Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-1_19-cv-00529/USCOURTS-caed-1_19-cv-00529-3/pdf.json

Parties Involved:
M. Francis
Defendant
Negre
Defendant
Etuate Sekona
Plaintiff

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UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF CALIFORNIA

ETUATE SEKONA,

Plaintiff,

v.

M. FRANCIS, Registered Nurse at Kern 

Valley State Prison and NEGRE, 

Registered Nurse at Kern Valley State 

Prison,

Defendants.

Case No. 1:19-cv-00529-DAD-HBK

FINDINGS AND RECOMMENDATION TO 

GRANT DEFENDANT NEGRE’S MOTION 

FOR SUMMARY JUDGMENT1

(Doc. No. 33)

FOURTEEN-DAY OBJECTION PERIOD

Pending before the Court is Defendant Negre’s Motion for Summary Judgment filed on 

October 14, 2020. (Doc. No. 33, “MSJ”). Plaintiff filed an opposition and Defendant filed a 

reply. (Doc. Nos. 34, 35). For the reasons stated below, the undersigned finds no genuine dispute 

as to any material facts and recommends Defendant Negre’s MSJ be granted.

I. BACKGROUND

Plaintiff Etuate Sekona (“Plaintiff” or “Sekona”), a state prisoner, initiated this action by 

filing a pro se civil rights complaint under 42 U.S.C. § 1983 on April 24, 2019. (Doc. No. 1). On 

1 This matter was referred to the undersigned pursuant to 28 U.S.C. § 636(b)(1)(B) and Local Rule 302 

(E.D. Cal. 2019). 

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October 22, 2019, the then-assigned magistrate judge screened the complaint pursuant to 28 

U.S.C. § 1915A, finding that Sekona had stated a cognizable claim of medical deliberate 

indifference against two registered nurses at Kern Valley State Prison – Defendants M. Francis 

and Negre. (Doc. No. 13). Defendants answered the complaint on January 14, 2020. (Doc. No. 

18). 

After discovery and in compliance with the modified scheduling order (Doc. No. 25), 

Defendant Negre (“Negre”) timely files the MSJ sub judice.

2

(Doc. No. 33). In support, Negre 

submits a statement of undisputed facts (Doc. No. 33-3); Negre’s declaration (Doc. No. 33-4 at 1-

4); and excerpts from Plaintiff’s medical records (Doc. No. 33-4 at 5-7). Plaintiff’s opposition 

(Doc. No. 34) includes his own declaration (Doc. No. 34 at 8-12) and a statement of “undisputed 

material facts” (Doc. No. 34 at 13-15). Defendant replies to Plaintiff’s opposition. (Doc. No. 

35). 

II. APPLICABLE LAW

A. Summary Judgment Standard

The “purpose of summary judgment is to pierce the pleadings and to assess the proof in 

order to see whether there is a genuine need for trial.” Matsushita Elec. Indus. Co. Ltd. v. 

Zenith Radio Corp., 475 U.S. 574, 587 (1986) (citation omitted). Summary judgment is 

appropriate when there is “no genuine dispute as to any material fact and the movant is entitled 

to judgment as a matter of law.” Fed. R. Civ. P. 56(a). Summary judgment should be entered 

“after adequate time for discovery and upon motion, against a party who fails to make a 

showing sufficient to establish the existence of an element essential to that party’s case, and on 

which that party will bear the burden of proof at trial.” Celotex Corp. v. Catrett, 477 U.S. 317, 

322 (1986). The moving party bears the “initial responsibility” of demonstrating the absence of 

a genuine issue of material fact. Id. at 323. An issue of material fact is genuine only if there is 

sufficient evidence for a reasonable fact finder to find for the non-moving party, while a fact is 

material if it “might affect the outcome of the suit under the governing law.” Anderson v. 

2 Defendant M. Francis did not move for summary judgment.

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Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). 

If the moving party meets its initial burden, the burden then shifts to the opposing party 

to present specific facts that show there to be a genuine issue of a material fact. See Fed R. Civ. 

