Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_20-cv-01120/USCOURTS-caed-1_20-cv-01120-10/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

EASTERN DISTRICT OF CALIFORNIA

RYAN BIGOSKI ODOM,

Plaintiff,

v.

J. TAYLOR, et al.,

Defendants.

Case No. 1:20-cv-01120-KES-CDB (PC)

FINDINGS AND RECOMMENDATIONS 

TO GRANT DEFENDANTS’ MOTION FOR 

SUMMARY JUDGMENT

(Doc. 42)

14-Day Deadline

Plaintiff Ryan Bigoski Odom is a state prisoner proceeding pro se and in forma pauperis

in this civil rights action. This action proceeds on Plaintiff’s Eighth Amendment deliberate 

indifference to serious medical needs claims against Defendants Taylor, Khoo, Attinello, 

Ezenwugo, Mitchell and Singh. 

I. INTRODUCTION

On August 28, 2024, Defendants filed a motion for summary judgment concerning the 

merits of Plaintiff’s claims. (Doc. 42.) The motion included a Rand1 warning (Doc. 42-3), 

addressing the requirements concerning an opposition to a motion for summary judgment.

On October 3, 2024, the Court issued its Order to Show Cause (OSC) Why Sanctions 

Should Not Be Imposed for Plaintiff’s Failure to File an Opposition or Statement of NonOpposition to the summary judgment motion. (Doc. 43.) Plaintiff was directed to show cause in 

1 Rand v. Rowland, 154 F.3d 952 (9th Cir. 1998). 

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writing within 14 days why sanctions should not be imposed for her failure to respond to 

Defendants’ summary judgment motion, or, alternatively, to file an opposition or statement of 

non-opposition to Defendants’ motion for summary judgment. (Id. at 2-3.) 

On October 11, 2024, Plaintiff filed a document titled “Decleration,” docketed as an 

opposition to the motion for summary judgment. (Doc. 44.) Defendants filed the Declaration of 

Eric Miersma in Response to Plaintiff’s Declaration re Defendants’ Motion for Summary 

Judgment (Doc. 45) on October 24, 2024.

On October 28, 2024, the Court issued its Order Discharging Order to Show Cause, Order 

Denying Request to Reopen Discovery, and Order Granting Extension of Time Within Which to 

File Opposition to Motion for Summary Judgment. (Doc. 46.) In relevant part, Plaintiff was 

granted an additional 30 days, from the date of service of the order, within which to file an 

opposition to Defendants’ summary judgment motion. (Id. at 5-6.) 

Plaintiff did not file an opposition to Defendants’ motion for summary judgment and the 

time to do so has passed. Thus, because a reply is unnecessary, the Court deems the motion 

submitted. Local Rule 230(l). 

II. APPLICABLE LEGAL STANDARDS

Motions for Summary Judgment

Summary judgment is appropriate when it is demonstrated that there “is no genuine 

dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. 

Civ. P. 56(a). Washington Mutual Inc. v. United States, 636 F.3d 1207, 1216 (9th Cir. 2011). A 

party asserting that a fact cannot be disputed must support the assertion by “citing to particular 

parts of materials in the record, including depositions, documents, electronically stored 

information, affidavits or declarations, stipulations (including those made for purposes of the 

motion only), admissions, interrogatory answers, or other materials....” Fed. R. Civ. P. 

56(c)(1)(A). 

Summary judgment should be entered, after adequate time for discovery and upon motion, 

against a party who fails to make a showing sufficient to establish the existence of an element 

essential to that party's case, and on which that party will bear the burden of proof at trial. See 

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Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986). “[A] complete failure of proof concerning an 

essential element of the nonmoving party’s case necessarily renders all other facts immaterial.” 

Id. If the moving party meets its initial responsibility, the burden then shifts to the opposing party 

to establish that a genuine issue as to any material fact actually does exist. See Matsushita Elec. 

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

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

of their pleadings but is required to tender evidence of specific facts in the form of affidavits, 

and/or admissible discovery material, in support of its contention that the dispute exists or shows 

that the materials cited by the movant do not establish the absence of a genuine dispute. See Fed. 

R. Civ. P. 56(c); Matsushita, 475 U.S. at 586 n.11. The opposing party must demonstrate that the 

fact in contention is material, i.e., a fact that might affect the outcome of the suit under the 

governing law. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986); T.W. Elec. Serv., 

Inc. v. Pacific Elec. Contractors Ass'n, 809 F.2d 626, 630 (9th Cir. 1987). Further, the opposing 

party must also demonstrate that the dispute is genuine, i.e., the evidence is such that a reasonable 

jury could return a verdict for the nonmoving party. See Wool v. Tandem Computers, Inc., 818 

F.2d 1433, 1436 (9th Cir. 1987). In seeking to establish the existence of a factual dispute, the 

opposing party need not establish a material issue of fact conclusively in its favor. It is sufficient 

that “the claimed factual dispute be shown to require a jury or judge to resolve the parties’ 

differing versions of the truth at trial.” T.W. Elec. Serv., 809 F.2d at 631. Thus, the “purpose of 

summary judgment is to ‘pierce the pleadings and to assess the proof in order to see whether there 

is a genuine need for trial.’” Matsushita, 475 U.S. at 587 (quoting Fed. R. Civ. P. 56(e) advisory 

committee's note on 1963 amendments).

In resolving the summary judgment motion, the evidence of the opposing party is to be 

believed. See Anderson, 477 U.S. at 255. All reasonable inferences that may be drawn from the 

facts placed before the court must be drawn in favor of the opposing party. See Matsushita, 475 

U.S. at 587. Nevertheless, “inferences are not drawn out of thin air” and it is the opposing party’s 

obligation to produce a factual predicate from which the inference may be drawn. See Richards v. 

Nielsen Freight Lines, 602 F. Supp. 1224, 1244-45 (E.D. Cal. 1985), aff'd, 810 F.2d 898, 902 (9th 

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Cir. 1987). Finally, to demonstrate a genuine issue, the opposing party “must do more than simply 

show that there is some metaphysical doubt as to the material facts.... Where the record taken as a 

whole could not lead a rational trier of fact to find for the nonmoving party, there is no ‘genuine 

issue for trial.’” Matsushita, 475 U.S. at 587 (citation omitted).

