Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_06-cv-00096/USCOURTS-azd-4_06-cv-00096-0/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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WO SVK

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Johnny T. Goswick, 

Plaintiff, 

vs.

Dora Schriro, et al., 

Defendants. 

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No. CV 06-0096-TUC-DCB

ORDER

Plaintiff Johnny T. Goswick, who is confined in the Arizona State Prison Complex,

filed this civil rights action against various officials of the Arizona Department of

Corrections (ADC). Plaintiff moved for a Temporary Restraining Order and Preliminary

Injunction asking the Court for an order directing Defendants to provide Plaintiff medical

footwear and an enhanced diet and to immediately begin treatment for Plaintiff’s hepatitis

C. (Doc. #21.) Defendants responded, and Plaintiff replied. (Doc. ##26, 31.) By Order

dated May 7, 2007, the Court denied the motion, with leave to renew with appropriate

medical evidence, insofar as Plaintiff’s requested shoes and a special medical diet. The

Court also ordered Defendants to show cause within 20 days of the date of the Order why the

Court should not order Defendants to immediately begin drug therapy treatment for

Plaintiff’s hepatitis C. 

On May 29, 2007, Defendants filed their Response to the Order to Show Cause, which

they supplemented on June 20, 2007. (Doc. #42, 44.) After reviewing the Responses and

attached affidavits, as well as Plaintiff’s Notice Regarding Defendants’ Response to Order

Case 4:06-cv-00096-DCB Document 49 Filed 07/12/07 Page 1 of 9
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to Show Cause (Doc. #45), the Court will deny Plaintiff’s motion for an order directing

Defendants to immediately begin drug treatment for Plaintiff’s hepatitis C but will require

Defendants to provide periodic status reports regarding Plaintiff’s progress in completing the

Substance Abuse Program and Defendants’ progress in completing the steps for approval of

Plaintiff’s drug therapy and providing treatment for his hepatitis C.

I. Background

In his Complaint, Plaintiff brought three counts for relief, including one regarding the

alleged denial of medical care for his hepatitis C. Specifically, Plaintiff alleged that he had

been requesting treatment for his hepatitis C since October 2000 (Doc. #1 at 5). He alleged

that he continuously requested diagnostic tests to determine the progression of the disease

and treatment for the condition, but Defendants refused to treat him (id. at 5b). The Court

ordered Defendants to answer the count. Plaintiff subsequently filed a Motion for a

Preliminary Injunction.

After reviewing the parties’ initial filings on the motion, the Court found the following

facts to be undisputed: (1) Plaintiff has hepatitis C, a chronic, progressive disease, (2) the

disease requires drug therapy, and (3) Plaintiff is receiving no treatment. According to

Defendants’ evidence, Plaintiff’s disease has progressed to Stage 2 and he has genotype 1

hepatitis, which requires a course of treatment twice as long as patients with genotype 2 or

3. Defendants asserted, however, that Plaintiff must first complete a drug abuse program and

that in June 2006 he was put on a waiting list for the program. But, as of December 2006

when Defendants submitted their opposition to the motion for preliminary relief, Plaintiff

was apparently not yet in a such a program. Plaintiff asserted that he had already undergone

substance abuse treatment and that there was no such program at Santa Rita and no waiting

list. The Court noted that Defendants provided no evidence or even information regarding

when the next substance abuse program was scheduled to begin and did not claim that

Plaintiff is a current drug abuser. 

Because neither Plaintiff nor the Court knew when or if Defendants would provide

treatment to Plaintiff, the Court directed Defendants to show cause why the Court should not

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order Defendants to immediately provide Plaintiff drug therapy treatment for his hepatitis C.

Specifically, the Court directed Defendants to state whether Plaintiff had completed a

substance abuse program while in the custody of ADC, and if so, why that did not satisfy the

requirements of the ADC hepatitis protocol; to state why Plaintiff could not complete such

a program while he underwent drug therapy treatment; to provide evidence of a drug abuse

program that is currently available to Plaintiff and a date certain when Plaintiff will begin the

program; to state whether there is evidence that Plaintiff is a current drug abuser; and to

provide the Court with a date certain on which Plaintiff’s drug therapy would begin.

