Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_13-cv-02506/USCOURTS-caed-2_13-cv-02506-2/pdf.json

Parties Involved:
Horowitz
Defendant
Richard Peacock
Plaintiff

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UNITED STATES DISTRICT COURT 

FOR THE EASTERN DISTRICT OF CALIFORNIA 

RICHARD PEACOCK, 

Plaintiff, 

v. 

HOROWITZ, 

Defendants. 

No. 2:13-cv-02506 TLN AC P 

FINDINGS & RECOMMENDATIONS 

 Plaintiff is a state prisoner proceeding pro se an in forma pauperis with a civil rights 

action pursuant to 42 U.S.C. § 1983. Presently before the court is defendant’s motion to dismiss, 

ECF No. 16. 

Plaintiff’s Allegations 

 Plaintiff alleges that since September 2007, he has suffered from and been treated for 

degenerative spinal issues that cause him to suffer “sever[e], debilitating pain, [r]equring daily 

treatment with pain medication, [p]hysical therapy, and surg[e]ry.” ECF No. 1 at 6, ¶¶ 6-7. He 

maintains that after his transfer to Mule Creek State Prison (MCSP) in January 2013, his 

previously approved and effective pain management treatment was discontinued and he was 

prescribed “a maintenance dose of methadone 5mg. Which is such a low dose that it is equal to 

no treatment at all.” Id., ¶¶ 8-9. He further alleges that defendant Horowitz has denied him 

effective treatment for his chronic pain, despite the fact that he repeatedly advised her of 

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methadone’s ineffectiveness, and that she stated “‘I won’t put anyone on morphine and I don[’]t 

give it out at this prison, I don[’]t care what you used to get before.’” Id. Defendant also 

allegedly stated that “‘we can’t allow you to be on ms contin at MCSP when no one else is 

allowed to’” and “that she doesn’t want any inmate to be given narcotics.” Id. at 15. Plaintiff 

asserts that his medical condition constitutes a serious medical need, and that failure to treat his 

condition results in “[l]oss of [m]obility, muscle atrophy, and very severe pain,” and affects his 

daily activities. Id. at 7, ¶ 12. 

 MOTION TO DISMISS 

Defendant Horowitz moves for dismissal pursuant to Federal Rule of Civil Procedure 

12(b)(6). Defendant argues that plaintiff fails to state a claim against her upon which relief can 

be granted because allegations of medical malpractice or a disagreement over treatment are 

insufficient to support a claim under § 1983. Motion to Dismiss (MTD), ECF No. 16-1 at 2. 

I. Legal Standard for Motion to Dismiss under Fed, R. Civ. P. 12(b)(6) 

In order to survive dismissal for failure to state a claim pursuant to Rule 12(b)(6), a 

complaint must contain more than a “formulaic recitation of the elements of a cause of action;” it 

must contain factual allegations sufficient to “raise a right to relief above the speculative level.” 

Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555 (2007). “The pleading must contain 

something more . . . than . . . a statement of facts that merely creates a suspicion [of] a legally 

cognizable right of action.” Id., quoting 5 C. Wright & A. Miller, Federal Practice and Procedure 

' 1216, pp. 235-236 (3d ed. 2004). “[A] complaint must contain sufficient 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) (quoting Twombly, 550 U.S. at 570). “A claim has facial plausibility when 

the plaintiff pleads factual content that allows the court to draw the reasonable inference that the 

defendant is liable for the misconduct alleged.” Id. 

In considering a motion to dismiss, the court must accept as true the allegations of the 

complaint in question, Hospital Bldg. Co. v. Rex Hospital Trustees, 425 U.S. 738, 740 (1976), 

and construe the pleading in the light most favorable to the party opposing the motion and resolve 

all doubts in the pleader’s favor. Jenkins v. McKeithen, 395 U.S. 411, 421, reh’g denied, 396 

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U.S. 869 (1969). The court will “‘presume that general allegations embrace those specific facts 

that are necessary to support the claim.’” National Organization for Women, Inc. v. Scheidler, 

510 U.S. 249, 256 (1994), quoting Lujan v. Defenders of Wildlife, 504 U.S. 555, 561 (1992). 

Moreover, pro se pleadings are held to a less stringent standard than those drafted by lawyers. 

Haines v. Kerner, 404 U.S. 519, 520 (1972). 

