Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_11-cv-01297/USCOURTS-caed-1_11-cv-01297-11/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

I. Introduction

Plaintiff Michael Vincent Cisneros (“Plaintiff”) is a state prisoner proceeding pro se and in 

forma pauperis in this civil rights action pursuant to 42 U.S.C. § 1983. This action proceeds on 

Plaintiff’s complaint, filed on August 5, 2011, against Defendant Neubarth for deliberate indifference 

to Plaintiff’s medical needs in violation of the Eighth Amendment. 

On August 21, 2014, Defendant Neubarth filed a motion for summary judgment on the grounds 

that he did not violate Plaintiff’s Eighth Amendment rights and that he is entitled to qualified 

immunity.1 (ECF No. 45.) On September 22, 2014, Plaintiff filed his opposition. (ECF No. 49.) 

 

1

Concurrent with the motion, Plaintiff was provided with notice of the requirements for opposing a motion for summary 

judgment. (ECF No. 45-4); See Woods v. Carey, 684 F.3d 934 (9th Cir. 2012); Rand v. Rowland, 154 F.3d 952, 957 (9th 

Cir. 1988); Klingele v. Eikenberry, 849 F.2d 409, 411-12 (9th Cir. 1988). 

MICHAEL VINCENT CISNEROS,

 Plaintiff,

v.

DR. M. DHAM, et al.,

Defendants.

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Case No.: 1:11-cv-01297-LJO-BAM (PC)

FINDINGS AND RECOMMENDATIONS 

REGARDING DEFENDANT’S MOTION FOR 

SUMMARY JUDGMENT

(ECF No. 45)

THIRTY-DAY DEADLINE

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Following an extension of time, Defendant filed a reply on October 21, 2014, which included 

objections to Plaintiff’s evidence. (ECF No. 54.) On October 29, 2014, Plaintiff filed a response to 

Defendant’s objections.2 (ECF No. 55.) The motion is deemed submitted. Local Rule 230(l). 

II. Defendant’s Motion for Summary Judgment

A. Legal Standard for Summary Judgment

Pursuant to Federal Rule of Civil Procedure 56(a) summary judgment is appropriate when the 

movant shows that there is no genuine dispute as to any material fact and the movant is entitled to 

judgment as a matter of law. Summary judgment must 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.” 

Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986). However, the court is to liberally construe the 

filings and motions of pro se litigants. Thomas v. Ponder, 611 F.3d 1144, 1150 (9th Cir. 2010). The 

“party seeking summary judgment always bears the initial responsibility of informing the district court 

of the basis for its motion, and identifying those portions of the pleadings, depositions, answers to 

interrogatories, and admissions on file, together with the affidavits, if any, which it believes 

demonstrate the absence of a genuine issue of material fact.” Celotex, 477 U.S. at 323 (internal 

quotations and citations omitted). 

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. 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 denials of its pleadings, but is required to 

tender evidence of specific facts in the form of affidavits, and/or admissible discovery material, in 

 

2 On October 14, 2014, the Court granted Defendant an extension of time to file a reply in support of the motion for 

summary judgment. (ECF No. 53.) The order was served on Plaintiff by mail on the same date. On October 21, 2014, 

Defendant filed his reply, which included objections to Plaintiff’s evidence. (ECF No. 54.) Plaintiff filed his response to

Defendants’ objections on October 29, 2014. (ECF No. 55.) On November 25, 2014, the United States Postal Service 

returned the Court’s order granting Defendant an extension of time to file a reply sent to Plaintiff. As it appears Plaintiff 

was served with Defendant’s reply, the failure to receive the Court’s order regarding an extension of time is harmless. 

Nonetheless, the Clerk of the Court has re-served the order on Plaintiff. 

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support of its contention that the dispute exists. Fed. R. Civ. P. 56(c); Matsushita, 475 U.S. at 586

n.11. 

In arriving at these Findings and Recommendations, the Court carefully reviewed and 

considered all arguments, points and authorities, declarations, exhibits, statements of undisputed facts 

and responses thereto, if any, objections, and other papers filed by the parties. Omission of reference 

to an argument, document, paper, or objection is not to be construed to the effect that this Court did 

not consider the argument, document, paper, or objection. This Court thoroughly reviewed and 

considered the evidence it deemed admissible, material, and appropriate. 

B. Defendant’s Evidentiary Objections

On October 21, 2014, Defendant filed objections to Exhibits 1, 2 and 3 submitted by Plaintiff 

in his opposition. (ECF No. 54-2.) Plaintiff filed his response to the objections on October 29, 2014. 

(ECF No. 54.)

