Sifuentes v. Ola, et al.
Filing
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ORDER ADOPTING IN PART 23 FINDINGS AND RECOMMENDATIONS signed by District Judge Dale A. Drozd on 7/18/2018. This matter is referred back to the assigned magistrate judge for further proceedings consistent with this order. (Jessen, A)
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UNITED STATES DISTRICT COURT
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FOR THE EASTERN DISTRICT OF CALIFORNIA
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MIGUEL G. SIFUENTES,
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Plaintiff,
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v.
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No. 1:16-cv-00241-DAD-GSA
DR. OLA, et al.,
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ORDER DECLINING IN PART TO ADOPT
FINDINGS AND RECOMMENDATIONS
(Doc. No. 23)
Defendants.
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Plaintiff Miguel G. Sifuentes is a state prisoner proceeding pro se in this civil rights action
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brought pursuant to 42 U.S.C. § 1983. The matter was referred to a United States Magistrate
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Judge pursuant to 28 U.S.C. § 636(b)(1)(B) and Local Rule 302.
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On March 15, 2018, the assigned magistrate judge issued findings and recommendations,
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recommending that this action be dismissed due to plaintiff’s failure to state a claim upon which
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relief may be granted. (Doc. No. 23.) The findings and recommendations were served on
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plaintiff and contained notice that any objections thereto were to be filed within fourteen days
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from the date of service. (Id. at 10.) Plaintiff filed objections on April 2, 2018. (Doc. No. 24.)
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In accordance with the provisions of 28 U.S.C. § 636 (b)(1)(B) and Local Rule 304, this
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court has conducted a de novo review of this case. Having carefully reviewed the entire file,
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including plaintiff’s objections, the court concludes the findings and recommendations are not
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supported by the record and declines to adopt them in part.
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In his first amended complaint, plaintiff alleges as follows. On May 29, 2014, at
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approximately 11:45 a.m., plaintiff was examined by Dr. Fortune regarding a puncture wound to
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his abdomen. (Doc. No. 21 at 12.) Plaintiff contends that this examination was “cursory at best,”
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and that “no significant diagnosis or treatment was given.” (Id.) At 12:29 p.m. that same day,
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plaintiff was examined by Dr. Ola for this same injury. (Id.) Dr. Ola examined plaintiff, had an
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x-ray taken, and noted a “possible penetration of [plaintiff’s] abdominal wall.” (Id. at 13.)
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Plaintiff was provided with two sutures, and was prescribed Tylenol for his pain. (Id.) Dr. Ola
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scheduled plaintiff for a follow-up examination on June 2, 2014. (Id. at 13.) Plaintiff was placed
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in Administrative Segregation at approximately 3:00 p.m. that same day. (Id. at 8.) He remained
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there for approximately 55 hours, during which he was bed-ridden and suffered from excruciating
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pain and weakness due to internal bleeding. (Id. at 8–9.) On May 31, 2014, plaintiff was
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transported to UCSF-Fresno for treatment. (Id. at 9.) While hospitalized, plaintiff was in a coma
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for two days and suffered an abdominal infection. (Id.) He lost 2.5 liters of blood as a result of
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his internal bleeding, and remained at UCSF-Fresno for 13 days. Plaintiff was eventually
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discharged to the Pleasant Valley State Prison infirmary, where he remained until July 10, 2014.
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(Id. at 7.)
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“Under 42 U.S.C. § 1983, to maintain an Eighth Amendment claim based on prison
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medical treatment, an inmate must show ‘deliberate indifference to serious medical needs.’” Jett
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v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) (quoting Estelle v. Gamble, 429 U.S. 97, 104
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(1976)). Such a claim has two parts. First, the plaintiff must allege and ultimately demonstrate a
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serious medical need. Id. A medical need is serious “if the failure to treat a prisoner’s condition
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could result in further significant injury or the ‘unnecessary or wanton infliction of pain.’”