P. 56(e); Matsushita, 475 U.S. at 586. An opposing party “must do more than simply show that 

there is some metaphysical doubt as to the material facts.” Matsushita, 475 U.S. at 587. The 

party is required to tender evidence of specific facts in the form of affidavits, and/or admissible 

discovery material, in support of its contention that a factual dispute exists. Fed. R. Civ. P. 

56(c); Matsushita, 475 U.S. at 586 n.11. The opposing party is not required to establish a 

material issue of fact conclusively in its favor; it is sufficient that “the claimed factual dispute be 

shown to require a jury or judge to resolve the parties’ differing versions of the truth at trial.” 

T.W. Electrical Serv., Inc. v. Pacific Elec. Contractors Assoc., 809 F.2d 626, 630 (9th Cir. 

1987). However, “failure of proof concerning an essential element of the nonmoving party’s 

case necessarily renders all other facts immaterial.” Celotex, 477 U.S. at 323. 

The court must apply standards consistent with Rule 56 to determine whether the 

moving party demonstrated there is no genuine issue of material fact and showed judgment to be 

appropriate as a matter of law. See Henry v. Gill Indus., Inc., 983 F.2d 943, 950 (9th Cir. 1993). 

“[A] court ruling on a motion for summary judgment may not engage in credibility 

determinations or the weighing of evidence.” Manley v. Rowley, 847 F.3d 705, 711 (9th Cir. 

2017) (citation omitted). The evidence must be viewed “in the light most favorable to the 

nonmoving party” and “all justifiable inferences” must be drawn in favor of the nonmoving 

party. Orr v. Bank of America, NT & SA, 285 F.3d 764, 772 (9th Cir. 2002). The mere scintilla 

of evidence is not sufficient to establish a genuine dispute to defeat an otherwise properly 

supported summary judgment motion. Anderson v. Liberty Lobby, Inc., 477 U.S. at 252. 

However, where “opposing parties tell two different stories, one of which is blatantly 

contradicted by the record” courts “should not adopt that version of the facts for purposes of 

ruling on a motion for summary judgment.” Scott v. Harris, 550 U.S. 372, 380 (2007).

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B. Eighth Amendment Medical Deliberate Indifference

The Constitution indisputably requires prison officials to provide inmates with reasonably 

adequate medical care. Estelle v. Gamble, 429 U.S. 97, 103 (1976). To hold an official liable for 

violating this duty under the Eighth Amendment, the inmate must satisfy two prongs, an objective 

prong and subjective prong. First, the inmate must suffer from a serious medical need (the 

objective prong); and, second the official must be deliberately indifferent to the inmate’s serious 

medical need (the subjective prong). 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); 

Wilhelm v. Rotman, 680 F.3d 1113, 1122 (9th Cir. 2012). A medical need is “serious” if the

failure to treat “could result in further significant injury or the unnecessary and wanton infliction 

of pain.” Jett v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) (internal citations omitted). The

“second prong—defendant’s response to the need was deliberately indifferent—is satisfied by 

showing (a) a purposeful act or failure to respond to a prisoner’s pain or possible medical need 

and (b) harm caused by the indifference.” Id. (internal citations omitted). This standard requires

that 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 (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 v. County of Washoe, Nevada, 290 F.3d 1175, 1188 (9th Cir. 

2002). This “subjective approach” focuses only “on what a defendant’s mental attitude actually 

was.” Farmer, 511 U.S. at 839.

Deliberate indifference is a higher standard than medical negligence or malpractice, and a 

difference of opinion between medical professionals—or between a physician and the prisoner—

generally does not amount to deliberate indifference. See generally Toguchi v. Chung, 391 F.3d 

1051 (9th Cir. 2004); Jackson v. McIntosh, 90 F.3d 330, 332 (9th Cir. 1996) (A mere “difference 

of medical opinion . . . [is] insufficient, as a matter of law, to establish deliberate indifference.”).

