Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-akd-3_19-cv-00151/USCOURTS-akd-3_19-cv-00151-4/pdf.json

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

---

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ALASKA

HECTOR HUGO HERNANDEZ,

Plaintiff,

vs.

DARLENE LORD, et al.,

Defendants.

Case No. 3:19-cv-00151-RRB

ORDER GRANTING IN PART AND 

DENYING IN PART DEFENDANTS’

MOTION FOR SUMMARY JUDGMENT

AND DENYING PLAINTIFF’S

CROSS-MOTION FOR SUMMARY 

JUDGMENT

(Dockets 169, 173)

I. INTRODUCTION

Plaintiff, proceeding pro se, filed his original Complaint pursuant to 

42 U.S.C. § 1983 on May 23, 2019, alleging injuries sustained on April 10, 2019.1

 His 

First Amended Complaint was filed on June 17, 2020,2 and on July 7, 2021, Plaintiff moved 

for leave to file his Second Amended Complaint.3

 The Court allowed the amendment over 

Defendants’ objections.4

 Now before the Court are cross-motions for summary judgment.5

II. BACKGROUND

Plaintiff was in an altercation with another inmate on April 10, 2019. On 

that occasion, he was administered Motrin (ibuprofen), to which Plaintiff is allergic, and 

1 Docket 1.

2 Docket 62.

3 Dockets 100, 101. The Second Amended Complaint is found at Docket 101-1. 

4 Docket 125. 

5 Dockets 169, 173. 

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was then, he claims, placed in a cell located up 17 stairs, and left unattended with a broken 

ankle to manage his allergic reaction.

6 He later was prescribed Tylenol for pain. On 

April 12, 2019, a nurse spoke with Plaintiff from outside his cell, and noted that Plaintiff’s 

right ankle was swollen and discolored and instructed him to roll up his blanket to elevate 

his right foot.7

 On April 14, Plaintiff was transported to medical by wheelchair and was 

provided a splint, advised to limit motion and not put weight on the ankle, provided extra 

linen, crutches, and Tylenol, and prescribed a bottom bunk/bottom tier housing 

assignment.

8 X-rays were scheduled. On April 16, 2019, he returned to medical where a 

nurse opined that his ankle was either sprained or fractured, but that she could not tell until 

the swelling went down. She again prescribed Tylenol.9 A “spiral fracture of the distal 

fibula” was confirmed by X-ray on April 18, 2019.10 Plaintiff alleges, and the record 

supports, that he was not prescribed prescription pain medication (Tylenol 3) until April 19, 

nine days after fracturing his ankle.11 

Plaintiff then was moved several times in the next few weeks, sometimes to 

a bottom bunk and sometimes to a top bunk.

12 He initially was not permitted to have his 

crutches with him in his cell, but on April 22, 2019, nursing staff reiterated that it was 

6 Docket 173 at 3. 

7

 Docket 170, Exhibit 1 at 82. The nurse was unable to meet and assess outside of cell due to 

correctional officer availability. Id. 8 Docket 170-11, Lawrence Affidavit, at 4. 

9 Docket 170, Exhibit 1 at 76. 

10 Docket 173-1 at 81. “Diagnostic Imaging of Alaska only comes to GCCC to provide x-ray 

imaging services on Fridays.” Docket 170-11 at 4. Defendants assert that Plaintiff’s ankle was not X-rayed 

until 8 days after the altercation because the injury sustained on a Thursday was not apparent until Saturday. 11 Docket 173 at 12. 

12 Docket 173-3 at 3.

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important not to put weight on the fractured leg, and Superintendent Houser allowed 

crutches to be provided.

13 On April 23, 2019, Plaintiff was seen by an orthopedic 

physician, Dr. Michael Montano, who reviewed his x-rays and prescribed “weightbearing 

as tolerated in a walker boot,” and further examination in six weeks.14 Plaintiff has never 

been returned to see Dr. Montano.15 He was provided with a “bottom bunk order for 30 

days” on April 25, 2019.16 A July 16, 2019, follow-up x-ray indicated a “healing 

fracture.”17 Although Plaintiff continued to complain in January 2020 that his ankle had 

not healed, September 18, 2019, X-ray images revealed a healed distal fibula fracture.18 In 

February 2020, a mental health counselor opined that Plaintiff “appeared to be malingering 

for medications and personal gain.”19

Plaintiff filed multiple grievances, most, if not all, of which were denied. 

