Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_10-cv-01179/USCOURTS-casd-3_10-cv-01179-2/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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UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

MICHAEL VAUGHAN,

Plaintiff,

CASE NO. 10-cv-01179-L (WMc)

REPORT AND

RECOMMENDATION OF

MAGISTRATE JUDGE

GRANTING IN PART AND

DENYING IN PART

DEFENDANTS’ MOTION TO

DISMISS PLAINTIFF’S FIRST

AMENDED COMPLAINT

[ECF No. 26]

vs.

STATE OF CALIFORNIA, et al.,

Defendant.

I. INTRODUCTION

Plaintiff Michael Vaughan (“Plaintiff”), a former state prisoner at Calipatria State Prison

(“Calipatria”), filed a First Amended Complaint (“FAC”) pursuant to 42 U.S.C. § 1983 alleging:

(1) deliberate indifference to his medical needs in violation of the Eighth Amendment; and (2)

medical malpractice under California law stemming from the medical care he received at

Calipatria. Defendants Reymia Ramos, RN (“Nurse Ramos”), Cheryl Burnette, O.D. (“Dr.

Burnette”), and Alberto Lopez, RN (“Nurse Lopez”) move to dismiss Plaintiff’s FAC pursuant to

Federal Rule of Civil Procedure 12(b)(6). [ECF No. 26.]

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The Court submits this Report and Recommendation to United States District Judge M.

James Lorenz pursuant to 28 U.S.C. § 636(b)(1) and Local Civil Rule H.C.2 of the United States

District Court for the Southern District of California. After reviewing the pleadings, parties’

briefs, and exhibits in support thereof, the Court recommends Defendants’ Motion to Dismiss be

GRANTED in part and DENIED in part. 

II. PROCEDURAL HISTORY

On June 1, 2010, Plaintiff filed a complaint against the State of California, Department of

Corrections and Rehabilitation, Calipatria, Warden Leland McEwen, and Dr. Katrina Ball (“Dr.

Ball”) alleging deliberate indifference to his medical needs. (ECF No. 1.) On September 2, 2010,

the State of California, Department of Corrections and Rehabilitation, Calipatria, McEwen, and

Dr. Ball filed a Motion to Dismiss pursuant to Rule 12(b)(6). (ECF No. 6.) 

On November 10, 2010, this Court issued a Report and Recommendation, recommending

the Court issue an order: (1) denying Defendants’ Motion to Dismiss Plaintiff’s claims for

deliberate indifference against McEwen and Dr. Ball in their individual capacities; (2) granting

Defendants’ Motion to Dismiss Plaintiff’s claim against McEwen and Dr. Ball in their official

capacities; (3) granting Defendants’ Motion to Dismiss claims against the State of California,

California Department of Corrections and Rehabilitation, and Calipatria; and (4) granting Plaintiff

leave to amend his Complaint to add a cause of action against McEwen and Dr. Ball for medical

malpractice. (ECF No. 14.) 

On July 21, 2011, Judge Lorenz adopted the Report and Recommendation with

modifications and denied Defendants’ Motion to Dismiss Plaintiff’s claims for deliberate

indifference against Dr. Ball in her individual capacity. (ECF No. 18.) In addition, Judge Lorenz

dismissed with prejudice Plaintiff’s claims against the State of California, California Department

of Corrections and Rehabilitation, and Calipatria. (ECF No. 18.) Judge Lorenz also dismissed

with prejudice Plaintiff’s claim for injunctive relief as to all parties. (ECF No. 18.) Finally, Judge

Lorenz granted Plaintiff leave to amend his complaint. (ECF No. 18.)

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On August 15, 2011, Plaintiff filed a FAC against Dr. Ball and added Nurse Ramos, Dr.

Burnette, Nurse Lopez1

, and DOES 1 to 50. (ECF No. 19.) Additionally, Plaintiff added a

medical malpractice cause of action against Dr. Ball, Nurse Ramos, Dr. Burnette, Nurse Lopez and

DOES 1 to 50. (ECF No. 19.) Plaintiff sued Dr. Ball, Nurse Ramos, Dr. Burnette, and Nurse

Lopez individually and in their official capacities. (ECF No. 19 at 3-4.) On August 31, 2011, Dr.

Ball answered Plaintiff's FAC. (ECF No. 20.) On February 9, 2012, Nurse Ramos, Dr. Burnette,

and Nurse Lopez (“Defendants”) moved, pursuant to Rule 12(b)(6), for an order dismissing

Plaintiff’s FAC.2

 (ECF No. 26.) 

III. STATEMENT OF FACTS 

Plaintiff was a state inmate incarcerated at Calipatria commencing on or about June 26,

2008.3

 (ECF No. 19 ¶ 12.) Upon arrival at Calipatria, medical personnel gave Plaintiff a

medical examination and Plaintiff provided Calipatria medical personnel with a detailed history of

his injuries and medical treatment. (ECF No. 19 ¶ 13.) 

On March 25, 2009, Plaintiff had surgery to correct beefy pterygium in his left eye. (ECF

No. 19 at ¶ 14.) At the time, Dr. Narendra J. Patel, a physician specializing in Ophthalmology,

cared for Plaintiff’s left eye. Dr. Patel discharged Plaintiff in early May 2009. (ECF No. 19 at ¶

14.) From early May 2009 to June 2009, Plaintiff reported pain and discomfort in his left eye

weekly to Calipatria medical personnel. (ECF No. 19 at ¶ 15.) However, Calipatria medical

personnel ignored and/or refused Plaintiff’s need for specialized treatment and prescription

medication. (ECF No. 19 at ¶ 15.) 

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1

Plaintiff did not name Nurse Ramos, Dr. Burnette, and Nurse Lopez in his original complaint. 

(ECF No. 1.) Plaintiff subsequently added Nurse Ramos, Dr. Burnette, and Nurse Lopez in his FAC.

(ECF No. 19.) 

2

 Dr. Ball filed an answer to the FAC and is not a moving Defendant. 

