Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_12-cv-02800/USCOURTS-cand-3_12-cv-02800-2/pdf.json

Nature of Suit Code: 555
Nature of Suit: Prisoner - Prison Condition
Cause of Action: 42:1983 Prisoner Civil Rights

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United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

ROBERTO JUAREZ,

Plaintiff,

v.

R. ROCAMORA, et al.,

Defendants.

Case No. 12-cv-02800-WHO (PR) 

ORDER GRANTING DEFENDANTS' 

MOTION FOR SUMMARY 

JUDGMENT

INTRODUCTION

Plaintiff Roberto Juarez claims that medical staff at Soledad State Prison provided 

constitutionally inadequate medical care for his injured wrist in violation of 42 U.S.C. 

§ 1983. Juarez’s burden with respect to these claims is significant: he must show that the 

defendants were deliberately indifferent to his serious medical needs, establishing both that 

the course of his treatment was medically unacceptable and that it was pursued in 

conscious disregard of an excessive risk to his health. Negligence is not enough. Having

provided Juarez with the required warnings under Rand v. Rowland, 154 F.3d 952, 962–63 

(9th Cir. 1998) (en banc), defendants move for summary judgment (Docket No. 59). 

While some facts may be in dispute, they are not material to the essential issue of whether 

defendants were deliberately indifferent to Juarez’s serious medical needs. They were not. 

Defendants’ motion for summary judgment is GRANTED.

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STANDARD OF REVIEW

Summary judgment is proper where the pleadings, discovery and affidavits 

demonstrate that there is “no genuine dispute as to any material fact and [that] the movant 

is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). Material facts are those 

which may affect the outcome of the case. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 

248 (1986). A dispute as to a material fact is genuine if there is sufficient evidence for a 

reasonable jury to return a verdict for the nonmoving party. Id.

The party moving for summary judgment bears the initial burden of identifying 

those portions of the pleadings, discovery and affidavits which demonstrate the absence of 

a genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). 

Where the moving party will have the burden of proof on an issue at trial, it must 

affirmatively demonstrate that no reasonable trier of fact could find other than for the 

moving party. On an issue for which the opposing party by contrast will have the burden 

of proof at trial, as is the case here, the moving party need only point out “that there is an 

absence of evidence to support the nonmoving party’s case.” Id. at 325. 

Once the moving party meets its initial burden, the nonmoving party must go 

beyond the pleadings and, by its own affidavits or discovery, set forth specific facts 

showing that there is a genuine issue for trial. Fed. R. Civ. P. 56(c). The Court is 

concerned only with disputes over material facts and “[f]actual disputes that are irrelevant 

or unnecessary will not be counted.” Anderson, 477 U.S. at 248. It is not the task of the 

court to scour the record in search of a genuine issue of triable fact. Keenan v. Allan, 91 

F.3d 1275, 1279 (9th Cir. 1996). The nonmoving party has the burden of identifying, with 

reasonable particularity, the evidence that precludes summary judgment. Id. If the 

nonmoving party fails to make this showing, “the moving party is entitled to a judgment as 

a matter of law.” Celotex, 477 U.S. at 323 (internal quotations omitted).

DISCUSSION

The factual allegations given below are undisputed unless specifically noted 

otherwise. Juarez, an inmate at Soledad State Prison, alleges that (A) De Luna, a nurse, 

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(B) Rocamora, a nurse, (C) Estamo, a nurse, and (D) Sepulveda, a doctor, were 

deliberately indifferent to a wrist he injured during a softball game on June 6, 2011. As of 

June 20th, Juarez was able to play basketball despite the pain. (Pl.’s Opp. (“Opp.”), Pl.’s 

Decl., Ex. C at 13.) X-rays taken on July 5, 2011 “revealed no acute bone injury,” but 

rather a “small avulsion,” or chip fracture. (Id.; Ex. D at 21.) 

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

Amendment’s proscription against cruel and unusual punishment. See Estelle v. Gamble, 

429 U.S. 97, 104 (1976). A determination of “deliberate indifference” involves an 

examination of two elements: the seriousness of the prisoner’s medical needs and the 

nature of the defendant’s response to those needs. McGuckin v. Smith, 974 F.2d 1050, 

1059 (9th Cir. 1992) (overruled on other grounds, WMX Technologies, Inc. v. Miller, 104 

F.3d 1133, 1136 (9th Cir. 1997) (en banc)). 