Plaintiff now proceeds against twelve prison health care workers and correctional officers 

alleging that his injury was left untreated for “weeks” while he was required to climb the 

stairs and use a top bunk in his cell. He alleges “extreme and unrelenting pain,” and that 

the lack of prompt treatment resulted in a failure to heal properly, causing ongoing pain 

and mobility issues, in addition to PTSD from the traumatic experience.20 He says 

13 Docket 170, Exhibit 1 at 68–69. 

14 Docket 170, Exhibit 1 at 74.

15 Docket 173 at 11.

16 Docket 170, Exhibit 1 at 55.

17 Docket 170, Exhibit 1 at 15.

18 Docket 170, Exhibit 1 (Unnumbered exhibit, Bates # SOA00976). 

19 Docket 170 at 18, citing Exhibit 1 at 108. 

20 Docket 101-1. 

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Defendants were deliberately indifferent to his medical needs in a “willing, premeditated, 

malicious, and at many times in a sadistic manner[.]”21 

III. APPLICABLE LAW

A. Standard of Review 

Summary judgment is proper where there is no genuine issue of material fact 

and the moving party is entitled to judgment as a matter of law.22 A party asserting that a 

fact is undisputed must support such an assertion by citing to materials in the record, 

including depositions, affidavits or declarations, stipulations, admissions, answers to 

interrogatories, or other materials.23 An issue is “genuine” only if the evidence is such that 

a reasonable jury could return a verdict for the nonmoving party,

24 and a dispute is 

“material” only if it could affect the outcome of the suit under the governing law.25 When 

considering the evidence on a motion for summary judgment, courts are required to view 

the facts and draw reasonable inferences in the light most favorable to the party opposing 

summary judgment.26 

B. 42 U.S.C. § 1983 and the Eighth Amendment

Title 42 U.S.C. § 1983 “is not itself a source of substantive rights,” but 

provides “a method for vindicating rights [found] elsewhere,”27 such as the Eighth 

21 Docket 173 at 2. 

22 Fed. R. Civ. P. 56(a). 23 Fed. R. Civ. P. 56(c)(1).

24 Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). 25 Anderson, 477 U.S. at 248.

26 Scott v. Harris, 550 U.S. 372, 378, 127 S. Ct. 1769, 1774, 167 L. Ed. 2d 686 (2007). 27 Graham v. Connor, 490 U.S. 386, 393–94 (1989) (quoting Baker v. McCollan, 443 U.S. 137, 

144 n.3 (1979)).

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Amendment. The prohibition of “cruel and unusual punishment” under the Eighth 

Amendment prohibits excessive physical force against prisoners, requires officials to 

provide humane conditions of confinement, including “adequate food, clothing, shelter, 

and medical care, and must take reasonable measures to guarantee the safety of the 

inmates[.]”28 Although the Constitution does not mandate “comfortable prisons,” the 

United States Supreme Court has clearly stated that it also does not permit “inhumane 

ones.”29 Accordingly, the Supreme Court has established the standard for claims alleging 

failure to provide medical treatment to a prisoner as “deliberate indifference to serious 

medical needs.”30

Deliberate indifference to serious medical needs presents a cognizable claim 

where prison officials deny, delay, or intentionally interfere with medical treatment.

31 

The Ninth Circuit has explained that “deliberate indifference” is a high legal standard. 