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McGuckin v. Smith, 974 F.2d 1050, 1059 (9th Cir. 1992) (quoting Estelle, 429 U.S. at 104),
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overruled on other grounds by WMX Techs., Inc. v. Miller, 104 F.3d 1133 (9th Cir. 1997).
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Examples of such serious medical needs include “an injury that a reasonable doctor or patient
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would find important and worthy of comment or treatment; the presence of a medical condition
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that significantly affects an individual's daily activities; or the existence of chronic and substantial
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pain.” Id. at 1059–60 (citing Wood v. Housewright, 900 F.2d 1332, 1337–41 (9th Cir. 1990) and
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Hunt v. Dental Dep’t, 865 F.2d 198, 200–01 (9th Cir. 1989)). If a serious medical need is
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established, a plaintiff must then allege and demonstrate that the defendant’s response to that
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serious medical need was deliberately indifferent. This prong is satisfied by showing “(a) a
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purposeful act or failure to respond to a prisoner’s pain or possible medical need and (b) harm
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caused by the indifference.” Jett, 439 F.3d at 1096. “Indifference ‘may appear when prison
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officials deny, delay or intentionally interfere with medical treatment, or it may be shown by the
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way in which prison physicians provide medical care.’” Id. (quoting McGuckin, 974 F.2d at
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1059); see also McGuckin, 974 F.2d at 1062 (noting that a plaintiff may succeed on a deliberate
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indifference claim by demonstrating that the medical treatment he received was “woefully
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inadequate”). However, “a prison official acts with ‘deliberate indifference . . . only if the prison
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official knows of and disregards an excessive risk to inmate health and safety.” Toguchi v.
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Chung, 391 F.3d 1051, 1057 (9th Cir. 2004) (quoting Gibson v. County of Washoe, 290 F.3d
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1175, 1187 (9th Cir. 2002)) (internal brackets omitted). It is not enough for the prison official to
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“be aware of facts from which the inference could be drawn that a substantial risk of serious harm
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exists.” Farmer v. Brennan, 511 U.S. 825, 837 (1994). Instead, the prison official “must also
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draw the inference.” Id.
Here, the allegations of plaintiff’s complaint, if proven, are sufficient to demonstrate that
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plaintiff plainly suffered from a serious medical need. The puncture wound to his abdomen
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caused him severe pain and blood loss, eventually rendering him comatose for two days. The
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magistrate judge concluded that plaintiff failed to state a claim against any of the named
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defendants, for two reasons. First, the magistrate judge concluded that the facts as alleged “do
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not cause the court to infer that any of the Defendants knew that Plaintiff was suffering from a
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life-threatening condition and yet proceeded to ignore a substantial risk of serious harm to
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Plaintiff’s health.” (Doc. No. 23 at 7.) Second, the magistrate judge found that “Plaintiff has not
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shown that the course of treatment chosen by medical personnel was medically unacceptable
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under the circumstances nor that they chose this course in conscious disregard of an excessive
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risk to Plaintiff’s health.” (Id.) Each of these conclusions will be addressed in turn below.
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Regarding whether Dr. Ola possessed knowledge of plaintiff’s condition and nonetheless
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ignored it, there is no factual allegation bearing directly on the Dr. Ola’s state of mind. This is
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unsurprising—it is a rare defendant who openly admits to a culpable state of mind. For this
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reason, “whether a prison official had the requisite knowledge of a substantial risk is a question of
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fact subject to demonstration in the usual ways, including inference from circumstantial
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evidence.” Harrington v. Scribner, 785 F.3d 1299, 1304 (9th Cir. 2015) (quoting Farmer, 511
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U.S. at 826). The court finds such circumstantial allegations to be present in plaintiff’s first
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amended complaint. For instance, plaintiff alleges defendant Ola’s notes from his examination of
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plaintiff state that plaintiff’s “distal end shows possible penetration of the abdominal wall.” (Doc.