To prevail on a claim involving choices between alternative courses of treatment, a prisoner must 

show that the chosen course of treatment “was medically unacceptable under the circumstances,”

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and was chosen “in conscious disregard of an excessive risk to [the prisoner’s] health.” Jackson, 

90 F.3d at 332.

Neither will an “inadvertent failure to provide medical care” sustain a claim. Estelle v. 

Gamble, 429 U.S. 97, 105 (1976). Misdiagnosis alone is not a basis for a claim, see Wilhelm v. 

Rotman, 680 F.3d 1113, 1123 (9th Cir. 2012), and a “mere delay” in treatment, “without more, is 

insufficient to state a claim of deliberate medical indifference,” Shapley v. Nevada Bd. of State 

Prison Comm’rs, 766 F.2d 404, 407 (9th Cir. 1985). Instead a prisoner must show that a delay 

“would cause significant harm and that defendants should have known this to be the case.” 

Hallett v. Morgan, 296 F.3d 732, 746 (9th Cir. 2002). 

III. ANALYSIS

A. Allegations of Deliberate Indifference in Plaintiff’s Complaint

The Complaint predicates liability to Negre for deliberate indifferent to Sekona’s serious 

medical need in violation of his Eighth Amendment rights for Negre’s refusal to provide Plaintiff 

with painkillers that had not been crushed and floated in water and refusal to empty Plaintiff’s 

catheter, filled with blood. (Doc. No. 1 at 5-17). Negre served as a registered nurse at Plaintiff’s 

institution, Kern Valley State Prison. (Id. at 2 ¶ 2). 

According to the Complaint, Plaintiff returned to Kern Valley State Prison on September 

19, 2018 following urolift surgery. (Id. at 4). After requesting them repeatedly from prison 

guards, Negre offered Plaintiff painkillers that had been crushed and floated in water. (Id. at 5). 

Plaintiff declined the painkillers because he suffers from a heart condition and he feared Negre 

was trying to poison him by overdosing him. (Id.). When Plaintiff refused to take the painkillers,

Negre declined to empty Plaintiff’s urine bag despite it being full and bloody, and despite other

officers requesting Negra to do so. (Id.). Plaintiff contends he experienced great pain for 48 

hours because he had no painkillers and could not urinate due to the full urine bag. (Id. at 5-7). 

After two days an unnamed nurse emptied Plaintiff’s urine bag. (Id. at 7).

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B. Undisputed Facts

1. Defendant’s Evidence 

Defendant Negre’s MSJ attaches a list of undisputed facts. (Doc. No. 33-3). Each listed 

fact cites to either Negre’s declaration (Doc. No. 33-4 at 1-4) or Plaintiff’s excerpted medical 

records (Doc. No. 33-4 at 5-7). Having reviewed the record, the undersigned finds the following 

facts to be undisputed.

Negre has served as a registered nurse at Kern Valley State Prison since 2014. (Doc. No. 

33-3 at ¶ 1). His primary duties include monitoring inmates’ health by conducting rounds, 

providing prescribed medications, responding to medical emergencies and other requests for care, 

and communicating the inmate-patient’s doctor. (Id. at ¶ 3). As a registered nurse, Negre does 

not have authority to prescribe medication or alter prescriptions or medical treatments but can 

only communicate an inmate’s disapproval with his treatment regimen to the prescribing 

physician. (Id. at ¶ 4). 

Negre first encountered Plaintiff on September 19, 2018 at 11:00 p.m. in the Treatment 

and Triage Area (“TTA”) following Plaintiff’s urolift surgery earlier that day. (Id. at ¶¶ 2, 5). 

Plaintiff’s doctor prescribed him two Tylenol-3 (Tylenol with codeine) tablets to be taken 

“crushed and floated” three times per day as needed for pain. (Id. at ¶ 5 ). Doctors at the prison 

typically prescribe pain medication to be crushed and floated in water to ensure inmates do not 

hoard or trade them. (Id.). Negre offered Plaintiff the prepared pain medication crushed and 

floated in water as prescribed by Plaintiff’s physician, but Plaintiff refused to take the prescribed 

painkillers. (Id.). Negre did not perceive Plaintiff as being in “distress” and saw “no need” to 

change Plaintiff’s urine bag on September 19, 2018. (Id.). Negre had no other interaction with 

Plaintiff between September 19, 2018 and April 24, 2019. (Id.). 

