Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_13-cv-00714/USCOURTS-cand-3_13-cv-00714-15/pdf.json

Nature of Suit Code: 550
Nature of Suit: Prisoner - Civil Rights (U.S. defendant)
Cause of Action: 42:1983 Prisoner Civil Rights

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United States District Court

For the Northern District of California

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IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF CALIFORNIA

TIO DINERO SESSOMS,

Plaintiff,

 v.

DARRIN BRIGHT, M.D.,

Defendant. /

No. C 13-00714 WHA

ORDER RE MOTION FOR

SUMMARY JUDGMENT

INTRODUCTION

Plaintiff, a California prisoner proceeding pro se, filed this civil rights case under 42

U.S.C. 1983 alleging deliberate indifference to his medical needs. He has since retained pro

bono counsel. Now, the remaining defendant moves for summary judgment. For the reasons

stated below, defendant’s motion is DENIED.

STATEMENT

1. BACKGROUND OF THE CASE.

The facts of this case have been laid out in a previous order granting in part and denying

in part defendants’ motions for summary judgment (Dkt. No. 68). That order dismissed all

defendants except defendant Dr. Darrin Bright, who filed the present supplemental motion for

summary judgment. In brief, in 2011, plaintiff Tio Sessions requested medical treatment for a

“knot” in his right calf. He also complained that he had suffered knee problems for several

years. After several visits, an MRI, and a referral to a tumor specialist, doctors ultimately 

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discovered the knot to be a hematoma. Plaintiff underwent surgery to remove the knot in July

2012. Doctors ordered several rounds of follow-up visits after surgery (Plaintiff Exh. A at AG

1, 21, 61, 155, 168). 

In September 2012, plaintiff sat for a follow-up appointment with Dr. James Pucelik, an

orthopedic surgeon at San Joaquin General Hospital. Dr. Pucelik noted that plaintiff had

recovered from the calf surgery, but also observed that plaintiff suffered ongoing right knee

problems and suggested that plaintiff “may have a torn meniscus.” Dr. Pucelik recommended

that plaintiff receive a follow-up MRI on his right knee (Plaintiff Exh. A at AG 266, 342).

The next day, plaintiff sat for a further follow-up appointment with Dr. T.W. Wy,

plaintiff’s primary care physician, who noted plaintiff’s “chronic right knee pain.” Dr. Wy then

submitted a formal request for plaintiff to receive an MRI on his right knee, agreeing with Dr.

Pucelik’s assessment, and observing that plaintiff suffered from years of “knee pain and

popping” (Plaintiff Exh. A at AG 75, 265).

One week later, defendant Bright, who never examined plaintiff and is not an orthopedic

specialist, denied the request for an MRI of plaintiff’s right knee, claiming that it was not

medically necessary based on internal criteria and stating “[t]he ortho note is not clear why they

want an MRI of a knee for a calf injury” (Plaintiff Exh. B). Nobody notified plaintiff of the

MRI denial.

One month later, Dr. Wy again examined plaintiff, who continued to complain of knee

pain and asked about the status of his MRI. Dr. Wy then ordered an x-ray of plaintiff’s knee,

which occurred. The radiologist found the x-ray to be normal and recommended “further

imaging evaluation with MRI.” Dr. Wy then recommended physical therapy. Defendant Bright

denied this request and the denial did not mention anything about the multiple requests for an

MRI or the recent request for physical therapy (Plaintiff Exh. A at AG 172, 265, 272–79).

After another month, in December 2012, Dr. Wy submitted a request for plaintiff to be

sent to the orthopedic clinic to be evaluated by a specialist. Once again, defendant Bright

denied the request. After this most recent denial, Dr. Wy submitted another request for an MRI,

noting plaintiff’s knee had been “popping” and “giving way.” Dr. Wy again mentioned that Dr.

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Pucelik, an orthopedic specialist, had previously recommended an MRI. Defendant Bright

again denied the request (Plaintiff Exh. A at AG 81–86).

In May 2013, after filing this lawsuit, plaintiff was approved for physical therapy. Dr.