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No. 21 at 13.) If true, this allegation would establish that Dr. Ola was therefore on actual notice
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of plaintiff’s injury. In addition, the allegation that Dr. Ola scheduled plaintiff for follow-up
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treatment provides further support for the conclusion that Dr. Ola was aware of the seriousness of
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plaintiff’s condition. See Jones v. Wong, No. 2:15-cv-0734-TLN-AC, 2018 WL 2297056, at *4
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(E.D. Cal. May 21, 2018) (noting that a defendant’s “alleged offer to schedule additional
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treatment by a specialist is adequate to allow the court to infer that she believed plaintiff’s
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symptoms presented a serious medical need”). This alleged awareness, when combined with the
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severe harm plaintiff ultimately suffered due to blood loss, provides a plausible basis to support a
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finding of deliberate indifference. See Jett, 439 F.3d at 1096 (“A prisoner need not show his
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harm was substantial; however, such would provide additional support for the inmate’s claim that
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the defendant was deliberately indifferent to his needs.”); see also McGuckin, 974 F.2d at 1060
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(9th Cir. 1992) (“The requirement of deliberate indifference is less stringent in cases involving a
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prisoner’s medical needs than in other cases involving harm to incarcerated individuals because
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‘[t]he State’s responsibility to provide inmates with medical care ordinarily does not conflict with
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competing administrative concerns.’”) (quoting Hudson v. McMillian, 503 U.S. 1, 6 (1993)).
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The magistrate judge also recommended dismissal of the first amended complaint because
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“Plaintiff has not shown that the course of treatment chosen by medical personnel was medically
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unacceptable under the circumstances nor that they chose this course in conscious disregard of an
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excessive risk to Plaintiff’s health.” (Doc. No. 23 at 7.) The undersigned disagrees. It is not
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plaintiff’s burden at this pleading stage of the proceedings to affirmatively show that the course of
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treatment was medically unacceptable. Instead, at this stage, plaintiff need only come forward
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with sufficient factual allegations to “state a claim to relief that is plausible on its face.” Ashcroft
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v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570
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(2007)). In this pro se civil rights action, in which courts are instructed to “construe the pleadings
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liberally and to afford the [plaintiff] the benefit of any doubt,” the undersigned concludes that
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dismissal would be inappropriate in light of plaintiff’s allegations. Hebbe v. Pliler, 627 F.3d
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338, 342 (9th Cir. 2010) (quoting Bretz v. Kelman, 773 F.2d 1026, 1027 n.1 (9th Cir. 1985) (en
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banc)). As this case proceeds through discovery, it may be established that plaintiff being treated
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by receiving stitches and Tylenol was medically acceptable, or that such minimal treatment
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merely amounted to medical malpractice or a difference of medical opinion, neither of which
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provides an adequate basis for a § 1983 medical care claim. However, given the allegations of
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plaintiff’s first amended complaint tending to show defendant Dr. Ola’s apparent awareness of
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the seriousness of plaintiff’s condition, as well as the allegations laying out the harm eventually
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suffered by plaintiff, the court finds that dismissal of the first amended complaint is not
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appropriate.
The findings and recommendations also recommended dismissal of plaintiff’s state law
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claim based upon plaintiff’s noncompliance with the California Government Claims Act, and
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recommended denial of plaintiff’s request for court-appointed counsel. Plaintiff has not
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challenged either of these conclusions in his objections, and the undersigned concurs with and
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adopts these recommendations.
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For these reasons,
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1.
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The findings and recommendations issued March 15, 2018 (Doc. No. 23) are
adopted in part;
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2.
Plaintiff’s cause of action based upon California state law is dismissed without
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prejudice due to his failure to comply with the claim presentment requirements of
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the California Government Claims Act;
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Plaintiff’s request for court-appointed counsel is denied without prejudice; and
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This matter is referred back to the assigned magistrate judge for further
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proceedings consistent with this order.
IT IS SO ORDERED.
Dated:
July 18, 2018
UNITED STATES DISTRICT JUDGE
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