Exhibit 1

Exhibit 1 is the sworn declaration of Plaintiff’s mother, Diana Collier. Defendant objects to 

this declaration as vague, ambiguous, conclusory, not relevant, lacking foundation, and containing 

impermissible hearsay in violation of Federal Rules of Evidence 402, 602, 802. Defendant further 

objects that Diana Collier’s declaration claiming that Neurontin use caused damage to Plaintiff’s eyes 

is not admissible under Federal Rule of Evidence 702 because competent expert testimony is required 

in order to establish medical causation between a particular event and the damage claimed by the 

Plaintiff. 

Plaintiff counters that he did not submit the declaration of Diana Collier as expert testimony. 

Rather, Plaintiff states that he submitted the declaration to demonstrate how he obtained the 

pharmacy-listed side effects of gabapentin and to demonstrate that he had to obtain the side effects 

himself because no doctor would check the side effects. 

Despite Plaintiff’s assertions, there is no indication in the declaration of Diana Collier that she 

provided Plaintiff with a copy of any pharmacy-listed side effects of gabapentin or that it was the only 

means to obtain the side effects. (Pl’s Ex. 1, ECF No. 49, p. 31.) It appears instead that Ms. Collier is 

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providing testimony regarding the purported side effects of Neurontin, the diagnosis of Plaintiff 

following an eye exam and Plaintiff’s vision status prior to taking Neurontin. (Id.) 

Although Ms. Collier declares that she is a nurse, she has not been qualified as a medical

expert pursuant to Federal Rule of Evidence 702. As such, Ms. Collier’s non-expert testimony is 

limited to statements “(a) rationally based on the witness’s perception; (b) helpful to clearly 

understanding the witness’s testimony or to determining a fact in issue; and (c) not based on scientific, 

technical, or other specialized knowledge within the scope of Rule 702.” Fed. R. Evid. 701. 

Therefore, she may not offer medical testimony regarding Plaintiff’s vision status, diagnosis or 

medication side effects. She also may not provide testimony regarding causation. “[G]enerally 

plaintiff must prove causation by expert medical testimony except where there is an obvious causal 

relationship-one where injuries are immediate and direct.” Walker v. Contra Costa County, 2006 WL 

3371438 at * 9 (N.D. Cal. 2006), quoting In re Baycol Products Litigation, 321 F.Supp.2d 1118, 1125 

(D. Minn. 2004) (citation omitted) (internal quotation omitted).

Defendant’s objections to Ms. Collier’s declaration on the grounds that she is not a medical 

expert pursuant to Federal Rule of Evidence 702 are SUSTAINED.

Exhibit 2

Exhibit 2 appears to be internet printouts of the warnings, precautions and side effects of 

Gabapentin and Neurontin. Exhibit 2 also includes information from the Food and Drug 

Administration (“FDA”), a federal government agency. Defendant does not object to the FDA 

documents. Accordingly, the Court’s ruling is limited to the internet printouts regarding the side 

effects of Neurontin and Gabapentin, Plaintiff’s Exhibit 2, ECF No. 49, pp. 34-41. 

Defendant objects that the internet documents lack foundation and authentication, and cannot 

be substituted for expert testimony that is required in order to establish medical causation between a 

particular event and the damage claimed by the Plaintiff. Plaintiff counters that his mother, a 

registered nurse, obtained the listed side effects of Gabapentin and sent them to him. 

Defendant’s objections that the documents printed from the internet comprising Exhibit 2 lack

foundation and authentication are SUSTAINED. Plaintiff has failed to produce evidence that these 

documents are what Plaintiff claims them to be and he cannot lay a foundation for records composed 

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by third parties because he lacks personal knowledge regarding their contents. Fed. R. Evid. 602, 902. 

Plaintiff does not submit the testimony of a witness with knowledge of the documents. Fed. R. Evid. 

901. Further, Defendant’s objection that Plaintiff cannot substitute these documents in place of expert 

testimony regarding medical causation is SUSTAINED. See Walker, 2006 WL 3371438 at *9; 

Domingo v. T.K., 289 F.3d 600, 607 (9th Cir. 2001) (competent expert testimony is required to 

establish medical causation between a particular event and any injury); Scott v. MTA Keller, 2010 WL 

3635728, *6 (E.D. Cal. Sept. 14, 2010); Cf. Hutchinson v. United States, 838 F.2d 390, 393 (9th Cir. 

1988). 

Exhibit 3

Exhibit 3 is comprised of photos of Plaintiff’s mother and father. Defendant objects that these 

documents are not relevant and they cannot be substituted for competent expert testimony to establish 

medical causation. Plaintiff responds that the pictures of his parents are meant to show that Plaintiff 

does not “suffer from a genetic eye disorder.” (ECF No. 55, p. 1.) 

