Saldana v. Sayre

Filing 48

ORDER GRANTING DEFENDANTS' MOTION FOR SUMMARY JUDGMENT; ORDER GRANTING DEFENDANTS' MOTION TO DISMISS. Defendants' motion for summary judgment (Docket No. 24) is GRANTED as to all claims against defendants Claire Williams, Nnenna Ikegbu, Michael Sayre, and Maureen McLean. Defendants' motion to dismiss is GRANTED, and Saldana's state law claims are DISMISSED without prejudice. Signed by Judge William H. Orrick on 03/17/2014. (jmdS, COURT STAFF) (Filed on 3/17/2014)

1
2
3
4
5
6
7
8

UNITED STATES DISTRICT COURT

9

NORTHERN DISTRICT OF CALIFORNIA

10
11

SAMUEL SALDANA,

Case No. 11-cv-03921-WHO (PR)

United States District Court
Northern District of California

Plaintiff,
12

ORDER GRANTING DEFENDANTS'
MOTION FOR SUMMARY JUDGMENT

v.
13
14

MICHAEL SAYRE, et al.,

ORDER GRANTING DEFENDANTS'
MOTION TO DISMISS

Defendants.
15
16
17
18

INTRODUCTION
Plaintiff Samuel Saldana is a state prisoner proceeding pro se in this civil rights

19

action brought under 42 U.S.C. § 1983, in which he alleges that defendants, employees of

20

Pelican Bay State Prison, were deliberately indifferent to his medical needs in violation of

21

the Eighth Amendment. Defendants move for summary judgment and to dismiss. (Docket

22

No. 24.) For the reasons stated herein, defendants’ motions are GRANTED.

23
24

BACKGROUND
The facts of this case are undisputed unless noted otherwise. In late August or early

25

September of 2008, Saldana sustained injuries to his upper back, exacerbating existing

26

lower back injuries when he fell from the top bunk of his bed onto the concrete floor

27

below. (Am. Compl. ¶¶ 10–13.) Throughout 2008 and 2009, Saldana was treated by

28

Pelican Bay medical staff for his injury. X-rays taken in December 2008 of Saldana’s

1

cervical and lumbar spines were normal and failed to reveal the source of Saldana’s pain.

2

(Defs.’ Mot. to Dismiss and Mot. for Summ. J. (“MSJ”), Williams Decl. ¶ 3, Ex. A.)

3

Nevertheless, in response to Saldana's reports of pain, Pelican Bay’s medical staff

4

prescribed various muscle relaxants and pain medications. (Am. Compl. ¶¶ 14–20; MSJ,

5

Williams Decl., Ex. D.)

6

In late 2008 or early 2010 defendant Claire Williams, Saldana’s primary care

7

physician, began treating Saldana for back pain. (Am. Compl. ¶ 17, MSJ, Williams Decl.

8

¶ 3.) On January 8, 2010, Williams examined Saldana who complained of pain in his

9

lower back that radiated to his right hip. (MSJ, Williams Decl. ¶ 4, Ex. E.) Williams
diagnosed Saldana with chronic lower back pain, prescribed him Naprosyn for pain

11
United States District Court
Northern District of California

10

management and provided him with information regarding back care exercises and

12

techniques to help alleviate pain. (Id.)

13

Saldana continued to experience severe back pain and muscle spasms and returned

14

to Williams for treatment on June 3, 2010. (Id. ¶ 5.) Williams informed Saldana that he

15

could not determine the source of Saldana’s pain and would not refer him to an outside

16

specialist. (Am. Compl. ¶¶ 26–27.) Williams ordered additional x-rays of Saldana’s back

17

which once again failed to reveal the source of his pain. (MSJ, Williams Decl. ¶ 6.) He

18

renewed Saldana’s pain medication prescriptions and informed Saldana that no follow-up

19

visits were necessary. (Id. ¶¶ 5–6.)

