Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_09-cv-00108/USCOURTS-casd-3_09-cv-00108-0/pdf.json

Nature of Suit Code: 550
Nature of Suit: Prisoner - Civil Rights (U.S. defendant)
Cause of Action: 42:1983 Prisoner Civil Rights

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1 Because Lopez’s Amended Complaint is not consecutively

paginated, the Court will use the page numbers assigned by the

electronic case filing system when citing this document.

2

 Although the Complaint names R. Torchia, Defendant corrects

his name to Richard Torchia in the Motion to Dismiss. (Am. Compl.

1-2, 4; Def. Torchia’s Mot. Dismiss 1.)

1 09cv0108 JM (RBB)

UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF CALIFORNIA

ADAM RAY LOPEZ,

Plaintiff,

v.

P. SANTOYO, D.D.S, C.

ROBERTSON, C.D.O., and R.

TORCHIA, D.D.S.,

Defendants. 

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Civil No. 09cv108 JM(RBB)

REPORT AND RECOMMENDATION

GRANTING IN PART AND DENYING

IN PART DEFENDANTS TORCHIA,

SANTOYO, AND ROBERTSON’S

MOTIONS TO DISMISS [DOC. NOS.

12, 16] AND DENYING

PLAINTIFF’S MOTION FOR DEFAULT

CALLING FOR SANCTIONS [DOC.

NO. 28]

Plaintiff Adam Ray Lopez, a state prisoner proceeding pro se

and in forma pauperis, filed a Complaint on January 16, 2009,

pursuant to 42 U.S.C. § 1983 [doc. no. 1]. Plaintiff filed a First

Amended Complaint (“Complaint”) on July 15, 2009 [doc. no. 7].1

Lopez asserts that Defendants P. Santoyo, D.D.S., C. Robertson,

Chief Dental Officer, and R. Torchia, D.D.S., violated his Eighth

Amendment rights by acting with deliberate indifference to his

dental needs.2 (Am. Compl. 4.) On September 23, 2009, Defendant

Case 3:09-cv-00108-W-RBB Document 48 Filed 06/17/10 Page 1 of 35
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Torchia filed a Motion to Dismiss, a Memorandum of Points and

Authorities, and a Declaration from David P. Burke with an exhibit

[doc. no. 12]. Torchia argues that Lopez’s Complaint should be

dismissed pursuant to Federal Rule of Civil Procedure 12(b)(6) for

failure to state a claim upon which relief can be granted. (Def.

Torchia’s Mot. Dismiss Attach. #2 Mem. P. & A. 1.) 

On December 2, 2009, Defendants Santoyo and Robertson filed a

Motion to Dismiss along with a Memorandum of Points and Authorities

[doc. no. 16]. Santoyo and Robertson assert that Plaintiff’s

Complaint should be dismissed because he failed to exhaust

administrative remedies, the Complaint fails to state a claim, and

they are entitled to Eleventh Amendment and qualified immunities. 

(Defs. Santoyo’s & Robertson’s Mot. Dismiss 8-16.) On February 4,

2010, Defendants Santoyo and Robertson filed a Notice of Errata re.

Notice of Motion to Dismiss which included declarations from D.

Bell and J. Walker as well as exhibits showing Plaintiff’s

grievance process [doc. no. 25].

The Court issued a Klingele/Rand Notice advising Lopez of

Defendants Santoyo and Robertson’s pending Motion to Dismiss for

failure to exhaust administrative remedies and allowing him time to

present any additional evidence demonstrating exhaustion [doc. no.

17]. 

On December 30, 2009, Plaintiff’s Request for Extension of

Time to File Opposition to Defendants Motion to Dismiss was filed

[doc. no. 19]. This request did not specify if Lopez sought an

extension of time to oppose both Motions to Dismiss, or merely

Defendant Santoyo and Robertson’s Motion. On January 27, 2010, the

Court ordered Defendant Torchia to re-serve his Motion to Dismiss

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and allowed Lopez an extension of time to respond to the doctor’s

Motion [doc. no. 23]. 

Plaintiff, on February 11, 2010, filed a Motion for Default

Calling for Sanctions and alleged he did not receive a copy of

Defendant Torchia’s Motion to Dismiss [doc. no. 28]. Defendant

Torchia filed an Opposition to Plaintiff’s Motion the same day,

explaining that his Motion to Dismiss was first served on September

23, 2009, and was again served on January 27, 2010 [doc. no. 29]. 

Because Defendant timely filed a Motion to Dismiss, and Plaintiff

had already been provided with another copy of the Motion and

additional time to file an opposition, the Court finds that the

Motion for Default should be DENIED. 

On March 3, 2010, Plaintiff’s Request for Extension of Time to

File Opposition to Torchia’s Motion to Dismiss was filed [doc. no.

30]. The Court granted Plaintiff’s request [doc. no. 31]. Next,

Lopez filed two additional Motions seeking additional time to

oppose both Defendant Torchia’s Motion to Dismiss and Defendants

Santoyo and Robertson’s Motion to Dismiss [doc. nos. 33-34]. The

Court granted this request [doc. no. 36]. Plaintiff timely filed

his Opposition to Defendant Richard Torchia’s Motion to Dismiss

[doc. no. 39] and his Opposition to Defendants [Santoyo and

Robertson’s] Motion to Dismiss [doc. no. 40].

Torchia filed a Reply on May 6, 2010 [doc. no. 41], and

Santoyo and Robertson filed their Reply on May 11, 2010, which the

Court struck because it was late [doc. nos. 42-43]. Lopez

submitted a Request for Leave of the Court to File Surreply to

Defendant Torchia[‘s] Reply, which was granted [doc. nos. 45-46]. 

His Surreply was filed on June 4, 2010 [doc. no. 47]. 

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I. FACTUAL BACKGROUND

At the time Plaintiff filed the First Amended Complaint, he

was incarcerated at the California Substance Abuse Treatment

Facility and State Prison in Corcoran, California. (Am. Compl. 4.) 

The events giving rise to this suit occurred while he was housed at

Calipatria State Prison. (Id.)

On July 26, 2006, Plaintiff submitted a Health Care Service

Request form to prison officials at Calipatria requesting

extraction of his wisdom teeth and complaining of extreme pain and

discomfort. (Id.; id. Attach. #1 Ex. A at 1.) Defendant Santoyo,

a dentist at Calipatria, saw Lopez on November 1, 2006, regarding

his dental request. (Am. Compl. 4.) Dr. Santoyo examined

Plaintiff and completed a Physician Request for Services form

indicating that Lopez was in “urgent” need of oral surgery for two

impacted molars, citing swelling, pain, and infection. (Id.; id.

Attach. #1 Ex. C at 1.) The proposed service provider was Dr.

Torchia. (Id. Attach. #1 Ex. C at 1.) 

Plaintiff alleges that Dr. Santoyo refused to provide him the

necessary pain medication even though Lopez was suffering; his

“tooth had become infected, swollen and cause[d] [P]laintiff with

[sic] severe migraine headaches and earaches which significantly

affected [P]laintiff[‘s] daily activities by preventing [P]laintiff

from eating food, sleeping, and talking.” (Am. Compl. 4.) 

Plaintiff faults Santoyo for failing to follow up on his

recommendation for oral surgery, although he was aware that

Plaintiff’s need was “urgent.” (Id.) Lopez also asserts that Dr.

Santoyo had no justification for referring Plaintiff to an oral

surgeon because Santoyo performs tooth extractions. (Id. at 8.) 

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Chief Dental Officer Robertson approved the referral to an

oral surgeon on November 2, 2006 (Am. Compl. 5-6; id. Attach. #1

Ex. C at 1.) Lopez contends that Defendant Robertson was “grossly

negligent in managing the people he was suppose to supervise.” 