Progress Notes from Plaintiff’s medical records reveal Plaintiff arrived in the TTA at 

11:10 p.m. via wheelchair and was seen by Negre. (Doc. No. 33-4 at 5). Plaintiff requested pain 

medication stating he was “experiencing 6/10 pain to the pelvic area.” (Id). Negre reviewed the 

prescription ordered and offered Plaintiff his first dose of Tylenol-3, crushed, and Plaintiff 

refused medication and requested “to go to hospital for pain instead.” (Id). Negre attempted to 

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educate Plaintiff about the medication but he “became augmentative and agitated.” (Id.) Negre 

offered Plaintiff the medication again but Plaintiff refused and said, “get out off [sic] my face, I 

don’t fuck around.” (Id.). Plaintiff was escorted via a wheelchair back to custody “without 

apparent distress.” (Id.). The notation reflects the medical notes were electronically signed less 

than one hour later, at 12:08 a.m. (Id.). 

Progress Notes from Plaintiff’s medical records dated September 20, 2018 reveal he was 

seen by another registered nurse at 11:32 a.m. and reported “no issues at this time.” (Id.). 

“Approx 225cc of clear, brown urine was removed catheter. (Id.). No clots or sediments was 

seen.” The notes make no mention of Plaintiff claiming his bag had not been timely emptied. 

(Id.). 

Progress Notes from September 21, 2018 reveal Plaintiff was seen by a different 

registered nurse and reported “pain during urination,” “feeling a little bloated” and “tenderness” 

in abdomen. (Doc. No. 33-4 at 7). Staff advised Plaintiff the orange discoloration in his urine 

was due to “pyridium” he was taking. (Id.). No sediment or blood was noted in the urine bag or 

tubing. (Id.). 

2. Plaintiff’s Evidence

As the non-moving party, Plaintiff is required to provide affidavits, and/or admissible 

discovery material demonstrating a factual dispute exists. Fed. R. Civ. P. 56(c); Matsushita, 475 

U.S. at 586 n.11. Summary judgment cannot be avoided by making conclusory allegations 

unsupported by factual data. Arpin v. Santa Clara Valley Transportation Agency, 261 F.3d 912, 

922 (9th Cir. 2001) (citing Taylor v. List, 880 F.2d 1040, 1045 (9th Cir. 1989)). Local Rule 

260(b) requires that the party opposing summary judgment “reproduce the itemized facts in the 

Statement of Undisputed Facts and admit those facts that are undisputed and deny those that are 

disputed, including with each denial a citation to the particular portions of any pleading, affidavit, 

deposition, interrogatory answer, admission, or other document relied upon in support of that 

denial.”

Plaintiff’s opposition (Doc. No. 34) includes Plaintiff’s “declaration” (Doc. No. 34 at 8-

12), which consists of Plaintiff expressing his disagreements with Defendant’s undisputed facts. 

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Plaintiff’s filing does not comply with Local Rule 260 as it does not cite to any evidence 

underpinning why the facts are disputed. The filing instead consists of conclusory statements the 

Ninth Circuit has held cannot form the basis for denying summary judgment. Arpin, 261 F.3d at 

922. (9th Cir. 2001). Plaintiff’s declaration accordingly holds little weight when evaluating 

whether a genuine factual dispute exists.

Plaintiff’s declaration claims that he requested painkillers shortly after arriving back at the 

prison but, despite making multiple requests to prison staff, he was not taken to TTA until six 

hours later. (Doc. No. 34 at 8-9). When Negre arrived with the Plaintiff’s painkillers, Plaintiff 

alleges Negre refused to detail the dosage amount. (Id. at 9-11). Fearing he would overdose and 

die, Plaintiff declined to take the painkillers. (Id.). Plaintiff disputes that Negre was required to 

crush and float the painkillers. (Id. at 11). Plaintiff then reiterates that Negre refused to empty 

Plaintiff’s urine bag despite Plaintiff and prison guards requesting he do so. (Id. at 10). With a 

full urine bag and no painkillers, Plaintiff claims he was in extreme pain from the surgery and 

from his inability to urinate. (Id. at 10, 12).

