Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_10-cv-02103/USCOURTS-caed-2_10-cv-02103-12/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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IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

VINCENTE SOLOMON,

Plaintiff, No. CIV S-10-2103 WBS GGH P

vs.

J. NEGRETE, et al., ORDER and

Defendants. FINDINGS AND RECOMMENDATIONS

 /

Introduction

Plaintiff, a state prisoner proceeding pro se, seeks relief pursuant to 42 U.S.C. §

1983. By order, filed on October 18, 2011, service of process was directed upon the defendants. 

Prior to this order, on September 8, 2011 (docket # 41), plaintiff brought a motion for a court

order to renew his pain medications. By order, filed on September 19, 2011 (docket # 43), this

court directed defendant Dr. Tate to file a response to the motion. Dr. Tate’s response, in the

form of a declaration was filed on October 5, 2011 (docket # 48); defendant Tate having made an

appearance in this case, no further service of process was required for him to be deemed served. 

1

\\\\

 Nevertheless, defendant Tate will not be required to respond to the amended complaint 1

before the remaining defendants to be served will be required to respond. 

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Plaintiff has repeatedly sought an “emergency transfer,” and motions for various

other forms of preliminary injunctive relief. See filings dated, April 25, 2011 (docket # 20),

May 12, 2011 (docket # 22), June 3, 2011 (docket # 24), June 21, 2011 (docket # 28), June 27,

2011 (docket # 31). These insufficiently supported and duplicative, as well as largely premature,

motions have been either vacated or denied. See, e.g., Orders, filed on May 3, 2011 (docket #

21), May 20, 2011 (docket # 23), June 24, 2011 (docket # 30), July 21, 2011 (docket # 35). By

order filed on June 24, 2011, the undersigned ordered plaintiff not to continue to engage in

seriatim filings “of inadequately supported and inapposite requests for preliminary injunctive

relief, particularly while such a request is still pending....” Plaintiff was cautioned that should he

continue to do so, the court would disregard such filings. Id. Notwithstanding, before the court

had ruled on the September 8, 2011, motion plaintiff filed two more, one on September 26, 2011,

and another on October 5, 2011, both seeking a court-ordered transfer. These motions will be

disregarded. Plaintiff is also cautioned that the seriatim filings, particularly those made in

disregard of court orders, may be construed as an abuse of process.

Plaintiff’s Underlying Allegations

Plaintiff, who was at the E.O.P. (Enhanced Outpatient) level of care, alleges that,

on November 16, 2009, defendant Dr. Tate wrote him up, cutting plaintiff off his chronic pain

medication as a form of punishment for plaintiff’s having asked for help and for renewal of his

medication. First Amended Complaint (FAC), p. 70. Plaintiff states that he (plaintiff) had been 2

approved by both the medical review board and health care manager board. Id. Plaintiff claims

that defendant Tate told him there was nothing wrong with him medically; plaintiff references xrays and therapy received at Tehachapi Hospital and MRI reports at Salinas Valley State Prison

(SVSP) and at Californian Correctional Institution (CCI) on November 30, 2009 and December

30, 2009. Id. Plaintiff alleges that defendant Tate was deliberately indifferent to his pain and the

 Here the court sets forth only those claims of the first amended complaint relevant to 2

plaintiff’s present motion for a preliminary injunction. 

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suffering caused by Tate’s suddenly cutting him off a powerful narcotic and that such medication

is intended to be decreased gradually and not cut off abruptly. Id. Plaintiff claims that a mental

health patient is never to be cut off medication prescribed for physical needs without first

obtaining permission from his health manager. Id. Plaintiff claims defendant Tate’s action was

taken with malice and with a deliberate intent to hurt plaintiff or to force him to kill himself. Id. 

As relief, plaintiff asks for money damages, including punitives. Id., at 3. Although he does not

expressly seek prospective injunctive relief, the undersigned will liberally deem his incomplete

request “ and whatever relief this court...” as a request for whatever other relief the court deems

appropriate and will find that his claims for relief encompass a claim for prospective injunctive

relief. Id.