The court may consider facts established by exhibits attached to the complaint. Durning 

v. First Boston Corp., 815 F.2d 1265, 1267 (9th Cir. 1987). The court may also consider facts 

which may be judicially noticed, Mullis v. United States Bankruptcy Ct., 828 F.2d 1385, 1388 

(9th Cir. 1987); and matters of public record, including pleadings, orders, and other papers filed 

with the court, Mack v. South Bay Beer Distributors, 798 F.2d 1279, 1282 (9th Cir. 1986). The 

court need not accept legal conclusions “cast in the form of factual allegations.” 

II. Inadequate Medical Care 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 (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 

(1991); McKinney v. Anderson, 959 F.2d 853, 854 (9th Cir. 1992) (on remand). The requisite 

state of mind for a medical claim is “deliberate indifference.” Hudson v. McMillian, 503 U.S. 1, 

5 (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 

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

In Farmer v. Brennan, 511 U.S. 825 (1994), the Supreme Court established a very 

demanding standard for “deliberate indifference.” Negligence is insufficient. Farmer, 511 U.S. 

at 835. 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 to establish an Eighth Amendment 

violation. Id. at 836-37. It is not enough that a reasonable person would have known of the risk 

or that a defendant should have known of the risk. Id. at 842. Rather, deliberate indifference is 

established only where the defendant subjectively “knows of and disregards an excessive risk to 

inmate health and safety.” Toguchi v. Chung, 391 F.3d 1051, 1057 (9th Cir. 2004) (internal 

citation omitted) (emphasis added). Deliberate indifference can be established “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 v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) (citations 

omitted). A difference of opinion between an inmate and prison medical personnel—or between 

medical professionals—regarding appropriate medical diagnosis and treatment are not enough to 

establish a deliberate indifference claim. Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir. 1989); 

Toguchi, 391 F.3d at 1058. 

III. Request for Judicial Notice 

 In considering the motion to dismiss, defendant has made two requests for judicial notice: 

(1) that MS Contin is the trademark name of a slow-release morphine sulfate tablet and (2) that 

methadone is a narcotic drug that is similar to morphine but stronger and of longer duration. ECF 

No. 17. The court may take notice of facts that are capable of accurate and ready determination 

by resort to sources whose accuracy cannot reasonably be questioned. Fed.R.Evid. 201(b); United 

States v. Bernal–Obeso, 989 F.2d 331, 333 (9th Cir.1993). 

The court will take judicial notice of the first request; however, the second request raises 

conflicts with plaintiff’s allegations that methadone had no effect and defendant’s evidentiary 

showing arguably raises triable issues of disputed fact. Whether or not methadone in fact 

provided pain relief for plaintiff’s pain treatment is not a matter appropriate for resolution under 

Federal Rule of Civil Procedure 12(b)(6). The court will therefore deny the second request for 

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judicial notice. 

IV. Plaintiff’s Allegations State An Eighth Amendment Claim 

Defendant’s motion does not challenge that plaintiff has pled sufficient facts to allege a 

serious medical need. The question before the court is whether plaintiff has pled facts sufficient 

to allege that defendant Horowitz was deliberately indifferent to the alleged serious medical need. 

ECF No. 16-1 at 2-6. 

Defendant argues that plaintiff’s claims amount to a disagreement over treatment or, at 

most, medical negligence, neither of which states a claim of deliberate indifference. Id. While 

the court agrees that plaintiff does not have a constitutional right to choose his own medication 

and medical negligence is not deliberate indifference, the Eighth Amendment does protect 

plaintiff from the “unnecessary and wanton infliction of pain.” Estelle, 429 U.S. at 104. Plaintiff 

has alleged that he suffers from a serious medical condition, and that defendant’s decision to 

change his pain management treatment was made for purely non-medical reasons. ECF No. 1 at 

6, 14-15. He claims that upon his transfer to MCSP defendant refused to continue him on MS 

Contin, not because she determined that it was medically unnecessary or that methadone was a 

more appropriate treatment, but solely because she had a policy of refusing to prescribe inmates 

with morphine. Id. Plaintiff has alleged that the alternative pain medication that the defendant 

prescribed was ineffective in treating his pain, to the point that it was “equal to no treatment at 

all.” Id. at 6, ¶ 8. Moreover, he alleges that he “repeatedly” informed the defendant that the 

alternative pain medication offered no relief, and that she knew that to be the case but nonetheless 

refused to prescribe morphine, which had been previously approved and effective in managing his 

pain. Id., ¶¶ 7-9. 