3

 Plaintiff was released from custody in July 2011. (ECF No. 19 ¶ 14.)

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On June 2, 2009, Dr. Burnette, a licensed optometrist, noted in Plaintiff’s medical records

that Plaintiff was exhibiting physical signs and symptoms of a corneal ulcer in his left eye. (ECF

No. 19 at ¶ 16.) Dr. Burnette did not refer Plaintiff to an ophthalmologist for treatment.4

 (ECF

No. 19 at ¶ 16.) Between June 2, 2009 and June 16, 2009, Calipatria medical personnel did not

provide Plaintiff treatment or care for his left eye. (ECF No.19 at ¶ 17.)

On June 16, 2009, Plaintiff presented to the prison medical clinic complaining of

worsening symptoms and requested medical treatment and pain medication. (ECF No. 19 at ¶ 18.) 

Plaintiff’s left eye was swollen shut with yellow discharge. (ECF No. 19 at ¶ 18.) An unknown

staff member, DOE 1, took Plaintiff’s written request and directed Plaintiff to return to his cell. 

(ECF No. 19 at ¶ 18.) Between June 16, 2009 and June 18, 2009, Calipatria medical personnel

failed to treat Plaintiff’s left eye. (ECF No.19 at ¶ 19.)

On June 18, 2009, Dr. Burnette noted in Plaintiff’s medical records that Plaintiff was

exhibiting physical signs and symptoms of a corneal ulcer in his left eye. (ECF No. 19 at ¶ 20.) 

Again, Dr. Burnette did not refer Plaintiff to an ophthalmologist for treatment. (ECF No. 19 at ¶

20.) Dr. Burnette directed Plaintiff to return to his cell without any medication or explanation. 

(ECF No. 19 at ¶ 20.) Between June 19, 2009 and June 20, 2009, Calipatria medical personnel did

nothing to treat Plaintiff. (ECF No. 19 at ¶ 21.) 

On June 20, 2009, Dr. Le, an ophthalmologist, noted Plaintiff was exhibiting physical signs

and symptoms of corneal ulcer in his left eye. (ECF No. 19 at ¶ 22.) Dr. Le wrote Plaintiff a

prescription for antibiotic eye drops. (ECF No. 19 at ¶ 22.) However, between June 20, 2009 and

June 22, 2009, Calipatria medical personnel failed to provide Plaintiff with medication for his left

eye. (ECF No. 19 at ¶ 23.)

On June 22, 2009, Plaintiff presented to Calipatria medical clinic and complained he had

not received his eye drops. (ECF No. 19 at ¶ 24.) Nurse Ramos noted Dr. Le prescribed Plaintiff

antibiotic eye drops for his left eye. (ECF No. 19 at ¶ 24.) Nurse Ramos did not explain why

Calipatria medical personnel had not filled Plaintiff’s prescription, but noted Plaintiff’s medical

chart was missing. (ECF No. 19 at ¶ 24.) Nurse Ramos directed Plaintiff to return to his cell

4

 Dr. Burnette cannot prescribe medication. (ECF No. 19 ¶ 16.)

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without his eye drops. (ECF No. 19 at ¶ 24.) Between June 22, 2009 and June 25, 2009, Plaintiff

still received no medication for his left eye. (ECF No. 19 at ¶ 25.) 

On June 25, 2009, Plaintiff presented to Calipatria medical clinic and again complained he

had not received his antibiotic eye drops. (ECF No. 19 at ¶ 26.) Nurse Lopez noted in Plaintiff’s

medical records that he was exhibiting physical signs and symptoms of a corneal ulcer in his left

eye. (ECF No. 19 at ¶ 26.) Yet, Nurse Lopez did not refer Plaintiff to an ophthalmologist. (ECF

No. 19 at ¶ 26.) Nurse Lopez directed Plaintiff to return to his cell without his antibiotic eye drops

or an examination by an ophthalmologist. (ECF No. 19 at ¶ 26.)

On July 3, 2009, an outside ophthalmologist examined Plaintiff’s left eye. The

ophthalmologist diagnosed Plaintiff with an advanced corneal ulcer and a severe eye infection

caused by bacteria in the anterior chamber of his left eye. (ECF No. 19 at ¶ 27.) The

ophthalmologist prescribed antibiotics and administered the antibiotics into Plaintiff’s left eye. 

(ECF No. 19 at ¶ 27.) Plaintiff required ongoing treatment and care for his infected left eye, which

included administering antibiotic eye drops. (ECF No. 19 at ¶ 27.)

In August 2009, Calipatria ran out of Plaintiff’s prescribed eye drops. (ECF No. 19 at ¶

28.) Consequently, Dr. Ball instructed Nurse Lopez to administer medication which Plaintiff’s

ophthalmologist had discontinued. (ECF No. 19 at ¶ 28.) Dr. Ball changed Plaintiff’s eye

medication without consulting Plaintiff’s ophthalmologist. (ECF No. 19 at ¶ 28.) Subsequently,

Plaintiff had surgery to excise a corneal ulcer in his left eye. (ECF No. 19 at ¶ 29.) 

IV. STANDARD OF REVIEW

A motion to dismiss for failure to state a claim pursuant to Federal Rule of Civil Procedure

12(b)(6) tests the legal sufficiency of the claims in the complaint. See Davis v. Monroe County

Bd. of Educ., 526 U.S. 629, 633 (1999). A Rule 12(b)(6) dismissal may be based on either a “

‘lack of a cognizable legal theory’ or ‘the absence of sufficient facts alleged under a cognizable

legal theory.’ ” Johnson v. Riverside Healthcare System, LP, 534 F.3d 1116, 1121-22 (9th Cir.

2008) (quoting Balistreri v. Pacifica Police Dep’t, 901 F.2d 696, 699 (9th Cir. 1990)). In other

words, the complaint must provide a “short and plain statement of the claim showing that

[plaintiff] is entitled to relief.” Id. The court does not look at whether the plaintiff will “ultimately

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prevail but whether the [plaintiff] is entitled to offer evidence to support the claims.” Scheuer v. 