Eighth Amendment Deliberate Indifference to Serious Medical Needs

Prison officials violate the Eighth Amendment if they are “deliberate[ly] indifferen[t] to [a 

prisoner’s] serious medical needs.” Estelle v. Gamble, 429 U.S. 97, 104 (1976). “A medical need 

is serious if failure to treat it will result in ‘“significant injury or the unnecessary and wanton 

infliction of pain.”’” Peralta v. Dillard, 744 F.3d 1076, 1081-82 (9th Cir. 2014) (quoting Jett v. 

Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) (quoting McGuckin v. Smith, 974 F.2d 1050, 1059 

(9th Cir. 1992), overruled on other grounds by WMX Techs., Inc. v. Miller, 104 F.3d 1133 (9th 

Cir. 1997) (en banc)). 

To maintain an Eighth Amendment claim based on medical care in prison, a plaintiff must 

first “show a serious medical need by demonstrating that failure to treat a prisoner’s condition 

could result in further significant injury or the unnecessary and wanton infliction of pain. Second, 

the plaintiff must show the defendants’ response to the need was deliberately indifferent.” 

Wilhelm v. Rotman, 680 F.3d 1113, 1122 (9th Cir. 2012) (quoting Jett, 439 F.3d at 1096 

(quotation marks omitted)). 

As to the first prong, indications of a serious medical need “include the 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.” Colwell v. Bannister, 763 F.3d 1060, 

1066 (9th Cir. 2014) (citation & internal quotation marks omitted); accord Wilhelm, 680 F.3d at 

1122; Lopez v. Smith, 203 F.3d 1122, 1131 (9th Cir. 2000) (“Examples of serious medical needs 

include ‘[t]he existence of an injury that a reasonable doctor or patient would find important and 

worthy of comment or treatment; the presence of a medical condition that significantly affects an 

individual’s daily activities; or the existence of chronic and substantial pain”). 

As to the second prong, deliberate indifference is “a state of mind more blameworthy than 

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negligence” and “requires ‘more than ordinary lack of due care for the prisoner’s interests or 

safety.’” Farmer v. Brennan, 511 U.S. 825, 835 (1994) (quoting Whitley v. Albers, 475 U.S. 312, 

319 (1986)). Thus, deliberate indifference is shown where a prison official “knows that inmates 

face a substantial risk of serious harm and disregards that risk by failing to take reasonable 

measures to abate it.” Id. at 847. In medical cases, this requires showing: (a) a purposeful act or 

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

indifference. Wilhelm, 680 F.3d at 1122 (quoting Jett, 439 F.3d at 1096). “A prisoner need not 

show his harm was substantial; however, such would provide additional support for the inmate’s 

claim that the defendant was deliberately indifferent to his needs.” Jett, 439 F.3d at 1096, citing 

McGuckin, 974 F.2d at 1060. 

Deliberate indifference is a high legal standard. Toguchi v. Chung, 391 F.3d 1051, 1060 

(9th Cir. 2004). Although the state of mind for deliberate indifference commonly is characterized 

as “subjective recklessness,” that standard is “less stringent in cases involving a prisoner’s 

medical needs ... because the State’s responsibility to provide inmates with medical care 

ordinarily does not conflict with competing administrative concerns.” Snow v. McDaniel, 681 

F.3d 978, 985 (9th Cir. 2012) (internal quotations and citations omitted). “Under this standard, the 

prison official must not only ‘be aware of the facts from which the inference could be drawn that 

a substantial risk of serious harm exists,’ but that person ‘must also draw the inference.’” Id. at 

1057 (quoting Farmer, 511 U.S. at 837). “‘If a prison official should have been aware of the risk, 

but was not, then the official has not violated the Eighth Amendment, no matter how severe the 

risk.’” Id. (quoting Gibson v. County of Washoe, Nevada, 290 F.3d 1175, 1188 (9th Cir. 2002)).

To prevail on a deliberate-indifference claim, a plaintiff must also show that harm resulted 

from a defendant’s wrongful conduct. Wilhelm, 680 F.3d at 1122; see also Jett, 439 F.3d at 1096; 

Hallett v. Morgan, 296 F.3d 732, 746 (9th Cir. 2002) (prisoner alleging deliberate indifference 

based on delay in treatment must show delay led to further injury). 

III. PLAINTIFF’S CLAIMS

In the operative second amended complaint, Plaintiff alleges as follows:

///

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Plaintiff contends she suffers from osteoarthritis and degenerative 

joint disease in her left hip, a one and one-half inch length 

discrepancy in her left hip, scoliosis of her spine, HIV induced 

neuropathy and carpel tunnel syndrome. She has experienced severe 

and increasing pain throughout her body during her incarceration at 

the Central California Women’s Facility (CCWF). 

Plaintiff alleges all named Defendants knew of her worsening joint 

and bone pain because she filed several grievances, imaging results 

were obtained, and assessments performed by the primary care 

physicians. Plaintiff notes Defendants Mitchell and Singh “have been 

aware and reviewed [her] medical issues on more than one occasion.” 

Plaintiff contends none of the named Defendants “did anything to 

delay the progress” of her disorder, placing her at substantial risk of 

injury for a total hip replacement at a young age. Plaintiff received a 

total hip replacement after being sent to a physician for a cortisone 

injection in August 2019, only to be refused the procedure because 

the doctor reviewed her x-rays and advised Plaintiff that she had no 

hip joint the doctor could “inject into.” Orthopedic practitioners who 

reviewed the “same x-ray images that all 6 defendants have seen” 

were surprised Plaintiff could even walk. Plaintiff contends her pain 

was never controlled and the progress of her disorder was never 

delayed, resulting in her need to have replacement surgery at forty 

years old. Plaintiff asserts her mobility and function “only worsened, 

never did it improve.” 

Plaintiff contends Defendants Taylor, Khoo, Antenello and 

Eznewugo were aware of “each and every medication” Plaintiff has 

been prescribed because Plaintiff discussed it with them verbally and 

referenced the medications in grievances and other medical forms. 

