Document ID: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-caed-2_05-cv-02530/USCOURTS-caed-2_05-cv-02530-5/pdf.json

Parties Involved:
Michael Roche
Defendant
David Runnels
Defendant
Victoria Wright
Plaintiff

Document Text:

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1

UNITED STATES DISTRICT COURT

EASTERN DISTRICT OF CALIFORNIA

VICTORIA WRIGHT,

No. 2:05-cv-02530-MCE-EFB

Plaintiff,

v. MEMORANDUM AND ORDER

DAVID RUNNELS, Warden,

CALIFORNIA STATE PRISON -

SUSANVILLE; MICHAEL ROCHE,

M.D.; and DOES 1 to 10,

inclusive,

Defendants.

----oo0oo----

Plaintiff Victoria Wright (“Plaintiff”) seeks damages in

this action as a result of the August 23, 2005 death of her

husband, Jay Wright, while incarcerated at High Desert State

Prison (“HDSP”) in Susanville, California. Defendants David

Runnels and Michael Roche, M.D., the Warden and Chief Medical

Officer, respectively, of HDSP, now move for summary judgment. 

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 Defendants have requested judicial notice, pursuant to 1

Federal Rule of Evidence 201, of the Abstract of Judgment

memorializing the conviction that resulted in Mr. Wright’s

incarceration. That request is unopposed and is granted.

2

Plaintiff’s complaint alleges a single claim for violation of

civil rights cognizable under 42 U.S.C. § 1983, premised on

Mr. Wright’s right to be free of cruel and unusual punishment

(deliberate indifference) under the Eighth Amendment to the

United States Constitution, as well as his Fourteenth Amendment

right to due process. Plaintiff brings this claim under

California’s survival statute, California Code of Civil Procedure

section 377.30. For the reasons set forth below, that Motion is

denied.

BACKGROUND

While serving an eighteen-month sentence for worker’s

compensation and tax fraud, Jay Wright, age 53, was transferred 1

on August 15, 2005 from San Quentin State Prison to the High

Desert State Prison in Susanville. Mr. Wright suffered from a

chronic heart condition, atypical angina, and had been taking a

calcium channel blocker (either Norvasc or Procardia) along with

low dosage aspirin to treat that condition since his first heart

attack in 1992 at the age of 39. In 1999, after a second heart

attack resulting from blockage to Wright’s right coronary artery,

a stent was surgically placed to alleviate the blockage. As a

result of his atypical angina, however, Wright remained on 

calcium channel blockers to prevent spasm of the coronary

arteries which could cause another heart attack. 

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3

The aspirin, in conjunction, served to alleviate any clot

formation should spasm occur. Plaintiff apparently took both

medications on a daily basis.

Although Wright had received both Procardia and aspirin

while housed at San Quentin, Plaintiff alleges he received no

heart medication whatsoever after being transferred to Susanville

despite the fact it was critical he not miss a single dose. 

Although a prescription for Procardia, was eventually filled on

August 22, 2005, a week after his transfer to Susanville,

Plaintiff claims that no medication was actually administered to

her husband before he died the next day as a result of acute

thrombosis (heart attack) of his right coronary artery.

Mr. Wright’s medical records at HDSP indicate that the

medications prescribed at San Quentin were detained with his

personal belongings. Although the reception nurse noted upon

Wright’s arrival that he was taking Procardia and aspirin, those

prescriptions were not filled. Even after Wright submitted a

Health Care Services Request Form indicating that he needed his

“heart meds (Procardia)” on August 17, 2005, two days after

arriving at the HDSP, no refill was placed until five days later

and not received by Wright prior to his death. 

Defendant Roche became the Chief Medical Officer at HDSP in

January of 2005. As CMO, Roche was ultimately responsible for

the supervision of medical staff, including the pharmacy. Roche

did not generally see patients, however, and did not see

Mr. Wright during his seven-day tenure at HDSP. He did not

directly supervise the nurses who evaluated and examined

Mr. Wright before his death. 

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4

With respect to the other named defendant, Warden David

Runnels, Mr. Runnels was responsible for the custody and security

of inmates at HDSP and did not have any role in hiring, training,

or supervising the prison’s medical staff. Like Dr. Roche,

Mr. Runnels had no personal knowledge of Mr. Wright until after

he died.

STANDARD

The Federal Rules of Civil Procedure provide for summary

judgment when “the pleadings, depositions, answers to

interrogatories, and admissions on file, together with

affidavits, if any, show that there is no genuine issue as to any

material fact and that the moving party is entitled to a judgment

as a matter of law.” Fed. R. Civ. P. 56(c). One of the

principal purposes of Rule 56 is to dispose of factually

unsupported claims or defenses. Celotex Corp. v. Catrett, 477

U.S. 317, 325 (1986).