Motion for Preliminary Injunctive Relief 

Legal Standard

“The proper legal standard for preliminary injunctive relief requires a party to

demonstrate ‘that he is likely to succeed on the merits, that he is likely to suffer irreparable harm

in the absence of preliminary relief, that the balance of equities tips in his favor, and that an

injunction is in the public interest.’” Stormans, Inc. v. Selecky, 586 F.3d 1109, 1127 (9 Cir. th

2009), quoting Winter v. Natural Res. Def. Council, Inc., ___ U.S. ___, 129 S. Ct. 365, 374

(2008).

A Ninth Circuit panel has found that post-Winter, this circuit’s sliding scale

approach or “serious questions” test survives “when applied as part of the four-element Winter

test.” Alliance for Wild Rockies v. Cottrell, 632 F.3d 1127, 1131-1132 (9 Cir. 2011). “In other th

words, ‘serious questions going to the merits,’ and a hardship balance that tips sharply toward the

plaintiff can support issuance of an injunction, assuming the other two elements of the Winter

test are also met.” Id., at 1132.

In cases brought by prisoners involving conditions of confinement, any

preliminary injunction “must be narrowly drawn, extend no further than necessary to correct the

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harm the court finds requires preliminary relief, and be the least intrusive means necessary to

correct the harm.” 18 U.S.C. § 3626(a)(2).

Legal Standard for Eighth Amendment Claim

In order to state a § 1983 claim for violation of the Eighth Amendment based on

inadequate medical care, plaintiff must allege “acts or omissions sufficiently harmful to evidence

deliberate indifference to serious medical needs.” Estelle v. Gamble, 429 U.S. 97, 106, 97 S. Ct.

285, 292 (1976). To prevail, plaintiff must show both that his medical needs were objectively

serious, and that defendants possessed a sufficiently culpable state of mind. Wilson v. Seiter,

501 U.S. 294, 299, 111 S. Ct. 2321, 2324 (1991); McKinney v. Anderson, 959 F.2d 853 (9th Cir.

1992) (on remand). The requisite state of mind for a medical claim is “deliberate indifference.” 

Hudson v. McMillian, 503 U.S. 1, 4, 112 S. Ct. 995, 998 (1992). 

A serious medical need exists if the failure to treat a prisoner’s condition could

result in further significant injury or the unnecessary and wanton infliction of pain. Indications

that a prisoner has a serious need for medical treatment are the following: the existence of an

injury that a reasonable doctor or patient would find important and worthy of comment or

treatment; the presence of a medical condition that significantly affects an individual’s daily

activities; or the existence of chronic and substantial pain. See, e.g., Wood v. Housewright, 900

F. 2d 1332, 1337-41 (9th Cir. 1990) (citing cases); Hunt v. Dental Dept., 865 F.2d 198, 200-01

(9th Cir. 1989). McGuckin v. Smith, 974 F.2d 1050, 1059-60 (9th Cir. 1992), overruled on other

grounds, WMX Technologies v. Miller, 104 F.3d 1133 (9th Cir. 1997) (en banc).

In Farmer v. Brennan, 511 U.S. 825, 114 S. Ct. 1970 (1994) the Supreme Court 

defined a very strict standard which a plaintiff must meet in order to establish “deliberate

indifference.” Of course, negligence is insufficient. Farmer, 511 U.S. at 835, 114 S. Ct. at 1978. 

However, even civil recklessness (failure to act in the face of an unjustifiably high risk of harm

which is so obvious that it should be known) is insufficient. Id. at 836-37, 114 S. Ct. at 1979. 

Neither is it sufficient that a reasonable person would have known of the risk or that a defendant

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should have known of the risk. Id. at 842, 114 S. Ct. at 1981.