However, they continued to prescribe the same medications, 

including two on her “allergy list,” putting Plaintiff at a substantial 

risk of serious harm. Plaintiff contends Ibuprofen and Naproxen 

“were definitely medically unacceptable” for her type of pain as she 

had previously explained to these medical providers that she had 

been treated with Ibuprofen and Naproxen for several years prior to 

her incarceration but neither helped any longer. Plaintiff asserts she 

suffered physical and mental harm because her pain was not 

controlled. Plaintiff contends she has suffered from severe 

depression for more than two years, and the Ibuprofen and Naproxen 

have caused kidney function issues and “put [her] other organs at 

substantial risk” because she is HIV positive. 

Plaintiff asserts Defendants Mitchell and Singh both have the 

authority to grant her the use of a double mattress or egg crate. She 

contends her disease was significant enough in 2014 or 2015 to 

justify a double mattress, and that as her disease continues to 

progress, denials of her requests for a double mattress or egg crate 

are medically unacceptable. 

In conclusion, Plaintiff contends her health issues are “discussed 

daily at the morning medical meetings that all” named Defendants 

attend and all of her medical issues are known to them. Plaintiff 

asserts her hip replacement did not address her chronic pain because 

she still suffers from osteoarthritis in other areas of her body, 

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including her back, and has HIV induced neuropathy and carpal 

tunnel.

(See Doc. 21 at 3-5, citations omitted.) The undersigned found:

Plaintiff’s allegations satisfy the first, objective prong. Plaintiff 

suffers from several medical conditions—osteoarthritis and 

degenerative joint disease in her left hip, a one and one-half inch 

length discrepancy in her left hip, scoliosis of her spine, HIV induced 

neuropathy and carpel tunnel—that significantly affect her daily 

activities. And as the Court has determined in a prior screening order, 

it is clear Plaintiff’s medical conditions caused her significant pain 

and were worthy of treatment.

Liberally construing the second amended complaint, Plaintiff has 

plausibly alleged facts to satisfy the second, subjective prong. Her 

allegations plausibly demonstrate a failure by all named Defendants 

to respond to Plaintiff’s serious medical needs concerning the 

progression of her disease and pain control, and further, that 

Defendants Taylor, Khoo, Antenello and Eznewugo were aware of 

Plaintiff’s previous adverse and allergic reactions to Ibuprofen and 

Naproxen or their generic counterparts, subjecting her to substantial 

risk of harm. 

As concerns Defendants Mitchell and Singh and Plaintiff’s requests 

for a double mattress or egg crate, liberally construing the second 

amended complaint, Plaintiff has plausibly alleged Mitchell and 

Singh chose to deny her a double mattress and/or egg crate despite 

having knowledge of her serious medical conditions and the relief 

either a double mattress or egg crate would have afforded, amounting 

to a medically unacceptable choice made in conscious disregard of 

an excessive risk to Plaintiff’s health due to their failure to take 

reasonable measures to abate that risk.

(Id. at 6-7.) 

IV. DEFENDANTS’ STATEMENT OF UNDISPUTED FACTS2(Doc. 42-4)

1. Plaintiff Ryan Odom is a state-prison inmate incarcerated at Central California 

Women’s Facility (“CCWF”) at the time of the incidents alleged in her SAC.

2. In approximately 1989, at the age of 9, Odom broke her left hip on a merry-go-round. 

2 Because Plaintiff did not file an opposition, she neither admitted or denied the facts set forth by Defendants as 

undisputed nor filed a separate statement of disputed facts. Local Rule 260(b). A verified complaint in a pro se civil 

rights action may constitute an opposing affidavit for purposes of the summary judgment rule, where the complaint is 

based on an inmate’s personal knowledge of admissible evidence, and not merely on the inmate’s belief. Jones v. 

Blanas, 393 F.3d 918, 923 (9th Cir. 2004); Fed. R. Civ. P. 56(e). Here, because Plaintiff has not complied with Rule 

260(b), the Court deems Plaintiff to have admitted those facts not disputed by her complaint or other submissions. 

See, e.g., Beard v. Banks, 548 U.S. 521, 527 (2006) (“by failing specifically to challenge the facts identified in the 

defendant's statement of undisputed facts, [plaintiff] is deemed to have admitted the validity of the facts contained in 

the [defendant’s] statement”); Brito v. Barr, No. 2:18-cv-00097-KJM-DB, 2020 WL 4003824, at *6 (E.D. Cal. July 

15, 2020) (deeming defendant’s undisputed facts as admitted after plaintiff failed to comply with Local Rule 260(b)).

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She had 7 surgeries on her left hip between the ages of 9 and 12. Odom states her left 

leg is now about an inch shorter than her right leg and she uses a shoe insert to 

compensate. She further states that in 2010, approximately three years prior to arriving 

at CCWF, she was in a motorcycle accident from which she sustained a traumatic 

brain injury.

3. Odom first entered CCWF on November 13, 2013.

4. On December 13, 2013, Odom saw nondefendant Nurse Practitioner Loadholt who 

performed an intake history and physical examination. NP Loadholt checked the box 

NKA, meaning no known drug allergies, and then added in parentheses that Odom 

reported that codeine and morphine gave her stomach cramps and dizziness. NP 

Loadholt documented “this is intolerance,” or unpleasant side effect, rather than an 

allergic reaction to medication.

5. On January 9, 2014, Odom saw nondefendant Dr. Gonzalez for a Form #602 

healthcare grievance with six requests: to see orthotics for her leg length discrepancy; 

to receive pain medication for her left hip; to have a left hip replacement; to receive a 

double mattress; to receive soft shoes; and to receive an extra blanket. It is unclear 

why Odom filed a grievance for these items that she had not previously requested nor 

been denied. Dr. Gonzalez referred Odom to orthotics for her leg length discrepancy 

and to orthopedic surgery to be evaluated for possible hip replacement. Dr. Gonzalez 

prescribed Tylenol #3, which is Tylenol plus codeine, to be used as needed for pain. 

Dr. Gonzalez also documented that Odom “does not meet the criteria for a double 

mattress, soft shoes, or an extra blanket.”

6. On February 6, 2014, Odom saw nondefendant Dr. Romero after submitting another 

Form #602 healthcare grievance with the same six requests. Dr. Romero noted that the 

orthotic and orthopedic referrals were in progress, that the pain issue was a duplicate 

with no answer per the appeals department, and reiterated that Odom did not meet 

criteria for a double mattress, soft shoes, or an extra blanket. 