“Mere negligence in diagnosing or treating a medical condition, without more, does not 

violate a prisoner’s Eighth Amendment rights.”32 “It is obduracy and wantonness, not 

inadvertence or error in good faith, that characterize the conduct prohibited by the Cruel 

and Unusual Punishments Clause.”33 “A difference of opinion between a physician and 

the prisoner—or between medical professionals—concerning what medical care is 

28 Id. 29 Farmer v. Brennan, 511 U.S. 825, 832 (1994) (internal citations omitted). 

30 Ziglar v. Abbasi, 582 U.S. 120, 148 (2017) (citing Estelle v. Gamble, 429 U.S. 97, 104 (1976)). 

31 Estelle, 429 U.S. at 104–05 (emphasis added).

32 Toguchi v. Chung, 391 F.3d 1051, 1057 (9th Cir. 2004) (citation and internal quotation marks 

omitted). For instance, a “medical decision not to order an X-ray, or like measures, does not represent cruel

and unusual punishment. At most it is medical malpractice.” Estelle, 429 U.S. at 107. 33 Whitley v. Albers, 475 U.S. 312, 319 (1986) (quoting Estelle, 429 U.S. at 103).

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appropriate does not amount to deliberate indifference.”34 “To show deliberate 

indifference, the plaintiff must show that the course of treatment . . . was medically 

unacceptable under the circumstances and that the defendants chose this course in 

conscious disregard of an excessive risk to the plaintiff’s health.”35 “Deliberate 

indifference to serious medical needs of prisoners constitutes the ‘unnecessary and 

wanton infliction of pain’ . . . proscribed by the Eighth Amendment. This is true 

whether the indifference is manifested by prison doctors in their response to the 

prisoner’s needs or by prison guards in intentionally denying or delaying access to 

medical care or intentionally interfering with the treatment once prescribed.”36

IV. DISCUSSION 

The defense argues that there is no dispute of material fact that 

Mr. Hernandez recovered from his distal fibula fracture at the rate expected and did not 

suffer any adverse effect from consuming Motrin. Accordingly, they argue that Plaintiff

did not suffer a legally cognizable harm to maintain a deliberate medical indifference 

claim.37 But Plaintiff argues that he endured “[nine] days of horrible mental, psychological 

and physical trauma and pain [until he] finally was prescribed medication that could 

actually assist with bearing so much pain.”38 He also alleges ongoing pain and suffering 

as a result. 

34 Hamby v. Hammond, 821 F.3d 1085, 1092 (9th Cir. 2016) (emphasis added).

35 Id. 36 Estelle, 429 U.S. at 104–05. 

37 Docket 170. 

38 Docket 173 at 12. See generally Dockets 101-1 and 173.

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The Court has reviewed the motions and related papers, as well as over 700 

pages of exhibits filed by the parties.39 Despite being permitted to file an overlength brief 

of 94 pages, the defense briefing has provided little relevant caselaw to support the specific 

facts of this case. Instead, counsel has relied almost entirely on the Declaration of 

Dr. Robert Lawrence, the Chief Medical Officer for the State of Alaska DOC, whom they 

characterize as a “non-retained expert witness.”40 

However, “[i]n deciding whether there has been deliberate indifference to an 

inmate’s serious medical needs, [courts] need not defer to the judgment of prison doctors 

or administrators.’”41 Where a claim “does not depend on technical determinations but 

instead hinges on the intent of the prison administrators,” expert testimony is not 

necessarily helpful or required.42 Dr. Lawrence does not address what was not done for 

Mr. Hernandez, which is the crux of his complaint.

A. Medical Treatment 

Defendants argue that there is no dispute of material fact that medical 

providers Land, Strommer, Lord, Sullivan, Baca, and Coyle did not show deliberate 

medical indifference to Plaintiff’s medical needs because there is no dispute of material 

fact that they “provided him with appropriate care.” Defendants rely exclusively on the 

declarations of Dr. Lawrence and each Defendant.

39 Dockets 169, 170, 173, 174, 184, 187. 

40 Docket 170-11 at 2. 

41 Snow v. McDaniel, 681 F.3d 978, 985 (9th Cir. 2012) (quoting Hunt v. Dental Dep’t, 865 F.2d 

198, 200 (9th Cir. 1989)).