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

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

to abate it. Farmer v. Brennan, 511 U.S. 825, 837 (1994) (equating standard with that of 

criminal recklessness). The prison official must not only “be aware of facts from which 

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

draw the inference.” Id. Consequently, in order for deliberate indifference to be 

established, there must exist both a purposeful act or failure to act on the part of the 

defendant and harm resulting therefrom. See McGuckin, 974 F.2d at 1060. 

 In order to prevail on a claim of deliberate indifference to medical needs, a plaintiff 

must establish that the course of treatment the doctors chose was “medically unacceptable 

under the circumstances” and that they embarked on this course in “conscious disregard of 

an excessive risk to [plaintiff’s] health.” See Toguchi v. Chung, 391 F.3d 1051, 1058-60 

(9th Cir. 2004). A claim of mere negligence related to medical problems, or “the 

inadvertent failure to provide medical care, or a difference of opinion between a prisoner 

patient and a medical doctor, is not enough to make out a violation of the Eighth 

Amendment. Id.; Franklin v. Oregon, 662 F.2d 1337, 1344 (9th Cir. 1981). The mere fact 

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that a prisoner does not receive adequate medical care does not necessarily create a claim 

for “deliberate indifference” to serious medical needs for purposes of imposing liability 

under 42 U.S.C. Section 1983. Id. at 105-06. Mere negligence or “the inadvertent failure 

to provide medical care” will not sustain a Section 1983 claim. Id. at 105. 

A. De Luna

On the day he injured his wrist, Juarez visited the emergency room (also known as

the Triage Treatment Area) of the north medical clinic, where he was examined by 

De Luna, a registered nurse. (Defs.’ Mot. for Summ. J. (“MSJ”)1, De Luna Decl. ¶¶ 7-8.) 

De Luna noted that he did not present a medical emergency, informed him there was no 

physician at the clinic at that time, and advised him to complete a 7362 health care services 

request form, which he did. (Id.) At the clinic at that time, physicians were available on 

an on-call basis to treat “medically necessary emergency” cases. (Id.) Juarez alleges that 

he told De Luna that he believed his wrist was broken. (Am. Compl. ¶ 5.) According to 

Juarez, De Luna denied his requests for ice, a splint, and x-rays, even though his wrist was 

“swollen, black and blue” and he was in extreme pain. (Id.) This June 6th meeting was 

the only contact Juarez had with De Luna. (MSJ, De Luna Decl. ¶ 10.) 

Summary judgment will be granted in De Luna’s favor. The undisputed facts 

surrounding his contact with Juarez do not show a genuine dispute of material fact that De 

Luna was deliberately indifferent. With no physician available, De Luna conducted a 

reasonable emergency nursing assessment. During this assessment, he determined that 

Juarez did not have a medical emergency, and referred him for further medical treatment 

by advising him to complete a 7362 request. That request was granted two days later on 

June 8th. 

Under Juarez’s facts, De Luna’s actions do not show deliberate indifference. De 

Luna’s denial of his requests to provide him with ice and a splint indicate only a difference 

 

1 Defendants filed one MSJ on their behalf, and each defendant (excepting De Luna) filed a 

separate MSJ on his or her behalf. “MSJ” in this order refers to the MSJ filed on behalf of 

all defendants.

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of opinion between a prisoner patient and medical staff and is insufficient to sustain a 

Section 1983 cause of action. Toguchi, 391 F.3d at 1038. Neither De Luna nor Juarez 

knew that his wrist was fractured, as it had not been x-rayed, though both certainly knew it 

had been injured. Swelling and pain would normally be seen in a just-injured wrist. It was 

not unreasonable for De Luna to assume that this fresh injury did not present a medical 

emergency. He was assessing patients for emergency situations while no doctor was 

present. Under Juarez’s allegations, De Luna’s actions constituted at most negligence or 

gross negligence, Farmer, 511 U.S. 825, 835–36 & n.4, or “the inadvertent failure to 

provide medical care,” none of which are actionable under section 1983, Toguchi, 391 

F.3d at 1038. Juarez has not provided any evidence that could support a claim that De 

Luna’s treatment was “medically unacceptable under the circumstances” and was chosen 

in “conscious disregard of an excessive risk to his health.” Id. 

B. Rocamora

On June 8th, Juarez was examined by Rocamora, a nurse, who was following up on 

his June 6th 7362 request. According to Juarez, his wrist was entirely immobile and had 

visible bruising. He told Rocamora that his wrist, which was yellow, black and blue, was 

fractured (he told her he had heard a “loud cracking sound” when he slid into second base) 

and that he was in extreme pain which prevented him from sleeping. (Am. Compl. ¶¶ 7-8.) 

