Garza et al v. Yuma County et al

Filing 275

ORDER denying 223 Motion for Partial Summary Judgment. Signed by Judge John W Sedwick on 11/16/11.(JWS)

UNITED STATES DISTRICT COURT
DISTRICT OF ARIZONA

M.M., et al.,
Plaintiffs,
vs.
YUMA COUNTY, et al.,
Defendants.

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2:07-cv-01270 JWS
ORDER AND OPINION
[Re: Motion at Docket 223]

I. MOTION PRESENTED
At docket 223, defendant Radu Timis (“defendant” or “Timis”) moves for partial
summary judgment pursuant to Federal Rule of Civil Procedure 56. Plaintiffs M.M.,
Ashley Ingraham (“Ingraham”), and Alex Garza (“Garza”; collectively “plaintiffs”) oppose
the motion at docket 244. Defendant’s reply is at docket 261. Oral argument was not
requested and would not assist the court.
II. BACKGROUND
This lawsuit arises out of the premature birth of M.M. Ingraham is M.M’s mother
and Garza is M.M’s father. Timis is a registered nurse. At the time of M.M’s birth, Timis
was employed by Northend Health Associates (“Northend”). Northend contracted to
provide medical services at the Yuma County Detention Center.

Inghraham was taken into custody at the Yuma County Detention Center on
September 7, 2006. Ingraham was examined at intake by Elanor Snyder (“Snyder”).
She informed Snyder that she was pregnant, suffered from bipolar disorder, and was
taking medication. Ingraham was given prenatal vitamins. The following day, at
10:39 a.m., Ingraham was examined by defendant Kindra Gonzales (“Gonzales”),
Northend’s Director of Nursing. Gonzales was informed that Ingraham had an outburst
at a court hearing that morning. She was unaware whether Ingraham would be in jail
for an extended period, but was told that Ingraham was pregnant, acknowledged the
need for Ingraham’s medical records, and ordered a vital sign check and a urinalysis to
confirm the pregnancy.
Ingraham was brought back to the medical department at 10:56 a.m. after she
complained that she was having contractions and needed her psychiatric medications.
Gonzales performed an abdominal exam and did not notice anything out of the ordinary.
Ingraham asked to be taken to the hospital and stated that her water broke. Gonzales
examined Ingraham’s underwear and found “a small amount of yellow fluid with urine
smell [and] no bloody show.”1 Gonzales reported that it did “not appear to be amniotic
fluid” and that she was “unable to test” it.2 Gonzales then contacted Northend’s Medical
Director, Jose Piscoya (“Piscoya”). Piscoya ordered that Ingraham be given Tylenol for
pain and instructed that she not be sent to the hospital at that time.

1

Doc. 207-1 at 6.

2

Id. at 7.

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Timis’s first interaction with Ingraham was on September 9, 2006, at around
3:30 p.m. It was reported to Timis that Ingraham was jumping on her abdomen to
trigger a miscarriage.3 Timis examined Ingraham’s abdomen in the presence of
Sergeant Joe Franklin (“Franklin”). Franklin told Ingraham that if she continued her
behavior, it may be necessary to restrain her or place her on suicide watch.
Approximately an hour later, Timis reassessed Ingraham, again in Franklin’s
presence. Ingraham was crying, told them that she was not a good mother because
she was in jail, and that she wanted to terminate her pregnancy. Ingraham requested
pain medication for back, abdominal, and lower pelvic pain. Timis suggested that
Ingraham give her child up for adoption and told her again that suicide watch might be
necessary. Franklin told her that she could be charged with “premeditated
manslaughter” if she successfully aborted her pregnancy in jail.4
Timis examined Ingraham again at 8:05 p.m. Ingraham was complaining of
lower pelvic pain and was bleeding. She was also “crying hysterically that she want[ed]
to keep the child.”5 Timis observed three to four pads approximately one-third full of
“fresh red blood” and bloody water in the toilet bowl.6 Timis noted that Ingraham’s
abdomen was “large, soft, [and] non tender,” and that her “lower pelvic area [was] non

3

Doc. 224-1 at 11–12.

4

Id. at 11.

5

Id.

6

Id.

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tender in palpation.”7 Timis checked for uterine contractions and did not feel any. Timis
put Ingraham on medical watch, bed rest, and a pad count.
Timis examined Ingraham a fourth and final time at approximately 9:27 p.m. after
Ingraham complained that her mucus plug had come out. Timis observed a pad “with a
filament of mucus that seemed to be from [Ingraham’s] nose.”8 Timis noted that
Ingraham would be placed in a dry cell9 and noted an instruction that if Ingraham
miscarried, she was not to flush the “foetal product” down the toilet.10 Timis ordered that
Ingraham be provided with a personal water jug for hydration.
Subsequently, Ingraham yelled from her cell that she was in labor, was in pain,
needed her medications, and that she had been experiencing vaginal bleeding for
hours. At around 1:00 a.m. on September 10, 2006, Ingraham gave birth to M.M. in her
cell.
Ingraham and Garza, individually and on behalf of M.M., filed a lawsuit against
the Yuma County Jail District, various jail officers, and various employees of Northend,
inlcuding Timis. Plaintiffs’ complaint alleges that all defendants deprived them of their
civil rights in violation of 42 U.S.C. § 1983 and that all defendants were negligent.