Defendants responded by stating that Plaintiff began an HCV drug abuse program on

May 18, 2007; the program is a self-study, workbook series. Defendants also admitted that

Plaintiff has not had a drug abuse violation in more than five years and has taken other drug

abuse programs. They did not explain why the required drug abuse program could not be

taken concurrently with the hepatitis drug therapy.

The Court issued a second order to show cause directing Defendant to state when

Plaintiff had taken the other drug abuse programs. According to Defendants’ response,

Plaintiff has taken two drug abuse programs since the time of his last drug violation. In

addition, Defendants now assert that the required drug abuse program and the drug therapy

are generally not done concurrently because providing the drug therapy creates a disincentive

to complete the drug abuse program and because the side effects of the drug therapy can

make an individual too sick to complete the drug abuse program. Plaintiff filed a Notice

Regarding Defendants’ Response to Order to Show Cause.

II. Motion for Preliminary Injunction 

A. Legal Standard

A preliminary injunction is an extraordinary and drastic remedy and will not be

granted absent a clear showing of likely success in the underlying claim and possible

irreparable injury. See Mazurek v. Armstrong, 520 U.S. 968, 972 (1997) (per curiam);

Warsoldier v. Woodford, 418 F.3d 989, 993-94 (9th Cir. 2005); Pratt v. Rowland, 65 F.3d

802, 805 (9th Cir. 1995). Alternately, a party may show that serious questions going to the

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merits were raised and the balance of hardships tips sharply in his favor. Warsoldier, 418

F.3d at 994. These two alternatives are extremes of a single continuum, rather than two

separate tests. Nike, Inc. v. McCarthy, 379 F.3d 576, 580 (9th Cir. 2004). Thus the greater

the relative hardship to the moving party, the less probability of success must be shown. Id.

(citing Walczak v. EPL Prolong, Inc., 198 F.3d 725, 731 (9th Cir. 1999)). Under either test,

the movant bears the burden of persuasion, Mattel, Inc. v. Greiner & Hausser GmbH, 354

F.3d 857, 869 (9th Cir. 2003), and must demonstrate a significant threat of irreparable injury.

AGCC v. Coalition for Economic Equity, 950 F.2d 1401, 1410 (9th Cir. 1991). 

B. Defendants’ Responses to the Order to Show Cause

Defendants assert that Plaintiff is now enrolled in Defendants’ HCV Substance Abuse

Program, which is a self-study workbook program that can be completed in approximately

four months. Defendants maintain that following completion of the Program, if existing

medical and mental health assessments are not current, Plaintiff will need additional

assessments before drug therapy is finally approved and instituted. Finally, Defendants

assert that Plaintiff is in no immediate need of drug therapy based on the condition of his

liver and the slow progression of the disease. 

C. Analysis—Irreparable Harm

Although a court may find irreparable harm where the movant’s health is in imminent

danger, see Al-Joudi v. Bush, 406 F. Supp.2d 13, 20 (D.D.C. 2005), mere “[s]peculative

injury does not constitute irreparable harm sufficient to warrant granting a preliminary

injunction.” Caribbean Marine Services Co., Inc. v. Baldrige, 844 F. 2d 668, 674-675 (9th

Cir. 1988). To meet the “irreparable harm” requirement, a Plaintiff must do more than

merely allege imminent harm; he must demonstrate it. Id. at 674. Compare with Wilson v.

Group Hospitalization and Medical Services, Inc., 791 F. Supp. 309, 313, 313-14 (D.D.C.

1992) (finding irreparable harm where the record contained evidence regarding a particular

treatment for breast cancer and it was uncontroverted that without the chemotherapy

treatment, the plaintiff would have died within months).

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1

 With their second report, Defendants also submit the affidavit of C. Moody,

Counselor Coordinator Administrator in the Program Services Division at ADC Central.

(Moody Aff. Ex. A Doc. #44.) 

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In support of their Responses to the Orders to Show Cause, Defendants submit the

affidavits of James Baird, Medical Program Director of ADC, who is licensed to practice

medicine in Arizona, and K. Hellman, Addictions Treatment Program Manager of ADC.