Rhodes, 416 U.S. 232, 236 (1974).

The court will grant a motion to dismiss if plaintiff fails to proffer “enough facts to state a

claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). 

“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.” Ashcroft v.

Iqbal, 556 U.S. 662, 129 S.Ct. 1937, 1949 (2009). The court must accept as true all material

allegations in the complaint, as well as reasonable inferences to be drawn from them, and must

construe the complaint in the light most favorable to the plaintiff. Cholla Ready Mix, Inc. v.

Civish, 382 F.3d 969, 973 (9th Cir. 2004) (citing Karam v. City of Burbank, 352 F.3d 1188, 1192

(9th Cir. 2003)). The court need not accept conclusory allegations in the complaint as true. 

Rather, the court must “examine whether [the conclusory allegations] follow from the description

of facts as alleged by the plaintiff.” Holden v. Hagopian, 978 F.2d 1115, 1121 (9th Cir. 1992).

V. DISCUSSION

A. Eighth Amendment Deliberate Indifference

1. Defendants’ Motion to Dismiss

Nurse Lopez and Nurse Ramos contend they were not deliberately indifferent to Plaintiff’s

serious medical needs because a difference of medical opinion between the inmate and prison

medical authorities regarding a diagnosis and/or treatment is insufficient to prove deliberate

indifference. (ECF No. 26-1 at 13-14; ECF No. 30 at 2-5.) Moreover, Nurse Lopez and Nurse

Ramos contend Plaintiff cannot prove they were aware of facts from which an inference of

substantial risk of serious harm could be drawn and that they actually drew the inference, but

failed to act. (ECF No. 26-1 at 13-14; ECF No. 30 at 2-5.) Finally, Nurse Lopez and Nurse

Ramos contend they both only saw Plaintiff one time in June 2009. According to Nurse Lopez

and Nurse Ramos, this isolated and brief contact with Plaintiff is insufficient to violate the Eighth

Amendment. (ECF No. 26-1 at 13-14; ECF No. 30 at 2-5.) 

Dr. Burnette contends she was not deliberately indifferent to Plaintiff’s serious medical

needs because the Constitution does not require prisoners be given every medical treatment they

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desire. (ECF No. 26-1 at 14-15; ECF No. 30 at 5.) Dr. Burnette further argues the Constitution

does not grant an inmate an independent right to outside medical care additional and supplemental

to the care provided by prison medical staff. (ECF No. 26-1 at 14-15; ECF No. 30 at 5.) Finally,

Dr. Burnette contends a difference of medical opinion between the inmate and prison medical

authorities regarding a diagnosis and/or treatment is insufficient to prove deliberate indifference. 

(ECF No. 26-1 at 14-15; ECF No. 30 at 5.)

2. Plaintiff’s Opposition

Plaintiff contends he has alleged sufficient facts to support a claim that Defendants acted

with deliberate indifference to his serious medical needs. Specifically, Plaintiff argues he alleged

Defendants noted in his medical records that he was exhibiting symptoms of an infection in his left

eye and that is the same as alleging Defendants literally “saw” Plaintiff was exhibiting symptoms

of an eye infection. Plaintiff contends these allegations establish Defendants recognized the

symptoms, saw an inmate in pain, and did nothing to treat a medical condition. (ECF No. 27 at

8-10.)

In addition, Plaintiff argues there is no difference of medical opinion at issue because

Defendants did not render a medical opinion. Instead, Defendants sent Plaintiff back to his cell

without explanation, opinion, or cause. Further, Plaintiff argues he has alleged Defendants’ delay

or lack of treatment contributed and/or caused the need for Plaintiff’s second surgery. (ECF No.

27 at 8-10.) 

Finally, Plaintiff argues Defendants’ actions were not isolated occurrences or exceptions. 

Plaintiff states that when each of the Defendants saw Plaintiff, they knew from Plaintiff’s medical

records that the Defendant before them had seen Plaintiff and not treated Plaintiff’s medical

condition. None of Defendants attempted to follow up with Plaintiff to see if he received medical

care. Therefore, Plaintiff argues Defendants’ acts of deliberate indifference continued over a

period of thirty (30) days making not one isolated occurrence, but thirty (30) occurrences. (ECF

No. 27 at 8-10.)

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3. Relevant Legal Standard 

A prison official’s deliberate indifference to a prisoner’s serious medical needs constitutes

the “unnecessary and wanton infliction of pain proscribed by the Eighth Amendment.” Estelle v.

Gamble, 429 U.S. 97, 104; Jett v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006). To prevail a

plaintiff must show: (1) a serious medical need and (2) defendant’s response to plaintiff’s serious

medical need was deliberately indifferent. Jett, 439 F.3d at 1096; McGuckin v. Smith, 974 F.2d

1050, 1059 (9th Cir. 1992), overruled on other grounds in WMX Techs., Inc. v. Miller, 104 F.3d

1133, 1136 (9th Cir. 1997) (en banc)). 

First, “[a] ‘serious’ medical need exists if the failure to treat a prisoner’s condition could

result in further significant injury or the ‘unnecessary and wanton infliction of pain.’ ” McGuckin,

974 F.2d at 1059 (quoting Estelle, 429 U.S. at 104). The following are examples of serious

medical need: “[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;

see, e.g., Wood v. Housewright, 900 F.2d 1332, 1337-41 (9th Cir. 1990); Hunt v. Dental Dept., 865

F.2d 198, 200-01 (9th Cir. 1989). 