7. On February 11, 2014, Odom saw nondefendant Dr. Galang for a telemedicine 

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orthopedic consultation. Dr. Galang’s impression was that Odom had “severe 

degenerative arthritis of the left hip with some shortening. Due to her age, it is best to 

treat it conservatively. She will need a total hip replacement in the future.”

8. On February 12, 2014, Odom was seen in the orthotics department for her left length 

discrepancy where size 9-1/2 shoes with a left heel lift were ordered.

9. On February 19, 2014, Odom saw Defendant NP Ezenwugo for the first time. NP 

Ezenwugo reviewed the recent orthopedic and orthotic consultations. Odom requested 

an eggcrate mattress and was once against told there was “no indication at this time.” 

In response to Odom’s complaint that the Tylenol #3 was not working for her pain, NP 

Ezenwugo increased the prescription from 1 tablet twice a day to 2 tablets twice a day.

10. Between March 12, 2014, and November 18, 2014, Odom saw medical staff multiple 

times regarding her orthopedic shoes with heel lift and ultimately refused further 

appointments with the orthotics department stating that she was “happy with the 

product” and she was already wearing the proper shoe lifts. During this time period, 

Odom also made multiple requests for an eggcrate mattress but was denied because 

there was no indication for one. As noted above, she did not qualify for a double 

mattress because she was ambulatory with a body mass index of less than 30. Medical 

staff did grant her request for a wedge pillow and a TENS unit, a machine that uses 

transcutaneous electrical nerve stimulation in an attempt to block or change one’s 

perception of pain. 

11. On July 6, 2015, Odom saw NP Ezenwugo for follow-up of her chronic medical 

conditions. Regarding her chronic pain, Odom noted nortriptyline, which appeared to 

have been started for her HIV neuropathy, was causing her to have panic attacks, and 

she felt that she would do better with an increase in the Tylenol with codeine. NP 

Ezenwugo obliged that request. 

12. Between July 14, 2015, and August 10, 2015, Odom saw nondefendant Dr. Harris four 

times. Dr. Harris changed her medication from nortriptyline to Trileptal, and then 

changed again to Tegretol when Odom reported having nausea and headaches. Dr. 

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Harris referred her for an orthopedic follow-up, but the referral for surgery was denied 

because of incomplete information. The denial noted, “What conservative treatment 

has tried in this young patient before considering hip replacement.”

13. On August 21, 2015, Odom saw nondefendant Dr. Mudunuri regarding her chronic 

pain. Odom reported that Tegretol made her dizzy and nauseated and Dr. Mudunuri 

replaced it with gabapentin.

14. Between September 8, 2015, and June 13, 2016, NP Ezenwugo saw Odom multiple

times for the denial of her referral to orthopedic surgery and for her chronic pain. NP 

Ezenwugo informed Odom of the denial and reminded her that when seen by Dr. 

Galang of orthopedic surgery the prior year he had stated that hip replacement was not 

indicated at that time due to her age. Odom reported that the gabapentin was helpful 

for her nerve pain, but not her other pains. In response, NP Ezenwugo first added 

Salsalate to take as needed for pain, and then changed to Tylenol with codeine at 

Odom’s request. On June 13, 2016, Odom reported that she did “not want any further 

pain control” and requested a referral to the orthotics department to adjust her 

orthotics. NP Ezenwugo referred Odom as requested.

15. On July 19, 2016, Odom was seen in the orthotics department where a new left heel 

lift was provided. The orthotist also suggested that Odom might benefit from a 

physical therapy referral.

16. On August 2, 2016, Odom saw nondefendant Dr. Dhaliwal regarding her chronic pain. 

Dr. Dhaliwal noted the recommendation for a physical therapy referral and submitted 

the order. Dr. Dhaliwal also documented that Odom said she had reported having an 

allergy to morphine when she was incarcerated, but that she would like that allergy to 

be removed from her record. Odom stated that morphine caused her to get some 

nausea and bloating but no other side effects. Dr. Dhaliwal documented that he would 

remove her listed allergy to morphine at her request after she explained that she did 

not have any allergic reactions to morphine, just mild side effects.

17. On October 12, 2016, Odom saw Defendant Dr. Khoo for the first time. Regarding her 

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chronic pain, Dr. Khoo confirmed with scheduling staff that Odom was approved for 

and awaiting her appointment with physical therapy.

18. On November 8, 2016, Odom was seen in the physical therapy department at San 

Joaquin General Hospital. Only brief handwritten notes were returned to her, which 

indicated plans for her to be seen weekly for 4 weeks.

19. On November 22, 2016, Odom saw Dr. Khoo for follow-up. Regarding her chronic 

left hip pain, Odom reported it as “mild.” On physical exam, Dr. Khoo noted that there 

was no discrepancy of leg length when Odom was standing up with her orthotic shoes 

with lifts in place, and no significant tenderness over the left hip area as well as no 

swelling or redness. Dr. Khoo documented that Odom did not want the medication and 

the plan was to continue physical therapy and follow-up thereafter.

20. On January 3, 2017, Odom saw Dr. Khoo for follow-up after she had been discharged 

from physical therapy. They discussed that Odom had had significant improvement 

from physical therapy with good range of motion, strength, and mobility. However, 

Odom requested adjustments to her orthotics and orthotic shoes, and Dr. Khoo 

submitted a referral to the orthotics department. The Orthotics department measured 

Odom for new orthotics on January 17, 2017. Odom saw Dr. Khoo for a follow-up on 

February 2, 2017, and had no complaints. On February 21, 2017, Odom’s orthotics 

were delivered to her, and it was documented that the fit and function were good.

21. On May 18, 2017, Odom saw NP Ezenwugo for the final time, for review of her 

chronic medical conditions. Regarding her chronic left hip and back pain, “patient 

states her back and left hip no longer bother her since she received insert in her shoe.” 

Of note, NP Ezenwugo included in this documentation results of recent lab work from 

March 30, 2017, which included a creatinine of 0.87 mg/dL, consistent with normal 

kidney function. 