(Baird Aff. #1, ¶ 1, Ex. A, Doc. #42 ; Hellman Aff. #1, ¶ 1, Ex. B, Doc. #42; Baird Aff. #2

¶ 1, Ex. C, Doc. #44, and Hellman Aff. #2, ¶ 1, Ex. B, Doc. #44.)1

 Dr. Baird states that

Plaintiff has had a liver biopsy, which is the “gold standard to assess HCV progression and

based on these results, and though under the [ADC] protocol he is eligible for the drug

therapy (grades 2-4), [Plaintiff] is in no immediate urgency to receive drug therapy based on

the condition of his liver and the naturally-slow progression of HCV.” (Baird Aff. #1, ¶ 27

(emphasis added.)) Dr. Baird also states that Plaintiff has not yet been approved for drug

treatment and must complete the HCV Substance Abuse Program and have current clinical

and mental health assessments before approval, due to potential serious side effects of the

drug therapy. (Id. at ¶¶ 22-24, 28, and 29.) He does not provide a time frame for completion

of these assessments, final approval, or beginning the drug therapy.

K. Hellman states that due to a shortage of substance abuse counselors, ADC recently

re-instituted and expanded a self-study, substance abuse workbook program for hepatitis C,

entitled A New Direction. (Hellman Aff. #1, ¶ 5.) Hellman states that the ADC program uses

four separate workbooks, which a motivated inmate can easily complete at the rate of one

workbook per month. (Id. ¶ 11.) The workbooks are written at the fifth-grade level. (Id. ¶

16.) The inmate takes an open-book test after completing each workbook (id.). A passing

score is 70% and a failing test can be resubmitted. (Id.) The affidavit contains a description

of the contents of the workbooks. (Id. ¶¶ 11-15.) Hellman states that Plaintiff was enrolled

in the workbook program on May 18, 2007, and has received his first workbook. (Id. ¶ 20.)

In the June 20th report, Hellman asserts that Plaintiff has completed the first workbook and

will receive the second workbook on June 29, 2007. (Hellman Aff. #2, ¶ 9.) 

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Defendants admit that Plaintiff has completed other substance abuse programs. (Baird

Aff. #1, ¶ 29.) However, they assert that the HCV Substance Abuse Program is geared

toward the specific needs of HCV patients and “was developed and is delivered by licensed

substance abuse professionals while the general substance abuse classes are taught by

correctional officers III.” (Id. ¶ 29; Hellman Aff.#1, ¶ 20.) According to Dr. Baird, the

completed workbooks are reviewed by licensed Addiction Treatment Services counselors.

(Baird Aff. #1, ¶ 30.) In the June 20th report, Defendants assert that while the required drug

abuse program and the hepatitis drug therapy are generally not done concurrently, exceptions

have been made when the patient’s disease has advanced such that further delay will be

harmful or when the patient’s discharge from ADC custody is imminent. (Baird Aff. #2 ¶

10.) Plaintiff does not fit either exception. (Id.).

Hellman also states that Plaintiff’s Drug and Alcohol classification score “is at the

highest level, indicating his persistent difficulties with substance abuse. He has continued to

abuse drugs while incarcerated.” (Hellman Aff. #1, ¶ 21.) Dr. Baird states that hepatitis can

be contracted when inmates use infected needles for tattooing, that Plaintiff’s medical records

show he is covered in tattoos, and that Plaintiff has been found guilty of a tattoo violation.

(Baird Aff. #1, ¶¶ 9 and 10.) Plaintiff’s most recent ADC drug or tattoo violation occurred

on January 19, 2002. (Baird Aff. #1, ¶¶ 13 and 14 and Doc. #42 at 4).) Plaintiff has taken

two substance abuse programs since his last drug violation. (Moody Aff. ¶ 6.)

Thus, Plaintiff has had no drug violations in more than five years and has completed

other substance abuse counseling programs since that time. At this time, the Court is not

persuaded by Defendants’ explanation regarding why the other drug programs are not

sufficient to meet the ADC substance abuse prerequisite for treatment of hepatitis C.

Although Defendants claim the new program is geared toward specific needs of HCV patients,

the description of the workbooks never mentions hepatitis C or hepatitis C patients. Hellman

describes the workbook program as “moderate treatment,” as opposed to other programs,

which are “intensive treatment.” (Hellman Aff.#1, ¶ 4.) Moreover, although Dr. Baird asserts

that the new program “is delivered by licensed substance abuse professionals while the

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2

 The Court makes no finding at this time, however, that ADC’s protocol requiring

completion of the additional drug abuse course unreasonably delays treatment.

3 This finding does not preclude Plaintiff from demonstrating injury as a result of

Defendants’ alleged deliberate indifference. 