Second, a defendant must purposefully ignore or fail to respond to a prisoner’s pain or

medical need. McGuckin, 974 F.2d at 1060. Plaintiff must allege “prison officials acted with a

culpable state of mind.” Wilson v. Seiter, 501 U.S. 294, 302 (1991). A culpable state of mind

entails more than mere negligence, but less than conduct undertaken for the very purpose of

causing harm. Farmer v. Brennan, 511 U.S. 825, 837 (1994). A prison official does not act in a

deliberately indifferent manner unless the official “knows of and disregards an excessive risk to

inmate health or safety.” Id. at 834. A prison official must “be aware of the facts from which the

inference could be drawn that a substantial risk of serious harm exists,” and “must also draw the

inference.” Toguchi v. Chung, 391 F.3d 1051, 1057-58 (9th Cir. 2004) (quoting Farmer, 511 U.S.

at 837).

A prison official abridges a prisoner’s civil rights only if the prison official’s indifference

to the prisoner’s medical needs was substantial. Broughton v. Cutter Laboratories, 622 F.2d 458,

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460 (9th Cir. 1980) (citing Estelle, 429 U.S. at 105-06). Inadequate treatment due to mere

indifference, medical malpractice, or even gross negligence, does not violate the Eighth

Amendment. Id.; Estelle, 429 U.S. at 106; Toguchi, 391 F.3d at 1060; Wood, 900 F.2d at 1334;

see Anderson v. County of Kern, 45 F.3d 1310, 1316 (9th Cir. 1995).

 Deliberate indifference may be manifested “when prison officials deny, delay or

intentionally interfere with medical treatment.” McGuckin, 974 F.2d at 1059. However, mere

delay or denial of treatment does not violate the Eighth Amendment, unless the delay or denial

was harmful. Id. at 1060; Shapley v. Nevada Bd. of State Prison Comm’rs, 766 F.2d 404, 407 (9th

Cir. 1985). If a prisoner is seriously harmed by a prison official’s inaction, that harm tends to

support a claim of deliberate indifference to a serious medical need. McGuckin, 974 F.2d at 1060.

Prison inmates have no independent constitutional right to outside medical care additional

and supplemental to the medical care provided by the prison staff. See Roberts v. Spalding, 783

F.2d 867, 870 (9th Cir. 1986). Further, differences in judgment between an inmate and prison

medical personnel regarding appropriate medical diagnosis and treatment are not enough to

establish a deliberate indifference claim. Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir. 1989). 

However, a plaintiff can show the course of treatment the doctors chose was “medically

unacceptable under the circumstances” and prison officials “chose this course in conscious

disregard of an excessive risk to plaintiff’s health.” Jackson v. McIntosh, 90 F.3d 330, 332 (9th

Cir. 1986). 

Finally, deliberate indifference may include “a failure to respond to a known medical

problem . . . and a failure to provide medical staff competent to examine and diagnose inmate's

problems.” Eres v. County of Alameda, 1999 WL 66519, at 8 (N.D.Cal. Feb.1, 1999). Deliberate

indifference may also include medical care “so cursory as to amount to no treatment at all.” See

Tolbert v. Eyman, 434 F.2d 625, 626 (9th Cir. 1970); see, e.g. Parzyck v. Prison Health Servs.,

Inc., 290 Fed.Appx. 289, 291 (11th Cir. 2008) (failure of prison medical staff to provide an

orthopedic consultation on two occasions even though consultations were recommended and

prisoner was in pain). 

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4. Application to Plaintiff’s Allegations

a. Allegations against Nurse Lopez

On June 25, 2009, Plaintiff presented to Calipatria medical clinic and again complained he

had not received his eye drops. (ECF No. 19 at ¶ 26.) Nurse Lopez noted in Plaintiff’s medical

records that he was exhibiting physical signs and symptoms of a corneal ulcer in his left eye. 

(ECF No. 19 at ¶ 26.) Yet, Nurse Lopez did not refer Plaintiff to an ophthalmologist. (ECF No.

19 at ¶ 26.) Nurse Lopez directed Plaintiff to return to his cell without his antibiotic eye drops or

an examination by an ophthalmologist. (ECF No. 19 at ¶ 26.) 

Plaintiff adequately pleads sufficient facts for the first element of deliberate indifference,

his serious medical need. McGuckin, 974 F.2d at 1059. Plaintiff states he suffered an advanced

corneal ulcer and a severe eye infection caused by bacteria in the anterior chamber of his left eye. 

(ECF No. 19 at ¶ 27.) Plaintiff contends that as a result of Defendant’s actions he required a

subsequent surgery to excise the corneal ulcer. (ECF No. 19 at ¶ 29.) The failure to treat

Plaintiff’s injury may have resulted in further significant injury (i.e. surgery to excise a corneal

ulcer) and unnecessary and wanton infliction of pain. McGuckin, 974 F.2d at 1059 (quoting

Estelle, 429 U.S. at 104). Therefore, Plaintiff adequately pleads sufficient facts to demonstrate his

serious medical need.

Plaintiff also adequately pleads sufficient facts for the second element, that Nurse Lopez

acted with a culpable state of mind in denying, delaying, or interfering with Plaintiff’s medical

care. Wilson, 501 U.S. at 302; Hunt, 865 F.2d at 201. Nurse Lopez attempts to characterize

Plaintiff’s allegations as a difference in medical opinion between a prisoner and prison medical

personnel. Sanchez, 891 F.2d 240, 242. However, Nurse Lopez’s reliance on this characterization

is misplaced because Plaintiff alleges Nurse Lopez delayed giving Plaintiff eye drops which were

already prescribed to him, not that Nurse Lopez erroneously diagnosed his condition. (ECF No.

19 at ¶ 26.)

Plaintiff sufficiently alleges Nurse Lopez knew of his serious medical needs by stating

Nurse Lopez noted in Plaintiff’s medical chart that he was exhibiting symptoms of a corneal ulcer. 

(ECF No. 19 at ¶ 26.) A reasonable inference based on Plaintiff’s allegations is that Nurse

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Lopez’s medical training would have alerted him to Plaintiff’s serious medical needs when he

noted Plaintiff was exhibiting symptoms of a corneal ulcer. Plaintiff contends, despite this

knowledge, Nurse Lopez purposely ignored or failed to respond to Plaintiff’s pain and serious

medical need when he directed Plaintiff to return to his cell without examination by an

ophthalmologist or his prescribed eye drops. (ECF No. 19 at ¶ 26.) From the alleged facts the

Court can reasonably infer Nurse Lopez made a decision not to treat Plaintiff’s serious medical

needs despite his knowledge of Plaintiff’s serious medical need. 

