hyperthyroidism.

8. On February 16, 2006, Defendant Emler informed Plaintiff that

his thyroid was abnormally large, his uptake was abnormal, and

his palpitations were due to cardiac problems. Defendant Emler

informed Plaintiff that he would see an endocrinologist as soon

as possible and requested a thyroid uptake test for the following

week.

9. On March 3, 2006, an endocrinologist saw Plaintiff, informed

Plaintiff that he needed immediate Ablation, and told Plaintiff

that prison staff would have to “schedule the correct process so

that Plaintiff could obtain the medication and correct treatment

and follow up.”

10. On March 16, 2006, Defendant Castillo met with Plaintiff.

Plaintiff informed Defendant Castillo of his symptoms and

informed Defendant Castillo that the endocrinologist had

recommended Ablation. Defendant Castillo discontinued

Plaintiff’s thyroid medication and prescribed a different

medication. He did not start Ablation.

11. On April 12, 2006, Defendant Castillo informed Plaintiff that

Defendant Castillo was requesting a blood test and that Plaintiff

would soon be receiving Ablation. The blood test was

performed on May 2nd.

12. On June 1, 2006, Defendant Castillo saw Plaintiff, told him that

he would be given Ablation very soon based on the result of the

blood test, and advised Plaintiff to stop taking his medication so

another test could be performed. A blood test was performed on

July 5th and a thyroid stimulation hormone test (TSH) was

performed on July 17th.

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13. On August 3, 2006, Plaintiff saw Defendant Emler to discuss

Ablation treatment. On August 16th, Plaintiff saw Defendant

Castillo, complained about his symptoms, and pleaded to start

receiving Ablation.

14. On August 24, 2006, Defendant Vilaysane saw Plaintiff, placed

Plaintiff back on medication, and ordered another TSH test. On

September 14th, Plaintiff went to the medical department

because his heart was racing, his vision was blurry, and he was

dizzy. A nurse informed him that he would soon be given

Ablation.

15. On September 20, 2006, the endocrinologist saw Plaintiff,

explained that Plaintiff needed to be started on Ablation, and

stated that repeated consultations were unnecessary because

hyperthyroidism had already been diagnosed. Plaintiff was

placed back on medication.

16. On September 26, 2006, Plaintiff saw Defendant Vilaysane to

discuss scheduling Plaintiff for Ablation. On October 25th,

Defendant Vilaysane informed Plaintiff that he would be seen

by an endocrinologist soon for a followup. On November 15th,

Defendant Vilaysane told Plaintiff that he needed another TSH

test and a cardiac exam. On December 6th, Defendant

Vilaysane explained that the TSH test results were high and that

Plaintiff was at risk for a heart attack. Plaintiff explained that

the endocrinologist had stated in September that Plaintiff should

have been started on Ablation as soon as possible. Defendant

Vilaysane ordered more blood tests.

17. On February 2, 2007, Defendant Vilaysane examined Plaintiff,

told Plaintiff that he was scheduled to see an endocrinologist,

and that he was suffering from anemia. Defendant Vilaysane

ordered more blood tests.

18. On February 14, 2007, Plaintiff saw the endocrinologist, who

stated that he was very disappointed that prison medical staff

had not given Plaintiff Ablation and stressed that it was

extremely important for Plaintiff to have the treatment. The

endocrinologist recommended that Plaintiff at least restart the

thyroid medication.

19. On March 16, 2007, Defendant Vilaysane saw Plaintiff and told

Plaintiff that he would see the endocrinologist again soon.

Defendant Vilaysane discontinued Plaintiff’sthyroid medication

after Plaintiff complained of hot and cold flashes.

20. On March 25, 2007, after complaining of constipation,

confusion, and pain, Plaintiff was seen by Defendant Diep, who

opined that the constipation was caused by Plaintiff’s

hyperthyroidism and submitted a request for Plaintiff to see an

endocrinologist.

. . . .

. . . .

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21. On April 12, 2007, Plaintiff saw Defendant Doehring, who

reviewed Plaintiff’s medical file and determined that he needed

Ablation, ordered Plaintiff’s test results, and prescribed a

medication for Plaintiff’s heart palpitations.