Defendant also argues that plaintiff’s deliberate indifference claim is undermined by his 

statements and the exhibits to the complaint reflecting that he is receiving alternative medications 

to treat his pain. ECF No. 16-1 at 5-6. Defendant claims that this is especially true because 

methadone, the medication she prescribed plaintiff, is “more effective and more potent than 

morphine,” the medication she discontinued. Id. at 4; ECF No. 20 at 2. However, as addressed in 

the denial of defendant’s second request for judicial notice, defendant’s arguments regarding the 

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efficacy of methadone raise potential issues of fact that are not properly resolved on a motion 

brought pursuant to Rule 12(b)(6). Moreover, “[a] prisoner need not prove that he was 

completely denied medical care. Rather, he can establish deliberate indifference by showing that 

officials intentionally interfered with his medical treatment.” Lopez v. Smith, 203 F.3d 1122, 

1132 (9th Cir. 2000) (citations omitted) (en banc). Here, plaintiff alleges that defendant changed 

his approved pain management treatment for purely non-medical reasons then proceeded to 

ignore him when he advised her that the new treatment offered no relief. ECF No. 1 at 6, ¶¶ 8-9. 

Defendant’s final argument is that the complaint admits that morphine was not medically 

necessary because plaintiff is able to perform daily activities, is functional on his current 

treatment plan, and has a Comprehensive Accommodation Chrono, which establishes that he is 

receiving treatment for his pain. ECF 16-1 at 6 (citing ECF No. 1 at 20-21, 23-24). However, 

these purported admissions are taken from the response to plaintiff’s second level healthcare 

appeal. They are not statements made by plaintiff and there is no indication that he has adopted 

these statements as true. See Gant v. Wallingford Bd. of Educ., 69 F.3d 669, 674 (2nd Cir. 1995) 

(Rule 10(c) does not require “plaintiff to adopt as true the full contents of any document attached 

to a complaint or adopted by reference.”); see also, Northern Indiana Gun & Outdoor Shows, Inc. 

v. City of South Bend, 163 F.3d 449, 455 (7th Cir.1998) (“To conclude summarily, however, that 

letters written by Century Center represent the truth with regard to the defendants’ intent simply 

because NIGOS attached them to its complaint for reasons unrelated to their truthfulness is 

inappropriate.”). Plaintiff’s complaint specifically alleges that defendant removed him from 

morphine without any medical reason. ECF No. 1 at 6, ¶ 9. 

In her reply, defendant tries to bolster her argument that plaintiff has admitted that 

morphine was not medically necessary by arguing that plaintiff “reiterates in his opposition the 

accuracy of the information attached to his complaint as to his ability to mobilize and take care of 

the necessities of daily living.” ECF No. 20 at 2. But though plaintiff’s opposition may have 

verified that defendant accurately quoted the appeal, ECF No. 19 at 3, any implication that he was 

verifying the accuracy of the contents of the statements overreaches. Plaintiff argued that 

defendant’s statement was a “smokescreen” and that she was “minimizing” his condition, 

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indicating that he disagrees with the truth of the statements, id., which coincides with his 

allegations that he has suffered loss of mobility and muscle atrophy, ECF No. 1 at 7, ¶ 12. 

Plaintiff does not explain why he attached the documents he did, but the court can imagine 

several reasons he may have done so -- such as to establish that he exhausted his administrative 

remedies -- that have nothing to do with the truth of the statements made therein. Based on the 

record before it, the court does not agree that the attachments to the complaint establish facts 

sufficient to contradict the allegations in the complaint. 

Finally, the court also notes that plaintiff does not state that he is not an invalid, as 

defendant claims. ECF No. 20 at 2-3. And while it is not entirely clear what plaintiff meant 

when he stated that it “don’t mean that a person got to be invalid,” it appears from the context of 

the statement that he was not referring to himself specifically, but rather to inmates in need of 

pain relief generally. ECF No. 19 at 3. Even if plaintiff meant that he is not an invalid, as 

defendant suggests, that is not the same as an admission that the treatment he is receiving is 

effective or sufficient. 

V. Conclusion 

At the pleading stage, the court must take as true the allegations in the complaint and 

construe the pleading in plaintiff’s favor. Therefore, for the reasons set forth above, plaintiff has 

adequately alleged an Eighth Amendment violation and the motion to dismiss should be denied. 

 IT IS HEREBY RECOMMENDED that the motion to dismiss filed by defendant 

Horowitz (ECF No. 16) 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 twenty-one 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 response to the 

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

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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: February 17, 2015 

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