Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-casd-3_18-cv-02199/USCOURTS-casd-3_18-cv-02199-1/pdf.json

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

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UNITED STATES DISTRICT COURT 

SOUTHERN DISTRICT OF CALIFORNIA 

WARNER LIVINGSTON, 

CDCR #D-64125, 

Plaintiff,

vs. 

D. UGBOR, Registered Nurse, 

Defendant.

 Case No.: 3:18-cv-02199-LAB-JLB 

ORDER DISMISSING AMENDED 

COMPLAINT FOR FAILING 

TO STATE A CLAIM 

PURSUANT TO 

28 U.S.C. § 1915A(b)(1) 

Warner Livingston, incarcerated at California State Prison Solano in Vacaville, 

California, is proceeding pro se in this civil rights action, filed pursuant to 42 U.S.C. 

§ 1983. Unlike most prisoners, Livingston is not proceeding in forma pauperis pursuant to 

28 U.S.C. § 1915(a), but has instead pre-paid the civil filing fee as required by 28 U.S.C. 

§ 1914(a). (See ECF No. 1-1, Receipt No. 104780.) 

 On January 11, 2019, the Court conducted its mandatory initial screening of 

Livingston’s original Complaint pursuant to 28 U.S.C. § 1915A, and dismissed it sua 

sponte for failing to state a claim. (See ECF No. 2.) The Court also granted him leave to 

file an Amended Complaint in order to address the deficiencies of pleading it identified. 

(Id. at 7-8; see also Lopez v. Smith, 203 F.3d 1122, 1130-31 (9th Cir. 2000) (en banc) (“[A] 

district court should grant leave to amend even if no request to amend the pleading was 

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made, unless it determines that the pleading could not possibly be cured.”) (citations 

omitted).) 

 Livingston then requested and was granted an extension of time in which to comply 

with the January 11, 2019 Order. (ECF Nos. 5-6.) He has since filed his Amended 

Complaint (“FAC”). (ECF No. 7.) 

I. Screening pursuant to 28 U.S.C. § 1915A 

 A. Standard of Review 

Title 28 U.S.C. § 1915A “mandates early review—‘before docketing [] or [] as soon 

as practicable after docketing’—for all complaints ‘in which a prisoner seeks redress from 

a governmental entity or officer or employee of a governmental entity.’” Chavez v. 

Robinson, 817 F.3d 1162, 1168 (9th Cir. 2016). The mandatory screening provisions of 

§ 1915A apply to all prisoners, no matter their fee status, who bring suit against a 

governmental entity, officer, or employee. See, e.g. Resnick v. Hayes, 213 F.3d 443, 446-

47 (9th Cir. 2000). 

“On review, the court shall ... dismiss the complaint, or any portion of the 

complaint,” if it “(1) is frivolous, malicious, or fails to state a claim upon which relief may 

be granted; or (2) seeks monetary relief from a defendant who is immune from such relief.” 

Olivas v. Nevada ex rel. Dept. of Corr., 856 F.3d 1281, 1283 (9th Cir. 2017) (quoting 28 

U.S.C. § 1915A(b)). “The purpose of § 1915A is to ‘ensure that the targets of frivolous or 

malicious suits need not bear the expense of responding.’” Nordstrom v. Ryan, 762 F.3d 

903, 907 n.1 (9th Cir. 2014) (quoting Wheeler v. Wexford Health Sources, Inc., 689 F.3d 

680, 681 (7th Cir. 2012)).1

Section 1915A “incorporates the familiar standard applied in the context of failure 

to state a claim under Federal Rule of Civil Procedure 12(b)(6).” Wilhelm v. Rotman, 680 

F.3d 1113, 1121 (9th Cir. 2012). Rule 12(b)(6) requires a complaint “contain sufficient 

                                               

1 A similar screening would be required if Plaintiff were proceeding IFP. See 28 U.S.C. 

§ 1915(e)(2)(B); Lopez v. Smith, 203 F.3d 1122, 1130 (9th Cir. 2000) (en banc). 

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factual matter, accepted as true, to state a claim to relief that is plausible on its face.” 

Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (internal quotation marks omitted); Wilhelm, 

680 F.3d at 1121. Detailed factual allegations are not required, but “[t]hreadbare recitals of 

the elements of a cause of action, supported by mere conclusory statements, do not suffice.” 

Iqbal, 556 U.S. at 678. “Determining whether a complaint states a plausible claim for relief 

[is] ... a context-specific task that requires the reviewing court to draw on its judicial 

experience and common sense.” Id. The “mere possibility of misconduct” or “unadorned, 

the defendant-unlawfully-harmed me accusation[s]” fall short of meeting this plausibility 

standard. Id.; see also Moss v. U.S. Secret Service, 572 F.3d 962, 969 (9th Cir. 2009). 

“When there are well-pleaded factual allegations, a court should assume their 

veracity, and then determine whether they plausibly give rise to an entitlement to relief.” 

Iqbal, 556 U.S. at 679; see also Resnick, 213 F.3d at 447 (“[W]hen determining whether a 

complaint states a claim, a court must accept as true all allegations of material fact and 

must construe those facts in the light most favorable to the plaintiff.”). However, while the 

court “ha[s] an obligation where the petitioner is pro se, particularly in civil rights cases, 

to construe the pleadings liberally and to afford the petitioner the benefit of any doubt,” 

Hebbe v. Pliler, 627 F.3d 338, 342 & n.7 (9th Cir. 2010) (citing Bretz v. Kelman, 773 F.2d 

1026, 1027 n.1 (9th Cir. 1985)), it may not “supply essential elements of claims that were 

not initially pled.” Ivey v. Board of Regents of the University of Alaska, 673 F.2d 266, 268 

(9th Cir. 1982). 

Finally, the “[c]ourt[] must consider the complaint in its entirety,” including 

“documents incorporated into the complaint by reference” to be part of the pleading when 

determining whether the plaintiff has stated a claim upon which relief may be granted. 

Tellabs, Inc. v. Makor Issues & Rights, Ltd., 551 U.S. 308, 322 (2007); Fed. R. Civ. P. 

10(c) (“A copy of a written instrument that is an exhibit to a pleading for all purposes.”); 

Schneider v. California Dept. of Corrections, 151 F.3d 1194, 1197 n.1 (9th Cir. 1998). 

/// 

/// 

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B. Amended Complaint 

 The factual allegations in Livingston’s Amended Complaint do not differ 

significantly than those in his original Complaint. As he did previously, Livingston claims 

Defendant D. Ugbor, a registered nurse employed by the CDCR at Centinela State Prison 

(“CEN”) “failed to examine” his swollen knee in the A-Yard Clinic on March 14, 2016. 

(See FAC, ECF No. 7 at 3.) Livingston spoke with Ugbor, informed her of the “serious 

pain” it was causing him, and explained that “walking on it cause[d] more pain.” (Id.) 

Ugbor, however “refused to provide any type of medical treatment at that time,” and 

instead “kicked Livingston out of the clinic.” (Id.)2

 Livingston contends Ugbor’s refusal to 

examine his knee resulted in “unnecessary pain and suffering and damage ... caused by 

walking on it at the time.” (Id.) 

 Livingston’s knee pain persisted, and a doctor later administered steroid injections. 

(See id. & Ex. A at 7.) He received outpatient physical therapy on November 2, 2017, after 

he was transferred to CSP-Solano, id., Ex. C, followed by a MRI of his right knee on 

November 4, 2014, which showed a large medial meniscus tear, a small radial tear of the 

lateral meniscus, and mild patellofemoral joint arthritis. (Id., Ex. B at 9.) 

Livingston concludes that Ugbor’s failure to physically examine him on March 14, 

2016, however, was the cause of his “continuous physical therapy,” need for “more steroid 

                                               

2

 Before “kick[ing] [him] out” of the clinic on March 14, 2016, Livingston previously 

admitted Ugbor directed him to complete a CDC 7362 medical request form, informed a 

yard sergeant that he had been prescribed pain medication, and indicated Livingston would 

be seen the following day. See Compl., ECF No. 1 at 3. Livingston now omits those 

allegations in the body of his FAC, but he attaches a Second Level Appeal Response to a 

CDCR 602 staff complaint he filed related to the March 14, 2016 incident which includes 

both his claim that Ugbor failed to “take[] [him] into an exam room for a physical 

assessment,” and that she “told [him he] could wait to be seen tomorrow because [he] had 

pain medications ordered.” See FAC, ECF No. 7, Ex. D at 13. The Court may consider this 

exhibit in determining whether Livingston has stated a plausible Eighth Amendment claim 

since it was attached as an exhibit to his pleading. See Tellabs, 551 U.S. at 322; Fed. R. 