20

By September 2010 Saldana’s pain had become so severe that it was difficult for

21

him to perform necessary daily activities. (Am. Compl. ¶ 33.) Williams prescribed

22

Indomethacin, an anti-inflammatory to reduce pain and swelling, for Saldana and ordered a

23

third set of x-rays, which were also objectively normal. (MSJ, Williams Decl. ¶ 8, Ex. C.)

24

On June 1, 2011, Saldana was treated by Nnenna Ikegbu, who replaced Williams as

25

his primary care physician. (Am. Compl. ¶ 42; MSJ, Ikegbu Decl. ¶ 5, Ex. C.) Saldana

26

once again complained that his current pain medication was ineffective, but Ikegbu

27

concluded that the Ibuprofen and back exercises were sufficient and ordered Saldana to

28

continue his current pain management regiment. (MSJ, Ikegbu Decl. ¶ 5, Ex. C.) Saldana
2

1

returned to Ikegbu on August 18, 2011, who concluded that the Ibuprofen was no longer

2

effectively addressing Saldana’s back pain. Ikegbu instead provided Saldana prescriptions

3

for Methocarbomol, a muscle relaxant, and Salsalate, for pain and inflammation reduction.

4

(Id. at ¶ 6, Ex. D.) Saldana states that these medications were also ineffective. (Am.

5

Compl. ¶¶ 45–46.)

6

On October 10, 2011 Saldana was once more treated by Ikegbu, who could not find

7

an objective cause for his radiating upper and lower back pain. (MSJ, Ikegbu Decl. ¶ 7,

8

Ex. E.) Saldana contends that as a result of the inadequate care he received from Williams

9

and Ikegbu, he is now experiencing secondary injuries in his knee and hip which greatly

10

United States District Court
Northern District of California

11

reduce his ability to perform basic daily functions. (Am. Compl. ¶ 48.)
Saldana states that at one of his visits with Williams, the doctor informed him that

12

he would not and could not prescribe Saldana stronger pain medication as doing so would

13

get him in trouble with his supervisors, defendants Michael Sayre and Maureen McLean.

14

(Am. Compl. ¶¶ 35–37.) He alleges that Williams gave other inmate–patients similar

15

information regarding decreasing medical care in order to cut costs. (Id. ¶ 37, Ex. D, Cole

16

Decl.) Saldana further alleges that a study was released showing that Pelican Bay was

17

issuing above-average amounts of medication to its prisoner-patients compared to other

18

prisons in the area, that Williams was blamed for the number of medications prescribed,

19

and that Williams was threatened with termination if he did not lower his medication and

20

treatment prescriptions. (Id. ¶¶ 38–39.) Finally, Saldana alleges that defendant Sayre

21

issued a memorandum in 2008 or 2009 instructing all medical personnel to provide Pelican

22

Bay inmate-patients with the minimum level of medical care. (Id. ¶¶ 39–40.)

23

Williams denies that he was ever “required by the management or staff members at

24

Pelican Bay to deny inmates, including Saldana, necessary treatment to minimize

25

treatment costs.” (MSJ, Williams Decl. ¶11). So does Ikegbu. (Ikegbu Decl. ¶10.) No

26

copy of the alleged study or memorandum has been provided to or filed with the Court.

27

In sum, Saldana alleges that defendants failed to adequately diagnose and

28

treat his ongoing back pain in violation of his Eighth Amendment rights. Saldana further
3

1

alleges claims of negligence, infliction of emotional distress and medical malpractice

2

against defendants.

3

STANDARD OF REVIEW

4

Summary judgment is proper where the pleadings, discovery and affidavits

5

demonstrate that there is “there is no genuine dispute as to any material fact and [that] the

6

movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). Material facts

7

are those which may affect the outcome of the case. Anderson v. Liberty Lobby, Inc., 477

8

U.S. 242, 248 (1986). A dispute as to a material fact is genuine if there is sufficient

9

evidence for a reasonable jury to return a verdict for the nonmoving party. Id.