He alleges that Rocamora provided no treatment or diagnosis, did not refer him to a doctor, 

and denied his requests for ice, a splint or x-rays, saying that there was nothing in stock to 

give him. (Id. ¶¶ 10-12.) A fellow inmate, S.A. Leggett, asserts that Juarez returned from 

this appointment without any bandage or ice. (Opp., Ex. I, Leggett Decl.) 

Rocamora states that on June 8th she assessed Juarez. (MSJ, Rocamora Decl. ¶ 7.) 

His vital signs were normal, he was alert and oriented, was not in acute distress, could 

move his finger, and had limited wrist movement. (Id. ¶ 9.) She noted that he had been 

seen on June 6th in the prison’s triage area, treated per nursing protocol, and that he was 

allergic to ibuprofen. (Id.) According to a document Juarez submitted, she gave him an 

ACE wrap to support his injured wrist, referred him for a routine evaluation by a physician 

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within two weeks, and gave him acetaminophen and ice to treat the pain. (Opp., Pl.’s 

Decl., Ex. A at 1.)

On June 29th, Juarez’s primary care physician, Dr. Kalisher, ordered x-rays to be 

taken of Juarez’s left wrist, but the x-rays were not taken until July 5th because the x-ray 

machine was broken. (MSJ, Rocamora Decl. ¶ 10.) On July 1, Juarez completed a 7362 

form stating that he was still waiting to have the x-rays taken. (Id.) On July 5, Rocamora 

received the 7362 form and called the x-ray department to follow up. (Id.) The 

department informed Rocamora that Juarez had been x-rayed earlier that day. (Id.) 

On July 18, Juarez completed another 7362 form stating he had still not seen 

Kalisher regarding the x-ray results and asking for a better wrist support. (Id. ¶ 11.) 

Rocamora received the form on July 18 and referred Juarez to medical unit scheduler to 

make an appointment with Kalisher. (Id.) 

Juarez’s assertions that Rocamora provided no treatment are contradicted by his 

own assertions and by the record. First, his assertion that Rocamora did not refer him to a 

physician is contradicted by a Health Care Services Form (“HCSF”) Juarez submitted as 

an exhibit. (Opp., Pl.’s Decl., Ex. A at 1.) He asserts that Rocamora failed to fill out the 

form so that he could see his primary care physician on a specific date. (Id., Pl.’s Decl. at 

19.) However, the form shows that Rocamora checked off the box that referred Juarez to a 

routine appointment with a physician within 14 days. (Id., Ex. A at 1.) Second, the record 

contradicts his assertion that she provided no pain medication. He admits that he was 

prescribed medication to which he was allergic. (Opp., Pl.’s Decl. at 19.) On the same 

HCSF, Rocamora indicated that Juarez was allergic to ibuprofen and that he should 

continue taking acetaminophen, which, according to the records Juarez submitted, was last 

dispensed on June 8, 2011, the day he saw Rocamora, which indicates that she did provide 

some treatment. (Id., Pl.’s Decl., Ex. C at 9.) There is nothing to support Juarez’s 

assertion that he was allergic to this drug, which he had been taking since at least April 

2011. (Id.) 

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Juarez further alleges that Rocamora refused to schedule an appointment for him to 

see Kalisher and that he had to file a health care appeal form 602 to see him because of 

Rocamora’s refusal. (Am. Compl. ¶ 14.) The undisputed facts do not support Juarez’s 

allegation. First, as discussed above, the evidence shows that Rocamora did schedule a 

doctor’s appointment for Juarez. Though it may not have been the doctor he preferred, 

Rocamora’s referring him to a doctor cannot plausibly be called “medically unacceptable 

under the circumstances.” Toguchi, 391 F.3d at 1038. Second, Juarez’s 602 appeal was 

filed on June 7, the day before he saw Rocamora.2 (Opp., Pl.’s Decl., Ex. B at 3, 4.) 

Juarez’s claims cannot survive summary judgment. Evidence provided by Juarez 

shows that Rocamora did schedule him to see a physician and recommended that he 

continue taking acetaminophen. Although he may not have received the treatment he 

wanted, it is undisputed that Rocamora provided reasonable and timely treatment in 

response to his medical condition. Also, if, as Juarez alleges, she lacked what he asked 

for, Rocamora cannot be held liable for failing to provide such items. 