The standard that applies to a motion for summary

adjudication is the same as that which applies to a motion for

summary judgment. See Fed. R. Civ. P. 56(a), 56(c); Mora v.

ChemTronics, 16 F. Supp. 2d. 1192, 1200 (S.D. Cal. 1998).

Under summary judgment practice, the moving party

always bears the initial responsibility of informing

the district court of the basis for its motion, and

identifying those portions of ‘the pleadings,

depositions, answers to interrogatories, and admissions

on file together with the affidavits, if any,’ which it

believes demonstrate the absence of a genuine issue of

material fact.

Celotex Corp. v. Catrett, 477 U.S. at 323 (quoting Rule 56(c)).

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5

If the moving party meets its initial responsibility, the

burden then shifts to the opposing party to establish that a

genuine issue as to any material fact actually does exist. 

Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574,

585-87 (1986); First Nat’l Bank v. Cities Serv. Co., 391 U.S.

253, 288-89 (1968).

In attempting to establish the existence of this factual

dispute, the opposing party must tender evidence of specific

facts in the form of affidavits, and/or admissible discovery

material, in support of its contention that the dispute exists. 

Fed. R. Civ. P. 56(e). The opposing party must demonstrate that

the fact in contention is material, i.e., a fact that might

affect the outcome of the suit under the governing law, and that

the dispute is genuine, i.e., the evidence is such that a

reasonable jury could return a verdict for the nonmoving party. 

Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248, 251-52

(1986); Owens v. Local No. 169, Assoc. of W. Pulp and Paper

Workers, 971 F.2d 347, 355 (9th Cir. 1987). Stated another way,

“before the evidence is left to the jury, there is a preliminary

question for the judge, not whether there is literally no

evidence, but whether there is any upon which a jury could

properly proceed to find a verdict for the party producing it,

upon whom the onus of proof is imposed.” Anderson, 477 U.S. at

251 (quoting Improvement Co. v. Munson, 14 Wall. 442, 448, 20

L.Ed. 867 (1872)). 

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As the Supreme Court explained, “[w]hen the moving party has

carried its burden under Rule 56(c), its opponent must do more

than simply show that there is some metaphysical doubt as to the

material facts .... Where the record taken as a whole could not

lead a rational trier of fact to find for the nonmoving party,

there is no ‘genuine issue for trial.’” Matsushita, 475 U.S. at

586-87.

In resolving a summary judgment motion, the evidence of the

opposing party is to be believed, and all reasonable inferences

that may be drawn from the facts placed before the court must be

drawn in favor of the opposing party. Anderson, 477 U.S. at 255. 

Nevertheless, inferences are not drawn out of the air, and it is

the opposing party’s obligation to produce a factual predicate

from which the inference may be drawn. Richards v. Nielsen

Freight Lines, 602 F. Supp. 1224, 1244-45 (E.D. Cal. 1985),

aff’d, 810 F.2d 898 (9th Cir. 1987).

ANALYSIS

A. Deliberate Indifference

While medical care of pretrial detainees is analyzed under

the due process clause of the Fourteenth Amendment, convicted

prisoner claims for allegedly constitutionally inadequate medical

care are governed by the Eighth Amendment. City of Revere v.

Mass. Gen. Hosp., 463 U.S. 239, 243-44 (1983). 

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 While Plaintiff’s complaint appears to invoke the 2

protections afforded by the Fifth and Ninth Amendments as well,

neither are applicable under the circumstances of this case. As

Defendants point out, the due process clause contained within the

Fifth Amendment, and the equal protection component thereof,

applies only to the actions of federal officials, not state

actors like Defendants herein. Lee v. City of Los Angeles, 250

F.3d 668, 687 (9th Cir. 2001), citing Schweiker v. Wilson, 450

U.S. 221, 227 (1981). Additionally, the Ninth Amendment has

never been recognized as independently supporting a

constitutional right in a civil rights action. Standberg v. City

of Helena, 791 F.2d 744, 748 (9th Cir. 1986). Plaintiff does not

oppose Defendants’ position in that regard. 

7

Therefore, although Plaintiff has also pled a Fourteenth

Amendment claim, Plaintiff’s claim that Defendants were

deliberately indifferent to her husband’s medical needs must be

analyzed under the Eighth Amendment’s proscription against cruel

and unusual punishment. Id. 

2

Plaintiff faces a substantial threshold in establishing that

Defendants herein had the requisite deliberate indifference. A

prison official acts with such indifference only if he knows of

and disregards an excessive risk to inmate health and safety. 

