Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-2_04-cv-00019/USCOURTS-azd-2_04-cv-00019-0/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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IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Danny Miller, 

Plaintiff, 

vs.

Donald Sloan, Facility Health

Administrator; Ronolfo Macabuhay,

Healthcare Provider; and Richard Pratt,

Medical Services Administrator, in their

individual and official capacities, 

Defendants. 

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No. CV-04-19-PHX-DGC (LOA)

ORDER

Pending before the Court are the parties’ motions for summary judgment. Docs.

##59, 72. For the reasons set forth below, the Court will deny Plaintiff’s motion and grant

Defendants’ motion in part.

Background

Plaintiff Danny M iller is an inmate at the Arizona State Prison Complex-Lewis.

Defendant Ronolfo Macabuhay is a physician who provides medical care t o t he prison’s

inmates. Defendants Donald Sloan and Richard Pratt are facility health administrators in

charge of organizing and evaluating the prison’s healthcare system.

Plaint iff commenced this action by filing a pro se civil rights complaint against

Defendants on January 5, 2004. Doc. #1. Plaintiff alleges in an amended complaint that

Case 2:04-cv-00019-DGC Document 87 Filed 12/01/05 Page 1 of 7
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Defendants violat ed his Eighth Amendment rights by being deliberately indifferent to his

serious medical needs. Doc. #50. Sp ecifically, Plaintiff alleges that he has irritable bowel

syndrome (“IBS”) and that Defendants failed to renew his Metamucil and Bentyl

prescriptions because they were too expensive and refused his request for a “no spice”

diet because he was not allergic to spices. Id.

Discussion

I. Summary Judgment Standard.

Summary judgment is approp riate if the evidence, viewed in the light most favorable

to the nonmoving party, “show[s] that there is no genuine issue as to any material fact and

that the moving party is ent it led t o judgment as a matter of law.” Fed. R. Civ. P. 56(c); see

Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986). Substantive law determines which

facts are material and “[o]nly disputes over facts that might affect the outcome of t he suit

. . . will properly preclude the ent ry of summary judgment.” Anderson v. Liberty Lobby,

Inc., 477 U.S. 242, 248 (1986). Similarly, to preclude summary judgment the dispute must

be genuine, that is, “the evidence [must be] such that a reasonable jury could return a

verdict for the nonmoving party.” Id.

II. Analysis.

A. The Eighth Amendment’s Deliberate Indifference Standard.

Prison officials “violate a prisoner’s Eighth Amendment rights if they are

deliberately indifferent to his serious medical needs.” Anderson v. County of Kern, 45 F.3d

1310, 1316 (9th Cir. 1995) (citing Estelle v. Gamble, 429 U.S. 97, 105-06 (1976)). Deliberate

indifference “may appear when prison officials deny, delay, or intentionally interfere with

medical treatment, or it may be shown by the way in which p rison physicians provide

medical care.” Hutchinson v. United States, 838 F.2d 390, 394 (9th Cir. 1988) (citing Estelle,

429 U.S. at 104-05). “The indifference to medical needs must be substantial; a

const itutional violation is not established by negligence or ‘an inadvertent failure to

provide adequate medical care.’” Anderson, 45 F.3d at 1310 (quoting Estelle, 429 U.S. at

105-06).

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IBS is a gastrointestinal disorder characterized by altered bowel habits and

abdominal pain. Docs. ##60 ¶ 5, 72 ¶ 14. Defendants admit that IBS can adversely affect

a person’s quality of life and that Plaintiff suffered from and was t reat ed for IBS. Doc. #72

¶¶ 12-16. There is thus no genuine dispute that Plaintiff had a serious medical need. See,

e.g., McGuckin v. Smith, 974 F.2d 1050, 1059-60 (9th Cir. 1992) (“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 subst ant ial pain are examples of indications

that a prisoner has a ‘serious’ need for medical treatment.”), overruled on other grounds,

WMX Tech., Inc. v. Miller, 104 F.3d 1133 (9th Cir. 1997).

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B. The Bentyl and Metamucil Prescriptions.

Plaintiff visited Dr. Macabuhay on December 10, 2001, complaining of chronic

diarrhea and stomach pain. Dr. Macabuhay diagnosed Plaintiff with IBS and p rescribed

him Metamucil fiber and Bentyl, an abdominal muscle relaxer and pain reliever. Docs. ##60

¶¶ 2-5, 73 ¶¶ 3, 11-14.1

 On Ap ril 24, 2002, Dr. Macabuhay renewed Plaintiff’s Bentyl

prescription and informed him that Metamucil was available at the inmate store. Docs.