A prison official acts with “deliberate indifference ... only if the

[prison official] knows of and disregards an excessive risk to

inmate health and safety.” Gibson v. County of Washoe, Nevada,

290 F.3d 1175, 1187 (9th Cir.2002) (citation and internal quotation

marks omitted). Under this standard, 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 that person “must

also draw the inference.” Farmer v. Brennan, 511 U.S. 825, 837,

114 S.Ct. 1970, 128 L.Ed.2d 811 (1994). “If a [prison official]

should have been aware of the risk, but was not, then the [official]

has not violated the Eighth Amendment, no matter how severe the

risk.” Gibson, 290 F.3d at 1188 (citation omitted). FN4 This

“subjective approach” focuses only “on what a defendant’s mental

attitude actually was.” Farmer, 511 U.S. at 839, 114 S.Ct. 1970.

“Mere negligence in diagnosing or treating a medical condition,

without more, does not violate a prisoner's Eighth Amendment

rights.” McGuckin, 974 F.2d at 1059 (alteration and citation

omitted).

FN4. In a recent case, we recognized that

“deliberate indifference to medical needs may be

shown by circumstantial evidence when the facts are

sufficient to demonstrate that a defendant actually

knew of a risk of harm.” Lolli v. County of Orange,

351 F.3d 410, 421 (9th Cir.2003) (citations

omitted); see also Gibson, 290 F.3d at 1197

(acknowledging that a plaintiff may demonstrate

that officers “must have known” of a risk of harm

by showing the obvious and extreme nature of a

detainee’s abnormal behavior). []

Toguchi v. Chung, 391 F.3d 1051, 1057 (9th Cir. 2004). 

Also significant to the analysis is the well established principle that mere

differences of opinion concerning the appropriate treatment cannot be the basis of an Eighth

Amendment violation. Jackson v. McIntosh, 90 F.3d 330 (9th Cir. 1996); Franklin v. Oregon,

662 F.2d 1337, 1344 (9th Cir. 1981).

Moreover, a physician need not fail to treat an inmate altogether in order to violate

that inmate’s Eighth Amendment rights. Ortiz v. City of Imperial, 884 F.2d 1312, 1314 (9th Cir.

1989). A failure to competently treat a serious medical condition, even if some treatment is

prescribed, may constitute deliberate indifference in a particular case. Id.

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Additionally, mere delay in medical treatment without more is insufficient to state

a claim of deliberate medical indifference. Shapley v. Nevada Bd. of State Prison Com’rs, 766

F.2d 404, 408 (9th Cir. 1985). Although the delay in medical treatment must be harmful, there is

no requirement that the delay cause “substantial” harm. McGuckin, 974 F.2d at 1060, citing

Wood v. Housewright, 900 F.2d 1332, 1339-1340 (9th Cir. 1990) and Hudson, 112 S. Ct. at 998-

1000. A finding that an inmate was seriously harmed by the defendant’s action or inaction tends

to provide additional support for a claim of deliberate indifference; however, it does not end the

inquiry. McGuckin, 974 F.2d 1050, 1060 (9th Cir. 1992). In summary, “the more serious the

medical needs of the prisoner, and the more unwarranted the defendant’s actions in light of those

needs, the more likely it is that a plaintiff has established deliberate indifference on the part of

the defendant.” McGuckin, 974 F.2d at 1061. 

Superimposed on these Eighth Amendment standards is the fact that in cases

involving complex medical issues where plaintiff contests the type of treatment he received,

expert opinion will almost always be necessary to establish the necessary level of deliberate

indifference. Hutchinson v. United States, 838 F.2d 390 (9th Cir. 1988). The dispositive

question is ultimately not what was the most appropriate course of treatment for plaintiff, but

whether the failure to timely give a certain type of treatment was, in essence, criminally reckless.