(Am. Compl. 5.) Plaintiff asserts that “had [D]efendant

[R]obertson been meticulous in his supervision duties, he would

have ensured that [P]laintiff received the proper pain medication

to relieve [P]laintiff[‘s] pain and suffering.” (Id.)

 Lopez argues that on April 30, 2007, after ten months of

suffering, including the time he initially waited to be seen by Dr.

Santoyo, Lopez finally received oral surgery. (Id. at 6-7.) 

Plaintiff alleges that during the surgery Defendant Torchia chipped

one of his teeth and refused to fill it. (Id. at 7.) “Instead of

filling-in the chipped tooth, defednet [sic] [T]orchia created a

physicians order for a [C]alipatria dental sick call indicating a

fillin[g] was needed for [P]laintiff now.” (Id.) As a result,

Lopez asserts his chipped tooth became infected causing him pain

and swelling, as well as migraines and earaches, that prevented him

from eating, sleeping, or talking. (Id.)

Dr. Santoyo saw Plaintiff on May 15, 2007, for his “chipped

tooth, swelling of the lower jaw and his inability to eat solid

foods.” (Id.) The doctor noted these and placed Plaintiff on a

liquid diet. (Id.) Dr. Santoyo filled Plaintiff’s tooth on July

10, 2007. (Id.) Plaintiff claims the interim delay caused him pain

and suffering and holds Dr. Torchia responsible for the pain he

experienced from April 30, 2007, when the surgeon chipped his tooth

to July 10, 2007, when Dr. Santoyo filled the chip. (Id. at 8.)

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II. LEGAL STANDARDS APPLICABLE TO DEFENDANTS’ MOTIONS TO DISMISS

A. Exhaustion

Title 42 U.S.C. § 1997e(a) of the Prison Litigation Reform Act

(“PLRA”) states: “No action shall be brought with respect to

prison conditions under section 1983 of this title, or any other

Federal law, by a prisoner confined in any jail, prison, or other

correctional facility until such administrative remedies as are

available are exhausted.” 42 U.S.C.A. § 1997e(a) (West 2010). The

exhaustion requirement applies regardless of the relief sought. 

Booth v. Churner, 532 U.S. 731, 741 (2001) (citation omitted). 

“‘[A]n action is “brought” for purposes of § 1997e(a) when the

complaint is tendered to the district clerk[]’ . . . .” Vaden v.

Summerhill, 449 F.3d 1047, 1050 (9th Cir. 2006) (quoting Ford v.

Johnson, 362 F.3d 395, 400 (7th Cir. 2004)). Therefore, prisoners

must “exhaust administrative remedies before submitting any papers

to the federal courts.” Id. at 1048 (emphasis added).

Section 1997e(a)’s exhaustion requirement creates an

affirmative defense. Wyatt v. Terhune, 315 F.3d 1108, 1119 (9th

Cir. 2003). “[D]efendants have the burden of raising and proving

the absence of exhaustion.” Id. (footnote omitted). Defendants in

§ 1983 actions properly raise the affirmative defense of failure to

exhaust administrative remedies through an unenumerated motion to

dismiss under Rule 12(b). Id. (citations omitted).

Unlike motions to dismiss for failure to state a claim for

which relief may be granted, “[i]n deciding a motion to dismiss for

failure to exhaust nonjudicial remedies, the court may look beyond

the pleadings and decide disputed issues of fact.” Id. at 1119-20

(citing Ritza v. Int’l Longshoremen’s & Warehousemen’s Union, 837

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F.2d 365, 369 (9th Cir. 1988)) (footnote omitted). Courts have

discretion regarding the method they use to resolve these factual

disputes. Ritza, 837 F.2d at 369 (citations omitted). “A court

ruling on a motion to dismiss also may take judicial notice of

‘matters of public record.’” Hazleton v. Alameida, 358 F. Supp. 2d

926, 928 (C.D. Cal. 2005) (citing Lee v. City of Los Angeles, 250

F.3d at 688 (citations omitted)). But “if the district court looks

beyond the pleadings to a factual record in deciding the motion to

dismiss for failure to exhaust[,] . . . the court must assure that

[the plaintiff] has fair notice of his opportunity to develop a

record.” Wyatt, 315 F.3d at 1120 n.14. 

“[When] the district court concludes that the prisoner has not

exhausted nonjudicial remedies, the proper remedy is dismissal of

the claim without prejudice.” Id. at 1120 (citing Ritza, 837 F.2d

at 368 n.3). 

B. The Administrative Grievance Process

“The California Department of Corrections [CDC] provides a

four-step grievance process for prisoners who seek review of an

administrative decision or perceived mistreatment: an informal

level, a first formal level, a second formal level, and the

Director’s level.” Vaden, 449 F.3d at 1048-49 (citing Brown v.

Valoff, 422 F.3d 926, 929-30 (9th Cir. 2005)). The administrative

appeal system can be found in title 15, sections 3084.1, 3084.5,

and 3084.6 of the California Code of Regulations. See Brown, 422

F.3d at 929-30 (citing Cal. Code Regs. tit. 15, §§ 3084.1(a),

3084.5(a)-(b), (e)(1)-(2), 3084.6 (c) (2010). 

To comply with the CDC’s administrative grievance procedure,

an inmate must file his grievance at the informal level “within 15

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working days of the event or decision being appealed . . . .” Cal.

Code Regs. tit. 15, § 3084.6 (c); see also Brown, 422 F.3d at 929. 

An appeal may be rejected when it “concerns an anticipated action

or decision.” Cal. Code Regs. tit. 15, § 3084.3(c)(3). An inmate

must proceed through all levels of the administrative grievance

process before initiating a § 1983 suit in federal court. See

Vaden, 449 F.3d at 1051.

A prisoner’s grievances must be “sufficient under the

circumstances to put the prison on notice of the potential claims

and to fulfill the basic purposes of the exhaustion requirement.” 

Irvin v. Zamora, 161 F. Supp. 2d 1125, 1135 (S.D. Cal. 2001). 

Exhaustion serves several important goals, including “allowing a

prison to address complaints about the program it administers

before being subjected to suit, reducing litigation to the extent

complaints are satisfactorily resolved, and improving litigation

that does occur by leading to the preparation of a useful record.” 

Jones v. Bock, 549 U.S. 199, 219 (2007) (citing Woodford v. Ngo,

548 U.S. 81, 88-91 (2006); Porter v. Nussle, 534 U.S. 516, 524-25

(2002)). 

1. Defendants Santoyo and Robertson

Defendants Santoyo and Robertson move to dismiss Lopez’s

Eighth Amendment claim against them for inadequate dental care

because Plaintiff failed to properly exhausted his administrative

remedies. (Defs. Santoyo & Robertson’s Mot. Dismiss Mem. P. & A.

9-10); see also Fed. R. Civ. P. 12(b).

 Plaintiff filed a 602 grievance on January 1, 2007, which was

received by prison administration on January 4, 2007. (Am. Compl.

4; Errata re Defs. Santoyo & Robertson’s Mot. Dismiss Attach. #1

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Decl. D. Bell Ex. B at 1.) In the grievance, Lopez states he had

“been patiently waiting since July 2006” to have his wisdom teeth

extracted and requested to be sent to an outside hospital to have

them removed. (Errata re Defs. Santoyo & Robertson’s Mot. Dismiss

Attach. #1 Decl. Bell Ex. B at 1.) On February 20, 2007, Lopez

received a reply informing him that he was on the oral surgery list

to be seen by an outside provider. (Id.) Dissatisfied with the

response, Plaintiff filed a first formal level appeal on February

22, 2007, seeking priority status to receive his surgery. (Id.;

Am. Compl. 5.) On April 23, 2007, Lopez received a first level

review decision which granted his request and set his surgery date

for April 30, 2007. (Errata re Defs. Santoyo & Robertson’s Mot.