42 See Salcido v. Zarek, 237 Fed. Appx. 151, (9th Cir. 2007). 

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(1) Initial treatment of ankle and allergic reaction 

Plaintiff alleges that Christi Land, APRN,

43 “did nothing professional to 

assess” his ankle after the incident and that she negligently prescribed pain medication 

(Motrin/ibuprofen) to which Plaintiff was allergic. He also alleges that Defendant David 

Coyle, LPN,

44 administered Motrin without checking his medical records for allergies.45

Plaintiff argues that because he was sent to segregation (with a broken ankle) within an 

hour of being given Motrin, “no one could see him in his agony and no one seemed to 

care.”46 

After being informed of his allergy, Defendant Land’s notes indicate that 

Plaintiff was “monitored in medical without appreciable side effect.”47 Four hours later, 

Defendant Coyle again noted “no signs of an allergic reaction,” specifically noting no facial 

oral swelling, no cyanosis, no urticaria/skin redness, clear lungs, and an O2 saturation of 

98.48 Accordingly, Defendants argue that “there is no dispute of material fact that 

APRN Land provided Mr. Hernandez appropriate medical care,” and seek summary 

judgment as to Claim 1.49

Defendants concede that Land improperly prescribed Motrin, and the Court 

notes that, at best, she overlooked Plaintiff’s fractured ankle, neither of which are best 

43 Affidavit at Docket 170-16–170-19. 

44 The record does not contain an Affidavit of Defendant Coyle. 

45 Defendants argue that it was Land who administered the Motrin. 

46 Docket 173 at 3 (citing Exhibit 4-8 at 2). 47 Docket 170, Exhibit 1 at 85. 

48 Id. 49 Docket 170 at 58–61. 

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described as “appropriate medical care.”50 Nevertheless, negligence does not support an 

Eighth Amendment claim.51 With respect to Plaintiff’s ankle, Plaintiff does not allege that 

Land was deliberately indifferent to it—only that she “did nothing professional to assess 

the type of injury.”52 He also specifically alleges that Defendants negligently prescribed 

and administered Motrin.53

Where a provider does not believe the use of a medication presents a serious 

risk of harm, the conduct cannot constitute deliberate indifference.54 “Without evidence 

that [the provider] was aware of the potential harm and consciously disregarded it, plaintiff 

has shown no more than negligence, if that.”55 Here, Defendant Land’s Declaration implies 

that she did not know of Plaintiff’s allergy to Motrin until after he had taken it.56 

Additionally, nothing in the record documents that Plaintiff actually 

experienced an allergic reaction, or that he has had any long-term effects from the 

medication. What is documented is a lack of allergic reactions both immediately after the 

medication, and four hours later. The Court also notes that none of the RFIs submitted by 

Plaintiff in the following days mentioned an allergic reaction.57 There simply is no 

50 Exhibit 4-3. Moreover, Land apparently did not administer Benadryl, which previously was 

administered to Plaintiff when medical records show that he was given aspirin (an NSAID like ibuprofen) 

by mistake. 51 Toguchi, 391 F.3d at 1057. “Mere indifference, medical malpractice, or negligence will not 

support a claim of deliberate indifference to serious medical needs.” Broughton v. Cutter Lab., 622 F.2d 

458, 460 (9th Cir. 1980) (per curiam).

52 Docket 173 at 2. 

53 Id. 54 Toguchi, 391 F.3d at 1058. 

55 Hardy v. 3 Unknown Agents, 690 F. Supp. 2d 1074, 1099 (C.D. Cal. 2010) (citing Toguchi, 391 

F.3d at 1058). 56 Docket 170-16 at 2. 

57 Id. at 54, 57, 67, 68, 70, 78, 83, 84.

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evidence of harm to support Plaintiff’s claim against medical personnel of deliberate 

indifference with respect to an allergic reaction. 

(2) Lack of pain medication

Plaintiff submitted several Request for Interview Forms (“RFIs”) in the days 

and weeks following his injuries. Plaintiff alleges that the Defendants who responded to 

the RFIs “personally participated” in causing his injuries by, among other things, failing to 

provide him with pain medication for nine days.