Gibson v. County of Washoe, 290 F.3d 1175, 1187 (9th Cir. 2002). 

Mere negligence in diagnosing or treating a medical condition,

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

rights. McGuckin v. Smith, 974 F.2d 1050, 1059 (9th Cir. 1991). 

Instead, officials must be subjectively aware of a substantial

risk of serious harm. Farmer v. Brennan, 511 U.S. 825, 837

(1994). Either inaction or action in the face of such knowledge,

however, is enough to support liability. Id. at 842. 

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Significantly, whether or not a prison official has the required

knowledge “is a question of fact subject to demonstration in the

usual ways, including inference from circumstantial evidence, and

a factfinder may conclude that a prison official knew of a

substantial risk from the very fact that the risk was obvious. 

Id. (internal citations omitted).

The propriety of summary judgment in this case boils down to

whether either Defendant Roche or Defendant Runnels were

deliberately indifferent to Jay Wright’s serious medical needs. 

That Wright’s medical needs were indeed serious can hardly be

questioned; he died of a heart attack involving the same right

coronary artery that had previously been symptomatic just days

after not receiving longstanding medications to control the

atypical angina that affected the artery and caused it to be

subject to spasm. Indeed, Plaintiff’s medical expert, Robert

Chesney, M.D., specifically attributes his death to the fact that

Plaintiff had not obtained the needed calcium channel blocker and

aspirin after his arrival at the HDSP. (Chesney Decl., ¶¶ 5-6,

Ex. “D” to Decl. of Jeff R. Vincent in Support of Defs.’ Mot.). 

Defendants themselves concede (at least “ideally”) that Wright

should have received both Procardia and aspirin each day he was

at the HDSP. (Opening Mem. of Points and Authorities, 13:9-10).

We next turn to whether either Dr. Roche or Warden Runnels

had awareness of Plaintiff’s needs sufficient for purposes of

imposing liability. As indicated above, the Supreme Court’s

decision in Farmer indicates that the required knowledge can be

inferred from circumstantial evidence, including the very fact

that the risk at issue was obvious. 

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Farmer v. Brennan, 511 U.S. at 842. Defendants are correct,

however, in asserting that their liability in this regard cannot

be on a respondeat superior basis and instead must derive from

their own personal action or inaction. An individual’s general

responsibility for supervising the operations of a prison is

insufficient to establish the needed personal involvement. See

Wesley v. Davis, 333 F. Supp. 2d 888, 892 (C.D. Cal. 2004). A

prison official can, however, be

liable for his own culpable action or inaction in the training,

supervision or control of subordinates, if that action evinces a

reckless or callous indifference to the rights of others. See 

Menotti v. City of Seattle, 409 F.3d 1113, 1149 (9th Cir. 2005). 

Deliberate indifference can be inferred through an established

practice or custom that violates a prisoner’s rights. Lolli v.

County of Orange, 351 F.3d 410, 421 (9th Cir. 2003). Liability

can exist where a supervisory official implements a policy or

practice so deficient that the policy “itself is a repudiation of

constitutional rights.” Hansen v. Black, 885 F.2d 642, 646 (9th

Cir. 1989); see also Gibson v. County of Washoe, 290 F.3d 1175,

1187-88 (9th Cir. 2002). 

Plaintiff has raised circumstantial evidence from which it

can be inferred that Dr. Roche knew that medical staffing at HDSP

posed a substantial risk of harm to incoming inmates, including

Mr. Wright. According to deposition testimony cited by

Plaintiff, Dr. Roche knew that the prison’s Receiving and Release

Department, which processed Jay Wright upon his arrival at HDSP,

had to process as many as several hundred inmates a week. Id. at

16:20-25; 17:1-8. 

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According to Roche, the Receiving and Release nursing staff was

“chronically short-staffed”. Id. at 20:3-21:22. Roche further

knew that it could take several days for an inmate to have an

intake evaluation performed, and he was unaware of how an inmate

would get necessary medication in the event of such a delay. Id.

at 23:21-24:13.

Defendant Roche’s lack of knowledge concerning critical

procedures was echoed by other medical staff. The nurse who

initially saw Jay Wright at arrival, M. Marlow, noted that

Mr. Wright did not have his heart medications but thought that

the first watch nurse, who completed the processing of Wright’s

reception after Marlow’s shift ended, would finish processing his

reception documents and would order medication to be provided the

next day. (Marlow Decl., ¶ 4) That expectation failed to

materialize, even though Nurse Marlow released Mr. Wright into

general custody. Indeed, it was only after three full days had

passed, and at Mr. Wright’s own behest, that the issue was

revisited by a triage nurse. Even after again being prompted,

staffing shortages and/or deficiencies prevented the

prescriptions recommended by that nurse (V. Unterreiner) from

being filled until four days later, on August 22, 2005, and the

medications were never delivered prior to Plaintiff’s death the

next day, after he had been lacking necessary heart medication

for over a week.