Dismiss Attach. #1 Decl. Bell Ex. B at 2-3.) 

Defendants contend that Plaintiff did not proceed to the

second or Director’s level of appeals. (Id. at 1-3; Defs. Santoyo

& Robertson’s Mot. Dismiss Mem. P. & A. 9-10.) They argue that

Lopez failed to fully pursue his appeal which renders his

administrative remedies unexhausted. (Id. (citing Cal. Code Regs.

Tit. 15, § 3084.6 (c)).) 

Although Plaintiff properly submitted his informal and first

formal grievances, he admits that he did not proceed beyond the

first level and pursue the next two steps of the review process. 

(Opp’n Defs. Santoyo & Robertson’s Mot. Dismiss 8); see also

Woodford, 548 U.S. at 90. Lopez explains that “the defendants are

correct, plaintiff did not proceed with his dental 602 to the

second level for the fact plaintiff received all his ‘action

requested,’ ‘relief,’ on April 30, 2007, after he received the

‘urgent’ oral surgery.” (Opp’n Defs. Santoyo & Robertson’s Mot.

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Dismiss 8.) He argues that because he received the surgery that he

requested, he had no other administrative remedies to exhaust. 

(Id. at 9.) If he had continued pursuing his grievance, it would

have been denied as moot. (Id.) “[R]equiring entirely pointless

exhaustion, when no possible relief is available, is more likely to

inflame than to ‘mollify passions.’” (Id. (citing Booth v. Churner,

532 U.S. 737; Dixon v. Page, 291 F.3d 485, 490-91 (7th Cir. 2002).) 

 “[A] prisoner need not press on to exhaust further levels of

review once he has either received all ‘available’ remedies at an

intermediate level of review or been reliably informed by an

administrator that no remedies are available.” Brown v. Valoff,

422 F.3d at 935 (agreeing with the Second, Seventh, and Tenth

circuits that exhaustion is not required when there is no pertinent

relief that can be obtained through the internal grievance

process); see also Abney v. McGinnis, 380 F.3d 663, 669 (2d Cir.

2004); Ross v. County of Bernalillo, 365 F.3d 1181, 1187 (10th Cir.

2004); Dixon v. Page, 291 F.3d at 490-91. 

Defendants fail to acknowledge or discuss Brown v. Valoff, 422

F.3d at 935, and its progeny. See also Hicks v. Evans, 357 F.

App’x 102, 102-03 (9th Cir. 2009); Wilson v. Mata, 348 F. App’x

237, 238 (9th Cir. 2009); O’Guinn v. Lovelock Corr. Ctr., 502 F.3d

1056, 1062 (9th Cir. 2007). Their exhaustion argument is, at best,

disingenuous. See Smith v. Scripto-Tokai, 170 F. Supp. 2d 533,

538-40 (W.D. Pa. 2001) (discussing attorney’s duty to disclose

adverse legal authority).

Because Plaintiff received the relief he requested in response

to his first level appeal, he did not need to pursue the appeal any

further to exhaust his claim. See Brown, 422 F.3d at 935 n.10

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(stating that “over-exhaustion” to the highest level “may be wise,”

but finding continued appeal was not required). Lopez’s Eighth

Amendment claim against Defendant Santoyo and Robertson was fully

exhausted; therefore, the Motion to Dismiss on this ground should

be DENIED. 

2. Defendant Torchia

In his Reply, Dr. Torchia argues that Lopez’s claim against

him should be dismissed for failure to exhaust administrative

remedies. (Reply 6-7.) Torchia explains that Plaintiff “makes no

mention [in his Complaint and the attached records] of any other

formal or informal level of appeal [other than the appeal regarding

scheduling of his oral surgery] and the Declarations of Bell and

Walker establish Plaintiff did not exhaust administrative remedies

prior to initiating the instant action.” (Id. at 7.) 

Plaintiff argues in his Surreply that Dr. Torchia waived his

affirmative defense of non-exhaustion because he failed to raise it

in his Motion to Dismiss. (Surreply 7.) Lopez explains that he

“has not had the opportunity to oppose this now surprise defense.” 

(Id.) 

“The district court need not consider arguments raised for the

first time in a reply brief.” Zamani v. Carnes, 491 F.3d 990, 997

(9th Cir. 2007) (citing Koerner v. Grigas, 328 F.3d 1039, 1048 (9th

Cir. 2003)); see also Bach v. Forever Living Prods. U.S., Inc., 473

F. Supp. 2d 1110, 1122 n.6 (W.D. Wash. 2007) (“It is well

established in this circuit that courts will not consider new

arguments raised for the first time in a reply brief.”); United

States v. Boyce, 148 F. Supp. 2d 1069, 1085 (S.D. Cal. 2001) (“[I]t

is improper for a party to raise a new argument in a reply

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brief.”); United States v. Boggi, 74 F.3d 470, 478 (3d Cir. 1996)

(noting the court’s general practice not to consider arguments

raised for first time in a reply brief because it deprives the

opposing party of an adequate opportunity to respond). 

Additionally, a court must give a prisoner fair notice and an

opportunity to develop the record in response to an administrative

exhaustion defense. Wyatt v. Terhune, 315 F.3d at 1120 n.14; see

also Marella v. Terhune, 568 F.3d 1024, 1027-28 (9th Cir. 2009).

Here, Dr. Torchia filed his Motion to Dismiss on September 23,

2009 [doc. no. 12]. The Motion did not argue that Lopez failed to

exhaust administrative remedies. On December 2, 2009, Defendants

Santoyo and Robertson filed their Motion to Dismiss and asserted,

among other things, that Plaintiff failed to exhaust [doc. no. 16]. 

In response to these arguments, the Court issued a Klingele/Rand

Notice on December 9, 2009 [doc. no. 17]. At no time before filing

his May 6, 2010 Reply did Defendant Torchia argue that Lopez failed

to exhaust his claims against Torchia. This Defendant did not join

Santoyo and Robertson’s Motion to Dismiss or, prior to May 6, 2010,

argue exhaustion. Nor has Torchia shown good cause for not raising

exhaustion at the time he filed his Motion to Dismiss or during the

eight months preceding his Reply. Because Defendant Torchia raises

the failure to exhaust argument in his Reply, Lopez has not

received fair notice and it would be improper to consider the

doctor’s new argument. See Marella, 568 F.3d at 1027-28; Wyatt,

315 F.3d at 1120 n.14. Thus, the Court will not consider Defendant

Torchia’s exhaustion argument raised for the first time in his

Reply.

// 

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C. Rule 12(b)(6) Motions to Dismiss

A motion to dismiss for failure to state a claim pursuant to

Federal Rule of Civil Procedure 12(b)(6) tests the legal

sufficiency of the claims in the complaint. See Davis v. Monroe

County Bd. of Educ., 526 U.S. 629, 633 (1999). “The old formula –-

that the complaint must not be dismissed unless it is beyond doubt

without merit –- was discarded by the Bell Atlantic decision [Bell

Atl. Corp. v. Twombly, 550 U.S. 544, 563 n.8 (2007)].” Limestone

Dev. Corp. v. Vill. of Lemont, 520 F.3d 797, 803 (7th Cir. 2008).

A complaint must be dismissed if it does not contain “enough

facts to state a claim to relief that is plausible on its face.” 