22. On July 22, 2007, Plaintiff was having heart palpitations, was

diagnosed with coronary ischemic arrhythmia, and received

nitroglycerine while en route to a medical center. At the

medical center, the doctor explained that Plaintiff was suffering

from Bradycardia “as a result of the hyperthyroid condition that

he had been left in for years.” The doctor stated that Plaintiff

should receive Ablation as soon as possible, the thyroid

medication should be discontinued, and the heart palpitation

medication probably caused damage to Plaintiff’s heart.

23. On July 31, 2007, Plaintiff saw Defendant Doehring and

explained that his symptoms were ongoing and that he had

repeatedly requested and been prescribed Ablation. Defendant

Doehring stated that she was doing all she could.

24. On September 27, 2007, Plaintiff was seen at a radiology

medical group and was given a thyroid uptake scan. It was

again concluded that Plaintiff should receive Ablation as soon

as possible.

25. On October 3, 2007, Defendant Doering stated that Plaintiff

would be getting Ablation.

26. On November 8, 2007, twenty-three months after Defendant

Kushner first informed Plaintiff that he needed Ablation,

Plaintiff received Ablation.

Plaintiff also allegesthat the California Department of Corrections and Rehabilitation

(CDCR) “has a policy where a Doctor will personally diagnose a patient, prescribe

medication and treatment, and a CDCR committee will override the diagnosis and

recommendation for medication and do so without any input or communication with an

inmate or the doctor that originally set forth a plan of treatment.”

Plaintiff contends that the following “cumulated into a series of incidents amounting

into countless delays, denials and intentional interferences of Plaintiff’s access to qualified

medical personnel constituting deliberate indifference to Plaintiff’s serious medical

condition”: (1) the actions of Defendants Ortiz and Corona from April 26, 2005 through

September 9, 2005; (2) the actions of Defendants Kushner, Salazar, Emler, and Castillo from

September 16, 2005 through August 16, 2006; and (3) the actions of Defendants Vilaysane,

Diep, and Doehring from August 24, 2006 through November 8, 2007.

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Plaintiff asserts that Defendants Ortiz, Corona, Kushner, Salazar, Emler, Castillo,

Vilaysane, Diep, and Doehring (1) “failed to discharge their mandatory duty pursuant to

California Government Code § 815.6, which is [to not] inflict any treatment or allow any lack

of care, . . . which would injure or impair the health of any prisoner in their custody”; and (2)

were negligent under California law because they “failed to use such skill, prudence and

diligence as other members of the medical profession commonly possess and exercise.”

Plaintiff seeks monetary damages and his costs.

IV. Failure to State a Claim

Not every claim by a prisoner that he has received inadequate medical treatmentstates

a violation of the Eighth Amendment. To state a § 1983 medical claim, a plaintiff must show

that the defendants acted with “deliberate indifference to serious medical needs.” Jett v.

Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) (quoting Estelle v. Gamble, 429 U.S. 97, 104

(1976)). A plaintiff must show (1) a “serious medical need” by demonstrating that failure

to treat the condition could result in further significant injury or the unnecessary and wanton

infliction of pain and (2) the defendant’sresponse was deliberately indifferent. Jett, 439 F.3d

at 1096 (quotations omitted).

To act with deliberate indifference, a prison official must both know of and disregard

an excessive risk to inmate health; 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

the inference. Farmer v. Brennan, 511 U.S. 825, 837 (1994). Deliberate indifference in the

medical context may be shown by a purposeful act or failure to respond to a prisoner’s pain

or possible medical need and harm caused by the indifference. Jett, 439 F.3d at 1096.

Deliberate indifference may also be shown when a prison official intentionally denies, delays,

or interferes with medical treatment or by the way prison doctors respond to the prisoner’s

medical needs. Estelle, 429 U.S. at 104-05; Jett, 439 F.3d at 1096.

“Deliberate indifference is a high legal standard.” Toguchi v. Chung, 391 F.3d 1051,

1060 (9th Cir. 2004). Deliberate indifference is a higher standard than negligence or lack of

ordinary due care for the prisoner’s safety. Farmer, 511 U.S. at 835. Medical malpractice

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or negligence is insufficient to establish an Eighth Amendment violation. Toguchi, 391 F.3d

at 1060. Thus, mere negligence in diagnosing or treating a condition does not violate the

Eighth Amendment. Id. at 1057. Also, an inadvertent failure to provide adequate medical

care alone does not rise to the Eighth Amendment level. Jett, 429 F.3d at 1096. A mere

delay in medical care, without more, is insufficient to state a claim against prison officials

for deliberate indifference. See Shapley v. Nevada Bd. of State Prison Comm’rs, 766 F.2d

404, 407 (9th Cir. 1985). The indifference must be substantial. The action must rise to a

level of “unnecessary and wanton infliction of pain.” Estelle, 429 U.S. at 105-06.