The photos of Plaintiff’s mother and father are not relevant to the claim of deliberate 

indifference to serious medical needs. Fed. R. Evid. 401. Further, the photos cannot be used to 

demonstrate that Plaintiff does not have a genetic eye disorder. Plaintiff is not a qualified medical 

expert able to testify regarding the presence or absence of genetic eye disorders. Fed. R. Evid. 702.

Defendant’s objections to Exhibit 3 are SUSTAINED. 

C. Plaintiff’s Evidentiary Objections

Plaintiff objects to Defendant’s Exhibit C, which is Mosby’s Medical Drug Reference 

regarding gabapentin. (Ex. C to Neubarth Dec.) Plaintiff contends that the edition of Mosby’s 

Medical Drug Reference submitted by Defendant Neubarth is not the edition used while working at 

CDCR. Plaintiff objects that the cited evidence lacks foundation and is not the relevant edition.

Defendant admits that Exhibit C is a copy of pages from another edition of Mosby’s Medical 

Drug Reference. (ECF No. 49, Pl’s Ex. 10, p. 99.) There is no indication that the edition relied upon 

by Defendant Neubarth was substantially the same as the exhibit supplied. Accordingly, Plaintiff’s 

objections to Exhibit C are SUSTAINED. 

///

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D. Summary of Relevant Allegations in Plaintiff’s Complaint

Plaintiff arrived at California State Prison, Corcoran (“Corcoran”) on August 26, 2009. During 

intake, he did not have any documented visual problems, but he had back problems. 

On October 14, 2009, Dr. McCabe prescribed Gabapentin for Plaintiff’s back pain. Plaintiff 

immediately started to experience blurred vision. On October 30, 2009, he submitted a Medical 

Request Form complaining of vision problems. 

On November 3, 2009, Nurse Barrera provided Plaintiff with eye drops for chronic dry eyes.

On November 19, 2009, Plaintiff submitted another Medical Request form complaining of 

vision problems.

On November 23, 2009, Nurse Barrera referred Plaintiff for follow up. His eye acuity was 

documented at 25/50 right eye and 20/70 left eye.

On November 25, 2009, Plaintiff saw Dr. Dham and expressed concerns that his vision 

problems could be due to medications. Plaintiff indicated that if his medication had side effects of 

blurred vision, then he would like to change medications. Dr. Dham refused to check the side effects 

of his medications and assured Plaintiff it was old age. Dr. Dham referred Plaintiff to optometry.

On December 6, 2009, Plaintiff saw Dr. Bondoc and expressed concerns that his vision 

problems could be due to his medications. Plaintiff asked to switch pain pills if blurred vision was a 

side effect of Gabapentin. Dr. Bondoc refused to check or switch his medications, suggesting it was 

old age. Dr. Neubarth signed off on this as well on January 6, 2010. 

On December 14, 2009, Plaintiff’s Gabapentin was refilled and the dosage increased by Dr. 

Neubarth. At this visit, Plaintiff expressed concerns that his vision problems were caused by his 

medications. Plaintiff requested to switch pain pills because the blurred vision started right after 

taking Gabapentin. Dr. Neubarth failed to check the medication for known side effects and refused to 

change the medication.

On January 19, 2009, Plaintiff was seen by optometry and prescribed glasses for blurred 

vision/myopia.

On February 23, 2010, Plaintiff submitted another medical request complaining that he was 

losing his vision and it was worsening.

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On February 24, 2010, Plaintiff submitted a medical appeal stating that he was losing his 

vision and that maybe his medications were affecting his vision. Plaintiff asked to switch pain pills if 

vision loss was a symptom. 

On March 1, 2010, Dr. Neubarth continued Plaintiff’s Gabapentin. Plaintiff expressed his 

concerns that his medication could be the cause of blurred vision. Plaintiff requested to switch pain 

pills.

Plaintiff was not taken off of Gabapentin until April 28, 2010. The person reviewing 

Plaintiff’s appeal took Plaintiff off of Neurontin because of his bipolar disorder and fear of the 

medication. Plaintiff’s prescription had expired and was not renewed. (ECF No. 1, Ex. 16.) 

Plaintiff alleges that prison policy at Corcoran has changed and doctors are not supposed to 

prescribe Gabapentin for back pain. 

E. Undisputed Material Facts (“UMF”)3

1. Plaintiff is a state inmate incarcerated at Corcoran, where the alleged events giving rise to this 

lawsuit arose.