Plaintiff’s Motion

Plaintiff’s most fundamental obstacle to obtaining preliminary injunctive relief is

that he does not provide adequate expert evidence to support his motion. Plaintiff seeks renewal

of his pain medications: morphine and Gabapentin , claiming that defendant Tate cut him off the 3

medications for no reason. Motion, p. 1. Plaintiff also contends that defendant Tate asked

plaintiff if he (plaintiff) was suing him and, when plaintiff said he was, states that defendant Tate

 Gabapentin is primarily an anti-convulsant medication, but it does have pain therapy 3

uses as well. As with all powerful medications, there are known, possible side effects including

strange or unusual thoughts (including suicide), anger, anxiety, and aggressive thinking. See

www.nim.nih.gov/medlines/druginfo/meds/a694007.html.

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then told him he saw no reason to continue to waste taxpayer money for the expensive

medication. Id. According to plaintiff, defendant Tate stated that he would need a court order

for the medications to be approved. Id. Plaintiff reiterates the allegations of the amended

complaint regarding defendant Tate’s having cut plaintiff off his medications in November of

2009 for the purpose of causing him pain and suffering. Id. Plaintiff references defendant Tate’s

having ordered x-rays and MRI’s from November 30, 2009 to December 30, 2009 and on

January 10, 2010; plaintiff avers that since that time he was ordered on the medications, by which

he presumably means, he was ordered back on the same medications that defendant Tate had

eliminated and that defendant Tate was supposedly disciplined for cutting him off. Id., at 3. 

Plaintiff claims that he will be in such pain for the rest of his life, arising from a beating he

sustained from correctional officers at High Desert State Prison on August 3, 2007, that he would

need to be on pills for the rest of his life; plaintiff claims that a spinal limb specialist so informed

him. Id. Plaintiff alleges that defendant Tate has once again cut plaintiff off his meds, that he is

also the appeals coordinator and that the Chief Medical Officers, Joaquin and Sheisha, as well as

a Ms. Ledford, are refusing to help. Id. Plaintiff claims his medical grievances keep getting

screened out, he never gets seen by a doctor and that none of his medications have been renewed. 

Id. Plaintiff claims that he has fallen more than fifty times, but it is unclear what relationship

this has to his claimed need for pain medication. Id. Plaintiff asks that his morphine and 4

Gabapentin prescriptions be renewed for three times daily. Id. Plaintiff includes a number of

copies of medical reports, some partial, none authenticated, as well as copies of grievances. 5

\\\\ 

 Unsteadiness is a known side effect of Gabapentin. See citation in footnote 3. A 4

demonstration of this side effect would be one reason for not perpetually prescribing this drug.

 While reference is therein made to plaintiff’s injuries arising from a gunshot wound in 5

1992; no reference is made to a beating in 2007 that plaintiff mentions. See, e.g., Motion, p. 11. 

Among the documents included in the response, confusingly, reference is made to a gunshot to

plaintiff occurring around 2007. See following.

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Defendant Tate’s Response 

 Defendant Tate declares that he is a CDCR staff physician and surgeon at CCI,

whose job it is to provide inmates’ primary medical care, including conducting physical

examinations, providing necessary treatment, prescribing medication, interpreting test results and

providing preventative information. Declaration of H. Tate, M.D., ¶¶ 2-3. Defendant Tate states

he could not conduct a thorough review of plaintiff’s eight-volume medical record in the time

allotted for a response, but has included, as Exhibit A, the records he has generated or signed in

treating plaintiff since November 2009, and as Exhibit B, plaintiff’s relevant medical records,

including the authentication of those records by CDCR’s custodian of records. Id., at ¶ 5. 

Defendant Tate states that he first saw plaintiff on November 8, 2009, plaintiff

having submitted a (CDC 7362) request for medical services stating that he had a medical

emergency. Tate Dec., ¶ 6. Plaintiff indicated in the request, per Dr. Tate, that plaintiff’s inmate

appeal regarding the renewal of his medication had already been granted; plaintiff asked that his

prescriptions for Oramorph (morphine sulfate used to relieve pain) and Gabapentin (for relief of

neuropathic pain), which were not due to expire until November 11, 2009, and April 11, 2010,