Bell Atl. Corp., 550 U.S. at 570. “A claim has facial plausibility

when the plaintiff pleads factual content that allows the court to

draw the reasonable inference that the defendant is liable for the

misconduct alleged.” Ashcroft v. Iqbal, __ U.S. __, 129 S.Ct.

1937, 1949 (2009). The court must accept as true all material

allegations in the complaint, as well as reasonable inferences to

be drawn from them, and must construe the complaint in the light

most favorable to the plaintiff. Cholla Ready Mix, Inc. v. Civish,

382 F.3d 969, 973 (9th Cir. 2004) (citing Karam v. City of Burbank,

352 F.3d 1188, 1192 (9th Cir. 2003)); Parks Sch. of Bus., Inc. v.

Symington, 51 F.3d 1480, 1484 (9th Cir. 1995); N.L. Indus., Inc. v.

Kaplan, 792 F.2d 896, 898 (9th Cir. 1986). 

 The court does not look at whether the plaintiff will

“ultimately prevail but whether the claimant is entitled to offer

evidence to support the claims.” Scheuer v. Rhodes, 416 U.S. 232,

236 (1974); see Bell Atl. Corp. v. Twombly, 550 U.S. at 563 n.8. A

dismissal under Rule 12(b)(6) is generally proper only where there

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“is no cognizable legal theory or an absence of sufficient facts

alleged to support a cognizable legal theory.” Navarro v. Block,

250 F.3d 729, 732 (9th Cir. 2001) (citing Balistreri v. Pacifica

Police Dep’t, 901 F.2d 696, 699 (9th Cir. 1988)). 

The court need not accept conclusory allegations in the

complaint as true; rather, it must “examine whether [they] follow

from the description of facts as alleged by the plaintiff.” Holden

v. Hagopian, 978 F.2d 1115, 1121 (9th Cir. 1992) (citation

omitted); see Halkin v. VeriFone, Inc., 11 F.3d 865, 868 (9th Cir.

1993); see also Cholla Ready Mix, 382 F.3d at 973 (citing Clegg v.

Cult Awareness Network, 18 F.3d 752, 754-55 (9th Cir. 1994))

(stating that on Rule 12(b)(6) motion, a court “is not required to

accept legal conclusions cast in the form of factual allegations if

those conclusions cannot reasonably be drawn from the facts

alleged[]”). “Nor is the court required to accept as true

allegations that are merely conclusory, unwarranted deductions of

fact, or unreasonable inferences.” Sprewell v. Golden State

Warriors, 266 F.3d 979, 988 (9th Cir. 2001).

In addition, when resolving a motion to dismiss for failure to

state a claim, courts may not generally consider materials outside

the pleadings. Schneider v. Cal. Dep’t of Corrs., 151 F.3d 1194,

1197 n.1 (9th Cir. 1998); Jacobellis v. State Farm Fire & Cas. Co.,

120 F.3d 171, 172 (9th Cir. 1997); Allarcom Pay Television Ltd. v.

Gen. Instrument Corp., 69 F.3d 381, 385 (9th Cir. 1995). “The

focus of any Rule 12(b)(6) dismissal . . . is the complaint.” 

Schneider, 151 F.3d at 1197 n.1. This precludes consideration of

“new” allegations that may be raised in a plaintiff’s opposition to

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a motion to dismiss brought pursuant to Rule 12(b)(6). Id. (citing

Harrell v. United States, 13 F.3d 232, 236 (7th Cir. 1993).

“When a plaintiff has attached various exhibits to the

complaint, those exhibits may be considered in determining whether

dismissal [i]s proper . . . .” Parks Sch. of Bus., 51 F.3d at 1484

(citing Cooper v. Bell, 628 F.2d 1208, 1210 n.2 (9th Cir. 1980)). 

“[If] the allegations of the complaint are refuted by an attached

document, the [c]ourt need not accept the allegations as being

true.” Roth v. Garcia Marquez, 942 F.2d 617, 625 n.1 (9th Cir.

1991) (citing Ott v. Home Savings & Loan Ass’n, 265 F.2d 643, 646

n.1 (9th Cir. 1958).) Similarly, the court may consider “documents

whose contents are alleged in a complaint and whose authenticity no

party questions, but which are not physically attached to the

pleading . . . .” Branch v. Tunnell, 14 F.3d 449, 454 (9th Cir.

1994), overruled on other grounds by Galbraith v. County of Santa

Clara, 307 F.3d 1119 (9th Cir. 2002); Stone v. Writer’s Guild of

Am. W., Inc., 101 F.3d 1312, 1313-14 (9th Cir. 1996). 

These Rule 12 (b)(6) guidelines apply to Defendants’ Motions

to Dismiss.

D. Standards Applicable to Pro Se Litigants

Where a plaintiff appears in propria persona in a civil rights

case, the court must construe the pleadings liberally and afford

the plaintiff any benefit of the doubt. Karim-Panahi v. Los

Angeles Police Dep’t, 839 F.2d 621, 623 (9th Cir. 1988). The rule

of liberal construction is “particularly important in civil rights

cases.” Ferdik v. Bonzelet, 963 F.2d 1258, 1261 (9th Cir. 1992). 

In giving liberal interpretation to a pro se civil rights

complaint, courts may not “supply essential elements of claims that

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were not initially pled.” Ivey v. Bd. of Regents of the Univ. of

Alaska, 673 F.2d 266, 268 (9th Cir. 1982). “Vague and conclusory

allegations of official participation in civil rights violations

are not sufficient to withstand a motion to dismiss.” Id.; see

also Jones v. Cmty. Redev. Agency, 733 F.2d 646, 649 (9th Cir.

1984) (finding conclusory allegations unsupported by facts

insufficient to state a claim under § 1983). “The plaintiff must

allege with at least some degree of particularity overt acts which

defendants engaged in that support the plaintiff’s claim.” Jones,

733 F.2d at 649 (internal quotation omitted).

Nevertheless, the court must give a pro se litigant leave to

amend his complaint “unless it determines that the pleading could

not possibly be cured by the allegation of other facts.” Lopez v.

Smith, 203 F.3d 1122, 1127 (9th Cir. 2000) (en banc) (quotation

omitted) (citing Noll v. Carlson, 809 F.2d 1446, 1447 (9th Cir.

1987)). Before a pro se civil rights complaint may be dismissed,

the court must provide the plaintiff with a statement of the

complaint’s deficiencies. Karim-Panahi, 839 F.2d at 623-24. But

where amendment of a pro se litigant’s complaint would be futile,

denial of leave to amend is appropriate. See James v. Giles, 221

F.3d 1074, 1077 (9th Cir. 2000).

E. Stating a Claim Under 42 U.S.C. § 1983

To state a claim under § 1983, the plaintiff must allege facts

sufficient to show (1) a person acting “under color of state law”

committed the conduct at issue, and (2) the conduct deprived the

plaintiff of some right, privilege, or immunity protected by the

Constitution or laws of the United States. 42 U.S.C.A. § 1983

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(West 2003); Shah v. County of Los Angeles, 797 F.2d 743, 746 (9th

Cir. 1986). 

III. DEFENDANTS’ MOTIONS TO DISMISS

A. Plaintiff Fails to State a Claim

Defendants Torchia, Santoyo, and Robertson move to dismiss the

Amended Complaint under Federal Rule of Civil Procedure 12(b)(6)

because Plaintiff’s allegations fail to state a claim upon which

relief can be granted. (Def. Torchia’s Mot. Dismiss Attach. #2

Mem. P. & A. 3; Defs. Santoyo & Robertson’s Mot. Dismiss Mem. P. &

A. 6-8.) The Court may grant a motion to dismiss for failure to

state a claim if the complaint does not contain enough facts to

state a claim that is “plausible on its face.” Bell Atl. Corp.,

550 U.S. at 570. “[F]acial plausibility [is] when the plaintiff

pleads factual content that allows the court to draw the reasonable

inference that the defendant is liable for the misconduct alleged.” 