58 

Defendants concede that Angela Strommer, ANP,

59 “likely read at least 

one” of the RFI’s from Plaintiff requesting medical care for his ankle.60 Carol Baca, RN,

61

responded to eight of Plaintiff’s RFIs regarding his ankle, his crutches, his bed assignment, 

pain medication, etc.62 Darlene Lord, RN, responded to seven of Plaintiff’s RFIs 

regarding his ankle injury.63 Kyle Sullivan, RN,

64 responded to nine of Plaintiff’s RFIs, 

the first being on April 24, 2019.65 Defendants suggest that prior to that date, RN Sullivan 

was unaware of Plaintiff’s injury, and his only action, other than to forward the RFIs to the 

provider, was to extend Plaintiff’s already existing bottom bunk prescription.66

58 Docket 101-1 at 2; Docket 173 at 12.

59 Affidavit and Exhibits at Dockets 170-12–170-15. See Errata at Docket 189 and Exhibits at 

Docket 191. 

60 Docket 170 at 31. 

61 Affidavit and Exhibits at Dockets 170-34–170-42. 

62 Docket 170 at 67. 

63 Docket 170 at 34 (citing Ex. 1 at 24, 34, 41, 46, 65, 67–68, 70, 115). Defendants note that 

Plaintiff’s allegation that RN Lord provided better medical care to another inmate has no relevance to 

whether RN Lord was deliberately indifferent to Plaintiff’s serious medical needs. 

64 Affidavit and Exhibits at Dockets 170-25–170-33.

65 Docket 170 at 37. 

66 Docket 170 at 38 (citing Ex. 1 at 80). 

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Although the initial failure to diagnose Plaintiff’s fracture may have been 

mere negligence, medical personnel were aware that Plaintiff had sustained some kind of 

ankle injury within two days, suspected that it was a fracture within four days, and obtained 

X-rays on the eighth day. It was not until the ninth day that Plaintiff was provided with 

prescription-strength pain medication, despite the numerous RFIs regarding “unbearable 

pain,” and specifically asking for medication stronger than Tylenol.67

“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 activities; or the existence of chronic and substantial pain.’”68 A 

fractured ankle arguably qualifies under all three categories. Defendants have provided the 

Court with no information about any prison policies or procedures that require withholding 

adequate pain medication until a broken bone is confirmed by X-ray. The Court finds 

genuine issues of material fact remain regarding the issue of withholding pain medication 

in light of numerous RFIs requesting same. 

C. Correctional Officer Treatment

Plaintiff alleges that: (1) Anthony Price, Jeffery Rush, Keith Rogers, and 

Bryan Lufkin69 improperly housed Plaintiff in an upstairs cell, and repeatedly assigned a 

top bunk, and “dragged” him up the stairs with a fractured ankle; (2) the foregoing, as well 

67 See Exhibit 1 at 57, 67, 68, 78, 83, 84.

68 Lopez v. Smith, 203 F.3d 1122, 1131 (9th Cir. 2000) (emphasis added). 

69 Declarations at Dockets 170-7; 170-8; 170-43–170-47; 170-9.

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as Defendant SSgt. Mark Sehl,

70 repeatedly confiscated Plaintiff’s medical equipment 

(crutches) in violation of policies and procedures applicable to individuals with disabilities;

(3) Defendant Lufkin forced Plaintiff to walk without crutches or a wheelchair, and to go 

up and down the stairs with a fractured leg and restraints “several times,” while Defendants 

Price and Rogers “sadistically laughed”; (4) Defendants Lufkin and Price commented 

on Plaintiff’s “degrading skin color”; (5) Defendant Rogers improperly denied the 

relevant grievances; and (6) Probation Officer Kerrisa Yarnot71 failed to take action to 

provide basic medical care after seeing the full extent of his injuries “during her [routine]

walks through the ‘Segregation Unit,’” and instead left him in the top tier cell for 4 days.72

Dr. Lawrence opines, in a single sentence, that the correctional officers “did 

not interfere with Mr. Hernandez’s medical treatment or impair his recovery.”73 The 

defense briefing has not established what qualifies a medical professional to evaluate the 

behavior of correctional officers in a deliberate indifference claim. Additionally, 

Dr. Lawrence misstates the criteria for deliberate indifference. As previously stated, 

“[d]eliberate indifference to serious medical needs presents a cognizable claim where 

prison officials deny, delay, or intentionally interfere with medical treatment,” and 

“constitutes the ‘unnecessary and wanton infliction of pain’ . . . proscribed by the 

Eighth Amendment.”74 A plaintiff’s ultimate recovery does not negate a finding of 

deliberate indifference.