7

Id.

8

Id.

9

A dry cell is a cell in which an inmate cannot flush the toilet unless prison administrators
turn on the water. Doc. 262-1 at 6. There is evidence that the dry cell was Timis’s idea.
Doc. 224-1 at 29.
10

Doc. 224-1 at 11.

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III. STANDARD OF REVIEW
Summary judgment is appropriate where “there is no genuine issue as to any
material fact and . . . the movant is entitled to judgment as a matter of law.”11 The
materiality requirement ensures that “only disputes over facts that might affect the
outcome of the suit under the governing law will properly preclude the entry of summary
judgment.”12 Ultimately, “summary judgment will not lie if the . . . evidence is such that a
reasonable jury could return a verdict for the nonmoving party.”13 In resolving a motion
for summary judgment, a court must view the evidence in the light most favorable to the
non-moving party.14 The reviewing court may not weigh evidence or assess the
credibility of witnesses.15 The burden of persuasion is on the moving party.16
IV. DISCUSSION
A. Timis’s Request to Strike References to Dr. Greifinger and Dr. Sinkhorn’s
Testimony
In his reply brief, Timis moves to strike references to Dr. Greifinger and
Dr. Sinkhorn’s testimony. The portions of those experts’ testimony relied on by plaintiffs

11

Fed. R. Civ. P. 56(c)(2).

12

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

13

Id.

14

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

15

Dominguez-Curry v. Nevada Transp. Dept., 424 F.3d 1027, 1036 (9th Cir. 2005).

16

Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986).

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has no bearing on disposition of Timis’s motion for summary judgment and therefore
need not be stricken from their response.
B. Whether Plaintiffs Have Presented Evidence Supporting a Conclusion that
Timis was Deliberately Indifferent to a Serious Medical Need
In order to prevail on their § 1983 claim, plaintiffs must show that Timis acted
with “deliberate indifference to [Ingraham’s] serious medical needs.”17 Negligence in
diagnosis or treatment–medical malpractice–does not necessarily rise to the level of
deliberate indifference.18 Deliberate indifference requires subjective awareness of a
serious medical need and a failure to adequately respond to that need.19
For purposes of this motion, Timis does not dispute that Ingraham had a serious
medical need. Timis argues that summary judgment on plaintiffs’ § 1983 claim is
nonetheless appropriate because Timis did not believe that Ingraham was in labor.
Because he was not subjectively aware that Ingraham was in labor, Timis argues, he
could not have been deliberately indifferent to her serious medical need.
Plaintiffs’ response is two-fold. First, plaintiffs argue that Timis was aware of
Ingraham’s mental illness and the reports of her attempting to trigger a miscarriage and
did not adequately respond. Second, plaintiffs argue Timis was aware that there was a
substantial risk that Ingraham was in labor and did not adequately respond.

17

Estelle v. Gamble, 429 U.S. 97, 104 (1976).

18

Id. at 106.

19

Simmons v. Navajo County, 609 F.3d 1011, 1017–18 (9th Cir. 2010).

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Plaintiffs have presented evidence from which a reasonable jury could conclude
that Timis was aware of a serious medical need. Timis was aware of reports that
Ingraham was “hitting her abdomen on [the jail cell] floor, hoping to start a
miscarriage.”20 Timis was aware that Ingraham–at least at some point–“want[ed] to
abort the pregnancy.”21 Timis was also aware that Ingraham might be susceptible to the
influence of other inmates and noted that it may have been other inmates that prompted
Ingraham to hit her abdomen on the floor.22 Timis was also aware that Ingraham was
bleeding, complaining of contractions, and that she claimed her mucus plug had come
out.23 Finally, Timis noted that “[i]n case of miscarriage, [Ingraham was] not to flush
down the drain the foetal product.”24 In conjunction with awareness of the facts above,
that statement could show that Timis was aware that birth or miscarriage was imminent
or that Timis was aware that Ingraham’s behavior imminently threatened the viability of
her pregnancy.
In either event, that evidence could support a conclusion that Timis knew of and
disregarded an excessive risk to Ingraham’s health.25 If a jury were to conclude only
that Timis was aware that Ingraham’s behavior put her and her pregnancy at serious

20

Doc. 224-1 at 11–12.

21

Id. at 11.

22

Id.

23

Id.

24

Id. Timis argues that it was Franklin who had Ingraham placed in a dry cell, but this
fact is disputed. Compare doc. 262-1 at 6 with doc. 224-1 at 29.
25

See Simmons, 609 F.3d at 1017.

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risk, it might conclude that Timis’s response was inadequate. Similarly, if a jury were to
conclude that Timis was subjectively aware that Ingraham was in labor or that labor was
imminent, it might also find that Timis’s response was inadequate.
V. CONCLUSION
For the reasons above, defendant’s motion for partial summary judgment
pursuant to Rule 56 is DENIED.
DATED this 16th day of November 2011.

/s/
JOHN W. SEDWICK
UNITED STATES DISTRICT JUDGE

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