Ashcroft v. Iqbal, __ U.S. at __, 129 S.Ct. at 1949.

1. Defendant Torchia

Defendant Torchia seeks to dismiss Plaintiff’s claim against

him because Lopez’s Complaint fails to assert an Eighth Amendment

violation amounting to deliberate indifference to serious dental

needs. (Def. Torchia’s Mot. Dismiss Attach. #2 Mem. P. & A. 3-7);

see also (Reply 2-6.) Dr. Torchia’s only contact with Lopez was on

April 30, 2007, when the Plaintiff was transported to Defendant’s

office for the removal of two of Plaintiff’s wisdom teeth. (Am.

Compl. 6-7.) Lopez had been referred to this outside provider by

Dr. Santoyo. (Id. Attach. #1 Ex. C at 6.) Plaintiff contends that

during the wisdom teeth extraction, Dr. Torchia chipped one of

Lopez’s teeth and refused to fill it. (Id. at 7.) Lopez alleges

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that Dr. Torchia’s failure to fill the tooth immediately was

deliberate indifference to Plaintiff’s dental needs which “caused

(and agrivated [sic]) an unnecessary and wanton infliction of pain

and suffering . . . .” (Id.) Lopez attributes his post-surgery

swollen jaw, infection, migraine headaches, and earaches to the

chipped tooth. (Id.)

The Eight Amendment requires that inmates have “ready access

to adequate dental care.” Hoptowit, 682 F.2d at 1253. Two

elements comprise an Eighth Amendment claim for 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 (1976)). “First, the plaintiff must 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.”’” Id. (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, 1136

(9th Cir. 1997) (en banc)). “Second, the plaintiff must show the

defendant’s response to the need was deliberately indifferent.” 

Id. (citing McGuckin v. Smith, 974 F.2d at 1060). Prison officials

are deliberately indifferent to a prisoner’s serious medical needs

when they “deny, delay or intentionally interfere with medical

treatment. Hutchinson v. United States, 838 F.2d 390, 394 (9th

Cir. 1988.)

“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

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activities; or the existence of chronic and substantial pain.’” 

Lopez v. Smith, 203 F.3d 1122, 1131 (9th Cir. 2000) (en banc)

(citing McGuckin, 974 F.2d at 1059-60). 

“[T]he official must be both aware of facts from which the

inference could be drawn that a substantial risk of serious harm

exists, and he must also draw the inference.” Farmer, 511 U.S. at

837. The indifference to medical needs must be substantial;

inadequate treatment due to malpractice, or even gross negligence,

does not amount to a constitutional violation. Wilson, 501 U.S. at

297 (quoting Estelle, 429 U.S. at 105-06); Toguchi v. Chung, 391

F.3d 1051, 1060 (9th Cir. 2004) (stating that medical malpractice,

negligence, or gross negligence are insufficient). Deliberate

indifference does not require an express intent to cause harm. 

Farmer, 511 U.S. at 835-36. But it does require more than mere

negligence. Id. at 835; Daniels v. Williams, 474 U.S. 327, 328

(1986); Estelle, 429 U.S. at 106. 

The prisoner must allege that the defendant purposefully

ignored or failed to respond to his pain or medical needs, because

an inadvertent failure to provide adequate care does not constitute

a violation. Estelle, 429 U.S. at 105-06; see also Wood v.

Housewright, 900 F.2d 1332, 1334 (9th Cir. 1990) (noting that

although plaintiff’s treatment was not “as prompt or efficient as a

free citizen might hope to receive,” it was not constitutionally

deficient). 

 Plaintiff alleges that Dr. Torchia’s failure to fill his

chipped tooth immediately was a wanton and unnecessary infliction

of pain that “significantly affected his daily activities,”

preventing him from eating, sleeping, and talking. (Am. Compl. 7);

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See Lopez, 203 F.3d at 1131. Although Lopez describes his injury

in more detail in his Opposition, Plaintiff’s Complaint provides

minimal facts demonstrating the severity of his chipped tooth. 

(Compare Am. Compl. 7, with Opp’n Torchia’s Mot. Dismiss 6-7.) The

symptoms Plaintiff attributes to his chipped tooth in his Complaint

are identical to post-operative symptoms of tooth extraction, thus

it is unclear whether the pain was caused by his chipped tooth or

normal post-operative pain. (Am. Compl. at 4, 7; Def. Torchia’s

Mot. Dismiss Attach. #2 Mem. P. & A. 4.) Viewing the facts in the

light most favorable to the Plaintiff, however, the Court will

assume the chipped tooth was the actual cause of pain. 

Lopez asserts that the chipped tooth was an “injury that a

reasonable doctor or patient would find important and worthy of

comment or treatment.” Lopez, 203 F.3d at 1131. Dr. Torchia not

only made a comment about Plaintiff’s tooth but also ordered a sick

call to fill the tooth. (Am. Compl. 7; id. Attach. #1 Ex. F at 1.) 

Plaintiff’s allegations establish that Lopez suffered a serious

medical need as a result of his chipped tooth. 

In order to succeed on an Eighth Amendment claim, the

Plaintiff must also satisfy the second element of deliberate

indifference. Jett, 439 F.3d at 1096. “An accident although it

may produce added anguish, is not on that basis alone to be

characterized as wanton infliction of unnecessary pain sufficient

to demonstrate deliberate indifference.” Estelle, 429 U.S. at 105. 

Lopez must allege that Defendant Torchia knew Lopez faced a

substantial risk of serious harm and was deliberately indifferent

to that harm. See Farmer, 511 U.S. at 836; Estelle, 429 U.S. at

104. 

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Plaintiff contends Dr. Torchia should have immediately filled

his tooth, and his refusal to do so amounted to deliberate

indifference. (Am. Compl. 7.) Dr. Torchia argues that he is an

oral surgeon, not a general dentist, thus it was reasonable to

refer Lopez to a general dentist, such as Dr. Santoyo, to fix the

chipped tooth. (Def. Torchia’s Mot. Dismiss Attach. #2 Mem. P. &

A. 5.) 

Plaintiff believes that even if Dr. Torchia was an oral

surgeon, he also would have been certified as a general dentist, so

he should have filled the chipped tooth immediately but failed to

do so because it was beneath him, he would not be paid for the

procedure, or he was prejudiced against prisoners. (Opp’n

Torchia’s Mot. Dismiss 8-9; see also Surreply 3-4.) Torchia

counters that “as a surgeon, [he] did not have the equipment in his

office to perform the needed filling.” (Reply 3.) Lopez disputes

this assertion because the risks involved in oral surgery

presumably “mandate” that Dr. Torchia equip his office to perform

needed fillings. (Surreply 4.) This exchange highlights a factual

dispute. Nevertheless, at this stage of the proceedings, the Court

must evaluate whether the Complaint alleges “enough facts to state

a claim that is plausible on its face.” Bell Atl. Corp., 550 U.S.

at 570. 

Dr. Torchia contends that his prescription for pain medication

and referral is direct evidence that he was responding to the

Plaintiff’s dental needs by ensuring the Plaintiff received

adequate care upon returning to the prison. (Def. Torchia’s Mot.

Dismiss Attach. #2 Mem. P. & A. 5; Am. Compl. Attach. #1 Ex. F at

1.) Thus, he did not purposefully ignore or fail to respond to the

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prisoner’s pain, which is required to establish deliberate

indifference. (Def. Torchia’s Mot. Dismiss Attach. #2 Mem. P. & A.