2. Dr. Neubarth is a medical doctor licensed in the State of California. He was employed as a 

Physician and Surgeon with the California Department of Corrections and Rehabilitation (“CDCR”) at 

Corcoran during the time period relevant to this lawsuit. (Neubarth Dec. ¶ 1.)

3. As a Physician and Surgeon at Corcoran, Dr. Neubarth’s work responsibilities included, but 

were not limited to, providing medical care to inmates, reviewing inmate appeals as necessary, and 

participating in physician review committees to discuss inmate patient cases and future treatment 

plans. (Neubarth Dec. ¶ 2.)

4. Dr. Neubarth has reviewed portions of the Unit Health Record (“UHR”) of Plaintiff during the 

time period relevant to this action, and he is familiar with the medical care Plaintiff received at 

Corcoran. (Neubarth Dec. ¶ 3.)

5. Dr. McCabe prescribed gabapentin to Plaintiff on or about October 14, 2009, for pain relief. 

(Neubarth Dec. ¶ 4.)

 

3

The undisputed facts are derived from Defendant’s Statement of Undisputed Facts. (ECF No. 45-2.) Unless otherwise 

indicated, only disputed material facts are omitted from this statement. 

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6. Dr. Neubarth’s review of Plaintiff’s UHR shows that he saw Plaintiff on or about December 

14, 2009, and March 1, 2010, related to the medication gabapentin. (Neubarth Dec. ¶ 5.)

7. The notes for Plaintiff’s December 14, 2009 visit contain no documentation that Plaintiff was 

complaining of blurred vision. (Neubarth Dec. ¶ 6.)

8. On January 7, 2010, due to Plaintiff’s complaints of pain, Dr. Neubarth prescribed Tylenol. 

(Neubarth Dec. ¶ 7.)

Plaintiff denies this statement of fact, arguing that Defendant Neubarth has a history of 

stamping papers that he had nothing to do with and the supporting exhibit does not contain Defendant 

Neubarth’s handwriting. Plaintiff has not raised a genuine dispute of material fact. Plaintiff is not a 

handwriting expert and his contentions regarding Defendant Neubarth’s stamping practices are mere 

speculation. The supporting exhibit contains both a signature and a stamp from Defendant Neubarth. 

(ECF No. 45-3, p. 10, Ex. A to Neubarth Dec.) Defendant Neubarth also declares under penalty of 

perjury that he prescribed the Tylenol. 

9. Dr. Neubarth increased the dosage of gabapentin for Plaintiff on or about March 1, 2010. The 

notes for this visit did not record any complaint of blurred vision. (Neubarth Dec. ¶ 8.)

10. Plaintiff filed an inmate appeal in February, 2010, demanding that he be provided with 

narcotics instead of gabapentin. Plaintiff stated in this appeal that he was following the necessary 

steps to sue CDCR for monetary compensation. At the first level of appeal, handled by medical care 

providers other than Dr. Neubarth, it was noted that Plaintiff had a history of bipolar disorder, and that 

his gabapentin expired in April 2010, and would not be renewed. (Neubarth Dec. ¶ 9.)

Plaintiff denies that he was demanding narcotics; however, the interviewer’s notes expressly 

state, “PT wants Narcotics in place of Neurontin . . . .” (ECF No. 45-3, p. 20, Ex. B to Neubarth Dec.) 

11. As a medical doctor, since Dr. Neubarth first started prescribing gabapentin over 10 years ago, 

it has been his custom and practice to regularly review the side effects of gabapentin. (Neubarth Dec. 

¶ 11.)

Although Plaintiff disputes this fact, he has not presented contradictory evidence regarding 

Defendant Neubarth’s custom or practice to raise a genuine dispute. 

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12. Dr. Neubarth has regularly utilized Mosby’s Medical Drug Reference to research gabapentin. 

(Neubarth Dec. ¶ 11.)

13. The FDA-approved documents regarding a medication’s side effects include conditions that 

are associated with the use of the medication, and they generally will include almost every potential 

side effect. Based on Dr. Neubarth’s medical training and experience and review of FDA-approved 

documentation, myopia is not a side effect of gabapentin. (Neubarth Dec. ¶ 12.)

Defendant Neubarth does not provide a copy of the FDA-approved documentation. However, 

Plaintiff’s Exhibit 2 is a copy of the FDA Adverse Event Reporting System for gabapentin. (ECF No. 

49, p. 42, Pl’s Ex. 2.) There is no express reference to myopia in the FDA document, and Plaintiff has 

not provided any expert testimony indicating that myopia is a side effect of, or caused by, gabapentin. 