While Plaintiff only alleges Nurse Lopez saw him once, the one time Nurse Lopez saw

Plaintiff he failed to respond to Plaintiff’s known medical condition. Eres, 1999 WL 66519 at 8. 

Plaintiff alleges, Nurse Lopez’s inaction, resulted in a delay in Plaintiff receiving his antibiotic eye

drops and an examination by an ophthalmologist. (ECF No. 19 at ¶ 26.) Plaintiff alleges this

delay in medical treatment ultimately resulted in a severe infection in his left eye which required

surgery to excise a corneal ulcer in his left eye. (ECF No. 19 at ¶ 29.) Thus, the Court can

reasonably infer Nurse Lopez’s inaction resulted in serious harm to Plaintiff, which tends to

support a claim of deliberate indifference. McGuckin, 874 F.2d at 1060. 

Therefore, Plaintiff pleads sufficient facts to show Nurse Lopez’s delay in treatment was

harmful, thereby constituting deliberate indifference to his medical needs. McGuckin, 974 F.2d at

1060. Accordingly, the Court recommends Nurse Lopez’s Motion to Dismiss Plaintiff's Eighth

Amendment claim be DENIED. 

b. Allegations against Nurse Ramos

On June 22, 2009, Plaintiff presented to Calipatria medical clinic and complained he had

not received his prescribed eye drops. (ECF No. 19 at ¶ 24.) Nurse Ramos noted Dr. Le

prescribed Plaintiff eye drops for his left eye. (ECF No. 19 at ¶ 24.) Nurse Ramos did not explain

why Calipatria medical personnel had not filled Plaintiff’s prescription, but noted Plaintiff’s

medical chart was missing. (ECF No. 19 at ¶ 24.) Nurse Ramos directed Plaintiff to return to his

cell without his prescribed eye drops. (ECF No. 19 at ¶ 24.) 

As discussed above in Section 4a, Plaintiff adequately pleads sufficient facts for the first

element of deliberate indifference, his serious medical need. McGuckin, 974 F.2d at 1059. 

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Additionally, Plaintiff adequately pleads sufficient facts for the second element, that Nurse Ramos

acted with a culpable state of mind in denying, delaying, or interfering with Plaintiff’s medical

care. Wilson, 501 U.S. at 302; Hunt, 865 F.2d at 201. Nurse Ramos, like Nurse Lopez, also

attempts to characterize Plaintiff’s allegations as a difference in medical opinion between a

prisoner and prison medical personnel. Sanchez, 891 F.2d 240, 242. However, Nurse Ramos’s

reliance on this characterization is also misplaced because Plaintiff alleges Nurse Ramos delayed

giving Plaintiff his prescribed eye drops, not that Nurse Ramos erroneously diagnosed his

condition. (ECF No. 19 at ¶ 24.)

Plaintiff alleges Nurse Ramos knew of his serious medical condition when she noted Dr.

Le prescribed antibiotic eye drops for Plaintiff. (ECF No. 19 at ¶ 24.) From the alleged facts the

Court can reasonably infer that Nurse Ramos’s medical training would have alerted her to

Plaintiff’s serious medical needs. Plaintiff contends, despite this knowledge, Nurse Ramos

purposefully ignored or failed to treat Plaintiff’s condition and directed him to return to his cell

without his eye drops. (ECF No. 19 at ¶ 24.) 

While Plaintiff alleges Nurse Ramos, like Nurse Lopez, only saw him once, the one time

Nurse Ramos saw Plaintiff she failed to respond to Plaintiff’s known medical condition. Eres,

1999 WL 66519 at 8. Plaintiff contends Nurse Ramos’s inaction caused a harmful delay in

Plaintiff receiving his antibiotic eye drops. (ECF No. 19 at ¶ 24.) Plaintiff alleges this delay in

medical treatment ultimately resulted in a severe infection in his left eye which required surgery to

excise a corneal ulcer in his left eye. (ECF No. 19 at ¶ 29.) Thus, the Court can reasonably infer

Nurse Ramos’s inaction resulted in serious harm to Plaintiff, which tends to support a claim of

deliberate indifference. McGuckin, 974 F.2d at 1060. 

Therefore, Plaintiff pleads sufficient facts to show Nurse Ramos’s delay in treatment was

harmful, thereby constituting deliberate indifference to his serious medical needs. McGuckin, 974

F.2d at 1060. Accordingly, the Court recommends Nurse Ramos’s Motion to Dismiss Plaintiff’s

Eighth Amendment claim be DENIED.

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c. Allegations against Dr. Burnette

On June 2, 2009, Dr. Burnette noted in Plaintiff’s medical records that Plaintiff was

exhibiting physical signs and symptoms of a corneal ulcer in his left eye. Dr. Burnette did not

refer Plaintiff to an ophthalmologist for treatment or medication. (ECF No. 19 at ¶ 16.) Later, on

June 18, 2009, Dr. Burnette again noted in Plaintiff’s medical records that Plaintiff was exhibiting

physical signs and symptoms of a corneal ulcer in his left eye. (ECF No. 19 at ¶ 20.) Yet, Dr. 

Burnette did not refer Plaintiff to an ophthalmologist for treatment or medication. (ECF No. 19 at

¶ 20.) Instead, Dr. Burnette directed Plaintiff to return to his cell without any medication or

explanation. (ECF No. 19 at ¶ 20.) 

As discussed above in Section 4a, Plaintiff adequately pleads sufficient facts for the first

element of deliberate indifference, his serious medical need. McGuckin, 974 F.2d at 1059. 