Plaintiff’s opposition includes his own list of “undisputed material facts” which do not

cite to any evidence, including his own “declaration.” (Doc. No. 34 at 13-15). This list primarily 

recites the allegations in Plaintiff’s complaint and declaration, but also includes the allegation that 

the delay in emptying his urine bag resulted in ongoing prostate, kidney, stomach and blood 

pressure issues. (Id.). Because it fails to cite to any evidence, this list offers little probative 

value. 

3. The Undisputed Material Facts Show Negre Was Not Deliberately Indifferent

Negre argues he is entitled to summary judgment because the undisputed facts 

demonstrate Negre provided Plaintiff a reasonable level of care. (See generally Doc. No. 33-2). 

Mere disagreement with the treatment regimen, Defendant contends, is insufficient to establish 

deliberate indifference. (Id. at 7 ¶¶ 16-18). 

The undersigned first must consider whether Defendant, the moving party, has met his

initial burden of showing prima facie entitlement to summary judgment on the issue of Plaintiff’s 

medical deliberate indifference claim. Celotex Corp., 477 U.S at 323. The prima facie elements

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of medical deliberate indifference are (1) 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” and (2) that the defendant’s “response to the need was deliberately 

indifferent.” Wilhelm, 680 F.3d at 1122 (internal quotation marks and citation omitted). The 

second prong is satisfied by showing “(a) a purposeful act or failure to respond to a prisoner’s 

pain or possible medical need and (b) harm caused by the indifference.” Jett, 439 F.3d at 1096 

(internal citations omitted). 

The undisputed facts, when viewed in the light most favorable to Sekona, indicate that he 

had a serious medical need. A serious medical need is evidenced by “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 are examples of indications that a prisoner has a 

‘serious’ need for medical treatment.” McGuckin v. Smith, 974 F.2d 1050, 1059-60 (9th Cir.

1992), overruled on other grounds by WMX Techs., Inc. v. Miller, 104 F.3d 1133 (9th Cir. 1997) 

(en banc). Plaintiff had just been released from surgery and presumably was in pain. A

reasonable jury therefore could find that Plaintiff’s post-surgery pain constituted a serious 

medical need. 

However, the second prong of medical deliberate indifference – failure to respond to a 

prisoner’s pain, resulting in harm – has not been demonstrated. Jett, 439 F.3d at 1096. A 

defendant “cannot be said to have been indifferent” to an inmate’s pain if they took steps to 

address it.” DeGeorge v. Mindoro, No. 17-CV-06069-LHK, 2019 WL 2123590, at *7 (N.D. Cal. 

May 15, 2019). Plaintiff admits that Negre offered him painkillers, but he refused to take them 

because he believed he would suffer an overdose. But Plaintiff’s declaration provides no basis 

for believing the dosage was excessive beyond the fact that painkillers were crushed and floated, 

a method for distributing prescriptions previously upheld by the Ninth Circuit. See Wright v. 

Swingle, 482 F. App'x 294, 295 (9th Cir. 2012). While Plaintiff alleges he waited hours before he 

was offered painkillers, Plaintiff does not allege Negre was responsible for that delay. 

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It is undisputed Plaintiff was offered painkillers to treat his pain following surgery. This 

offer was sufficient to negate Plaintiff’s prima facie case for medical deliberate indifference 

regarding Plaintiff’s post-surgery pain. Negre is accordingly entitled to summary judgment on 

this basis.