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 Even if these alternative procedures for filling 3

medications were available in Mr. Wright’s case, there is no

evidence that they were used. Nurse Unterreiner, who saw Jay

Wright on August 20, 2005 and asked that he receive a supply of

both Procardia and aspirin, confirms in her declaration that

there is no indication in Wright’s file that the prescription was

transmitted for filling by Documed, even though the jail pharmacy

would have been closed at the time she made the prescription

request. Unterreiner Decl., ¶¶ 3-4. Nor is there any indication

that other twenty-four hour community facilities were utilized.

11

Plaintiff also cites deposition testimony from Dr. Roche

which suggests that he was well aware of problems with filling

prescriptions, ranging from insufficient pharmacy staffing,

inadequate pharmacy software, after hours and weekend closure of

the pharmacy due to lack of resources, and ill-defined practices

for filling prescriptions when the pharmacy was closed, ranging

from obtaining medications through a secure vending service

(“Documed”) to emergency visits to local retail establishments

during off hours. Roche Dep., 36:16-25; 37:1-16; 38:10-25; 39:2-

24. Plaintiff argues that it was deliberately indifferent to 3

allow these practices to continue despite the high risk of

serious injury or death if inmates fail to timely receive

critical medications.

While Dr. Roche claims that he “constantly” tried to obtain

more pharmacy staff and was rebuffed for his efforts in doing so

by receiving a “poor” response, and although he intimates that a

similar lack of resources also accounted for the failure to

replace archaic pharmacy software that failed to adequately track

inmate orders, a lack of funds for facilities cannot justify an

unconstitutional lack of competent medical care and treatment for

inmates. 

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 While the Court recognizes that a recent Northern District 4

decision, Clouthier v. County of Contra Costa, 2007 WL 2422595

(N.D. Cal. 2007), appears to require that allegations of

understaffing cannot constitute deliberate indifference for

purposes of defeating summary judgment in the absence of expert

opinion, this Court is not obliged to follow Clouthier and

declines to do so.

12

See Ancata v. Prison Health Servs., Inc., 769 F.2d 700, 704-05

(11th Cir. 1985), citing Gates v. Collier, 501 F.2d 1291 (5th

Cir. 1974).4

All these issues raise factual determinations with respect

to the level of Dr. Roche’s knowledge, and whether that knowledge

amounted to deliberate indifference, which are not amenable to

determination on summary judgment. As indicated above, whether

or not a prison official has sufficient knowledge of a

substantial risk demonstrating such indifference is a question of

fact that should be assessed by the finder of fact upon

examination of all the evidence, including inference from

circumstantial evidence. Farmer v. Brennan, supra, 511 U.S. at

842. That multi-leveled factual analysis cannot be made within

the confines of this motion. Plaintiff has presented enough

information to survive summary judgment. 

If the trier of fact ultimately determines based on the

above described factors that Dr. Roche was aware of a

substantial, longstanding, pervasive or well-documented risk to

inmates, that may be sufficient to permit a trier of fact to find

that he had actual knowledge of the risk for purposes of showing

deliberate indifference. 

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Whether or not policies were employed to insure that prisoners

received vital medications, and whether that lack amounts to

deliberate indifference given Dr. Roche’s knowledge of the

situation, is a question of fact. Roche cannot say, as he must

to establish entitlement to summary judgment, that no

circumstantial evidence has been presented which could permit a

trier or fact to find knowledge of a substantial risk of harm

sufficient for finding deliberate indifference. See Lolli v.

County of Orange, supra, 351 F.3d at 421.

With respect to Defendant Runnels, however, there is no

evidence that he had any responsibility for either caring for Mr.

Wright or intervening to ensure that proper care was in fact

received. As Warden, he was not entrusted with ensuring that

inmates received their medications. That responsibility rested

with Defendant Roche as the prison’s Medical Director. Runnels

was not a medical doctor and has no ability to hire, fire, or

determine the appropriate level of staffing in the medical

department. Defs.’ UF No. 33-34. In the absence of such

responsibility, and in the absence of any personal knowledge on

Defendant Runnel’s part concerning Plaintiff’s condition, Runnels

could not have been deliberately indifferent. While Plaintiff

charges that Runnels was charged with ensuring that prescribed

medications were in fact dispensed to inmates, there is no

evidence that any deficiencies in the dispensing process actually

amounted to deliberate indifference.