Additionally, Plaintiff adequately pleads sufficient facts for the second element, that Dr. Burnette

acted with a culpable state of mind in denying, delaying, or interfering with Plaintiff’s medical

care. Wilson, 501 U.S. at 302; Hunt, 865 F.2d at 201. Specifically, Plaintiff alleges Dr. Burnette,

a licensed optometrist, knew of his serious medical needs when Dr. Burnette noted twice in

Plaintiff’s medical records that he was exhibiting physical signs and symptoms of a corneal ulcer. 

(ECF No. 19 at ¶¶ 16, 20.) 

Plaintiff contends, despite this knowledge, Dr. Burnette purposefully ignored or failed to

respond to Plaintiff’s pain and serious medical needs. Plaintiff alleges that two days after

presenting to Calipatria medical clinic with his left eye swollen shut with yellow discharge, Dr.

Burnette again noted Plaintiff was exhibiting symptoms of a corneal ulcer. (ECF No. 19 at ¶¶ 18,

20.) Instead of providing Plaintiff with treatment, Dr. Burnette directed Plaintiff to return to his

cell without treatment. (ECF No. 19 at ¶ 20.) The court may reasonably infer (a) Dr. Burnette’s

medical training would have alerted him to Plaintiff’s need for care, and (b) Dr. Burnette failed to

respond to Plaintiff’s known medical condition. Eres, 1999 WL 66519 at 8. 

Plaintiff alleges Dr. Burnette’s failure to respond to Plaintiff’s medical needs resulted in a

delay in Plaintiff receiving treatment for his left eye. Plaintiff alleges this delay in medical

treatment ultimately resulted in a severe infection in his left eye which required surgery to excise a

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corneal ulcer in his left eye. (ECF No. 19 at ¶ 29.) The Court can reasonably infer from Plaintiff’s

allegations that Dr. Burnette’s repeated failure to treat Plaintiff or refer Plaintiff to an

ophthalmologist for treatment can be construed as medical care so cursory as to afford Plaintiff no

treatment at all. Tolbert, 434 F.2d at 626. When allegations indicate this type of indifference,

dismissal prior to discovery is premature. Ancata v. Prison Health Services, Inc., 769 F.2d 700,

704 (11th Cir. 1985) (plaintiff alleged defendants failed to provide proper medical care and court

determined the medical care provided was so cursory as to amount to no treatment at all). 

Plaintiff pleads sufficient facts to show Dr. Burnette’s delay in treatment was harmful,

thereby constituting deliberate indifference to his medical needs. McGuckin, 974 F.2d at 1060. 

Accordingly, the Court recommends Dr. Burnette’s Motion to Dismiss Plaintiff’s Eighth

Amendment claim be DENIED.

B. Source of Constitutional Protection Governing Defendants’ Alleged Conduct 

1. Defendants’ Motion to Dismiss

 Defendants contend the Eighth Amendment provides the explicit textual source of

constitutional protection for Plaintiff because at all relevant times Plaintiff was an inmate at

Calipatria. (ECF No. 26-1 at 15; ECF No. 30 at 6.) Therefore, Defendants argue the Court should

dismiss Plaintiff’s Fifth, Ninth, and Fourteenth Amendment claims as superfluous. (ECF No. 26-1

at 15; ECF No. 30 at 6.) 

2. Relevant Legal Standard

Where a particular amendment “provides an explicit textual source of constitutional

protection against [certain] government conduct, that Amendment, not the more generalized notion

of ‘substantive due process,’ must be the guide for analyzing [a plaintiff’s] claims.” Graham v.

Connor, 490 U.S. 386, 395 (1989); see also Armendariz v. Penman, 75 F.3d 1311, 13 (9th Cir.

1996) (en banc), overruled in part on other grounds in Crown Point Dev., Inc. v. City of Sun

Valley, 506 F.3d 851 (9th Cir. 2007) (holding other constitutional claims preempted plaintiff’s

substantive due process claim). Therefore, the court may limit its inquiry to the Constitutional

Amendment that specifically addresses plaintiff’s claim. Graham, 490 U.S. at 395 n. 10. 

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3. Application to Plaintiff’s Allegations

a. Fifth Amendment 

Plaintiff claims Defendants violated his rights secured under the Fifth Amendment. 

However, violations of due process under the Fifth Amendment can only be made against the

federal government and not state actors. Bingue v. Prunchak, 512 F.3d 1169, 1174 (9th Cir. 2008;

Lee v. City of Los Angeles, 250 F.3d 668, 687 (9th Cir. 2001). Here, Plaintiff’s allegations relate

only to state actors. Accordingly, the Court recommends Defendants’ Motion to Dismiss

Plaintiff’s Fifth Amendment claim be GRANTED without leave to amend. 

b. Ninth Amendment

Plaintiff claims Defendants also violated his rights secured under the Ninth Amendment. 

The Ninth Amendment provides, “[t]he enumeration in the Constitution, of certain rights, shall not

be construed to deny or disparage others retained by the people.” U.S. Const., amend. IX. The

Ninth Amendment does not provide a basis upon which Plaintiff may impose liability under 42

U.S.C. § 1983 because it does not “independently [secure] any constitutional right.” Standberg v.

City of Helena, 791 F.2d 774, 748 (9th Cir. 1986) (citations omitted); Ramirez v. Butte-Silver Bow

County, 298 F.3d 1022, 1029 (9th Cir. 2002) (Ninth Amendment claim properly dismissed because

plaintiffs may not “ ‘double up’ constitutional claims”), aff’d sub nom. Groh v. Ramirez, 540 U.S.

551 (2004); Schowengerdt v. United States, 944 F.2d 483, 490 (9th Cir. 1991) (Ninth Amendment

“not interpreted as independently securing any constitutional rights for purposes of making out a

constitutional violation”). Accordingly, the Court recommends Defendants' Motion to Dismiss

Plaintiff’s Ninth Amendment claim be GRANTED without leave to amend.

c. Fourteenth Amendment

Plaintiff further claims Defendants violated his rights secured under the Fourteenth

Amendment. However, the Eighth Amendment specifically governs prisoner claims for

inadequate medical care. City of Revere v. Mass. Gen. Hosp., 463 U.S. 239, 243-44 (1983). 