Juarez has not provided any evidence that could support a claim that Rocamora’s 

treatment was “medically unacceptable under the circumstances” and was chosen in 

“conscious disregard of an excessive risk to his health.” Toguchi, 391 F.3d at 1038. 

Defendants’ motion for summary judgment in favor of Rocamora is GRANTED. 

C. Estamo

Juarez claims that on June 28, 2011, he was also interviewed by defendant Estamo, 

a nurse, on behalf of Dr. Sepulveda regarding his 602 appeal. (Am. Compl. ¶ 16.) He 

alleges that Estamo was deliberately indifferent in diagnosing his wrist injury as nonurgent and not broken and ignored his requests for ice, x-rays, and to see his primary care 

physician Kalisher. (Id. ¶¶ 17-20.) A fellow inmate, Kenneth W. Hughes, asserts that “in 

the month of June 2011” Juarez told him that he had seen Estamos on an unspecified day. 

(Opp., Pl.’s Decl., Ex. I, Hughes Decl. at 125.) 

 

2

In the later stages of his 602 appeal, Juarez does describe his examination by Rocamora on June 

8th. 

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Estamo asserts that she could not have interviewed Juarez on June 28th because on 

June 24th she went on maternity leave. (MSJ, Estamo’s Decl. ¶¶ 4-5, 9.) She asserted this 

also in response to Juarez’s interrogatories. (Opp., Pl.’s Decl., Ex. K at 136.) It is more 

than likely that Juarez confused Estamo with another nurse, Wall, who also interviewed 

Juarez regarding his 602 appeal on June 28th, the same day he alleges he met Estamo. 

(Id., Ex. C at 10.) Estamo’s assertion is supported by the fact that none of the prison’s 602 

appeal records submitted by Juarez bear Estamo’s name. 

Juarez has not shown evidence precluding summary judgment. The absence of 

Estamo’s name on relevant documents and Juarez having met another nurse on the same 

day regarding the same matter contradict his assertion that Estamo was responsible for the 

actions giving rise to his claim. Also, Hughes’s declaration is insufficient because he 

failed to provide the exact day he heard Juarez say he had seen Estamo. Because there is 

no evidence of Estamo’s involvement with Juarez’s medical care or subsequent 602 

appeals, there is no genuine issue of material fact that she acted with deliberate 

indifference or conscious disregard of an excessive risk to Juarez’s health. Also, even if 

Estamo had met with Juarez, he has not shown evidence precluding summary judgment. 

Her role, like Wall’s, was to interview Juarez regarding his 602 appeal, not to provide 

treatment. (Opp., Juarez Decl., Ex. B at 6; Ex. C at 10.) Accordingly, the motion for 

summary judgment as to Estamo is GRANTED.

D. Sepulveda

Juarez alleges that Dr. Sepulveda, Chief Medical Officer (“CME”) at Soledad, acted 

with deliberate indifference in denying Juarez’s requests for an MRI scan and consultation 

with a hand surgeon. (Am. Compl. ¶ 26.) However, the evidence submitted by Juarez 

contradicts these factual assertions. The exhibits show that a Dr. Darrin Bright, not 

Sepulveda, reviewed and finally denied all of Juarez’s requests for consultation with his 

primary care physician and for consultations with a hand surgeon. (Opp., Pl.’s Decl., Ex. 

E at 29 and 33.) 

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Sepulveda’s only personal involvement with Juarez’s treatment as CME was in 

reviewing Juarez’s second-level 602 appeal requesting to see a physician. (MSJ, 

Sepulveda Decl., Ex. B.) Sepulveda granted that appeal by ordering continued follow-up 

care with Juarez’s primary care physician. The record shows that Sepulveda acted 

appropriately with regard to Juarez’s injury and there is no additional evidence of his 

involvement showing that he acted with deliberate indifference. Juarez has not shown a 

genuine dispute whether Sepulveda violated his constitutional rights. Accordingly, 

defendants’ motion for summary judgment will is GRANTED in favor of Sepulveda. 

CONCLUSION

 Defendants’ motion for summary judgment (Docket No. 59) is GRANTED in favor 

of all defendants as to all claims. The Clerk shall enter judgment in favor of De Luna, 

Rocamora, Estamo, and Sepulveda, terminate Docket No. 59, and close the file. 

IT IS SO ORDERED.

Dated: March 18, 2015

_________________________

WILLIAM H. ORRICK

United States District Judge

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