5.) 

Lopez may have a difference of opinion regarding the dental

treatment he should have received; however, that disagreement is

not enough to establish deliberate indifference. Randall v.

Wyrick, 642 F.2d 304, 308 (8th Cir.1981); see also Sanchez v.

Vild, 891 F.2d 240, 242 (9th Cir. 1989) (stating that an

appellant’s difference of opinion over matters of expert medical

judgment or a prescribed course of medical treatment fails to state

a federal constitutional question). Additionally, Plaintiff’s

contention that the roughly two-month delay in treating his chipped

tooth amounted to deliberate indifference is insufficient because

mere delay in providing dental treatment, is not enough to

establish deliberate indifference. (Am. Compl. 8); McGuckin, 974

F.2d at 1060 (stating that a prisoner cannot make a claim for

deliberate medical indifference based on a delay of surgery unless

the denial was harmful). 

Dr. Torchia was an outside provider. Once the Plaintiff’s

oral surgery was complete and a “dental sick call” ordered, the

two-month delay to fill the chipped tooth cannot be attributed to

Dr. Torchia. Lopez argues that Dr. Torchia did not know how long

it would take the prison to act on his “sick call” request or that

the ibuprofen he prescribed was ineffective. (Opp’n Torchia’s Mot.

Dismiss 9; Surreply 6-7.) This oral surgeon extracted two of

Plaintiff’s wisdom teeth, he prescribed ibuprofen, and he wrote a

dental sick call for a dentist to repair a defective filling. (Am.

Compl. Attach. #1 Ex. C at 6, Ex. F at 10.) Plaintiff’s

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allegations against this Defendant are insufficient to show

deliberate indifference to Lopez’s serious medical need. 

This is not an instance where the Defendant “sat idly by”

while Lopez suffered harm. See McGuckin, 974 F.2d at 1060. There

is nothing in Plaintiff’s Complaint, Opposition, or Surreply that

suggests that Dr. Torchia knew that an immediate filling was

required. The doctor’s response was not a “patently ineffective

gesture[] purportedly directed towards remedying objectively

unconstitutional conditions . . . .” See Coleman v. Wilson, 912 F.

Supp. 1282, 1319 (E.D. Cal. 1995). 

Although Plaintiff has sufficiently pleaded a serious medical

need, his factual allegations do not rise to the level of

deliberate indifference and state an Eighth Amendment violation

against Dr. Torchia. Therefore, the Court recommends that

Plaintiff’s claim against Defendant Torchia be dismissed. 

In the context of treating Lopez’s impacted wisdom teeth, this

isolated instance of not immediately filling the chipped tooth is

not a constitutional violation. See Cicio v. Graham, No. 08-cv-534

(NAM/DEP), 2010 U.S. Dist. LEXIS 23822, at *30 (N.D.N.Y. Feb. 24,

2010). The allegations in the Amended Complaint and the arguments

in Plaintiff’s Opposition and Surreply show that any attempt to

amend this claim would be futile. Consequently, the Motion to

Dismiss should be GRANTED WITHOUT LEAVE TO AMEND.

2. Defendant Santoyo

Defendant Santoyo seeks to dismiss Plaintiff’s Eighth

Amendment claim because Lopez fails to state claim against him for

deliberate indifference to serious dental needs. (Defs. Santoyo &

Robertson’s Mot. Dismiss 10-11.) Plaintiff contends that after his

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November 1, 2006 appointment with Dr. Santoyo, the doctor “was put

on notice and well aware of the [P]laintiff[‘s] serious and urgent

medical/dental needs.” (Am. Compl. 4.) Dr. Santoyo was again put

on notice of the inadequate dental care on January 1, and February

27, 2007, when Plaintiff filed a 602 grievance and appeal

requesting the surgery Dr. Santoyo ordered. (Id.) Lopez asserts

that Defendant Santoyo was deliberately indifferent to Plaintiff’s

needs by “not following up” on Santoyo’s “urgent” recommendation. 

(Id.) Lopez further claims that from November 1, 2006, to April

30, 2007, Dr. Santoyo’s refusal “to act and respond appropriately

within his scope as a dentist at [C]alipatria[]” caused the

Plaintiff extreme pain and suffering. (Id. at 4.) Lopez also

alleges that Santoyo “refuse[d] to prescribe the necessary pain

medication” to alleviate Plaintiff’s pain. (Id.)

As discussed above, Eighth Amendment claims for deliberate

indifference to serious medical needs require a plaintiff to “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.”’ Jett v. Penner,

439 F.3d at 1096 (quoting McGuckin v. Smith, 974 F.2d at 1059). 

Furthermore, plaintiff must show the “defendant’s response to the

need was deliberately indifferent.” Id. (citing McGuckin, 974 F.2d

at 1060).

Plaintiff alleges a serious medical need on November 1, 2006,

because “[P]laintiff’s tooth had become infected, swollen, and

caused migraine headaches and earaches . . . .” (Am. Compl. 4.) 

During Plaintiff’s appointment, Dr. Santoyo recommended surgery to

extract two of Lopez’s wisdom teeth and indicated the requested

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treatment was “urgent.” (Id.; Attach. #1 Ex. C at 1.) These

actions show that Dr. Santoyo felt the surgery was “important and

worthy of comment or treatment.” Lopez, 203 F.3d at 1131. 

Additionally, Plaintiff’s symptoms continued after the appointment

and significantly affecting his daily activities. (Am. Compl. 4);

Lopez, 203 F.3d at 1131. Thus, Plaintiff had a serious medical

need, the extraction of his wisdom teeth.

Plaintiff must also establish that Dr. Santoyo was

deliberately indifferent to the medical need. Estelle, 429 U.S.

104. Plaintiff alleges that his extreme pain and suffering was

caused by the delay in surgery and Dr. Santoyo’s failure to

prescribe pain medication and follow up after the November 1, 2006

appointment. (Am. Compl. 4.) The doctor’s notes indicate that

during Plaintiff’s appointment, Dr. Santoyo informed Lopez that the

waiting list for the surgery was long and could take approximately

three months. (Id. Attach. #1 Ex. B at 1.) At that time, Santoyo

prescribed Peridex for Plaintiff. (Id.) Lopez disputes that he

was ever informed he would have to wait so long for surgery. 

(Opp’n Defs. Santoyo & Robertson’s Mot. Dismiss 11.) 

Plaintiff subsequently filed the January 1, 2007 informal

grievance. (Id. at 4-6.) Plaintiff received a response to the

grievance which informed him that he was on the list to be seen by

an outside oral surgeon. (Errata re. Defs. Santoyo & Robertson’s

Mot. Dismiss 10.) Lopez was dissatisfied with the response and

filed the February 27, 2007 formal grievance which was granted on

April 24, 2007, and surgery was scheduled for April 30, 2007. (Id.

at 11; Am. Compl. 4-6.) Plaintiff asserts that Dr. Santoyo was

aware of Plaintiff’s serious dental needs for six months “but

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refused to act and respond appropriately within his scope as a

dentist at [C]alipatria.” (Am. Compl. 4.) 

Although Lopez’s surgery took place six months after his

appointment with Dr. Santoyo, a “mere delay in surgery” does not

amount to deliberate indifference “unless the denial was harmful.” 

McGuckin, 974 F.2d at 1060 (quoting Shapley v. Nevada Bd. of State

Prison Comm’rs., 766 F.2d 404, 407 (9th Cir. 1985); Esposito v. D.