Plaintiff’s Fourteenth Amendment claims are more appropriately analyzed under the Eighth

Amendment and are subsumed by his Eighth Amendment claims. Whitley v. Albers, 475 U.S. 312,

327 (1986) (“the Eighth Amendment, which is specifically concerned with the unnecessary and

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wanton infliction of pain in penal institutions, serves as the primary source of substantive

protection to convicted prisoners”). Accordingly, the Court recommends Defendants’ Motion to

Dismiss Plaintiff’s Fourteenth Amendment claim be GRANTED without leave to amend.

C. California Medical Malpractice Cause of Action

1. Defendants’ Motion to Dismiss

Defendants contend Plaintiff’s California medical malpractice cause of action is timebarred because Plaintiff did not commence the action against them within six months of the

rejection of Plaintiff’s tort claims. (ECF No. 26-1 at 20; ECF No. 30 at 8.) Defendants argue

Plaintiff is not entitled to relation back under Rule 15(c)(1)(C) for a number of reasons. (ECF No.

26-1 at 20; ECF No. 30 at 8.) First, Defendants argue the amendment does not assert a claim or

defense that arose out of the conduct, transaction, or occurrence set out in the original pleading. 

(ECF No. 26-1 at 20; ECF No. 30 at 8.) Second, Defendants argue they did not receive notice of

the pending action within the time prescribed by Rule 4(m), namely, 120 days from the filing of

the original complaint in January 2010. (ECF No. 26-1 at 20; ECF No. 30 at 8.) Third,

Defendants argue Plaintiff cannot prove Defendants knew or should have known during the Rule

4(m) period that, but for some mistake, the action would have been brought against them. (ECF

No. 26-1 at 20; ECF No. 30 at 8.)

2. Plaintiff’s Opposition

Plaintiff contends his FAC relates back to his original complaint because his California

medical malpractice cause of action is based on the same incident and course of conduct alleged in

the original complaint. (ECF No. 27 at 11.) Plaintiff argues he named Calipatria in his original

complaint and Nurse Lopez, Nurse Ramos, and Dr. Burnette are the employees at Calipatria who

had actual contact with Plaintiff in the medical ward. (ECF No. 27 at 12.) Plaintiff notes he was

unable to specifically identify Defendants until he received his medical records on February 1,

2011. (ECF No. 27 at 12.) Finally, Plaintiff argues his FAC is a refinement based on those issues

raised in the Rule 12(b)(6) motion filed September 2, 2010. (ECF No. 27 at 12.)

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3. Relevant Legal Standard

To sue a California public employee, a claimant must first file an administrative tort claim

with the State. Cal. Gov. Code § 945.6. If California denies the claim, the claimant has six (6)

months from the date of the denial to file a civil action. Cal. Gov. Code § 945.6. “Prisoners are

not entitled to tolling of this limitations period.” Brown v. Grove, 647 F.Supp.2d 1178, 1187

(C.D. Cal. 2009); see also Moore v. Twomey, 120 Cal.App.4th 910, 914 (2004). 

An amended pleading, filed outside the applicable statute of limitations, may be considered

timely filed if it relates back to the date of a timely filed original pleading. Fed. R. Civ. P. 15(c). 

When a plaintiff adds new defendants in an amended complaint, the following requirements must

be satisfied for an amendment to relate back to the original complaint. Fed. R. Civ. P. 15(c)(1)(C). 

First, the claim against the new defendants must have arisen “out of the conduct,

transaction, or occurrence set out--or attempted to be set out--in the original” complaint. Fed. R.

Civ. P. 15(c)(1)(B). Second, the new defendants must have received notice of the action “within

the period provided by Rule 4(m) for serving the summons and complaint.” Fed. R. Civ. P.

15(c)(1)(C)(I). Newly added defendants must receive actual “notice of institution of action,” it is

not sufficient to demonstrate newly added defendants know of the events giving rise to the claim

for relief. Craig v. United States, 413 F.2d 854, 858 (9th Cir. 1969) (applying former Rule 15(c)). 

Newly added defendants must know Plaintiff filed the lawsuit. (Id.) Finally, the new defendants

must have known “or should have known that the action would have been brought against [them],

but for a mistake concerning the proper party's identity.” Fed. R. Civ. P. 15(c)(1)(C)(ii). The

Supreme Court explained, Rule 15(c)(1)(C)(ii) “asks what the prospective defendant knew or

should have known during the Rule 4(m) period, not what the plaintiff knew or should have known

at the time of the filing [his] original complaint.” Krupski v. Costa Crociere S.p.A., __ U.S. __,

130 S.Ct. 2485, 2494 (2010). 

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4. Analysis of California Medical Malpractice Cause of Action

Plaintiff filed two tort claims with the California Victim Compensation and Government

Board.5

 (ECF No. 26-2.) Plaintiff filed his first claim on September 17, 2009. (ECF No. 26-2 at

2-4.) The California Victim Compensation and Government Claims Board rejected Plaintiff's first

claim on December 24, 2009. (ECF No. 26-2 at 5.) Plaintiff filed his second claim on December

2, 2009. (ECF No. 26-2 at 10-11.) The California Victim Compensation and Government Claims

Board rejected Plaintiff’s second claim on January 28, 2010. (ECF No. 26-2 at 12.) 

Where, as here, the claim is denied, the claimant has six months from the date of the denial

to file a civil action. See Cal. Gov. Code § 945.6. After the California Victim and Compensation

and Government Claims Board denied Plaintiff’s second claim he had until June 28, 2010 to file a

civil action. On June 1, 2010, Plaintiff filed his original complaint against the State of California,

the Department of Corrections and Rehabilitation, Calipatria State Prison, Leland McEwen, and

Dr. Ball. (ECF No. 1.) On August 15, 2011, Plaintiff filed his FAC against the newly added

Defendants. (ECF No. 19.) Thus, Plaintiff did not commence the action against newly added

Defendants within six months of the denial of his claim unless relation back applies. 