10

The party moving for summary judgment bears the initial burden of identifying

United States District Court
Northern District of California

11

those portions of the pleadings, discovery and affidavits which demonstrate the absence of

12

a genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986).

13

Where the moving party will have the burden of proof on an issue at trial, it must

14

affirmatively demonstrate that no reasonable trier of fact could find other than for the

15

moving party. On an issue for which the opposing party by contrast will have the burden

16

of proof at trial, as is the case here, the moving party need only point out “that there is an

17

absence of evidence to support the nonmoving party’s case.” Id. at 325.

18

Once the moving party meets its initial burden, the nonmoving party must go

19

beyond the pleadings and, by its own affidavits or discovery, “set forth specific facts

20

showing that there is a genuine issue for trial.” Fed. R. Civ. P. 56(e). The court is only

21

concerned with disputes over material facts and “[f]actual disputes that are irrelevant or

22

unnecessary will not be counted.” Anderson, 477 U.S. at 248. It is not the task of the

23

court “to scour the record in search of a genuine issue of triable fact.” Keenan v. Allen, 91

24

F.3d 1275, 1279 (9th Cir. 1996). The nonmoving party has the burden of identifying, with

25

reasonable particularity, the evidence that precludes summary judgment. Id. If the

26

nonmoving party fails to make this showing, “the moving party is entitled to judgment as a

27

matter of law.” Celotex, 477 U.S. at 323.

28
4

DISCUSSION

1
2
3

I.

Motion for Summary Judgment
Deliberate indifference to a prisoner’s serious medical needs violates the Eighth

4

Amendment’s proscription against cruel and unusual punishment. See Estelle v. Gamble,

5

429 U.S. 97, 104 (1976). A determination of “deliberate indifference” involves an

6

examination of two elements: the seriousness of the prisoner’s medical needs and the

7

nature of the defendant’s response to those needs. McGuckin v. Smith, 974 F.2d 1050,

8

1059 (9th Cir. 1992) (overruled on other grounds, WMX Technologies, Inc. v. Miller, 104

9

F.3d 1133, 1136 (9th Cir. 1997) (en banc)).
A prison official is deliberately indifferent if he knows that a prisoner faces a

11
United States District Court
Northern District of California

10

substantial risk of serious harm and disregards that risk by failing to take reasonable steps

12

to abate it. Farmer v. Brennan, 511 U. S. 825, 837 (1994) (equating standard with that of

13

criminal recklessness). The prison official must not only “be aware of facts from which

14

the inference could be drawn that a substantial risk of serious harm exists,” but “must also

15

draw the inference.” Id. Consequently, in order for deliberate indifference to be

16

established, there must exist both a purposeful act or failure to act on the part of the

17

defendant and harm resulting therefrom. See McGuckin, 974 F.2d at 1060.

18

In order to prevail on a claim of deliberate indifference to medical needs, a plaintiff

19

must establish that the course of treatment the doctors chose was “medically unacceptable

20

under the circumstances” and that they embarked on this course in “conscious disregard of

21

an excessive risk to the plaintiff’s health.” See Toguchi v. Chung, 391 F.3d 1051, 1058–60

22

(9th Cir. 2004). A claim of mere negligence related to medical problems, or a difference

23

of opinion between a prisoner-patient and a medical doctor, is not enough to make out a

24

violation of the Eighth Amendment. Id.; Franklin v. Oregon, 662 F.2d 1337, 1344 (9th

25

Cir. 1981).

26

A.

Williams

27

Defendant Williams is entitled to summary judgment as a matter of law. The

28

undisputed record shows that Saldana received appropriate and reasonably timely medical
5

1
2

treatment.
On January 8, 2010, Williams treated Saldana for an increase in his lower back pain

3

with radiation to Saldana’s right hip. Williams performed a thorough physical

4

examination and found that Saldana had no complaints of numbness, weakness or loss of

5

sphincter control. Based on these findings, Williams prescribed Saldana Naprosyn, gave

6

him physical therapy exercises to address the injury and advised Saldana to come back if

7

his symptoms worsened, changed or persisted. (MSJ, Williams Decl. ¶ 4, Ex. E.)