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B. Qualified Immunity

Defendant Roche asserts that even if liability is otherwise

established, he still is entitled to qualified immunity because

his actions in supervising the medical care provided at HDSP were

reasonable. 

Roche is correct in asserting that qualified immunity

shields public officials from liability for civil damages so long

as their conduct does “not violate clearly established statutory

or constitutional rights of which a reasonable person would have

known.” Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982).

Qualified immunity hence “provides ample protection to all but

the plainly incompetent or those who knowingly violate the law.” 

Malley v. Briggs, 475 U.S. 335, 341 (1986).

Assessing the validity of a qualified immunity defense

entails a two-step inquiry. First, the court must determine the

threshold issue of whether, taken in the light most favorable to

the party asserting the injury, the facts show the violation of a

constitutional right. Saucier v. Katz, 533 U.S. 194, 201 (2001). 

If such violation is established, the court must next address

whether the particular right in question is clearly established. 

Id. While the Plaintiff bears the burden of proving the

existence of a clearly established right at the time of the

allegedly impermissible conduct (LSO, Ltd. v. Stroh, 205 F.3d

1146, 1157 (9th Cir. 2000)), if that burden is met the burden

switches to Defendant to demonstrate that their actions were

reasonable even in the face of potentially violating a clearly

established constitutional right. 

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Doe v. Petaluma City Sch. Dist., 54 F.3d 1447, 1450 (9th Cir.

1995).

Here there can be little argument that Plaintiff’s

allegations, taken in the light most favorable to her claim, show

that Plaintiff failed to receive necessary medical care given

HDSP’s failure to prescribe essential heart medications that he

had been taking for many years. It is equally plain that a

prisoner has the right to receive adequate medical care while

incarcerated. Moreover, Defendant concedes that a prisoner’s

right to receive such care is clearly established. (Opening Mem.

of Points and Authorities, 15:15-17).

Hence the only real issue with respect to the availability

of qualified immunity is whether Defendant Roche has established

that he acted reasonably. That question may be resolved on

summary judgment, as Roche seeks here, if the essential facts are

undisputed, or if no reasonable juror could conclude that Roche’s

actions were anything but reasonable. See Sinaloa Lake Owners

Ass’n v. City of Simi Valley, 70 F.3d 1095, 1100 (9th Cir. 1995).

Defendant has not made that showing. Under the

circumstances, a reasonable juror could conclude that Roche acted

unreasonably in failing to develop procedures adequate to ensure

that Mr. Wright received his essential medications. As such, he

is not entitled to qualified immunity upon summary judgment.

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C. Eleventh Amendment Immunity

While § 1983 does provide a method by which individuals can

sue for violations of their civil rights, one of the

prerequisites for imposition of § 1983 liability is that the

claimed violations are committed by a “person” acting under color

of state law. Will v. Mich. Dep’t of State Police, 491 U.S. 58 

(1989). Significantly, under the sovereign immunity generally

afforded to states by the Eleventh Amendment, a state and its

officials sued in their official capacity do not qualify as

“persons” within the meaning of § 1983, and consequently neither

are subject to suit under the statute. Id. at 70-71; Cortez v.

County of Los Angeles, 294 F.3d 1186, 1188 (9th Cir. 2001). Will

explains the extension of Eleventh Amendment immunity to state

officials as follows: “Obviously, state officials literally are

persons. But a suit against a state official in his or her

official capacity is not a suit against the official but rather a

suit against the official’s office.” Id. at 71. Hence a suit

against an individual in his official capacity is no different

than suit against the state itself, and immunity applies.

While Defendant Roche is correct in asserting that Eleventh

Amendment immunity also applies to bar Plaintiff’s claims against

him in his official capacity, he fails to mention that

Plaintiff’s Section 1983 claim is pled against in both his

individual and official capacities. He does not even argue that

the immunity afforded by the Eleventh Amendment applies to claims

against him personally and therefore, summary judgment on that

ground cannot be had.

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 Because oral argument will not be of material assistance, 5

the Court ordered this matter submitted on the briefs in

accordance with E.D. Local Rule 78-230(h).

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CONCLUSION

For all the foregoing reasons, Plaintiff’s Motion for

Summary Judgment is DENIED as to Defendant Roche, but GRANTED as

to Defendant Runnels.5

IT IS SO ORDERED.

Dated: March 6, 2008

_____________________________

MORRISON C. ENGLAND, JR.

UNITED STATES DISTRICT JUDGE

Case 2:05-cv-02530-MCE -EFB Document 65 Filed 03/06/08 Page 17 of 17