Khatri, No. 08cv742-H (WMc), 2009 WL 702218, at *10 (S.D. Cal. Mar.

16, 2009) (citations omitted); Chrisman v. Smith, No.

08CV975-IEG-LSP, 2008 WL 4891235, at *3 (S.D. Cal. Nov. 12, 2008)

(citation omitted); Velasquez v. Barrios, No. 07cv1130-LAB (CAB),

2008 WL 4078766, at *9 (S.D. Cal. Aug. 29, 2008). The prisoner

does not need to show that the harm was substantial, although doing

so would provide support for his claim of deliberate indifference. 

Jett v. Penner, 439 F.3d at 1096 (citation omitted). Plaintiff’s

Complaint sufficiently alleges substantial harm -- continued pain

and suffering -- during the delay. 

A Defendant’s acts or omissions rise to the level of

deliberate indifference and a constitutional violation if the

defendant acts with reckless disregard to a serious harm. Farmer,

511 U.S. at 836. Eighth Amendment liability is premised on Dr.

Santoyo knowing that Lopez faced a substantial risk of serious harm

yet failed to take reasonable measures to abate it. Id. at 847. 

Dr. Santoyo knew there was a substantial risk to Lopez because he

requested “urgent” care for the patient. (Am. Compl. 4; Id.

Attach. #1 Ex. C at 1.) He referred Lopez to an oral surgeon,

which was approved by prison officials the next day. (Id. Attach.

#1 Ex. C at 1.) This referral was a reasonable measure to prevent

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harm. Dr. Santoyo took appropriate measures to ensure Lopez

received treatment even though Plaintiff argues he should have done

more. (See Opp’n Defs. Santoyo & Robertson’s Mot. Dismiss 12.) 

There is no allegation or suggestion that Dr. Santoyo had any

authority to schedule Lopez’s subsequent oral surgery. The

doctor’s alleged failure to follow up and attempt to shorten

Plaintiff’s wait for surgery appears to allege no more than

negligence. And negligence does not amount to a constitutional

violation. Wilson, 501 U.S. at 297.

Lopez also alleges that Dr. Santoyo’s failure to perform the

oral surgery amounts to deliberate indifference. (Am. Compl. at 4,

8.) Plaintiff asserts that Dr. Santoyo did not need to refer Lopez

to an oral surgeon and instead could have minimized Lopez’s pain

and suffering by performing the wisdom teeth extraction himself. 

(Id. at 8.) In Plaintiff’s informal grievance, however, he asks to

be “sent to an outside hospital to have my wisdom teeth removed.” 

(Errata re. Defs. Santoyo & Robertson’s Mot. Dismiss 9.) Lopez

specifically requested to be referred to an outside provider

instead of Dr. Santoyo, but he now asserts Dr. Santoyo was

deliberately indifferent to his medical needs by failing to perform

the surgery. (Id.) Even if Dr. Santoyo could have performed the

oral surgery, his failure to do so would not violate the Eighth

Amendment unless this amounted to deliberate indifference. Lopez’s

Complaint does not show Dr. Santoyo acted with deliberate

indifference, and his failure to perform the surgery does not

change the Court’s conclusion. 

Plaintiff also states that Dr. Santoyo refused “to prescribe

the necessary pain medication to alleviate Plaintiff’s pain.” (Am.

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 Although the Complaint refers to the May 2, 2007 Health

Care Request form as Exhibit G, the exhibit was attached to the

original Complaint but omitted from the Amended Complaint. (Am.

Compl. 7.)

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Compl. 4.) On his May 2, 2007 progress notes, the doctor wrote

that Plaintiff was on pain medication; however, it is unclear when

this medication was prescribed and in what dosage. (Id.) In his

Complaint, Lopez fails to address why the medication was

inadequate, but he discusses his injury, pain, and medications in

more detail in his Opposition. 

Plaintiff additionally claims Dr. Santoyo displayed deliberate

indifference by failing to fill Lopez’s chipped tooth promptly.

(Id. at 8.) Plaintiff alleges his tooth was chipped on April 30,

2007, and it was not filled by Dr. Santoyo until July 10, 2007. 

(Id. at 7.) In the interim period, Plaintiff filed a Health Care

Request form on May 2, 2007, and was seen by Dr. Santoyo on May 15,

2007.3

 (Id.) Dr. Santoyo placed Plaintiff on a liquid diet citing

swelling of the lower jaw and inability to eat solid foods. (Id.) 

Again, ‘mere delay in surgery,’ does not amount to deliberate

indifference unless the delay was harmful and accompanied by an

officials reckless disregard for a risk of serious harm. McGuckin,

974 F.2d at 1060; Farmer, 511 U.S. at 836. Dr. Santoyo responded

to Plaintiff’s Health Care Request form and prescribed a course of

treatment until the tooth could be filled. (Am. Compl. 8.) 

Whether this amounts to deliberate indifference to a serious

medical need cannot be resolved at the pleading stage. 

Without more in the Complaint, Plaintiff’s Eighth Amendment

claims against Dr. Santoyo should be DISMISSED. The claim that

this Defendant violated Plaintiff’s Eighth Amendment rights by

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failing to follow up after the November 1, 2006 appointment to

ensure that the oral surgery was timely (id. at 4), failing to

perform the oral surgery himself (id. at 8), failing to prescribe

pain medication (id. at 8), and not promptly filling Lopez’s

chipped tooth himself (id. at 8), should be DISMISSED WITH LEAVE TO

AMEND.

3. Defendant Robertson

Defendant Robertson contends that Lopez fails to state an

Eighth Amendment claim against him and argues that respondeat

superior liability is inapplicable to § 1983 claims. (Defs.

Santoyo & Robertson’s Mot. Dismiss Mem. P. & A. 13-16.) As

previously discussed, Lopez asserts that he suffered a ‘serious

medical need,’ and the delay in extracting the wisdom teeth caused

him pain and inhibited his daily activities. (Am. Compl. 6);

Estelle, 429 U.S. 104. Lopez must allege a plausible claim that

Defendant Robertson acted with deliberate indifference to

Plaintiff’s serious dental needs. Jett, 439 F.3d at 1096. 

Plaintiff claims Defendant Robertson was initially put on

notice of Lopez’s medical need on November 2, 2006, when he

approved Lopez’s surgery request, and again when Plaintiff filed

his informal grievance and his first formal grievance on January 1,

and February 27, 2007, respectively. (Am. Compl. 5-6.) Plaintiff

contends that Robertson was “grossly negligent in managing the

people he was suppose to supervise” and had a duty as Chief Medical

Officer to supervise Dr. Santoyo to ensure the doctor followed up

and that Lopez received the surgery. (Id.) Plaintiff asserts

Robertson exhibited deliberate indifference by “refus[ing] to

intervene and alleviate [P]laintiffs pain and suffering.” (Id. at

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6.) As discussed previously, gross negligence does not amount to a

constitutional violation. Toguchi, 391 F.3d 1060. Furthermore,

Lopez’s claim does not rely on specific factual allegations of

deliberate indifference but on vicarious liability. (Defs. Santoyo

& Robertson’s Mot. Dismiss 13-14.)

Section 1983 of the Civil Rights Act does not authorize

bringing a cause of action based on respondeat superior liability. 

Monell v. Dep’t of Soc. Servs., 436 U.S. 658, 692-93 (1978) (“[T]he

fact that Congress did specifically provide that A’s tort became

B’s liability if B ‘caused’ A to subject another to a tort suggests

that Congress did not intend § 1983 liability to attach where such

causation was absent.”) (footnote omitted); see also Motley v.