Plaintiff has failed to state an Eighth Amendment claim against Defendants Ortiz,

Salazar, Kushner, Castillo, Vilaysane, Diep, Emler, and Doehring because their individual

conduct does not rise to the level of deliberate indifference to Plaintiff’s serious medical

needs. See Iqbal, 129 S. Ct. at 1948 (‘[A] plaintiff must plead that each Government-official

defendant, through the official’s own individual actions, has violated the Constitution.”).

The Court, therefore, will dismiss without prejudice Plaintiff’s Eighth Amendment claim

against Defendants Ortiz, Salazar, Kushner, Castillo, Vilaysane, Diep, Emler, and Doehring.

V. Claims for Which an Answer Will be Required

Liberally construed, Plaintiff has stated an Eighth Amendment claim against

Defendant Corona, whom Plaintiff contends cancelled Plaintiff’s June 2005 thyroid scan

appointment and is “responsible for all [Utilization Management] Review Processing for

health care services for all prisoners” at Pleasant Valley State Prison-Coalinga. Presumably,

Plaintiff is alleging that Defendant Corona is a member of the CDCR committee that

“override[s] the diagnosis and recommendation for medication and do[es] so without any

input or communication with an inmate or the doctor that originally set forth a plan of

treatment.” The Court will require Defendant Corona to answer the Eighth Amendment

deliberate indifference claim.

In addition, liberally construed, Plaintiff has stated state law claims under California

Government Code § 815.6 and for negligence/malpractice against Defendants Ortiz, Corona,

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Kushner, Salazar, Emler, Castillo, Vilaysane, Diep, and Doehring. The Court will require

these Defendants to answer the state law claims against them.

VI. Warnings

A. Address Changes

Plaintiff must file and serve a notice of a change of address in accordance with Rule

83-182(f) and 83-183(b) of the Local Rules of Civil Procedure. Plaintiff must not include

a motion for other relief with a notice of change of address. Failure to comply may result in

dismissal of this action.

B. Copies

Plaintiff must submit an additional copy of every filing for use by the Court. See

LRCiv 5-133(d)(2). Failure to comply may result in the filing being stricken without further

notice to Plaintiff.

C. Possible Dismissal

If Plaintiff fails to timely comply with every provision of this Order, including these

warnings, the Court may dismiss this action without further notice. See Ferdik, 963 F.2d at

1260-61 (a district court may dismiss an action for failure to comply with any order of the

Court).

IT IS ORDERED:

(1) Plaintiff’s Eighth Amendment claim against Defendants Ortiz, Salazar,

Kushner, Castillo, Vilaysane, Diep, Emler, and Doehring is dismissed without prejudice.

(2) Defendant Corona must answer Plaintiff’s Eighth Amendment claim and

Defendants Ortiz, Corona, Kushner, Salazar, Emler, Castillo, Vilaysane, Diep, and Doehring

must answer Plaintiff’s state law claims.

(3) The Clerk of Court must send Plaintiff a service packet including the Third

Amended Complaint (Doc. #20), this Order, a Notice of Submission of Documents form, an

instruction sheet, and copies of summons and USM-285 forms for Defendants Ortiz, Corona,

Kushner, Salazar, Emler, Castillo, Vilaysane, Diep, and Doehring.

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(4) Within 30 days of the date of filing of this Order, Plaintiff must complete and

return to the Clerk of Court the Notice of Submission of Documents. Plaintiff must submit

with the Notice of Submission of Documents: a copy of the Third Amended Complaint for

each Defendant, a copy of this Order for each Defendant, a completed summons for each

Defendant, and a completed USM-285 for each Defendant.

(5) Plaintiff must not attempt service on Defendants and must not request waiver

of service. Once the Clerk of Court has received the Notice of Submission of Documents

and the required documents, the Court will direct the United States Marshal to seek waiver

of service from each Defendant or serve each Defendant.

(6) If Plaintiff fails to return the Notice of Submission of Documents and the

required documents within 30 days of the date of filing of this Order, the Clerk of

Court must, without further notice, enter a judgment of dismissal of this action without

prejudice. See Fed. R. Civ. P. 41(b).

DATED this 11 day of February, 2010.

th

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