respectively, be renewed. Id., Exhibit (Ex.) A, 1-3 [court docket # 47-1, 2-4]. Defendant Tate

did not consider plaintiff’s request to be an emergency, but nevertheless examined him, noting

that plaintiff “was muscular with a powerful build.” Tate Dec., ¶ 7. Plaintiff told Dr. Tate that

he was taking the Oramorph and Gabapentin for a two-year-old gunshot wound and for problems

he did not specify with his shoulders, hip and low back. Id. According to defendant Tate,

plaintiff “did not state that he was in pain,” although the doctor “noted he had tenderness of the

biceps.” Id. The doctor’s review of several imaging studies of his lumbar spine and pelvis made

earlier in the year “showed some minor degenerative or arthritic changes,” but “no abnormalities,

fractures, dislocations, or misalignment.” Id. Defendant Tate’s diagnosis was that plaintiff had

“bicep tendonitis possibly caused by heavy exercise given his muscular build,” and, because he

did not see any medical evidence to justify plaintiff’s need for morphine and Gabapentin, he

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discontinued them and so informed plaintiff. Id., Ex. A, 1-2 [# 47-1, 2 -3]. Defendant Tate also

states that he informed plaintiff that he had abused the medical services request process and he

issued a disciplinary report against plaintiff for seeking emergency treatment when his

medications had not expired and after his appeal on the issue had previously been granted. Tate

Dec., ¶ 8. Defendant Tate avers that he did not treat plaintiff after November 8, 2009 again, until

May 2011. Id. 

Medical records show that plaintiff was seen by another CCI medical provider on 

November 10, 2009, complaining that his pain medication had been discontinued by defendant

Tate in retaliation for his submitting an emergency appeal. Tate Dec., ¶ 9. The medical staff

member took note that plaintiff, despite a complaint of bilateral shoulder pain, was observed

exercising, walking, and participating in daily activities without difficulty and that plaintiff had a

normal gait and very muscular shoulders without signs of atrophy. Id., Ex. B, 2 [# 47-2, 3]. The

practitioner saw no medical justification for morphine, but did renew Gabapentin for plaintiff and

prescribed him Tylenol. Id. Plaintiff’s medical records show that during November 2009, he

went for two days without Gabapentin or pain medication. Tate Dec., ¶ 10, Ex. B, 6-11 [# 47-2,

7-12]. Medical records also show that plaintiff received Gabapentin every day during December

of 2009, and was prescribed pain medication in the form of Tylenol and Motrin (Ibuprofen). 

Tate Dec., ¶ 11, Ex. B, 10-13 [# 47-2, 11-14]. 

Defendant Tate submits plaintiff’s medical records showing that a Dr. Lee (a nonparty) saw him on December 10, 2009, concerning plaintiff’s inmate 602 appeal, according to

Tate, filed against him (Tate) for discontinuing his medications on November 8, 2009. Tate

Dec., ¶ 12, Ex. B, 3-5 [# 47-2, 4-7]. Defendant Tate observes that Dr. Lee noted that plaintiff

was able to move his upper body freely, rotate his lumbar spine, flex and extend his legs, stand,

and sit without any pain, difficulty, or any facial grimaces for pain. Id. Dr. Lee

concluded further that plaintiff’s pain complaint did not correlate with the medical findings,

and he refused to renew plaintiff’s request for morphine. Id. Although plaintiff stated that 

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Gabapentin did “nothing for [him],” Dr. Lee recommended that plaintiff stay on the medication

based on a March 2009 EMG showing that he had decreased sensation of the lumbar spine. Id. 

The court’s review of the notes indicates that while Dr. Lee did “not see the Morphine Sulphate

[was] medically indicated based on CT and EMG, ” he also wrote that should the MRI of

plaintiff sedated showed more significant problems, a referral to a specialist might be needed. 

Docket # 47-1, p. 6.