Further, based on Defendant Neubarth’s training and experience, “no drug has ever been proven to 

cause myopia.” (ECF No. 54-1, Neubarth Supp. Dec. at ¶ 5.) 

14. Dr. Neubarth understands that Plaintiff claims in this lawsuit that, his brief use of gabapentin

for several months caused him to suffer visions problems, and he was later diagnosed with myopia. 

There are many causes of blurred vision, and myopia is one of them; however, myopia is a permanent 

condition. (Neubarth ¶ 13.) 

15. While gabapentin may cause temporary blurred vision lasting a few hours, gabapentin does not 

cause myopia or any other long-term vision problems. (Neubarth Dec. ¶ 14.)

Plaintiff argues that evidence from the FDA identifies a number of side effects from 

gabapentin, including vision blurred, visual impairment and visual acuity reduced. While the FDA 

document does identify these vision issues, it does not identify myopia or provide evidence regarding 

the permanence of any vision problem. (ECF No. 49, p. 46, Pl’s Ex. 2.) 

16. Based on Dr. Neubarth’s medical training and experience, it is common for patients who are in 

their twenties, similar to Plaintiff, to first report vision problems requiring corrective lens. Dr. 

Neubarth’s review of Plaintiff’s UHR indicates that Plaintiff eventually received glasses to correct 

very mild myopia. (Neubarth Dec. ¶ 15.)

17. Based on Dr. Neubarth’s medical training and experience, it is his expert medical opinion that 

Plaintiff’s brief use of gabapentin is not medically likely to cause the type of vision issues claimed by 

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Plaintiff in this lawsuit, and that gabapentin did not cause myopia or cause Plaintiff to have to 

eventually receive corrective lens to correct his very mild myopia. (Neubarth Dec. ¶ 16.)

Although Plaintiff attempts to raise a dispute by asserting that gabapentin caused his loss in 

visual acuity, he is not a medical expert qualified to testify regarding causation. Walker, 2006 WL 

3371438 at *9; Domingo, 289 F.3d at 607. Further, there is no evidence presented that myopia is

caused by gabapentin. 

18. Dr. Neubarth’s determination of whether gabapentin was medically indicated for Plaintiff was 

made following examinations of Plaintiff, evaluation of objective findings, and review of Plaintiff’s

UHR, and based on Dr. Neubarth’s medical training and expertise. (Neubarth Dec. ¶ 17.)

Plaintiff attempts to raise a dispute by arguing that gabapentin was not approved by the FDA 

for back pain and it was against CDCR policy to prescribe gabapentin for off-label use. Plaintiff has 

not presented competent, admissible evidence demonstrating that the FDA prohibited the prescription 

of gabapentin for off-label use or that CDCR policies forbade the practice in total at the time of the 

events in this action. In fact, Plaintiff’s own evidence and statements demonstrate that the FDA noted 

off-label use of gabapentin and that CDCR policies permitted off-label use of prescription medications 

based on documented evidence of need. (ECF No. 49, pp. 5-6, Pl’s Opp’n; p. 43, Pl’s Ex. 2.) Plaintiff 

cites Smith v. Adam, 2013 WL 1283478, *2-3 (N.D. Cal. Mar. 26, 2013), which discussed evidence 

that gabapentin was not truly effective for most cases of neuropathy and was currently only approved 

for adjunctive therapy for seizures and post-herpetic neuralgia. The evidence was supported by 

reference to a medical article published in May 2010 discussing medical studies on the off-label use of 

gabapentin, which concluded that off-label uses for neuropathic pain and migraine symptoms provided 

questionable benefit and could increase the potential for harmful side effects. Id. at 3. The evidence 

also indicated that CDCR’s practice was to not prescribe medication for off-label use unless there was 

documented evidence based on need. Id. at 3. Plaintiff has not raised a genuine dispute of material 

fact that CDCR precluded the off-label use of gabapentin in late 2009 and early 2010 or that 

Defendant Neubarth was aware of any medical research in December 2009 and March 2010 that failed 

to support its off-label use for pain. 

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Plaintiff also asserts that the manufacturer of gabapentin was sued and fined for illegally 

promoting gabapentin for off-label use of pain treatment without scientific evidence. To support this 

assertion, Plaintiff cites the declaration of a CDCR Chief Medical Officer, which was relied on in 

Ramirez v. Swingle, 2012 WL 5828549, *8 (E.D. Cal. Nov. 15, 2012) (findings and 

recommendations regarding motion for summary judgment in section 1983 action alleging deliberate 

indifference). The referenced declaration, rendered by the defendant in that action, refers to the 

manufacturer’s fine for promoting off-label use, but does not provide direct evidence of the fine or suit

and suggests that these events may have occurred after Plaintiff stopped using gabapentin. Id. at 8, 19. 