Civ. P. 10(c); Schneider, 151 F.3d at 1197 n.1. 

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injections,” and potential surgery. Id. at 3. He continues to seek $185,000 in general and 

punitive damages, and requests “proper physical therapy.” Id. at 5. 

 C. Eighth Amendment Medical Care Claims 

 Livingston claims Nurse Ugbor “violated [his] 8th Amendment rights against cruel 

and unusual punishment” when she failed to physically examine his knee in CEN’s medical 

clinic on March 14, 2016. (See FAC, ECF No. 7 at 3.) But this is merely a “legal 

conclusion[] [that] can provide the framework of a complaint,” and it “must be supported 

by factual allegations [that] ... plausibly give rise to an entitlement to relief.” Iqbal, 556 

U.S. at 678-79. 

 While the Eighth Amendment entitles Livingston to medical care, its prohibition of 

cruel and unusual punishment is violated only when a prison official acts with deliberate 

indifference to his serious medical needs. Snow v. McDaniel, 681 F.3d 978, 985 (9th Cir. 

2012), overruled in part on other grounds, Peralta v. Dillard, 744 F.3d 1076, 1082-83 (9th 

Cir. 2014) (en banc); Wilhelm, 680 F.3d at 1122; Jett v. Penner, 439 F.3d 1091, 1096 (9th 

Cir. 2006). 

Livingston must allege facts sufficient to plausibly show: (1) he suffered from an 

objectively serious medical need, i.e., the failure of which to treat could result in “further 

significant injury or the unnecessary and wanton infliction of pain,” and (2) that “the 

defendant’s response to the need was deliberately indifferent.” Wilhelm, 680 F.3d at 1122 

(citing Jett, 439 F.3d at 1096); McGuckin v. Smith, 974 F.2d 1050, 1059 (9th Cir. 1991), 

overruled on other grounds by WMX Techs., Inc. v. Miller, 104 F.3d 1133 (9th Cir. 1997) 

(en banc). 

To support a claim of “deliberate indifference” Livingston’s Amended Complaint 

must include sufficient factual content which plausibly shows Ugbor’s “purposeful act or 

failure to respond to [his] pain or possible medical need, and [] harm caused by the 

indifference.” Jett, 439 F.3d at 1096; Iqbal, 556 U.S. at 678. The requisite state of mind is 

one of subjective recklessness, which entails more than ordinary lack of due care. Wilhelm, 

680 F.3d at 1122. Ugbor may be found deliberately indifferent under this standard “only if 

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[she] ‘knows of and disregards an excessive risk to [Livingston’s] health and safety.’” Jett, 

439 F.3d at 1096 (quoting Toguchi v. Chung, 391 F.3d 1051, 1057 (9th Cir. 2004)). 

An “isolated exception” to an “overall [course of] treatment” however, is insufficient 

to support a claim of deliberate indifference. Jett, 439 F.3d at 1096. And “mere malpractice, 

or even gross negligence” in the provision of medical care also does not violate the Eighth 

Amendment. Wood v. Housewright, 900 F.2d 1332, 1334 (9th Cir. 1990); see also Farmer, 

511 U.S. at 835 (deliberate indifference is “a state of mind more blameworthy than 

negligence” and “requires ‘more than ordinary lack of due care for the prisoner’s interests 

or safety’”) (quoting Whitley v. Albers, 475 U.S. 312, 319 (1986)); Wilhelm, 680 F.3d at 

1123 (a “negligent misdiagnosis” does not state a claim for deliberate indifference). 