70 Declaration at Docket 170-10. 

71 Declaration and Exhibits at Dockets 170-20–170-23. 

72 Docket 101-1 at 10. 

73 Docket 170-11 at ¶ 5. 

74 Estelle, 429 U.S. at 104-05 (emphasis added).

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(1) Conforming with DOC policies

Defendants seek dismissal of Counts 6, 8, 9, and 11, arguing that there is no 

dispute of material fact that Defendants Yarnot, Lufkin, Sehl, and Rush acted in 

accordance with DOC policies that are reasonably related to legitimate governmental 

interests of correctional facility safety, and such acts cannot, as a matter of law, sustain a 

deliberate medical indifference claim.75 However, Defendants fail to identify the relevant 

policies. 

Defendants also note that GCCC policy prohibits inmates in segregation 

from having crutches in their cells because they can be used as weapons, and argue that 

actions taken pursuant to a prison security policy, “even if [they] impinge[] on an inmate’s 

constitutional rights, [are] valid if [the security policy] is reasonably related to legitimate 

penological interests, such as safety and security of staff and prisoner.”76 Again, the 

defense has not identified the relevant policy.77

(2) Defendant Yarnot

Defendants argue that Yarnot was physically present with Plaintiff on only 

one occasion—the first hearing.78 Accordingly, they argue that Yarnot’s actions “did not 

interfere with Mr. Hernandez receiving appropriate medical care and did not impair his 

75 Docket 170 at 85–87. 

76 Docket 170 at 85 (citing Cox v. McDaniel, 2007 WL 9658379 at *3 (D. Nev. Feb. 5, 2007) 

(citing Turner v. Safley, 482 U.S. 78, 89 (1987); Hewitt v. Helms, 459 U.S. 460, 472 (1983)). 

77 The Declarations of Lufkin, Rogers, Rush, and Sehl all suggest that this was a GCCC policy, 

or a judgment call on their part. However, Plaintiff has supplied DOC Policy and Procedure 804.01 

(effective 4/14/14) which discusses the procedures for handling prisoners in administrative segregation, 

including regular inspection and monitoring of the unit and the inmates themselves, including any “physical 

problems.” Docket 173, Exhibit 5-3.

78 Docket 170 at 40; Docket 170-20 (Yarnot Declaration) ¶ 4. 

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recovery.”79 But, as Plaintiff alleges that Yarnot actually visited him at his cell “during 

her [routine] walks through the Segregation Unit,”80 and that she questioned how he was 

able to make it up to his cell in his condition, a genuine issue of material fact exists as to 

whether this visit occurred, and what obligations she had to ensure Plaintiff received 

medical care. 

(3) Defendant Price

Finally, Defendants argue that there is no dispute of material fact that 

Defendant Price committed any individual act relating to Mr. Hernandez.

81 Because State 

officials are not subject to suit under section 1983 unless they play an affirmative part in 

the alleged deprivation of constitutional rights, the defense argues that Price cannot be 

liable under 42 U.S.C. § 1983 at all, because without allegations of personal participation, 

a claim must be dismissed.82 But Plaintiff has alleged that Officer Price routinely walked 

past Plaintiff’s cell, and when Plaintiff showed Price his severely bruised and swollen 

leg/ankle, “all he would do was to laugh at my situation and once more ignore my pleas.”83 

Price’s one-page Declaration stating that he did not conduct routine security checks, and 

had no reason to walk past Plaintiff’s cell, does not say that he did not, in fact, do so.84

Price’s Declaration creates a genuine issue of material fact as to his role, if any, in 

79 Docket 170 at 41. 

80 Docket 101-1 at 10. 

81 Defendant Price denies personally transporting inmates between cells or determining cell 

assignments, which Defendants argue is supported by Plaintiff’s bed history. Docket 170 at 53 (citing Ex. 3 

at 3). 82 See King v. Atiyeh, 814 F.2d 565, 568 (9th Cir. 1987) (citation omitted).

83 Docket 101-1 at 21. 

84 Docket 170-7.

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preventing Plaintiff from getting medical attention. 