In defendant Tate’s review of the records, he declares that they show plaintiff

received pain medication in all of January 2010, prescribed by non-party Dr. Kang on January 13,

2010, in the form of Tylenol, Ibuprofen, and Tramadol; he received Gabapentin also in January

2010, except for a ten-day period when it was temporarily discontinued by Dr. Kang. Tate Dec., ¶

13, Ex. B, 13-15 [# 47-2, 14-16]. Plaintiff received Tramadol and Gabapentin three times a day

in February, March, May, June, July, and August 2010, according to the Medical Authorization

Records in plaintiff’s file. Tate Dec., ¶ 14, Ex. B, 14-36 [# 47-2, 15- 31, # 47-3, 1-5]. In April

2010, in defendant Tate’s review, the records show Tramadol and Gabapentin were discontinued

for ten days, but plaintiff otherwise received these medications three times a day. Tate Dec., ¶

15, Ex. B, 21-24 [# 47-2, 22-25]. Plaintiff received Gabapentin, per the records, three times a

day in September 2010, but a different doctor discontinued the Tramadol and prescribed him

another pain medication—acetaminophen with cod[e]ine. Tate Dec., ¶ 16, Ex. B, 37-42 [# 47-3,

7-12]. According to the medical records, plaintiff received Tramadol (which had been renewed

in late September by the same doctor who had discontinued it) and Gabapentin three times a day

with occasional lapses of a day or two (which defendant Tate characterizes as “minor”) due to

changing or expiring prescriptions, from October 2010 to early May 2011; in March, 2011,

plaintiff was provided a prescription for Ibuprofen (800 mg tablets) to be taken three times daily. 

Tate Dec. ¶ 17, Ex. B, 43-69 [# 47-3, 13-30]; see also, Ex. B, 61-71 [# 47-4, 1-11]. 

Defendant Tate then declares that he saw plaintiff on May 2, 2011, for his

complaints of back pain and examined his back, torso, and lower extremities, noting that his

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build was still very muscular and that he did not appear to be in any distress during the

examination. Tate Dec., ¶ 18. Defendant Tate asserts that he informed plaintiff that he was

going to wean plaintiff off Gabapentin and Tramadol, ordering that he be weaned off these drugs

over the period of a week and renewing his Ibuprofen prescription to address any pain

complaints. Id., Ex. A, 3-4 [# 47-1, 5-6]. On May 16, 2011, Dr. Tate saw plaintiff regarding an

inmate appeal wherein he had complained that he had received neither pain nor blood-pressure

medication “a few months before.” Tate Dec. ¶ 19, Ex. A, 6 [# 47-1, 7] The court’s review of

defendant Tate’s own progress notes for that day indicate that while plaintiff did not provide a

specific date for when he had not received the medications, he identified the alleged omission as

having occurred in March and April (or during the preceding two months). Defendant’s notes

also set forth that at the time plaintiff filed the 602 on April 13, 2011, Tate’s review of the MAR

indicated that plaintiff had received all prescribed medications “at around that time.” Docket #

47-1, p. 7. 

Defendant Tate also noted that plaintiff asked that he be provided Gabapentin and

Tramadol again, but a review of plaintiff’s medical records by the doctor did not reveal to him

any medical necessity for these medications. Tate Dec. ¶ 19, Ex. A, 6 [# 47-1, 7]. Defendant 6

Tate maintains that plaintiff had “age appropriate degeneration of the spine and his muscular

appearance and movements did not support his claim of pain.” Id. Defendant Tate also avers

that plaintiff still had a prescription for Ibuprofen which the doctor “believed was more than

adequate to address any complaints of musculoskeletal pain he had.” Id. The court’s review of

defendant Tate’s progress notes for that visit states that plaintiff sought reinstatement of the pain

medications “based on ‘x-rays and MRI’s not present in his current UHR...’” and he maintained

that the Ibuprofen “‘ain’t doing nothing.’” Id. 

 Where the declaration cites pages that do not conform to pages of the exhibit identified 6

the court has corrected the page number; the bracketed pagination identifies the location of the

exhibit within the court’s electronic pagination system. 