22. On June 18, 2018, Odom saw Defendant NP Attinello for the first time, for a review of 

her chronic medical conditions. Regarding her chronic left hip pain, NP Attinello 

documented that Odom had been provided a shoe lift one year ago and that she was 

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“happy with the lift.” NP Attinello also noted that Odom had been started on the 

medication duloxetine 20 mg daily for chronic pain and that Odom verbalized a 

positive response to that medication and requested it be increased. NP Attinello 

obliged the request, increasing the medication to 20 mg twice a day.

23. On November 15, 2018, Odom saw NP Attinello for follow-up of her chronic left hip 

pain. Odom informed NP Attinello that “she is satisfied with ibuprofen, Tylenol, 

gabapentin for pain management. She uses TENS unit for her back.” Odom was 

restarting physical therapy and the plan was to return to clinic when physical therapy 

sessions were completed.

24. On or about April 18, 2019, CCHCS issued a memorandum stating that the 

Systemwide Pharmacy and Therapeutics Committee reviewed patient safety concerns 

and noted that recent articles had questioned the safety of gabapentin and urging 

healthcare providers to limit prescribing gabapentin to its FDA-approved indications, 

none of which Odom had.

25. On May 6, 2019, Odom saw NP Attinello for follow-up of several issues. Regarding 

her chronic pain, Odom stated that the gabapentin 600 mg three times daily was 

helpful but felt it was not enough and was asking for an increase in her dose. NP 

Attinello increased the gabapentin prescription to 800 mg three times a day.

26. On May 21, 2019, NP Attinello entered a brief note that states in its entirety: “Patient 

was placed on line requesting eggcrate and wedge pillow. Patient verbalizes 

understanding that she does not meet criteria for wedge pillow. She does not have 

GERD nor is she postsurgical. Eggcrate mattresses are no longer available through the 

department.”

27. In her SAC, Odom complains about her pain medication damaging her kidneys.

28. NP Attinello included in her June 18, 2018, documentation the results of recent lab 

work from April 25, 2018, which included a creatinine of 0.90 mg/dL, as well as a 

GFR (non African American) of 81 mL/min, both studies consistent with normal 

kidney function. Also included were the results of urine studies from May 15, 2018, 

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including a urine creatinine of 126 mg/dL and urine microalbumin of 0.9 mg/dL. 

These studies are not diagnostic in and of themselves, but combined into the urine 

microalbumin/creatinine ratio, it provides useful information regarding the amount of 

protein the kidneys are spilling into the urine. Here the result was 7mcg/mg creatinine. 

Any number less than 30 mcg/mg is normal. 

29. On May 24, 2019, Odom saw NP Attinello for follow-up of her chronic medical 

conditions. Regarding chronic hip pain, NP Attinello documented that Odom had 

completed physical therapy, and reported that the pain was controlled with the 800 mg 

of gabapentin three times daily. NP Attinello continued the gabapentin but instructed 

Odom to “stop ibuprofen related to microalbuminuria.” This appears to be based on 

labs from May 22, 2019, where the urine microalbumin was higher than previous 

values at 2.9 mg/dL. However, the urine creatinine from this sample was also higher 

than previous values at 295 mg/dL. Essentially, this indicates that the urine sample 

was more concentrated, suggesting that Odom was more dehydrated than when she 

gave previous samples.

30. Accounting for the variation attributable to hydration status is the purpose of looking 

at microalbumin levels in relationship to creatinine levels. In other words, by 

comparing microalbumin levels to creatinine levels, the urine microalbumin/creatinine 

ratio adjusts for urine concentration, making the measurement more reliable. When 

done so here, the result is 10 mcg/mg, once again well below the normal range of less 

than 30. NP Attinello’s apparent misinterpretation of this elevation in urine 

microalbumin levels as indicative of kidney damage, when in fact there was none, and 

subsequent discontinuation of ibuprofen, appears to be the basis of Odom’s erroneous 

claim on page 9 of her Second Amended Complaint that ibuprofen caused her kidney 

function to be impaired.

31. Dr. Feinberg generated a flowsheet for Odom's urine microalbumin to creatinine ratios 

from the relevant date range of January 1, 2013 through October 7, 2021. These values 

ranged between four and 10, all well below the normal range of less than 30. Dr. 

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Feinberg similarly generated a flowsheet for Odom’s creatinine levels, the most 

commonly used marker of kidney function, where the normal range is between 0.5 and 

1.1, during the same relevant timeframe. Odom's values ranged from 0.79-0.99, once 

again all well within the normal range. 

32. On June 25, 2019, Odom saw NP Attinello for the final time. On physical 

examination, NP Attinello noted that Odom “maneuver at [sic] up and off the 

examination table independently and without apparent difficulty.” NP Attinello 

performed measurements of the distance from Odom’s trochanters to her lateral 

ankles, and determined that the lengths were equal bilaterally, which Odom 

determined was “inconsistent with the patient’s notion that she has leg length 

discrepancy.” Whether or not this determination was correct, NP Attinello does not 

appear to have withdrawn any treatment in response, nor otherwise adversely affected 

Odom. Rather, NP Attinello ordered new x-rays of Odom’s hips and referred Odom 

back to physical therapy. NP Attinello did discuss with Odom tapering off of 

gabapentin “related to its poor safety profile and statewide mandates." This appears to 

refer to the CCHCS memorandum discussed above. NP Attinello documented that 

Odom agreed with tapering off the gabapentin, and requested to retry the pain 

medication Naprosyn, which NP Attinello obliged.

33. On July 5, 2019, Odom saw Defendant Dr. Taylor for the first time. This visit was 

primarily for Odom’s complaints of left hand and left big toe cramping and numbness. 

Odom did not raise any issues regarding her left hip osteoarthritis and pain though Dr. 

Taylor noted it could be one of many causes of Odom’s left toe numbness. Dr. Taylor 

treatment plan was to consider physical therapy and/or new shoe inserts.

34. On July 9, 2019, Odom saw Dr. Taylor specifically for follow-up of her chronic left 

hip pain. Dr. Taylor created and reviewed a more detailed history of Odom’s chronic 

hip pain and noted that a steroid injection had not yet been tried. Dr. Taylor submitted 

a referral to orthopedic surgery for further evaluation of her chronic left hip pain, 

including the consideration of a possible ultrasound-guided left hip steroid injection. 

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Thus, four days after first seeing Odom, Dr. Taylor referred her to an orthopedic 

surgeon. 