(4) Bunk assignments

Despite Plaintiff’s claims of being assigned to top bunks repeatedly and for 

extended periods of time, the Bed History provided at Exhibit 3 indicates Plaintiff was only 

assigned to top bunks on three occasions between April 10, 2019 (the date of his injury) 

and August 1, 2019.85 On the first occasion, April 19, Plaintiff was assigned to a top bunk 

for approximately thirteen hours before he was moved to a bottom bunk. On the second 

two occasions, the bed assignment lasted six hours on one occasion, and less than an hour 

on the other. Plaintiff’s allegations regarding being assigned to top bunks in the days 

immediately after his injury are not supported by the evidence, and do not survive summary 

judgment.

D. Medical Experts

In support of all of the foregoing, Defendants rely on the Declaration of 

Dr. Lawrence.

86 According to Lawrence, various Defendants did not show deliberate 

indifference to Plaintiff’s medical needs because their actions did not “interfere” with, 

“hinder,” or “impede” his recovery.87 The defense used similar phrases nineteen times in 

their brief.88 But, as explained above, interference with a plaintiff’s recovery is not the 

definition of deliberate indifference. The question is whether prison officials denied, 

85 Docket 170-5 at 3. 

86 Docket 170-11. 

87 Docket 170-11 at 3, 9, 14. 88 Docket 170 at 41, 45, 47, 50, 51, 58, 59, 69, 70, 71, 72, 74, 77, 78, 85, 87, 90, 91, 93.

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delayed, or intentionally interfered with medical treatment.

89

According to Dr. Lawrence, the response to each RFI by medical providers 

was “timely and appropriate,” but he does not indicate what qualifies as “timely.” The 

Court notes that when RFIs were answered (often 2–3 days later), the responses sometimes 

were incomplete. For example, Defendant Baca took two days to respond to an April 14th 

RFI, but then only responded that Plaintiff was scheduled for an X-ray, and failed to 

address his complaints of extreme pain.90 Another provider received an RFI on April 20th 

complaining of pain and issues with crutches. Two days later, the response addressed the 

crutches, but not the pain.91 Dr. Lawrence’s opinion that the RFI responses were “timely” 

and “appropriate” is unpersuasive without more information. 

Also troubling to the Court is Dr. Lawrence’s statement at paragraph 28 of 

his Declaration: “Because a distal fibula fracture is a partial weight bearing injury and 

because putting weight on the injured leg is, in fact, necessary to recovery, the need to walk 

across the segregation unit or within his cell would not have hindered Mr. Hernandez’s 

recovery.”92 The Court finds this statement, at best, misleading. Dr. Lawrence again 

misstates the relevant standard by suggesting that Plaintiff’s recovery was not “hindered.”

More importantly, he mischaracterizes the treatment of a distal fibula fracture as explained 

by Dr. Montano, who prescribed “weightbearing as tolerated in a walker boot.”93 Plaintiff 

89 Estelle, 429 U.S. at 104-05 (emphasis added). “Deliberate indifference to serious medical needs 

of prisoners constitutes the ‘unnecessary and wanton infliction of pain’ . . . proscribed by the Eighth 

Amendment.” Id. 90 Exhibit 1 at 78. 

91 Exhibit 1 at 57. 

92 Docket 170-11 at 9. 

93 Docket 170, Exhibit 1 at 74.

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was not fitted with a walker boot until April 23, 2019. Prior to that date, and according to 

the record, prison healthcare providers repeatedly told Plaintiff not to put weight on his 

foot, and to keep it elevated.94 Even after X-rays identified a fractured fibula, prison 

medical staff noted that Plaintiff was “non-weightbearing on his right leg,” and got 

permission for Plaintiff’s use of crutches in his cell.95 Dr. Lawrence suggests that leaving 

Plaintiff without treatment, effective pain medication, or crutches somehow was within the 

standard of care. The Court is skeptical. 

E. Findings

Defendants argue that “[g]iven that the factual allegations set forth in 

Mr. Hernandez’s motion are largely unsupported by any evidence, directly contradicted by 

the evidence relied upon, and drawn from the same evidence defendants relied on to 

support their motion for summary judgment, . . . there is no genuine dispute of material 

fact in this matter.”96 They argue that, at most, Mr. Hernandez can only produce a “mere 

difference of medical opinion” which, as the Ninth Circuit has held, is insufficient to 

support a claim for deliberate medical indifference. 