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When defendant Tate saw plaintiff on June 16, 2011, in response to plaintiff’s

emergency request for medical services, plaintiff complained that no doctor had seen him, he was

in extreme pain, and he requested morphine, Tramadol, and Gabapentin. Tate Dec. ¶ 20, Ex. 7-8

[# 47-1, 8-9]. Defendant Tate found plaintiff upset and agitated from the outset of the visit; the

doctor’s examination was visual because of plaintiff’s agitation and his insistence that Tate not

treat him due to “a conflict of interest.” Id. Defendant Tate noted that plaintiff walked and

moved without difficulty or signs of pain. Id. The defendant’s review of plaintiff’s medical

records indicated plaintiff had been seen by medical staff in response to his request for medical

services, including plaintiff’s visits to defendant Tate in the previous month when back exams

showed plaintiff’s back to be “within normal limits.” Id. Defendant Tate also showed plaintiff a

web page posted by plaintiff for a penpal, in which he “admitted” he is in good health and a

weight trainer. Id. Exhibit C is a copy of the penpal advertisement defendant Tate downloaded

from convicthouse.com. Id. Defendant states he reminded plaintiff that “labeling his request as

an emergency or lying about the treatment he has received was an abuse of the medical process,”

after which plaintiff uttered profanities to the defendant and left. Id. Defendant asserts that

following the June 16, 2011, visit, plaintiff “threatened” that should the doctor attempt to treat

him again, “he would take it as a threat to his life and he would protect himself.” Tate Dec., ¶ 

21. Defendant Tate’s notes for plaintiff’s visit that day indicate that he would be writing a 128- 7

B informational chrono and a 115 Rules Violation Report against plaintiff “for disrespect.” 

Docket # 47-1, 8. 

Defendant maintains that since June of 2011, although plaintiff refused to attend

medical appointments plaintiff had with him on July 21, July 28, August 11, August 18, August

22, and September 6, defendant rescheduled plaintiff for additional appointments “and made sure

 This aggressive, unusual thinking on the part of plaintiff could be perhaps a side effect

7

of Gabapentin. See footnote 3. Again, this type of behavior might be a reason for not continuing

Gabapentin.

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his prescriptions, including pain medication, were renewed.” Tate Dec. ¶ 22, Ex. A, 9-23; Ex. B,

78 [# 47-1, Ex. A, 10-24; # 47-4, Ex. B, 18]. 

Defendant observes that plaintiff’s medical records demonstrate that other CCI

medical staff have continued to monitor and treat plaintiff’s conditions, including prescribing

pain medication for him. Tate Dec. ¶ 23. Defendant Tate declares that the medical records

available to him through mid-September of 2011, indicate that “no medical provider has

determined that renewal of [plaintiff’s] prescription for morphine, Tramadol, or Gabapentin is

medically justified.” Id. Defendant maintains that he has neither denied plaintiff medical

treatment or pain medication and that on the basis of his review of the medical records, his

examinations of him, and his observation of plaintiff’s movements he does not see a medical

justification for prescribing plaintiff with morphine, Tramadol, or Gabapentin, the only reason he

discontinued their use. Tate Dec., ¶ 24.

Plaintiff further declares that plaintiff’s Ibuprofen prescription for his pain, which

he continues to receive, will not expire until November 17, 2011. Tate Dec. ¶ 25, Ex. B, 78 [# 8

47-4, 18]. Defendant Tate maintains his treatment is based on medical evidence and records

review, experience and training and is not retaliatory against plaintiff. Tate Dec. ¶ 26. He adds

that he was not aware of the instant action filed against him until he was contacted by the Office

of the Attorney General after issuance of this court’s order, filed on September 19, 2011. 

Discussion

 The record shows that defendant Tate cut plaintiff off his morphine and

Gabapentin in November of 2009, with no indication that the doctor tapered him off the

medication. However, that is not the question for purposes of this motion. Although on

November 10, 2009, a different medical provider found no medical justification for morphine,

plaintiff’s prescription for Gabapentin was reinstated. Dr. Lee later recommended in December

 The date for that prescription to expire as set forth in that exhibit is actually November 8

7, 2011.