35. On July 11, 2019, Defendant Dr. Singh approved the above request for an orthopedic 

surgery consultation.

36. On July 25, 2019, Odom saw nondefendant Dr. Castonguay for an orthopedic surgery 

consultation. Dr. Castonguay listed as Odom’s chief complaint “new patient here for 

left hip pain.” After obtaining a history of Odom’s left hip condition, and performing a 

physical examination noting that Odom’s “left leg is minimally shorter” than her right 

leg, Dr. Castonguay recommended that Odom be referred “to a tertiary care center for 

total hip replacement of the left hip. She has had at least 7 surgeries for this hip and 

will need specialty care for replacement.” Dr. Castonguay did not document any 

opinion regarding a possible left hip injection.

37. Between August 6, 2019, and September 20, 2019, Odom saw Dr. Taylor multiple 

times. Dr. Taylor changed her pain medication to Lyrica, and noted the referral for 

tertiary care for her hip. Dr. Singh initially denied the request tertiary care requesting 

more information, but on September 20, 2019, granted the request after Dr. Taylor 

provided more information.

38. On October 9, 2019, Odom was seen by Dr. Ellis in the orthopedic surgery clinic at 

the Riverside University Health System for the above requested tertiary care center 

evaluation for possible total hip replacement. After obtaining a history of Odom’s left 

hip and performing a physical exam, Dr. Ellis diagnosed Odom with posttraumatic 

osteoarthritis of the left hip. Dr. Ellis recommended a total hip replacement.

39. On October 22, 2019, Odom saw Dr. Taylor for follow-up. Dr. Taylor reviewed the 

above orthopedic surgery recommendation and submitted a request for total hip 

replacement. At Odom’s request, Dr. Taylor also began tapering her off of the Lyrica.

40. On November 6, 2019, the total hip replacement was approved, and on November 18, 

2019, Dr. Taylor began a trial of carbamazepine 200 mg twice daily for her chronic 

pain.

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41. On December 4, 2019, Odom was seen by Dr. Ellis in the orthopedic surgery clinic at 

the Riverside University Health System for follow-up after approval of total hip 

replacement surgery. A preoperative assessment was scheduled for December 19, 

2019, and the total hip replacement surgery was planned for December 30, 2019. 

However, Odom refused to go to the preoperative assessment because her children 

were coming to visit her, and she wanted to schedule the surgery for after the holidays. 

The preoperative assessment took place on January 9, 2020, and the total hip 

replacement surgery took place on January 27, 2020. 

42. Between February 5, 2020, and February 19, 2020, Odom left the prison for weekly 

follow-up appointments at Riverside University Health System and continued to 

recover well. 

43. On June 5, 2020, Odom was seen in the orthopedic surgery clinic at the Riverside 

University Health System for postoperative follow-up. Staff there felt that she was 

continuing to do well five months after surgery. Odom was discharged from the 

orthopedic surgery clinic at the Riverside University Health System.

44. On April 9, 2021, Odom saw Dr. Lee for an initial addiction medicine consultation. 

Odom reported that she had been using heroin for the past 11 years, and that her last 

use was the prior day. Dr. Lee diagnosed her with severe opioid use disorder and 

began treatment with Suboxone.

45. On May 10, 2021, Odom saw nondefendant Dr. Garcia for a few issues including a 

request for an eggcrate mattress. Dr. Garcia advised Odom that there was no Durable 

Medical Equipment order for eggcrate mattresses and medical staff did not provide 

those anywhere in the CDCR system. Odom acknowledged this indicating she was 

aware because she had read Title 15. Odom further indicated that she no longer needed 

an eggcrate mattress because she had been provided with a different mattress from 

custody staff that was “working great for her.”

46. Dr. Feinberg found no documentation of any involvement of Defendant Mitchell in 

Odom's care. It is possible that Dr. Mitchell denied the referral to orthopedic surgery 

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on August 10, 2015, where Dr. Feinberg was unable to ascertain the signature. 

However, it is medically acceptable and appropriate for a supervisor to deny a referral 

when incomplete justification is given, as was the case there as well as when Dr. Singh 

similarly denied an incomplete referral on September 3, 2019. It is for just such 

reasons that supervisor approval is required for referrals.

47. Based upon Dr. Feinberg’s review of the medical records, and his training and 

experience, it is his professional opinion that Defendants were not deliberately 

indifferent to her serious medical needs related to hip osteoarthritis. It is his 

professional opinion that Defendants provided Odom with timely, judicious, and 

medically appropriate care responsive to her medical needs.

48. Odom sued Defendant Dr. Taylor because she did not like telemedicine and disagreed 

with her about getting a cortisone shot.

49. Odom sued Dr. Singh because he was in a supervisory position as the Chief Medical 

Executive, and specifically because she believed he was on the Reasonable 

Accommodation Panel that denied her request for egg crate mattress and/or double 

mattress. Dr. Singh had no direct contact with Odom.

50. Odom sued Chief Medical Officer Dr. Mitchell because she claims he examined her 

hip on one occasion in 2018, but did not make any changes to her care.

(See Doc. 42-4 (UDF).) 

V. DISCUSSION

Defendants contend Plaintiff cannot prove they were deliberately indifferent to her serious 

medical needs. (Doc. 42 at 15-16.) Specifically, they argue their collective care of Plaintiff’s hip, 

pain medication, and the denial of an eggcrate mattress were medically appropriate. (Id. at 16-19.) 

Moreover, individually, none of the Defendants were deliberately indifferent to Plaintiff’s serious 

medical needs. (Id. at 19-21.) Lastly, Defendants contend they are entitled to qualified immunity. 

(Id. at 21.) As noted above, Plaintiff did not file an opposition to Defendants’ motion.

Defendants do not argue that Plaintiff fails to meet the first objective prong of the 

deliberate indifference test. Thus, the central question relevant to all of Plaintiff’s claims in this 

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action is the second subjective prong of the deliberate indifference test—whether Plaintiff has 

demonstrated a purposeful act or failure to respond to her pain or possible medical need by 

Defendants and harm caused by the indifference. Wilhelm, 680 F.3d at 1122. 