Fernando Tuvera examined plaintiff, noted his knee condition to be “abnormal” and sent

plaintiff for more physical therapy. The physical therapist recommended an MRI on plaintiff’s

right knee (Plaintiff Exh. A at AG 86, 182). Since then, plaintiff has continued to complain

about his knee and has received intermittent treatment. To this date, plaintiff has not undergone

an MRI of his right knee. 

2. PROCEDURAL HISTORY.

In April 2013, plaintiff filed a pro se complaint alleging constitutional violations against

several nurses and doctors who had treated him (Dkt. No. 6). After a handful of defendants

were dismissed, the remaining defendants moved for summary judgment. An order granted

summary judgment as to all defendants except defendant Bright, finding as follows (Dkt No. 68

at 6–7) (internal citations omitted):

Although Dr. Bright denied the MRI, a reasonable juror could find

that plaintiff in fact had a medical need for one based on the

opinion of the orthopedic specialist Dr. Pucelik alone. A

reasonable fact-finder could further find that Dr. Bright knew from

plaintiff’s medical records about Dr. Pucelik’s recommendation,

and that Dr. Bright deliberately disregarded the need to give him

an MRI. Dr. Bright in his declaration offers no explanation why

he contravened Dr. Pucelik’s recommendation and denied the

MRI. There is a genuine factual dispute as to whether Dr. Bright

deliberately disregarded plaintiff’s medical need for an M.R.I. for

his knee, and this issue is material to plaintiff’s Eighth Amendment

claim. Accordingly, Dr. Bright’s motion for summary judgment

will be denied on this issue.

Plaintiff then retained counsel through the Federal Pro Bono Project and Attorney Thomas

Weathers came into the case. Shortly thereafter, Attorney Weathers withdrew, and Attorneys

Bonnie Lau, Ivor Samson, and Jessica Duggan from the law firm Dentons US LLP became

counsel for plaintiff. 

Now, defendant Bright has filed a supplemental motion for summary judgment. This

order follows full briefing and oral argument.

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ANALYSIS

1. SUMMARY JUDGMENT MOTION.

Summary judgment is proper where the pleadings, discovery, and affidavits show that

there is “no genuine issue as to any material fact and that the moving party is entitled to

judgment as a matter of law.” Rule 56(c). Material facts are those which may affect the

outcome of the case. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). 

Plaintiff claims that defendant Bright was deliberately indifferent to his serious medical

needs by refusing to approve the requests for an MRI, in violation of the Eighth Amendment. 

Deliberate indifference to a prisoner’s serious medical needs violates the Eighth Amendment’s

proscription against cruel and unusual punishment. Estelle v. Gamble, 429 U.S. 97, 104 (1976). 

A prison official is deliberately indifferent if he knows that a prisoner faces a substantial risk of

serious harm and disregards that risk by failing to take reasonable steps to abate it. Farmer v.

Brennan, 511 U.S. 825, 837 (1994). Neither negligence nor gross negligence will constitute

deliberate indifference. Id. at 835--36, n.4. 

Here, there is a genuine factual dispute as to whether defendant deliberately disregarded

plaintiff’s medical needs when he overruled Dr. Pucelik and Dr. Wy’s recommendations that

plaintiff receive an MRI on his knee. Our court of appeals’ decision in Snow v. McDaniel, 681

F.3d 978 (9th Cir. 2012), is on point. In Snow, an inmate suffered from hip pain and an

orthopedic specialist recommended surgery. Instead, the non-specialist supervising doctor

merely ordered that the inmate receive pain medicine. After the district court granted

defendant’s motion for summary judgment, our court of appeals reversed, holding:

The defendants argue that this was merely a difference of opinion

that cannot amount to deliberate indifference. We disagree. Based

on the unchallenged medical records and inferences drawn in favor

of Snow, a reasonable jury could conclude that the decision of the

non-treating, non-specialist physicians to repeatedly deny the

recommendations for surgery was medically unacceptable under

all of the circumstances.

Id. at 988.