Finally, “[a] difference of opinion between a physician and the prisoner—or 

between medical professionals—concerning what medical care is appropriate does not 

amount to deliberate indifference.” Snow, 681 F.3d at 987 (citing Sanchez v. Vild, 891 F.2d 

240, 242 (9th Cir. 1989)); Wilhelm, 680 F.3d at 1122-23 (citing Jackson v. McIntosh, 90 

F.3d 330, 332 (9th Cir. 1986)). Rather, “the plaintiff ‘must show that the course of 

treatment the doctors chose 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.’” Hamby v. Hammond, 821 F.3d 1085, 1092 (9th Cir. 2016) (citation 

omitted); Snow, 681 F.3d at 988. 

In other words, so long as Livingston’s pleading includes allegations that Nurse 

Ugbor provided a medically acceptable course of treatment on March 14, 2016, her actions 

will not rise to level of deliberate indifference as a matter of law even if Livingston claims 

an alternative course of treatment was preferable to him and available to her. Jackson, 90 

F.3d at 332. 

D. Discussion 

The Court continues to assume, as it did with respect to the allegation in Livingston’s 

original Complaint, that on March 14, 2016, when he appeared in Ugbor’s medical clinic 

with a swollen right knee and complaints of “serious pain” and difficulty walking, that he 

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suffered from an objectively serious medical need. See Wilhelm, 680 F.3d at 1122; Lopez, 

203 F.3d at 1131 (“serious medical needs” include “a medical condition that significantly 

affects an individual’s daily activities,” and “the existence of chronic and substantial pain”) 

(citation and internal quotations omitted); Abbott v. Tootell, No. C 11-0183 LHK (PR), 

2014 WL 726561, at *5, *8 (N.D. Cal. Feb. 25, 2014) (assuming prisoner’s improperly 

healed Achilles tendon, swollen knee, separated shoulder, and complaints of “very severe 

pain” were objectively serious medical needs), aff’d, 631 F. App’x 487 (9th Cir. 2016). 

However, Livingston still fails to include factual content sufficient to plausibly show 

Ugbor knew of and consciously disregarded any excessive risk to his health and safety 

when she failed to physically examine him on March 14, 2016, and instead noted he “had 

pain medications ordered,” and directed him to return to clinic the following day. (See

FAC, ECF No. 7, Ex. D at 13.) Iqbal, 556 U.S. at 678; Jett, 439 F.3d at 1096. Livingston 

does not include facts to plausible show how or why Ugbor’s treatment decision was 

“medically unacceptable under the circumstances,” and offers none to plausibly suggest 

she “chose this course in conscious disregard of an excessive risk to [his] health.” Hamby, 

821 F.3d at 1092 (citation omitted).3 See also Toguchi, 391 F.3d at 1058; Chavira v. 

Olukanmi, No. LACV157371PAJCG, 2018 WL 1779349, at *2-3 (C.D. Cal. Mar. 14, 

                                               

3

 Livingston does claim Ugbor “violate[d] CDC Policies,” see FAC, ECF No. 7 at 3 & Ex. 

D at 13, but there is no independent cause of action under § 1983 for a violation of Title 

15 regulations. See, e.g., Chappell v. Newbarth, 2009 WL 1211372, at *9 (E.D. Cal. May 

1, 2009) (holding that there is no private right of action under Title 15 of the California 

Code of Regulations); Parra v. Hernandez, No. 08CV0191-H (CAB), 2009 WL 3818376, 

at *3 (S.D. Cal. Nov. 13, 2009) (granting motion to dismiss prisoner’s claims brought 

pursuant to Title 15 of the California Code of Regulations). “To the extent that the violation 

of a state law amounts to the deprivation of a state-created interest that reaches beyond that 

guaranteed by the federal Constitution, [s]ection 1983 offers no redress.” Sweaney v. Ada 

County, Idaho, 119 F.3d 1385, 1391 (9th Cir.1997); see also Davis v. Kissinger, 2009 WL 

256574, *12 n. 4 (E.D. Cal. Feb. 3, 2009) (“[T]here is not a single reported state or federal 

case permitting an independent cause of action pursuant to these regulations [Cal. Code 

Regs. tit. 15 § 3268]”). Similarly, there is no liability under § 1983 for violating prison 

policy. Cousins v. Lockyer, 568 F.3d 1063, 1070 (9th Cir. 2009). 