More importantly, Plaintiff has not established that Defendant Neubarth knew that off-label use of 

gabapentin was not medically indicated for Plaintiff’s condition at the time he prescribed it in 

December 2009 and March 2010. 

19. Based on Dr. Neubarth’s medical training and expertise, it is his expert medical opinion that 

Plaintiff received appropriate medical care within the standard of care. (Neubarth Dec. ¶ 19.)

F. Plaintiff’s Separate Statement of Undisputed Facts (“PUF”)4

1. There were no visual problems noted on Plaintiff’s medical history at Duel Vocational 

Institution on November 25, 2008, or on his Corcoran intake evaluation on August 26, 2009. (ECF 

No. 49, Pl’s Ex. 7.)

2. Plaintiff was seen by Dr. McCabe and was prescribed gabapentin for back pain. (ECF No. 49, 

Pl’s Ex. 7.)

3. On October 30, 2009, Plaintiff submitted a medical request form stating, “I get blurry vision 

alot these days.” (ECF No. 49, Pl’s Ex. 12, p. 101.)

4. On November 3, 2009, Plaintiff was seen for chronic dry eyes. (ECF No. 49, Pl’s Ex. 13, p. 

102.)

5. On November 19, 2009, Plaintiff submitted another medical request form stating, “I’m losing 

my far sight of vision everything is blurry I use to have perfect.” (ECF No. 49, Pl’s Ex. 13a, p. 103.)

 

4

Plaintiff’s separate statement of undisputed material facts is derived from his opposition papers and supporting exhibits. 

(ECF No. 49, pp. 8-10 and Exhibits 1-27.) Unless otherwise indicated, disputed or unsupported facts are omitted. 

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6. On November 23, 2009, Plaintiff was seen by a nurse concerning vision issues. Plaintiff’s 

visual acuity level was documented at 20/50 in his right eye and 20/70 in his left eye. Plaintiff was 

referred for follow up. (ECF No. 49, Pl’s Ex. 25, p. 117.)

7. On November 23, 2009, Plaintiff was seen by Dr. Dham for his vision. (ECF No. 49, Pl’s Ex. 

26.)

8. On December 4, 2009, Plaintiff was seen by Nurse Ceballos. Nurse Ceballos noted on the 

form “Also c/o vision problems.” (ECF No. 49, Pl’s Ex. 14, p. 104.)

9. On December 6, 2009, Plaintiff was seen by Dr. Bondoc for vision problems. (ECF No. 49, 

Pl’s Ex. 7.)

10. On December 14, 2009, Plaintiff was seen by Dr. Neubarth, who re-prescribed gabapentin 

twice a day and discontinued his eye drops. (ECF No. 49, Pl’s Ex. 11, p. 100.) Plaintiff’s file was 

accessible to Dr. Neubarth. (ECF No. 49, Pl’s Ex. 4, p. 52.) 

11. On January 6, 2010, Defendant signed Dr. Bondoc’s December 8, 2009 request for optometry, 

which was denied. (ECF No. 49, Pl’s Ex. 16, p. 106.)

12. On January 19, 2010, Plaintiff was prescribed glasses. (ECF No. 49, Pl’s Ex. 17, p. 107.)

13. Dr. Neubarth admits that myopia is a form of blurred vision. (ECF No. 49, Pl’s Ex. 4, p. 53.)

14. On January 20, 2010, Dr. Neubarth signed off on Plaintiff’s optometry services. (ECF No. 49, 

Pl’s Ex. 17, p. 107.)

15. On February 23, 2010, Plaintiff put in another medical request saying, “I’m progressively 

loosing [sic] my vision, it[’]s getting worse and worse . . . I need to be bumped up on the doctor line

cause it[’]s serious.” (ECF No. 49, Pl’s Ex. 15, p. 105.)

16. On February 24, 2010, Plaintiff put in a medical appeal saying, “I’m progressively loosing 

[sic] my vision . . . maybe my medications are affecting my vision.” Plaintiff requested to switch pain 

pills if vision loss is a symptom of Neurontin and to find out why he was “going blind.” Plaintiff

stated, “I’m not over exaggerating I’m loosing [sic] my vision, And I swear I will sue every one if it 

can be prevented and you (prison) are ignoring it.” (ECF No. 49, Pl’s Ex. 18, p. 108.)