Accordingly, the next issue is whether under these circumstances Plaintiff’s FAC relates

back to his original complaint under Rule 15(c)(1)(C). First, the medical malpractice claim against

newly added defendants must have arisen out of the conduct set forth in the original complaint. 

Fed. R. Civ. P. 15(c)(1)(C). Plaintiff’s original complaint arises from his medical care at

Calipatria State Prison from May 2009 through July 2009. (ECF No. 1 at ¶ 19.) Plaintiff’s FAC

also arises from his medical care at Calipatria State Prison from May 2009 through July 2009. 

(ECF No. 19.) Therefore, Plaintiff’s medical malpractice claims against newly added Defendants

arose out of the same conduct set forth in Plaintiff’s original complaint. 

Second, Plaintiff had to provide sufficient notice to newly added Defendants of the original

action within the period provided by Rule 4(m) for serving the summons and complaint. Fed. R.

5

 The Court recommends granting Defendants’ request to take judicial notice of Plaintiff’s tort

claims and related documents under Federal Rule of Civil Procedure 21(d). See United States v. State

of California, 655 F.2d 914, 918 (9th Cir. 1980) (it is proper for a federal court to determine whether

a plaintiff bringing tort claims against a public entity has complied with California Tort Claims Act). 

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Civ. P. 15(c)(1)(C)(I). It is not sufficient to show the newly added defendants knew of the events

giving rise to the claim for relief. Craig, 413 F.2d at 858. Here, Plaintiff served Nurse Lopez with

a copy of the FAC and summons on December 28, 2011.6

 Nurse Lopez received notice of the

action well outside the 120 day period provided by Rule 4(m) and there is nothing to suggest

Nurse Lopez knew Plaintiff filed the lawsuit. Plaintiff’s opposition suggests newly added

Defendants will not be prejudiced because they are represented by the same attorney representing

Calipatria employees since the beginning of this action. (ECF No. 27 at 12.) However, Rule

15(c)(1)(C) focuses on what the newly added defendants knew and not what the newly added

defendants’ attorney knew during the Rule 4(m) period. Therefore, Plaintiff did not provide newly

added Defendants with sufficient notice of the original action within the period provided by Rule

4(m). 

Third, Plaintiff must demonstrate that within the Rule 4(m) period, defendants “knew or

should have known that the action would have been brought against [them], but for a mistake

concerning the proper party’s identity.” Fed. R. Civ. P. 15(c)(1)(C)(ii). Plaintiff’s opposition

addresses what he knew about the identify of Defendants at the time he filed his original

complaint. (ECF No. 27 at 12.) However, Rule 15(c)(1)(C)(ii) “asks what the prospective

defendant knew or should have known during the Rule 4(m) period, not what the plaintiff knew or

should have known at the time of the filing of [his] original complaint.” Krupski, 130 S.Ct. at

2494. Plaintiff argues he was unable to specifically identify the newly added Defendants until he

received his medical records from Calipatria in February 2011. (ECF No. 27 at 12.) According to

Plaintiff, Defendants knew or should have known Plaintiff would have brought the action against

them because Defendants were the employees who had contact with Plaintiff in the medical ward. 

This argument is unsuccessful because Plaintiff has not established Defendants knew about the

institution of the action. Therefore, it is unlikely Defendants knew or should have known, but for

Plaintiff's mistake, the action would have been brought against them. Plaintiff has not

demonstrated that within the Rule 4(m) period, Defendants knew or should have known the action

6

 Plaintiff does not address when he served Nurse Ramos and Dr. Burnette with a copy of the

FAC and summons. Further, the record does not reflect when Plaintiff served Nurse Ramos and Dr.

Burnette with a copy of the FAC and summons.

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would have been brought against them. 

Accordingly, the Court recommends Defendants’ Motion to Dismiss Plaintiff’s medical

malpractice claim be GRANTED without leave to amend.

D. Supplemental Jurisdiction

The Court recommends Defendants’ request that the Court decline to exercise

supplemental jurisdiction over Plaintiff’s pendant state claim be DENIED as moot because the

Court has recommended Defendants’ Motion to Dismiss Plaintiff’s medical malpractice claim be

GRANTED without leave to amend. See 28 U.S.C. § 1367(c)(1)-(4); City of Chicago v.

International College of Surgeons, 522 U.S. 156, 172 (1997) (“[o]ur decisions have established

that pendent [supplemental] jurisdiction is a doctrine of discretion, not of plaintiff’s right ... ”). 

V. CONCLUSION AND RECOMMENDATION

For the reasons outlined above, IT IS HEREBY RECOMMENDED the Court issue an

Order: (1) approving and adopting this Report and Recommendation; (2) denying Defendants’

Motion to Dismiss Plaintiff’s claims for deliberate indifference; (3) granting Defendants’ Motion

to Dismiss Plaintiff’s Fifth, Ninth, and Fourteenth Amendment claims; (4) granting Defendants’

Motion to Dismiss Plaintiff’s malpractice claim; and (5) denying as moot Defendants’ request that

the Court decline to exercise supplemental jurisdiction over Plaintiff’s pendant state claim. 

IT IS ORDERED that no later than April 2, 2012, any party to this action may file

written objections with the Court and serve a copy on all parties. The document should be

captioned “Objections to Report and Recommendation.”

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IT IS FURTHER ORDERED that any reply to the objections shall be filed with the Court

and served on all parties no later than April 16, 2012. The parties are advised failure to file

objections within the specified time may waive the right to raise those objections on appeal of the

Court's order. See Turner v. Duncan, 158 F.3d 449, 455 (9th Cir.1998); see also Martinez v. Ylst,

951F.2d 1153, 1156 (9th Cir.1991).

IT IS SO ORDERED.

Date: March 16, 2012

Hon. William McCurine, Jr.

U.S. Magistrate Judge

United States District Court

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