Our court of appeals held similarly in Hamilton v. Endell, 981 F.2d 1062 (9th Cir. 1992)

(overruled in part on other grounds). There, a surgeon who had operated on the inmate’s ear

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recommended that he not fly on an airplane. Despite these instructions, prison officials

solicited a second opinion from a physician who had not treated the inmate. That physician

stated that based on his own experience, but not from any examination, that plaintiff could fly

immediately. Our court of appeals found that “choosing to rely upon a medical opinion which a

reasonable person would likely determine to be inferior” and forcing the inmate to fly “may

have amounted to the denial of medical treatment.” Id. at 1067.

So too here. Defendant Bright, a non-treating and non-specialist physician, denied the

request for an MRI of plaintiff’s knee despite the recommendation from Dr. Pucelik, who is a

specialist and treated defendant, and despite the recommendation of Dr. Wy, who treated

plaintiff on several occasions. As in Smith and Hamilton, a reasonable jury could find that this

amounted to a deliberate indifference to serious medical needs.

Defendant relies on our court of appeals’ decision in Sanchez v. Vild, 891 F.2d 240 (9th

Cir. 1989). In Sanchez, the plaintiff stated that one Dr. Abbot had told him he needed surgery,

despite all other treating physicians finding surgery to be unnecessary. There were no records

that the plaintiff ever saw a Dr. Abbot and the records indicated that the Department of

Corrections in that case had not employed anyone by that name. Even accepting the plaintiff’s

assertion as true, our court of appeals held that “[a] difference of [medical] opinion does not

amount to a deliberate indifference to Sanchez’ serious medical needs.” Id. at 242. Twentythree years after Sanchez (which came down in 1989), our court of appeals clarified what

degree of medical disagreement could rise to the level of an Eighth Amendment violation in

Smith, cited above. In our case, as in Smith, a non-treating and non-specialist physician went

against the recommendation of a specialist, treating physician. In Sanchez, no such specialist

opinion was disregarded, and Sanchez is thus distinguishable on that ground.

Defendant also relies on our court of appeals’ decision in Toguchi v. Chung, 391 F.3d

1051 (9th Cir. 2004). There, the estate of an inmate alleged constitutional violations against a

doctor who treated the inmate with a particular drug, despite knowing that the inmate had been

hospitalized years earlier for a negative reaction to that drug. Our court of appeals affirmed the

district court’s grant of summary judgment in favor of the defendant. The facts in Toguchi,

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however, were completely different than those in our case. Toguchi did not involve competing

recommendations from different doctors. Rather, it involved an allegedly unconstitutional

decision by a doctor to prescribe a certain drug. While Toguchi cites general principles

regarding Eighth Amendment claims centered around allegations of deliberate indifference to

medical needs, it is factually distinguishable from our case. 

Furthermore, defendant argues that there is no dispute of material fact because in his

opinion, plaintiff did not meet the criteria for approval of an MRI as set forth under California

Code of Regulations Title 15 and under the InterQual imaging criteria used by the California

Department of Corrections. Both of these criteria provide that inmates shall only be provided

medical services necessary to protect life, prevent significant illness or disability, or to alleviate

severe pain. A state regulation, however, cannot override a constitutional duty. 

As stated above, two treating physicians, one of whom was an orthopedic specialist,

recommended that plaintiff receive an MRI on his knee. Defendant disagreed and denied the

MRI requests, despite the fact that he never treated or examined plaintiff. Thus, a jury will need

to determine whether defendant’s actions constituted a deliberate indifference to plaintiff’s

serious medical needs.

2. MOTION FOR LEAVE TO FILE A SUR-REPLY.

After defendant filed his reply to plaintiff’s opposition, plaintiff (through pro bono

counsel) filed a motion for leave to file a sur-reply, and appended a proposed sur-reply. Under

Civil Local Rule 7–3(d)(1), any objection to a reply must be filed within seven days of that

reply’s submission. Plaintiff’s request to file a sur-reply came in eleven days after defendant’s

reply, and is thus untimely. Plaintiff’s request is DENIED.

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CONCLUSION

For the reasons stated above, defendant’s motion for summary judgment is DENIED. A

case management conference is hereby set for DECEMBER 10, 2015, AT ELEVEN A.M. The

parties shall submit a joint case management statement by DECEMBER 3, 2015.

IT IS SO ORDERED.

Dated: November 19, 2015. 

WILLIAM ALSUP

UNITED STATES DISTRICT JUDGE

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