8
9

When Saldana’s symptoms did not resolve he returned for treatment with Williams
on June 3, 2010. Williams ordered follow-up x-rays of Saldana’s back, prescribed
Ibuprofen to Saldana and advised Saldana to follow up with him as needed. (Id. ¶ 6.)

11
United States District Court
Northern District of California

10

Based on his examination and the results of the x-ray, Williams concluded that he could

12

not determine the exact source of Saldana’s pain and follow-up visits were no longer

13

needed.

14

Over the next year Williams prescribed Saldana a variety of muscle relaxants and

15

pain medications to address Saldana’s back pain and ordered a third x-ray of Saldana’s

16

back. These actions show that defendant Williams was aware of Saldana’s condition and

17

sought to treat it, rather than showing deliberate indifference.

18

Saldana alleges that Williams gave him inadequate medical treatment and failed to

19

follow Pelican Bay protocols regarding ongoing pain management and muscular-skeletal

20

disorders. Saldana argues that pursuant to these protocols he should have been given

21

stronger pain medications and referrals to outside specialists. "A difference of opinion

22

between a prisoner-patient and prison medical authorities regarding treatment does not

23

give rise to a § 1983 claim." Franklin, 662 F.2d at 1344. Similarly, a showing of nothing

24

more than a difference of medical opinion as to the need to pursue one course of treatment

25

over another is insufficient, as a matter of law, to establish deliberate indifference. See

26

Toguchi, 391 F.3d at 1058, 1059–60. In addition, “[a] prison inmate has no independent

27

constitutional right to outside medical care additional and supplemental to the medical care

28

provided by the prison staff within the institution.” See Roberts v. Spalding, 783 F.2d 867,
6

1
2

870 (9th Cir. 1986).
Saldana has offered no evidence to show that Pelican Bay had specific protocols in

3

place regarding pain management or muscular-skeletal disorders, that such protocols

4

would have applied to Saldana, or that they were not followed. Instead the record reflects

5

that Williams tried numerous courses of treatment and diagnostic testing in order to

6

ascertain the source of Saldana’s pain including three x-rays, physical therapy exercises,

7

and three different types of pain medication. That Saldana believes that his back pain

8

could have been resolved by stronger pain medications or outside medical attention does

9

not create a material dispute whether Williams acted with conscious disregard of an
excessive risk to Saldana’s health, particularly given that Williams continuously tried new

11
United States District Court
Northern District of California

10

diagnostic testing, medications and exercises in an attempt to resolve Saldana’s pain.

12

Saldana contends that Williams was instructed by defendants Sayre and McLean to

13

provide the bare minimum in medical care to prisoner-patients in an effort to reduce

14

medical costs at Pelican Bay. As proof, Saldana offers the declaration of his fellow inmate

15

Robert Cole, who asserts that he was told by Williams and two other medical personnel at

16

Pelican Bay that prescriptions were being curtailed or eliminated for cost reasons. (Cole

17

Decl., ¶¶ 4, 10 and 11.) Doctors Williams and Ikegbu, on the other hand, deny that they

18

were ever required not to provide necessary treatment to inmates. (Williams Decl. ¶ 11;

19

Ikegbu Decl. ¶ 10.)

20

The statements of Cole, Williams and Ikegbu do not necessarily conflict.

21

Consistent with the duty to provide constitutionally adequate medical treatment, physicians

22

and medical personnel are entitled to achieve that result in a cost-effective way. The issue

23

here is whether defendants were deliberately indifferent to Saldana’s needs, and the

24

evidence discussed above shows that they were not. Saldana fails to establish the

25

existence of a conspiracy to limit costs by providing nominal and constitutionally

26

inadequate treatment, and further fails to establish that if such a conspiracy existed it

27

applied in any way to the treatment he received from Williams. Saldana has failed to show

28

that there is a genuine dispute as to any material fact. The motion for summary judgment
7

1

as to Williams is GRANTED.