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general substance abuse classes are taught by correctional officers III,” the new program is,

in fact, self-study. It is not clear from Defendants’ exhibits how it is “delivered” by substance

abuse professionals or how it differs in content from general substance abuse programs.2

Nevertheless, the Court finds that Plaintiff has not established that he will suffer

irreparable harm without immediate drug therapy for the following reasons: (1) Dr. Baird

represents that Plaintiff is not in immediate need of drug therapy treatment for his hepatitis

C; (2) Dr. Baird states that Plaintiff has not yet received final approval for the treatment,

which may require additional or current medical and mental health assessments; (3) Plaintiff

is finally enrolled in the required substance abuse program, which he can complete in four

months, and (4) completing the drug abuse program concurrently with the drug therapy is not

recommended or, apparently, necessary in Plaintiff’s case.3

 Therefore, the Court will deny

Plaintiff’s request for an order directing Defendants to immediately begin the drug therapy.

However, it is clear that Defendants have delayed providing treatment for Plaintiff’s

condition by requiring drug counseling that was not, in fact, available. For example, it

appears that the loss of counselors occurred in May or June, 2006—about the time that

Plaintiff was placed on the waiting list for the required substance abuse program and

approximately six months before Defendants opposed Plaintiff’s motion for preliminary relief

and advised the Court that Plaintiff was on a waiting list for a program. (Hellman Aff. #1,¶5.)

In addition, the Court notes that Plaintiff was not enrolled in the self-study workbook program

until the Court issued its Order to Show Cause; the enrollment occurred approximately one

week after issuance of the Order, which suggests that the enrollment was the result of the

Court’s action. Further, although Plaintiff apparently completed his first workbook sometime

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28 4 Plaintiff represents that he completed the first workbook in two weeks and has been

waiting over three weeks to receive the second workbook. (Doc. #45 at 5.)

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before June 20th,

4

 Defendants will not provide him with the second workbook until June 29th,

and they offer no explanation for the delay. Finally, Defendants provide no time frame for

the steps following Plaintiff’s completion of the substance abuse program. Neither Dr.

Baird’s affidavit nor the protocol annexed to Defendants’ Opposition state when additional

assessments will be ordered relative to completion of the substance abuse program, when final

approval will take place after the assessments are completed, or when drug therapy will be

initiated following final approval (Doc. #26 , Ex. A, Attachment #1). Therefore, the Court

will require Defendants to provide a proposed time schedule addressing these omissions and

periodic status reports to the Court.

III. Proposes Schedule and Periodic Reporting

The Court will direct Defendants to provide periodic status reports regarding 

Plaintiff’s progress in completing the self-study workbooks and Defendants’ progress in

completing the steps for approval of Plaintiff’s drug therapy and providing Plaintiff treatment

for his hepatitis C. Within 30 days of the filing of this Order, Defendants must provide the

Court the first status report stating whether Plaintiff successfully completed the second

workbook and if so, the date he was provided the third workbook. If Plaintiff did not receive

a passing score on any workbook, Defendants must state the date when it was returned to him,

and if and when he resubmitted it. Thereafter, Defendants must provide a new status report

every 30 days on the succeeding workbooks until such time as Plaintiff has completed the

self-study program. 

In addition, within 30 days of the filing of this Order, Defendants must provide a

detailed schedule identifying each step remaining to determine Plaintiff’s eligibility for

hepatitis drug therapy and the anticipated time frame to begin and complete each such step.

After Plaintiff has completed the self-study workbook program, Defendants must provide

periodic reports regarding their progress in completing the remaining steps as identified in the

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report. The Defendants must file status reports every 30 days to track Plaintiff’s progress

through the remaining steps.

Accordingly,

IT IS ORDERED:

(1) Plaintiff’s Motion for a Temporary Restraining Order and Preliminary

Injunction requiring Defendants to immediately provide Plaintiff drug therapy treatment for

his hepatitis C (Doc. #21) is denied.

(2) As outlined in the Order, Defendants must provide status reports regarding

Plaintiff’s progress in completing the self-study workbooks and Defendants’ progress in

completing the steps for approval of Plaintiff’s drug therapy and providing Plaintiff treatment

for his hepatitis C. The proposed schedule and first status report must be provided within 30

days of the filing of this Order.

DATED this 11th day of July, 2007.

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