Negre is likewise entitled to summary judgment on Plaintiff’s deliberate indifference 

claim for allegedly failing to drain Plaintiff’s urine bag. Medical records from the day after 

Plaintiff’s surgery evidence Plaintiff’s urine bag was emptied and Plaintiff reported “no issues at 

this time.” (Doc. No. 33-4 at 5). The records are devoid of any indication that Plaintiff’s urine 

bag was full or that he was in severe pain. (Id.). The Progress Notes taken by a Kern Valley 

registered nurse approximately 36 hours after Plaintiff’s encounter with Negre indicate there was 

no blood in Plaintiff’s urine bag. (Id. at 7). Plaintiff’s declaration unsupported by any 

documentation is the sole evidence that Plaintiff’s bag was bloody and full. Where “opposing 

parties tell two different stories, one of which is blatantly contradicted by the record” courts 

“should not adopt that version of the facts for purposes of ruling on a motion for summary 

judgment.” Scott v. Harris, 550 U.S. 372, 380 (2007). 

Plaintiff claims his urine bag was not emptied from the time he left surgery until the time 

the nurse emptied the bag 36 hours later. This is disputed by the progress Note dated September 

20, 2018, the day after Plaintiff’s surgery, that states “225cc3of clear, brown urine was removed 

from the catheter. No clots or sediment seen.” (Doc. No. 33-4 at 5). There is no way to 

reconcile Plaintiff’s allegation that the bag was full and bloody and the medical records that state 

there was no blood in the bag and that Plaintiff expressed “no issues.” (Id.). A serious medical 

need must be “apparent” and “obvious.” Gardner v. Las Vegas Metro. Police Dep't, 831 F. App'x 

365, 366 (9th Cir. 2020). If the urine bag was not bloody and full, it would not have been 

apparent and obvious to Negre the bag needed to be changed. Even accepting as true Plaintiff’s 

allegations that prison guards asked Negre to empty Plaintiff’s urine bag, “a difference of opinion 

... concerning what medical care is appropriate does not amount to deliberate indifference.” 

3 The court takes judicial notice that 225cc is the equivalent of 7.6 ounces.

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Colwell v. Bannister, 763 F.3d 1060, 1068 (9th Cir. 2014) (quoting Snow v. McDaniel, 681 F.3d 

978, 987 (9th Cir. 2012)). 

The evidence before the Court overwhelmingly demonstrates that Negre offered Plaintiff 

pain medication and Plaintiff refused it. Further, the uncontroverted evidence reveals that 

Plaintiff’s urine bag was neither full nor bloody when Negre encountered Plaintiff on September 

19, 2018. The Court accordingly finds there is no genuine dispute of material facts over whether 

Negre was deliberately indifferent for declining to empty the urine bag.

Construing the evidence in the light most favorable to Plaintiff, the undersigned finds no

evidence to raise a triable issue as to whether Negre was deliberately indifferent for offering 

Plaintiff the crushed and floated painkillers that were prescribed by a physician and for not 

emptying Plaintiff’s urine bag.

4 The undersigned therefore concludes that Defendant Negre is

entitled to summary judgment as a matter of law. 

Accordingly, it is RECOMMENDED:

1. Defendant Negre’s Motion for Summary Judgment (Doc. No. 33) is GRANTED.

2. Judgment be entered in favor of the Defendant Negre.

3. This case proceeds only against Defendant M. Francis. 

NOTICE TO PARTIES

These findings and recommendations will be submitted to the United States District Judge 

assigned to the case, pursuant to the provisions of Title 28 U.S.C. § 636(b)(1). Within fourteen 

(14) days after being served with these findings and recommendations, a party may file written 

objections with the Court. The document should be captioned “Objections to Magistrate Judge’s 

Findings and Recommendations.” Parties are advised that failure to file objections within the 

specified time may result in the waiver of rights on appeal. Wilkerson v. Wheeler, 772 F.3d 834, 

838-39 (9th Cir. 2014) (citing Baxter v. Sullivan, 923 F.2d 1391, 1394 (9th Cir. 1991)).

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4 Negre also argues he is entitled to qualified immunity. (Doc. No. 33-2 at 11-13). Because the 

Court has found there is no evidence of deliberate indifference, the Court need not address this 

argument.

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Dated: September 2, 2021 

HELENA M. BARCH-KUCHTA

UNITED STATES MAGISTRATE JUDGE

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