Here, Defendants have presented evidence that each of the named Defendants responded 

to Plaintiff’s medical needs consistently and appropriately, and that there is no evidence Plaintiff 

suffered harm as a result of any indifference by Defendants, demonstrating there is no genuine 

dispute as to any material fact. Fed. R. Civ. P. 56(a). Thus, the burden shifts to Plaintiff as the 

non-moving party to establish that a genuine issue as to any material fact actually does exist. 

Matsushita, 475 U.S. at 586. Plaintiff has failed to do so; aside from the allegations of her 

complaint, she has tendered no evidence to support her claims in this action. Fed. R. Civ. P. 56(c); 

Matsushita, 475 U.S. at 586 n.11. 

In short, the assertions in Plaintiff’s second amended complaint do not establish the 

existence of any factual dispute. Fed. R. Civ. P. 56(c); Beard, 548 U.S. at 527; McElyea, 833 F.2d 

at 197-98. And Plaintiff has completely failed to offer proof concerning one of the essential 

elements of her Eighth Amendment deliberate indifference to serious medical needs claims. 

Celotex, 477 U.S. at 322. 

The Court briefly summarizes the evidence offered by Defendants. The Declaration of Dr. 

B. Feinberg provides nearly all evidentiary support for Defendants’ UDFs. Dr. Feinberg serves as 

the Chief Medical Consultant for the California Correctional Health Care Services (CCHCS) 

Office of Legal Affairs. (Doc. 42-1, ¶ 3.) He has held the position since February 2017 and 

regularly reviews medical records and medical procedures related to medical treatment in the 

correctional setting. (Id.) Dr. Feinberg is familiar with the standard of care and skill ordinarily 

exercised by reputable members of the medical profession providing medical care to patients in 

CDCR prisons. (Id., ¶ 5.) Dr. Feinberg was asked to review Plaintiff’s medical records and to 

provide his medical-expert opinion concerning her claims that Defendants were deliberately 

indifferent to her serious medical needs related to hip osteoarthritis. (Id., ¶ 7.) His opinion is 

based upon his review of Plaintiff’s second amended complaint, her deposition testimony, and his 

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analysis of the medical records3 maintained by CCHCS. (Id., ¶ 8.) In Dr. Feinberg’s opinion, 

Plaintiff’s claim that Defendants were deliberately indifferent to her serious medical needs related 

to his osteoarthritis is not supported by the medical record and that Defendants provided Plaintiff 

with timely, judicious, and medically appropriate care responsive to her needs. (Id., ¶ 82.) The 

undersigned finds it appropriate to quote the following directly from Dr. Feinberg’s declaration:

Odom claims on page seven of her Second Amended Complaint that 

“none of the defendants did anything to delay the progress of my 

disorder which placed me at a substantial risk by having to have a 

total hip replacement at an early age when several orthopedic doctors 

explained to me that a total hip replacement normally is done at a 

much later/older age due to the lifespan of the artificial joint and the 

risk of having to have repeat surgeries.” However, Odom provides 

no evidence to support her apparent belief that the course of 

treatment provided by Defendants did not in fact delay the 

progression of her left hip osteoarthritis, does not explain what 

alternative course of treatment she believes could or should have 

been done to further delay the progression of her left hip 

osteoarthritis, nor provide any evidence supporting such alternative 

treatments. While Odom is correct that most total hip replacements 

are done at older ages, that is because most total hip replacements are 

done for the wear-and-tear osteoarthritis that occurs over a lifetime 

of use. Posttraumatic osteoarthritis, as Odom had, makes up a much 

smaller percentage of hip replacements, even small still those like 

Odom who had such trauma in childhood with multiple subsequent 

surgeries. Total hip replacement at an early age was inevitable for 

Odom. Nonetheless, on the same page of her complaint where Odom 

takes exception to the early age at which she had her total hip 

replacement, she also takes exception to waiting several years for 

surgery rather than having it done at an even younger age. Yet this 

was precisely the reasons Odom noted regarding the lifespan of 

artificial joints and risks of repeat surgeries. More importantly, this 

was at the recommendation of orthopedic surgeon Dr. Galang, who 

on February 11, 2014 advised that “Due to her age, it is best to treat 

it conservatively. She will need a total hip replacement in the future.” 

Thus, in 2014, an orthopedic surgeon could already tell that Odom, 

who was only 34 years old at the time, would need a total hip 

replacement, just not at that time. In 2019, when an orthopedic 

surgeon advised that it was now time for the total hip replacement, it 

was approved and performed, with good results per the surgeons.

Odom further claims, on page nine of her Second Amended 

Complain, that she was prescribed improper pain medications which 

did not provide her relief. Odom claims that she was prescribed 

medications that were on her “allergy list.” While this is technically

true, it is only because Odom erroneously claimed to have an allergy 

to these medications when in fact she was repeatedly informed by 

Defendants and Nondefendants alike that her reactions to codeine 

and/or morphine were side effects of the medications and not allergic 

3 Relevant medical records are attached to Feinberg’s declaration as Exhibit B. (See Doc. 42-1 at 21-181.) 

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reactions. Odom also claims that naproxen and ibuprofen did not give 

her relief and caused her to suffer damage to her kidneys. As 

explained in paragraph 52 above, this appears to stem from NP 

Attinello’s apparent misinterpretation of kidney tests, which in fact 

were normal for the entire relevant time period showing no evidence 

of any kidney damage whatsoever. Moreover, while this 

interpretation of lab values was incorrect, it by no means would 

indicate any conscious disregard of any excessive risk to Odom’s 

health. Rather, NP Attinello’s subsequent discontinuation of these 

medications demonstrated due diligence in response to a perceived 

risk to Odom’s kidneys. Furthermore, when NP Attinello began 

tapering Odom off gabapentin on June 25, 2019, in response to the 

April 18, 2019 memorandum regarding gabapentin, Odom requested 

to be placed back on naproxen, suggesting that she had previously 

found it provided rel9ief. Moreover, there were often long stretches

of time, such as from mid-2016 through late-2018, when Odom 

reported minimal if any pain not well-controlled with her treatment 

plan. Defendants provided Odom with a large number of different 

pain medications. It is unclear what other pain medications Odom 

feels Defendants should have prescribed. It is difficult to assess the 

subjective complaint of pain in any patients. The treatment of pain is 

also notoriously difficult in an individual with severe opioid use 

disorder, such as Odom, who was regularly using illicit heroin during 

the relevant time period. Unfortunately, Odom withheld that 

information from Defendants, which could have allowed them to 

treat her for that condition. Doing so in turn would likely have 

improved her overall subjective experience of pain.