The Court disagrees. In the Ninth Circuit, to show an Eighth Amendment 

violation, a plaintiff must prove the following by a preponderance of the evidence:

1. The defendant made an intentional decision with 

respect to the conditions under which the plaintiff was 

confined;

94 Docket 170-11, at 3–5. 

95 Id. at 5. 

96 Docket 174 at 6.

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2. Those conditions put the plaintiff at substantial 

risk of suffering serious harm;

3. The defendant did not take reasonable available 

measures to abate that risk, even though a reasonable officer in 

the circumstances would have appreciated the high degree of 

risk involved—making the consequences of the defendant’s 

conduct obvious;97 and

4. By not taking such measures, the defendant 

caused the plaintiff’s injuries.98

Plaintiff claims that he endured “9 days of horrible mental, psychological and 

physical trauma and pain [until he] finally was prescribed medication that could actually 

assist with bearing so much pain.”99 Plaintiff further alleges that the lack of prompt 

treatment, as well as being forced to walk on a broken ankle, resulted in a failure to heal 

properly, causing ongoing pain and mobility issues.100 Defendant’s response is that 

Plaintiff cannot show “actual harm” because a September 2019 X-ray showed a healed 

fracture, and a mental health counselor opined that Plaintiff is malingering for financial 

gain.101 But “actual harm” need not last indefinitely. There remain genuine issues of 

material fact regarding the pain Plaintiff experienced during the nine days without pain 

medication, the allegations that Plaintiff was forced to walk on a fractured ankle, and 

regarding whether Plaintiff has long-standing pain and/or mobility issues as a result of his 

97 At this step, the defendant’s conduct “must be both objectively unreasonable and done with a 

subjective awareness of the risk of harm. In other words, the defendant must have known facts from which 

an inference could be drawn that there was a substantial risk of serious harm, and the defendant must have 

actually drawn that inference.” Id. 98 See Ninth Circuit Model Criminal Jury Instruction 9.28.

99 Docket 173 at 12. See generally Dockets 101-1, 173.

100 Docket 101-1. 

101 Docket 170 at 18 (citing Exhibit 1 at 108).

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injuries.

V. TRIAL SETTING CONFERENCE AND

SETTLEMENT CONFERENCE

Upon written request of the parties, the Court will attempt to locate a 

settlement judge if both parties agree. Otherwise, the matter should be set for trial and a 

Trial Setting Conference will be scheduled. At that time, the Court will consider 

appointing a medical expert pursuant to Federal Rule of Evidence 706 to evaluate Mr. 

Hernandez’s medical records, and to report to the Court on the standard of care for distal 

fibula fractures.

VI. CONCLUSION

In light of the foregoing, Defendants’ Motion for Summary Judgment at 

Docket 169 is Granted in Part and Denied in Part. The following are dismissed with 

prejudice: 

1. Any claim alleging negligent medical treatment on the day 

Plaintiff sustained his injury, April 10, 2019, including any allergic reaction, 

because negligence does not establish “deliberate indifference”;

2. Any claim with respect to top bunk assignments, as these 

claims are not supported by the record.

The Court finds, without concluding one way or the other, that genuine issues 

of material fact remain regarding the remaining issues, including whether various 

Defendants exhibited “deliberate indifference” to Plaintiff’s injury, including: ignoring 

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repeated requests for pain medication for nine days; forcing him to walk up stairs in 

restraints with a broken ankle; and preventing him from access to crutches for twelve days. 

Summary Judgment as to the remaining issues, and Plaintiff’s Motion for

Summary Judgment at Docket 173, therefore are DENIED. The parties are instructed 

to notify the Court on or before August 30, 2024, if they are interested in a settlement 

conference. 

 IT IS SO ORDERED this 9th day of August, 2024, at Anchorage, Alaska. 

 /s/ Ralph R. Beistline 

RALPH R. BEISTLINE 

Senior United States District Judge 

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