Parks, 432 F.3d 1072, 1081 (9th Cir. 2005). State officials are

subject to suit in their personal capacity if “they play an

affirmative part in the alleged deprivation of constitutional

rights.” King v. Atiyeh, 814 F.2d 565, 568 (9th Cir. 1987) (citing

Rizzo v. Goode, 423 U.S. 362, 377 (1976)). A supervisor may be

found personally liable if he “set[s] in motion a series of acts by

others . . . , which he knew or reasonably should have known, would

cause others to inflict the constitutional injury.” Motley, 432

F.3d at 1081 (quoting Larez v. City of Los Angeles, 946 F.2d 630,

646 (9th Cir. 1991)). 

Lopez has not sufficiently alleged a constitutional violation

by Robertson. He does not state any facts showing that Robertson

was responsible for the delay of Plaintiff’s dental surgery. See

Hunt v. Dental Dep’t, 865 F.2d at 200 (“As to [defendant] Lewis,

Hunt failed to allege any facts showing how he played a role in

denying Hunt medical care.”); see Gamache v. Williams, 2006 U.S.

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Dist. LEXIS 24869, at *12 (E.D. Cal. Mar. 27, 2006) (noting that

there were no allegations that defendant doctors were responsible

for scheduling inmate’s biopsy or hindered its performance). 

Robertson, as a member of the dental authorization review

committee, approved Plaintiff’s surgery request in a timely manner

and approved the response to Lopez’s first formal level grievance

which set the surgery date. (Am. Compl. 5-6; Errata re Defs.

Santoyo & Robertson’s Mot. Dismiss Attach. #1 Ex. B at 2.) In his

Opposition, Lopez argues that Robertson should have intervened to

ensure Plaintiff received oral surgery within sixty days of the

diagnosis that he was in urgent need of care. (Opp’n Defs. Santoyo

& Robertson’s Mot. Dismiss 16-18.) But Robertson’s minimal role,

approving the surgery and reviewing Plaintiff’s grievance, does not

state a plausible a claim that Robertson played an affirmative part

in the alleged deprivation of Lopez’s constitutional right to

dental care. King, 814 F.2d 568. 

Plaintiff makes no argument about the inadequacy of Defendant

Robertson’s policies and practices. In his Opposition, Lopez

acknowledges that he does not contend that a specific policy

violates the Constitution; instead, he maintains that Robertson

simply failed to evaluate the policy at Calipatria to ensure it was

effective. (Opp’n Santoyo & Robertson’s Mot. Dismiss 19.) Without

further allegations in the Complaint, Lopez does not state a claim

for deliberate indifference, but it is not clear that he is unable

to amend. See Lopez, 203 F.2d at 649. Thus, Plaintiff’s Eighth

Amendment claim against Robertson should be DISMISSED WITH LEAVE TO

AMEND.

//

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B. Immunity

1. Eleventh Amendment Immunity

Defendants Santoyo and Robertson argue that they cannot be

sued for damages “in their official capacity” in federal court; for

that reason, Lopez’s claims for monetary damages against them in

their official capacity should be dismissed. (Defs. Santoyo &

Robertson’s Mot. Dismiss 16.) The Eleventh Amendment grants the

states immunity from private civil suits. U.S. Const. Amend. XI;

Henry v. County of Shasta, 132 F.3d 512, 517 (9th Cir. 1997), as

amended, 137 F.3d 1372 (9th Cir. 1998). “[A] suit against a state

official in his or her official capacity is not a suit against the

official but rather is a suit against the official’s office.” Will

v. Mich. Dep’t of State Police, 491 U.S. 58, 71 (1989) (citing

Brandon v. Holt, 469 U.S. 464, 471 (1985)). 

Plaintiff makes claims against Defendants Santoyo and

Robertson in their individual and official capacities. (Am. Compl.

2.) The claim for monetary damages is properly alleged against

Defendants in their individual capacities. See Kentucky v. Graham,

473 U.S. 159, 166 (1985). But the claims against Defendants in

their official capacities are claims against the State of

California, which is absolutely immune from liability for damages. 

See Brandon, 469 U.S. at 471. 

Accordingly, Defendants’ Motion to Dismiss the monetary claims

against them in their official capacities should be GRANTED WITHOUT

LEAVE TO AMEND. Lopez may only proceed in his claim for monetary

damages against Defendants Santoyo and Robertson in their

individual capacities.

//

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2. Qualified Immunity

Defendants also argue that they are entitled to qualified

immunity because “no federal constitutional rights were personally

violated by Santoyo and Robertson.” (Defs. Santoyo & Robertson’s

Mot. Dismiss 17.) Additionally, they contend that “neither Santoyo

nor Robertson were causally involved in any violation of

Plaintiff’s civil rights.” (Id.) Plaintiff maintains that because

they were on notice of his need for surgery, Defendants should not

be entitled to qualified immunity. (Opp’n Defs. Santoyo &

Robertson’s Mot. Dismiss 20-23.) 

Indeed, the Court should attempt to resolve this threshold

immunity question at the earliest possible stage in the litigation. 

See Hunter v. Bryant, 502 U.S. 224, 227 (1991) (citations omitted);

Crawford-El v. Britton, 523 U.S. 574, 598 (1998) (noting that the

purpose of resolving immunity issues early is so that officials are

not subjected to unnecessary discovery). As noted above, the Court

has recommended that the majority of Plaintiff’s claims be

dismissed without prejudice. The qualified immunity issue is

premature until, and if, Lopez amends his Complaint. See Taylor v.

Vt. Dep’t of Educ., 313 F.3d 768, 793-94 (2nd Cir. 2002)

(explaining that ruling on qualified immunity in the context of a

Rule 12(b)(6) motion would be premature because the issue “turns on

factual questions that cannot be resolved at this stage of the

proceedings[]”); see also Harlow v. Fitzgerald, 457 U.S. 800, 818

(1982) (stating government officials are shielded from liability if

their conduct does not violate a constitutional right that was

clearly established) (citations omitted). Defendants’ Motion to

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Dismiss based on qualified immunity should be DENIED WITHOUT

PREJUDICE as premature.

IV. CONCLUSION

For the reasons stated above, Defendants’ Motions to Dismiss

should be GRANTED IN PART and DENIED IN PART. 

The Court should DENY Defendant Santoyo and Robertson’s Motion

to Dismiss the Eighth Amendment claim against them for failure to

exhaust. The Court should not consider the argument raised in

Defendant Torchia’s Reply that Lopez failed to exhaust his

administrative remedies. 

Plaintiff’s claim against Defendant Torchia should be

DISMISSED WITH PREJUDICE and his claims against Defendants Santoyo

and Robertson for Eighth Amendment violations due to inadequate

dental care should be DISMISSED WITHOUT PREJUDICE.

Defendant Santoyo and Robertson’s Motion to Dismiss monetary

claims against them in their official capacities should be GRANTED. 

Defendants’ Motion to Dismiss based on qualified immunity should be

DENIED WITHOUT PREJUDICE as premature. 

This Report and Recommendation will be submitted to the United

States District Court Judge assigned to this case, pursuant to the

provisions of 28 U.S.C. § 636(b)(1). Any party may file written

objections with the Court and serve a copy on all parties on or

before July 16, 2010. The document should be captioned “Objections

to Report and Recommendation.” Any reply to the objections shall

be served and filed on or before July 30, 2010. The parties are

advised that failure to file objections within the specified time 

//

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may waive the right to appeal the district court’s order. Martinez

v. Ylst, 951 F.2d 1153 (9th Cir. 1991). 

IT IS SO ORDERED.

DATE: June 17, 2010 _____________________________

RUBEN B. BROOKS

 United States Magistrate Judge

cc: Judge Miller

All Parties of Record

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