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2010 that plaintiff stay on the Gabapentin although apparently plaintiff said that it did nothing for

him. Plaintiff was more or less regularly prescribed Tramadol and Gabapentin from January

2010 through part of September of 2010, when a doctor took plaintiff off Gabapentin and gave

him acetaminophen with codeine; the same doctor then reinstated the Gabapentin and from

October 2010 until May of 2011, when plaintiff was seen again by defendant Tate, he remained,

with minor lapses, on Tramadol and Gabapentin three times daily. Plaintiff was provided a

prescription for Ibuprofen (800 mg tablets) in March of 2011. In May of 2011, when plaintiff

saw defendant Tate again, plaintiff’s Tramadol and Gabapentin was discontinued, although he

permitted continued use of Ibuprofen. It does appear from this record that defendant Tate is the

most stringent when it comes to providing plaintiff with pain medication. 

While it appears that other doctors did prescribe Gabapentin and Tramadol where

defendant Tate would not, it is also in the record that plaintiff has said that Gabapentin does

nothing for him. Although Dr. Lee continued to recommend Gabapentin based on a prior test

showing plaintiff had decreased sensation of the lumbar spine, the same doctor found no medical

justification for morphine in late 2009. Moreover, since May of 2011, apparently no physician

has found reinstatement of these medications a medical necessity for plaintiff. No medical

assessment indicates that plaintiff is hampered or shows pain in his movements in any way nor

do the examinations he has undergone lead the medical experts to conclude that plaintiff needs

more than his current pain medication. All evaluations indicate that he has a well-developed

musculature. His own web posting proclaims his good health. 

Although all medical practitioners would have some concern for the on-again-offagain nature of plaintiff’s drug prescriptions, plaintiff’s present, injunctive relief dispute with

defendant Tate as to what pain medication he should be prescribed at this point amounts to a

mere difference of opinion concerning the appropriate treatment which cannot be the basis of an

Eighth Amendment violation. Jackson v. McIntosh, 90 F.3d 330; Franklin v. Oregon, 662 F.2d

at 1344. It is also insufficient to make the requisite showing of a likelihood of plaintiff’s

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suffering irreparable injury should a preliminary injunction not issue. Although it is yet to be

determined whether there are “‘serious questions going to the merits,’” there is not here

demonstrated “a hardship balance that tips sharply toward the plaintiff.” Alliance for Wild

Rockies v. Cottrell, 632 F.3d at1132. The motion should be denied.

Accordingly, IT IS ORDERED that:

1. Although defendant Tate’s court-ordered response in this case is an appearance

and no further service has been ordered for him to be deemed served, he will not be required to

file any response before the remaining defendants to be served are so required; 

2. Plaintiff’s motions for a court-ordered transfer of prisons, filed on September

26, 2011 (docket # 45), and on October 5, 2011 (docket # 49), pursuant to the Order, filed on

June 24, 2011 (docket # 30), are disregarded. 

IT IS HEREBY RECOMMENDED that plaintiff’s motion for preliminary

injunctive relief in the form of an order renewing his pain medication, filed on September 8,

2011 (docket # 41), be denied.

These findings and recommendations are submitted to the United States District

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

days after being served with these findings and recommendations, any party may file written

objections with the court and serve a copy on all parties. Such a document should be captioned

“Objections to Magistrate Judge's Findings and Recommendations.” Any reply to the objections

shall be served and filed within fourteen days after service of the objections. The parties are

advised that failure to file objections within the specified time may waive the right to appeal the

District Court's order. Martinez v. Ylst, 951 F.2d 1153 (9th Cir. 1991).

DATED: October 20, 2011

 /s/ Gregory G. Hollows 

 UNITED STATES MAGISTRATE JUDGE 

GGH:009

solo2103.ofr

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