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2018) (finding no deliberate indifference where prisoner alleged to have been treated with 

non-steroidal anti-inflammatory medication for knee pain, but was denied a requested 

MRI), report and recommendation adopted, No. LACV157371PAJCG, 2018 WL 1787511 

(C.D. Cal. Apr. 11, 2018). 

Thus, while Livingston’s exhibits now show he was subsequently treated with 

steroids and given a MRI seven months later which revealed mild patellofemoral joint 

arthritis, no fracture, a large meniscus tear, and a small radial tear of the lateral meniscus 

in his right knee, see FAC Exs. A & B, ECF No. 7 at 7, 9, those facts may be “consistent 

with” a claim that his singular encounter with Ugbor on March 14, 2016 was too 

perfunctory, insufficient, or contributed to his continued pain. But without more, they 

simply “stop[] short of the line between possibility and plausibility of ‘entitlement to 

relief’” under Eighth Amendment standards. Iqbal, 556 U.S. at 678 (citing Bell Atlantic v. 

Twombly, 550 U.S. 544, 557 (2007)); Jett, 439 F.3d at 1096; Jackson, 90 F.3d at 332; see 

also Sublett v. Robertson, No. CV 11-0539-TUC-FRZ, 2013 WL 11312736, at *6 (D. Ariz. 

Apr. 30, 2013) (finding no purposeful act, failure to respond, or harm caused by defendant 

despite prisoner’s claims of continued pain and worsened condition over time), aff’d, 590 

F. App’x 700 (9th Cir. 2015). “Deliberate indifference is a high legal standard,” Toguchi, 

391 F.3d at 1060, and a mere delay in medical treatment, without a plausible allegation of 

resulting harm, is insufficient to meet it. See Edwards v. High Desert State Prison, 615 F. 

App’x 457 (9th Cir. 2015) (citing Wood, 900 F.2d at 1335); see also Colwell v. Bannister, 

763 F.3d 1060, 1081 (9th Cir. 2014). “In determining deliberate indifference, [courts must] 

scrutinize the particular facts and look for substantial indifference in the individual case 

[which] indicat[es] more than mere negligence or isolated occurrences of neglect.” Wood, 

900 F.2d at 1334 (citation omitted). 

In other words, even if the Ugbor wrongly or negligently assessed the severity of 

Livingston’s swollen knee on March 14, 2016, and failed to recognize an emergent need 

for a physical examination on that one occasion, a single oversight or incident of neglect 

does not an Eighth Amendment violation make. See Jett, 439 F.3d at 1096 (“If the harm is 

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an ‘isolated exception’ to the ...‘overall treatment of the prisoner [it] ordinarily militates 

against a finding of deliberate indifference.’”). In sum, “the offending conduct must be 

wanton.” Colwell, 763 F.3d at 1081 (citing Wilson v. Seiter, 501 U.S. 294, 302 (1991)). 

E. Leave to Amend 

Because Livingston has already been provided a short and plain statement of his 

pleading deficiencies as to Nurse Ugbor, and an opportunity to allege additional facts 

which might plausibly state an Eighth Amendment claim for relief against her, it finds 

further attempts to amend would be futile. See Gonzalez v. Planned Parenthood, 759, F.3d 

1112, 1116 (9th Cir. 2014) (“‘Futility of amendment can, by itself, justify the denial of ... 

leave to amend.’”) (quoting Bonin v. Calderon, 59 F.3d 815, 845 (9th Cir. 1995)); Zucco 

Partners, LLC v. Digimarc Corp., 552 F.3d 981, 1007 (9th Cir. 2009) (“[W]here the 

plaintiff has previously been granted leave to amend and has subsequently failed to add the 

requisite particularity to its claims, [t]he district court’s discretion to deny leave to amend 

is particularly broad.” (internal quotation marks omitted) (second alteration in original)). 

II. Conclusion and Order

 For all the reasons discussed, the Court dismisses Livingston’s Amended Complaint 

sua sponte for failing to state a claim upon which § 1983 relief may be granted pursuant to 

§ 1915A(b)(1) and without leave to amend. 

The Clerk of Court is directed to close the file. 

IT IS SO ORDERED. 

Dated: June 6, 2019 

 Hon. Larry Alan Burns 

Chief United States District Judge

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