Jones v. Sadeghi et al

Filing 34

ORDER by Judge Charles R. Breyer denying 30 Motion to clarification of order ; denying 31 Motion for discovery; granting 23 Motion for Summary Judgment; denying 29 Motion for independent examination by optometrist. (Attachments: # 1 Certificate/Proof of Service) (beS, COURT STAFF) (Filed on 6/6/2014)

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IN THE UNITED STATES DISTRICT COURT

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FOR THE NORTHERN DISTRICT OF CALIFORNIA

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ARTHUR RAY JONES,

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Plaintiff(s),

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vs.
J. SADEGHI, M.D.,
Defendant.

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No. C 13-1798 CRB (PR)
ORDER GRANTING
DEFENDANT’S MOTION FOR
SUMMARY JUDGMENT
(Docket #23, 29, 30 & 31)

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Plaintiff Arthur Ray Jones, a prisoner at San Quentin State Prison (SQSP),

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filed a pro se complaint for damages under 42 U.S.C. § 1983 alleging that he

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received improper medical care for his left eye. Plaintiff specifically alleges that

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SQSP Dr. Jahangir Sadeghi operated on Plaintiff’s left eye, which rendered

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Plaintiff blind. Plaintiff also claims that Dr. Sadeghi ignored Plaintiff’s post-

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surgery complaints.

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Per order filed on August 12, 2013, the Court screened Plaintiff’s

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complaint pursuant to 28 U.S.C. § 1915A and found that Plaintiff’s allegations,

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when liberally construed, stated a cognizable Eighth Amendment claim under

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§ 1983 for deliberate indifference to serious medical needs against Defendant Dr.

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Sadeghi and ordered him served. August 12, 2013 Order (dkt. #6) at 2.

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Defendant Dr. Sadeghi now moves for summary judgment under Federal

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Rule of Civil Procedure 56 on the ground that there are no material facts in

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dispute and that he is entitled to judgment as a matter of law. Mot. for Summ. J.

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(dkt. #23) at 1. Defendant specifically argues that, even when viewed in the light

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most favorable to Plaintiff, the evidence in the record does not demonstrate that

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he was deliberately indifferent to Plaintiff’s serious medical needs in violation of

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the Eighth Amendment. Id. at 10-16. Plaintiff filed an opposition, and

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Defendant filed a reply. On May 2, 2014, the Court issued a Rand notice, and

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permitted Plaintiff to file a supplemental opposition if he so desired. Order (dkt.

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#27) at 2, citing Rand v. Rowland,154 F.3d 952, 962-63 (9th Cir. 1998) (en

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banc). Thereafter, Plaintiff filed a supplemental opposition and Defendant filed a

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supplemental reply.

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Plaintiff also recently filed a motion for an independent examination by an

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optometrist, a motion for clarification, and a motion for discovery. Dkt. # 29, 30,

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& 31.

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UNDISPUTED FACTS
In February 2009, Plaintiff was housed at Solano State Prison. Compl.

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(dkt. #1) at 3A. Plaintiff’s eyes became blurred and Plaintiff had cataract surgery

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on his right eye – the worse of the two eyes. Id.; Stamper Decl. ¶ 6a. As a result,

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the vision in Plaintiff’s right eye became clear again. Compl. at 3A. Plaintiff

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was also provided with lenses for both of Plaintiff’s eyes. Thereafter, Plaintiff

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was transferred to SQSP. Id. On July 29, 2010, Defendant saw Plaintiff and

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noted that Plaintiff’s vision test for his left eye was 20/150. Stamper Decl. ¶ 6b.

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Defendant believed Plaintiff had cataract in his left eye. Id. On August 18, 2010,

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Defendant performed cataract surgery on Plaintiff’s left eye. Compl. at 3A; Opp.

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(dkt. #25) at 1. Defendant used a premium intralocular lens on Plaintiff’s left

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eye. Stamper Decl. ¶ 7b. The same kind of lens had been used for Plaintiff’s

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right eye. Id. No complications were identified during surgery. Id. Plaintiff was

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directed to keep an eye patch over his left eye for two days. Compl. at 3A. The

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following day, Plaintiff complained that he could not see out of his left eye.

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Defendant noted that Plaintiff had some corneal swelling due to the surgery, but

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that the intraocular lens was in good position. Stamper Decl. ¶¶ 6q, 7c. Plaintiff

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was instructed to return for a follow-up in one week. Sadeghi Decl. ¶ 5.
Plaintiff did not return for a post-operative visit with Defendant until

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December 1, 2011. Id. at ¶ 5. In the meantime, on September 16 and August 18,

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2011, Plaintiff had routine medical check-ups where Plaintiff had no complaints

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regarding his bilateral cataracts and was otherwise stable. Stamper Decl. ¶¶ 6h,

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6i.

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At Plaintiff’s next appointment with ophthalmology on December 1, 2011,

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Plaintiff informed Defendant that he still could not see out of his left eye.