Lastly, Odom claims on page nine of her Second Amended 

Complaint that she was improperly denied her requests for a double 

mattress and/or eggcrate mattress. Yet she provides no evidence to 

show that she had any medical indication for such accommodations. 

Rather, she was repeatedly informed by Defendants and 

Nondefendants alike that she had no such medical indication. 

Moreover, on May 10, 2021, several months before Odom filed her 

Second Amended Complaint, Odom reported being aware that 

eggcrate mattresses ware not provided by medical staff after having 

read Title 15.

(Doc. 42-1 at 15-17, ¶¶ 83-85.) Defendants’ UDF Nos. 2 (partial), 3 through 26, and 28 through 

47, are supported by the evidence supporting Defendants’ motion. Further, Plaintiff’s deposition 

testimony of March 26, 2024, supports UDF Nos. 2 (partial), and 48 through 50. (See Doc. 42-2, 

Ex. A.) 

Simply put, there is no genuine dispute of material fact as concerns the appropriateness of 

medical care afforded to Plaintiff for treatment of her left hip, the pain medication prescribed, or 

the denial of an eggcrate mattress. Farmer, 511 U.S. at 835, 847; Estelle, 429 U.S. at 104; 

Wilhelm, 680 F.3d at 1122; Jackson v. McIntosh, 90 F.3d 330, 332 (9th Cir. 1986). Plaintiff’s 

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dissatisfaction or difference of opinion concerning the treatment afforded by Defendants does not 

establish Defendants were deliberately indifferent to her serious medical needs. Sanchez v. Vild, 

891 F.2d 240, 242 (9th Cir. 1989) (prisoner’s mere disagreement with diagnosis or treatment does 

not support a claim of deliberate indifference). Plaintiff has not demonstrated, nor does it appear 

she could demonstrate, that Defendants knew of and disregarded an excessive risk to her health 

and safety. Toguchi, 391 F.3d at 1057. See, e.g., Saddozai v. Arqueza, No. 18-cv-03972 BLF 

(PR), 2023 WL 4206069, at *10 (N.D. Cal. June 26, 2023) (“Based on the evidence presented, 

Defendant has shown that there is no genuine issue of material fact with respect to Plaintiff’s 

deliberate indifference to serious medical needs claim. Having filed no opposition, Plaintiff has 

failed to point to specific facts showing that there is a genuine issue for trial, or identify with 

reasonable particularity the evidence that precludes summary judgment. Accordingly, Defendant 

is entitled to judgment as a matter of law” [citations omitted]); Jaimes v. Barnes, No. 1:14-cv00952-LJO-SAB (PC), 2017 WL 1398837, at *7 (E.D. Cal. Apr. 19, 2017) (“It is undisputed ...

that Dr. Barnes ordered the appropriate diagnostic tests and medication. Therefore, because Dr. 

Barnes provided reasonable and appropriate treatment .... Dr. Barnes actions in ordering an x-ray 

and prescribing appropriate pain medication militate against a finding he purposefully ignored, 

delayed, or failed to respond to Plaintiff’s medical needs. Furthermore, Plaintiff has simply failed 

to present any evidence that the treatment provided by Dr. Barnes was inadequate or rose to the 

level of deliberate indifference”); Tillisy v. Baird, No. 2:12-CV-02055-TSZ-BAT, 2013 WL 

7017957, at *1 (W.D. Wash. Nov. 25, 2013) (“Mr. Tillisy has filed no opposition to defendants’

motions for summary judgment and, because Mr. Tillisy has declined to present any evidence or 

argumentation to the contrary, defendants’ facts are accepted as undisputed. The Court 

recommends [granting] defendants’ unopposed motions for summary judgment because they have 

demonstrated that Mr. Tillisy’s allegations do not entitle him to relief”); Orona v. Calderon, No. 

C 95-4249 FMS, 1997 WL 61277, at *3 (N.D. Cal. Feb. 6, 1997) (“Because plaintiff has filed no 

opposition and presented no additional evidence concerning the essential elements of his claims, 

defendant’s motion for summary judgment is granted”). 

In sum, on this record, no rational trier of fact would find for Plaintiff as there is no 

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genuine issue for trial in this matter. Matsushita, 475 U.S. at 587. Defendants are entitled to 

summary judgment.4

VI. CONCLUSION AND RECOMMENDATION

Based on the foregoing, it is HEREBY RECOMMENDED that: 

1. Defendants’ motion for summary judgment (Doc. 42) be GRANTED; and

2. The Clerk of the Court be directed to enter judgment in favor of Defendants Taylor, 

Khoo, Attinello, Ezenwugo, Mitchell and Singh.

These Findings and Recommendations will be submitted to the United States District 

Judge assigned to this case, pursuant to the provisions of 28 U.S.C. § 636(b)(l). Within 14 days

after being served with a copy of these Findings and Recommendations, a party may file written 

objections with the Court. Local Rule 304(b). The document should be captioned, “Objections to 

Magistrate Judge’s Findings and Recommendations” and shall not exceed 15 pages without 

leave of Court and good cause shown. The Court will not consider exhibits attached to the 

Objections. To the extent a party wishes to refer to any exhibit(s), the party should reference the 

exhibit in the record by its CM/ECF document and page number, when possible, or otherwise 

reference the exhibit with specificity. Any pages filed in excess of the 15-page limitation may be 

disregarded by the District Judge when reviewing these Findings and Recommendations under 28 

U.S.C. § 636(b)(l)(C). A party’s failure to file any objections within the specified time may result 

in the waiver of certain rights on appeal. Wilkerson v. Wheeler, 772 F.3d 834, 839 (9th Cir. 2014).

IT IS SO ORDERED.

Dated: December 3, 2024 ___________________ _

UNITED STATES MAGISTRATE JUDGE

4 Because the Court has found that Defendants are entitled to judgment on the merits, the Court does not reach 

Defendants’ alternative argument that they are entitled to qualified immunity. 

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