##60 ¶¶ 7-8, 73 ¶ 27. Plaintiff has testified that Dr. Macabuhay told him t hat he would

have to purchase Metamucil from the inmate store because “the medical department was

cutting back on expenses.” Doc. #60 ¶ 8. Plaintiff has further testified that on June 4, 2002,

Dr. Macabuhay refused to renew his Bentyl prescription because it was too expensive.

Id. ¶ 11.

Defendants dispute this testimony, stating that medicat ion is never denied due to

cost and that at no time did Dr. Macabuhay refuse to prescribe Plaintiff Bentyl for any

reason. Doc. #73 ¶¶ 87, 90-91. Defendant s further state that, unlike the prescription drug

Bentyl, Metamucil generally must be purchased from the inmate store unless it is medically

necessary and the inmate is indigent, in which case Metamucil is provided to the inmate

at no cost. Docs. ##73 ¶¶ 88-89, 84 ¶¶ 5-6.

“Budgetary constraint s . . . do not justify cruel and unusual punishment.” Jones

v. Johnson, 781 F.2d 769, 771 (9th Cir. 1986) (citing Spain v. Procunier, 600 F.2d 189, 200

(9th Cir. 1979)). Given the conflicting testimony above, whether Plaintiff was denied a

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Bentyl prescrip tion due to its cost is a factual issue that must be resolved by a jury.

See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986) (“Credibility determinations,

the weighing of evidence, and the drawing of inferences from the facts are jury functions,

not those of a judge[.]”); Harris v. Itzhaki, 183 F.3d 1043, 1051 (9th Cir. 1999) (“ Issues of

credibility, including questions of intent, should be left to the jury.”). The Court will deny

the motions for summary judgment with respect to Plaintiff’s claim that he was denied a

Bentyl prescription because it was too expensive.

With respect to Plaintiff’s claim that he was denied Metamucil, however, Plaintiff

has presented no evidence that he was indigent or unable to purchase Metamucil from the

inmate store. The Court will grant summary judgment in Defendants’ favor with respect

to this claim. See Shapley v. Nev. Bd. of State Prison Comm’rs, 766 F.2d 404, 408 (9th Cir.

1985) (holding that the imposition of a three dollar fee for each medical visit did not state

a claim of deliberat e indifference because the plaintiff did not allege how the fee affected

him or that prison officials denied medical care to indigent prisoners).

C. The Special Diet Request.

On June 4, 2002, Dr. Macabuhay prescribed Plaintiff a “no spice” diet in response

to Plaintiff’s comp laint that spicy foods exacerbated his IBS. Docs. ##60 ¶¶ 10-11, 73 ¶ 31.

On June 10, 2003, Dr. Macabuhay renewed Plaintiff’s prescript ion for a “no cayenne pepper

or chili p owder” diet. Docs. ##60 ¶ 14, 73 ¶ 45. One week later, Dr. Macabuhay noted in

Plaint iff’s medical chart that the diet request had not been approved because Plaintiff had

not received an allergy test for cayenne or chili peppers, the only sp ices used in the

prison’s kitchen. Docs. ##60 ¶ 14, 73 ¶¶ 45-47, 57. Plaint iff promptly received an allergy

test, which came back negative for cayenne and chili peppers. Doc. #73 ¶¶ 48-50.

Plaintiff subsequently filed grievances regarding the denial of his diet request.

Docs. ##60 ¶¶ 16-21, 73 ¶¶ 56-61, 80 ¶¶ 25, 31, 33-34. The grievances were denied because

Plaintiff was not allergic to cayenne or chili peppers and his IBS was not a direct result of

spices in his diet. Id. Plaintiff was later provided with a “low residue/no spice” diet in

August 2004. Doc. #60 ¶ 24.

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Plaintiff contends t hat t he discontinuation of his special diet “is a classic case of

deliberate indifference.” Doc. #59 at 9-10 (citing Hunt v. Dental Dep’t, 865 F.2d 198, 200-01

(9th Cir. 1988)). Defendants argue that not providing Plaintiff with a special diet was a

reasonable response to his medical needs because Plaintiff was not allergic to spices

and continued to have diarrhea and st omach pain even when he was on a no spice diet.

Docs. ##72 at 11, 73 ¶ 83.