2

B.

Ikegbu

3

Defendant Ikegbu is also entitled to summary judgment. Saldana alleges that

4

Ikegbu refused to provide Saldana with effective treatment to address his pain. (Am.

5

Compl. ¶¶ 45–47.) However, Ikegbu provided Saldana with anti-inflammatory

6

medication, a muscle relaxant, and extensive advice regarding physical therapy and

7

stretching. (MSJ, Ikegbu Decl. ¶¶ 5–7.) Ikegbu’s actions were reasonable, especially

8

given that even after numerous tests and examinations, Saldana was never found to have

9

an objectively serious back condition.

10

There is consensus in the medical community “that the only treatments that have a

United States District Court
Northern District of California

11

positive impact for back pain are general exercise, stretching, occasional pain medications.

12

. . and infrequent muscle relaxants for short bursts.” (Id. at ¶ 9.) Ikegbu’s treatment of

13

Saldana’s back pain included all of the objectively reasonable and standard medical

14

treatments. The undisputed record shows that Saldana received appropriate and reasonably

15

timely medical treatment. Saldana has therefore failed to show that there is a “genuine

16

dispute as to any material fact and the movant is entitled to judgment as a matter of law.”

17

Fed. R. Civ. P. 56(a). Accordingly, the motion for summary judgment as to Ikegbu is

18

GRANTED.

19

C.

Michael Sayre

20

Saldana’s allegations against defendant Sayre, who never treated the Saldana, are

21

based on Sayre’s status as Williams’s supervisor. As Saldana has not shown that Williams

22

violated his Eighth Amendment rights, his claim against Sayre necessarily fails.

23

Accordingly, the motion for summary judgment as to Sayre is GRANTED.

24

D.

Maureen McLean

25

Saldana’s allegations against McLean rest on the same theory as those against

26

Sayre; that is, that McLean is Williams’s supervisor. As Saldana has not shown that

27

Williams violated his Eighth Amendment rights, his claims against McLean necessarily

28

fail. Accordingly, the motion for summary judgment as to McLean is GRANTED.
8

1

II.

Motion to Dismiss

2

The federal claims having been disposed of, the Court declines to exercise

3

jurisdiction over Saldana’s state law claims. Accordingly, Saldana’s state law claims are

4

DISMISSED without prejudice to Saldana pursuing such claims in state court.
CONCLUSION

5
6

Saldana has failed to show that there are triable issues of material fact as to any of
his claims. Defendants’ motion for summary judgment (Docket No. 24) is GRANTED as

8

to all claims against defendants Claire Williams, Nnenna Ikegbu, Michael Sayre, and

9

Maureen McLean. Defendants' motion to dismiss is GRANTED, and Saldana's state law

10

claims are DISMISSED without prejudice. The Clerk shall enter judgment in favor of all

11
United States District Court
Northern District of California

7

defendants as to all claims, terminate Docket No. 24, and close the file.

12
13

IT IS SO ORDERED.
Dated: March 17, 2014
_________________________
WILLIAM H. ORRICK
United States District Judge

14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
9

UNITED STATES DISTRICT COURT
FOR THE
NORTHERN DISTRICT OF CALIFORNIA

SAMUEL SALDANA,

Case Number: CV11-03921 WHO

Plaintiff,

CERTIFICATE OF SERVICE

v.
M SAYRE et al,
Defendant.

/

I, the undersigned, hereby certify that I am an employee in the Office of the Clerk, U.S. District
Court, Northern District of California.
That on March 17, 2014, I SERVED a true and correct copy of the attached, by placing said
copies in a postage paid envelope addressed to the person hereinafter listed, by depositing said
envelope in the U.S. Mail.

Samuel Saldana V-30056
Pelican Bay State Prison
D10-204
P.O. Box 7500
Crescent City, CA 95532

Dated: March 17, 2014
Richard W. Wieking, Clerk
By: Jean Davis, Deputy Clerk