17. On March 1, 2010, Plaintiff saw Dr. Neubarth, who noted an appeal. (ECF No. 49, Pl’s Ex. 

19, p. 109.) 

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G. Discussion

1. Eighth Amendment - Deliberate Indifference to Serious Medical Needs

A prisoner’s claim of inadequate medical care does not constitute cruel and unusual 

punishment in violation of the Eighth Amendment unless the mistreatment rises to the level of 

“deliberate indifference to serious medical needs.” Jett v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) 

(quoting Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976)). The two part test 

for deliberate indifference requires the plaintiff to show (1) “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,’” and (2) “the defendant’s response to the need was 

deliberately indifferent.” Jett, 439 F.3d at 1096. A defendant does not act in a deliberately indifferent 

manner unless the defendant “knows of and disregards an excessive risk to inmate health or safety.” 

Farmer v. Brennan, 511 U.S. 825, 837, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994). “Deliberate 

indifference is a high legal standard,” Simmons v. Navajo County Ariz., 609 F.3d 1011, 1019 (9th Cir.

2010); Toguchi v. Chung, 391 F.3d 1051, 1060 (9th Cir. 2004), and is shown where there was “a 

purposeful act or failure to respond to a prisoner’s pain or possible medical need” and the indifference 

caused harm, Jett, 439 F.3d at 1096.

In applying this standard, the Ninth Circuit has held that before it can be said that a prisoner’s 

civil rights have been abridged, “the indifference to his medical needs must be substantial. Mere 

‘indifference,’ ‘negligence,’ or ‘medical malpractice’ will not support this cause of action.” Broughton 

v. Cutter Laboratories, 622 F.2d 458, 460 (9th Cir. 1980), citing Estelle, 429 U.S. at 105 06. “[A] 

complaint that a physician has been negligent in diagnosing or treating a medical condition does not 

state a valid claim of medical mistreatment under the Eighth Amendment. Medical malpractice does 

not become a constitutional violation merely because the victim is a prisoner.” Estelle, 429 U.S. at 

106; see also Anderson v. County of Kern, 45 F.3d 1310, 1316 (9th Cir. 1995). Even gross negligence 

is insufficient to establish deliberate indifference to serious medical needs. See Wood v. Housewright, 

900 F.2d 1332, 1334 (9th Cir. 1990). Additionally, a prisoner’s mere disagreement with diagnosis or 

treatment does not support a claim of deliberate indifference. Sanchez v. Vild, 891 F.2d 240, 242 (9th 

Cir. 1989).

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Defendant Neubarth presents undisputed evidence that Dr. McCabe prescribed gabapentin for 

Plaintiff in October 2009. (UMF 5.) Thereafter, Defendant Neubarth continued Plaintiff’s gabapentin 

in December 2009, and increased the dosage in March 2010. During these visits, there are no noted

complaints by Plaintiff of any of blurred vision. (UMF 5, 6, 9.) 

Defendant Neubarth also presents undisputed expert testimony that Plaintiff’s diagnosed 

myopia was not caused by gabapentin, the side effects of gabapentin do not include myopia and 

Plaintiff’s brief use of gabapentin was not medically likely to have caused Plaintiff’s myopia. (UMF 

13, 15, 17.) Based on the undisputed facts, Defendant Neubarth has established that his actions in 

prescribing gabapentin did not result in harm to Plaintiff. Jett, 439 F.3d at 1096. Defendant Neubarth 

has met his initial responsibility to demonstrate that he is entitled to summary judgment on Plaintiff’s 

Eighth Amendment claim. The burden therefore shifts to Plaintiff to establish that a genuine issue as 

to any material fact actually does exist. Matsushita Elec. Indus. Co., 475 U.S. at 586. 

In his opposition, Plaintiff first challenges Defendant Neubarth’s credibility. However, in 

ruling on a motion for summary judgment, the court does not make credibility determinations. 

Soremekun v. Thrifty Payless, Inc., 509 F.3d 978, 984 (9th Cir. 2007). 

Second, Plaintiff argues that Defendant Neubarth violated CDCR policy in prescribing 

gabapentin for an off-label use. Despite this argument, Plaintiff has not presented competent, 

admissible evidence demonstrating that CDCR policies at the time precluded physicians from 

prescribing medications for off-label use. Plaintiff’s own evidence demonstrates that CDCR policies 

permitted prescription of medications for off-label use based on expert medical judgment. (ECF No. 

49, Pl’s Opp’n, pp. 5-6.) Plaintiff has not raised a genuine dispute that Defendant Neubarth violated 

CDCR policy by prescribing gabapentin for an off-label use. 