Construed in Plaintiff’s favor, the evidence shows, at most, that Defendants were

negligent in failing continuously to provide Plaintiff with a special diet. Medical st aff

examined and treated Plaintiff numerous times after he was diagnosed with IBS. Doc. #73

¶¶ 19-46, 49-51, 55. Plaintiff received a test to determine if he was allergic to cayenne and

chili peppers – the only spices used in the prison’s kitchen – and was denied a no sp ice

diet because his test results were negative. Docs. ##60 ¶ 14, 73 ¶¶ 45-50, 57, 80 ¶ 25.

Because Plaintiff cannot show that Defendant s p urposefully ignored or failed to respond

to his medical needs, he cannot establish deliberat e indifference. See McGuckin v. Smith,

974 F.2d 1050, 1060 (9t h Cir. 1992) (“A defendant must purposefully ignore or fail to

respond t o a p risoner’s pain or possible medical need in order for deliberate indifference

to be established.”), overruled on other grounds, WMX Tech., Inc. v. Miller, 104 F.3d 1133

(9th Cir. 1997); Estelle v. Gamble, 429 U.S. 97, 106-07 (1976) (“Medical malpractice does not

become a constitut ional violation merely because the victim is a prisoner.”); Frost v.

Agnos, 152 F.3d 1124, 1130 (9t h Cir. 1998) (“Mere negligence in the provision of medical

care . . . does not constitute a constitutional violation.”); Wood v. Housewright, 900 F.2d

1332, 1334 (9th Cir. 1990) (“While poor medical t reatment will at a certain point rise to the

level of constitutional violation, mere malpractice, or even gross negligence, does not

suffice.”); Jackson v. McIntosh, 90 F.3d 330, 332 (9th Cir. 1996) (“‘[A] difference of medical

opinion as to the need to pursue one course of treatment over another [is] insufficient, as

a matter of law, to establish deliberate indifference.”) (citation omitted). The Court will

grant summary judgment in favor of Defendants with respect to Plaintiff’s claim that he was

denied a special diet. See Toussaint v. McCarthy, 801 F.2d 1080, 1112 (9th Cir. 1986)

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Plaintiff’s reliance on Hunt is misp laced because evidence in that case showed that

the defendants deliberately failed to provide the plaintiff with any dental care despite the

plaintiff’s repeated comp laints that the loss of his dentures was causing severe pain and

permanent damage to his teeth. 865 F.2d at 200-01. 

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(“Neither precedent nor common sense suggests that delay in providing a special diet

arises to the level of deliberate indifference.”).2

D. Qualified Immunity.

Defendants argue that they are entitled to qualified immunity because the

constitut ional right in question was not clearly established. Doc. #72 at 12-15. The Court

disagrees. “It is settled law that deliberate indifference to serious medical needs of

prisoners violates the Eighth Amendment.” Jackson, 90 F.3d at 332 (citing Estelle, 429 U.S.

at 104). “For a right to be clearly established it is not necessary that the very act ion in

question have previously been unlawful. To define the law in question too narrowly would

be to allow [D]efendants ‘to define away all pot ent ial claims.’” Id. (citations omitted).

Moreover, with respect to Plaintiff’s claim that he was denied a Bent y l p rescription, it is

clear under the law of this Circuit that prisoners cannot be denied treatment due to

budgetary const raints, the issue on which Plaintiff has raised a question of fact. See Spain

v. Procunier, 600 F.2d 189, 200 (9th Cir. 1979); Jones v. Johnson, 781 F.2d 769, 771 (9th Cir.

1986). The Court will deny Defendant’s motion for summary judgment with respect to t his

issue.

E. Eleventh Amendment Immunity.

Defendants argue that the Eleventh Amendment to t he Unit ed States Constitution

bars any monetary claims against them to the extent they have been sued in their official

capacities. Doc. #72 at 15 (citing Edelman v. Jordan, 415 U.S. 651, 663 (1974) (“It is . . . well

established that even though a State is not a named party to the action, the suit may

nonetheless be barred by the Eleventh Amendment.”)). Plaintiff does not respond to this

argument. See Docs. ##78-79. The Court finds the argument well-taken and will grant

Defendant’s motion for summary judgment on Plaintiff’s claims for monetary damages.

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IT IS ORDERED that Plaintiff’s motion for summary judgment (Doc. #59) is denied.

IT IS FURTHER ORDERED that Defendants’ cross motion for summary judgment

(Doc. #72) is granted in part and denied in part as set forth in this order.

The Court will set a pretrial conference by separate order.

DATED this 28th day of November, 2005.

Case 2:04-cv-00019-DGC Document 87 Filed 12/01/05 Page 7 of 7