Plaintiff also attempts to raise a dispute by arguing that gabapentin was not approved by the 

FDA for back pain and the manufacturer of gabapentin was sued and fined for illegally promoting 

gabapentin for off-label use of pain treatment without scientific evidence. However, Plaintiff does not 

provide direct evidence of such suit or fine, he does not indicate that these purported events occurred 

while he was prescribed and taking gabapentin in 2009 and 2010, and he does not establish that 

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Defendant Neubarth knew of such events while prescribing gabapentin for Plaintiff in 2009 and 2010. 

(ECF No. 49, Pl’s Opp’n, pp. 5-6.) 

Third, Plaintiff argues that Defendant Neubarth knew of Plaintiff’s loss of visual acuity. 

Plaintiff has presented evidence that Defendant Neubarth signed off on various requests for optometry 

services for Plaintiff. (PUF 11, 14.) Plaintiff also has presented his own sworn statement that he told 

Defendant Neubarth about his suspicions that gabapentin was causing blurred vision. (ECF No. 49, p. 

21.) Defendant Neubarth’s knowledge of Plaintiff’s vision issues, however, does not raise a genuine 

dispute of material fact because, as discussed below, there is no evidence that gabapentin caused 

Plaintiff’s myopia. Even if Defendant Neubarth disregarded Plaintiff’s complaints of blurred vision,

such indifference amounts, at most, to negligence, which does not support an Eighth Amendment 

claim. Broughton, 622 F.2d at 460 (negligence); Wood, 900 F.2d at 1334 (gross negligence).

Finally, Plaintiff argues that gabapentin caused him permanent loss in visual acuity. Plaintiff 

believes that the correlation between him experiencing a sudden onset of blurred vision immediately 

after taking gabapentin, the blurred vision worsening after Defendant Neubarth increased the dose of 

gabapentin, and the progressive loss of vision stopping after Plaintiff stopped taking gabapentin proves 

that gabapentin was the cause of the permanent loss of visual acuity that Plaintiff suffered. (ECF No. 

49, pp. 11-12.) Despite this belief, Plaintiff has not presented any competent testimony from a 

medical expert to demonstrate that gabapentin caused his diagnosed myopia and need for glasses. 

Walker, 2006 WL 3371438 at *9; Domingo, 289 F.3d at 607. In contrast, Defendant Neubarth has

presented undisputed expert testimony that Plaintiff’s diagnosed myopia was not caused by 

gabapentin, Plaintiff’s brief use of gabapentin was not medically likely to have caused Plaintiff’s 

myopia and no drug has ever been proven to cause myopia. (UMF 15, 17; ECF No. 54-1, Neubarth 

Supp. Dec. ¶ 5.) Absent testimony from a medical expert, Plaintiff has failed to raise a genuine issue 

of material fact that he sustained any harm as a result of the use of gabapentin. Jett, 439 F.3d at 1096

To the extent Plaintiff believes he should have been prescribed some other approved pain 

medication instead of gabapentin, this does not amount to a constitutional violation. At best, this is a 

mere disagreement between Plaintiff and Defendant Neubarth regarding the prescribed course of 

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treatment for Plaintiff, which does not support a claim of deliberate indifference. Sanchez, 891 F.2d at 

242.

The Court therefore finds that summary judgment should be entered in favor of Defendant 

Neubarth. 

2. Qualified Immunity

Based on the Court’s finding that Defendant Neubarth is entitled to summary judgment on 

Plaintiff’s Eighth Amendment claim for deliberate indifference to serious medical needs, it is 

unnecessary to address the issue of qualified immunity. 

III. Conclusion and Recommendation

For the reasons discussed above, it is HEREBY RECOMMENDED that:

1. Defendant’s motion for summary judgment, filed on August 21, 2014, be GRANTED; and

2. Judgment be entered in favor of Defendant Neubarth. 

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

assigned to the case, pursuant to the provisions of Title 28 U.S.C. § 636(b)(l). Within thirty (30) days

after being served with these Findings and Recommendations, Plaintiff may file written objections 

with the Court. The document should be captioned “Objections to Magistrate Judge’s Findings and 

Recommendations.” Plaintiff is advised that failure to file objections within the specified time may 

result in the waiver of the “right to challenge the magistrate’s factual findings” on appeal. Wilkerson 

v. Wheeler, 772 F.3d 834, 839 (9th Cir. 2014) (citing Baxter v. Sullivan, 923 F.2d 1391, 1394 (9th Cir. 

1991)).

IT IS SO ORDERED.

Dated: February 7, 2015 /s/ Barbara A. McAuliffe _

UNITED STATES MAGISTRATE JUDGE

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