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Compl. at 3A. Defendant made Plaintiff glasses for his left eye, but the glasses

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did not help.1 Stamper Decl. ¶ 6g. Plaintiff received the glasses on January 16,

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2012. Id. ¶ 6k. Defendant told Plaintiff to return in six months. Id. ¶ 6j. At

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some point, Defendant made a second set of glasses, which were also unhelpful.

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Compl. at 3A.

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On March 1, 2012, Plaintiff told Defendant that his vision had changed.

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Stamper Decl. ¶ 6l. Defendant noted that Plaintiff’s uncorrected vision in his left

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eye was 20/100. Id. Defendant also observed that the intraocular lens in

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Plaintiff’s left eye was dislocated so Defendant submitted a request for services

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to SQSP and planned to exchange the intraocular lens for an anterior chamber

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Defendant asserts that he did not actually give Plaintiff glasses, but wrote a
prescription instead. Sadeghi Decl. ¶ 6.

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intraocular lens. Id.

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On April 18, 2012, Defendant operated on Plaintiff’s left eye again.

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Compl. at 3A-3B. During surgery, Defendant discovered that the posterior

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capsule was broken, but because a significant amount of the anterior capsule and

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part of the posterior capsule remained, Defendant felt there was sufficient

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material left to continue using an intraocular lens rather than replacing it with an

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anterior chamber intraocular lens. Stamper Decl. ¶ 6o. However, the second

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surgery did not cure Plaintiff’s blindness in his left eye, and Plaintiff began

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experiencing pain in that left eye. Compl. at 3B. Plaintiff informed Defendant,

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and Defendant responded that he would make Plaintiff another set of glasses. Id.

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On April 26, 2012, and May 3, 2012, Defendant noted that the intraocular lens

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was in a good position and Plaintiff’s vision test for his left eye was 20/80.

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Stamper Decl. ¶¶ 6r, 6s.

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After a third set of glasses failed to help Plaintiff’s eyesight in his left eye,

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Plaintiff asked Defendant to obtain the previous set of lenses that the previous

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ophthalmologist had gotten for him at Solano State Prison. Compl. at 3B.

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Defendant refused. Id.

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On May 24, 2012, Defendant saw Plaintiff and noted that both intraocular

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lenses were in good positions. Stamper Decl. ¶ 6v. On July 27, 2012, Defendant

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saw Plaintiff and noted that his left eye vision test was 20/100-2. Id. ¶ 6w.

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Defendant recommended distance glasses and instructed Plaintiff to return in

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three months. Id.

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Instead of returning in three months, as directed, Plaintiff saw Defendant

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again fifteen months later on October 31, 2013. Id. ¶ 6z. Plaintiff reported blurry

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vision and stated that the glasses were unhelpful. Id. Defendant noted that

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Plaintiff’s intraocular lenses were in good positions, and that Plaintiff’s corrected

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vision was 20/25 in both eyes at Plaintiff’s last visit, but was now showing 20/40-

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1. Id. Defendant recommended optical coherence tomography to make sure that

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Plaintiff did not have cystoid macular edema. Id. On February 12, 2014,

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Plaintiff underwent the procedure, and the test was negative, revealing a normal

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retina. Id.
On April 19, 2012, Plaintiff filed the instant action alleging that Defendant

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was deliberately indifferent to his serious medical needs when he operated on

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Plaintiff’s left eye, which rendered Plaintiff blind, and when he ignored

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Plaintiff’s post-surgery complaints.
DISCUSSION

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A.

Standard of Review
Summary judgment is proper when the pleadings, discovery, and affidavits

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

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

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Material facts are those which may affect the outcome of the case. Anderson v.

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Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). A dispute as to a material fact is

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genuine if there is sufficient evidence for a reasonable jury to return a verdict for

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the nonmoving party. Id.

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The party moving for summary judgment bears the initial burden of

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identifying those portions of the pleadings, discovery, and affidavits which

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demonstrate the absence of a genuine dispute of material fact. Celotex Corp. v.

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Cattrett, 477 U.S. 317, 323 (1986). Where the moving party will have the burden

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of proof on an issue at trial, it must affirmatively demonstrate that no reasonable

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trier of fact could find other than for the moving party. Id. But on an issue for

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which the nonmoving party will have the burden of proof at trial, as is the case

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here, the moving party need only point out “that there is an absence of evidence

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to support the nonmoving party’s case.” Id.

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

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go beyond the pleadings to demonstrate the existence of a genuine dispute of

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material fact by “citing to particular parts of materials in the record” or “showing

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that the materials cited do not establish the absence or presence of a genuine

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dispute.” Fed. R. Civ. P. 56(c). A triable dispute of fact exists only if there is

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sufficient evidence favoring the nonmoving party to allow a reasonable jury to

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return a verdict for that party. Anderson, 477 U.S. at 249. If the nonmoving

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

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

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B.

Analysis

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A prison official violates the Eighth Amendment’s proscription against

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cruel and unusual punishment when he acts with deliberate indifference to the

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serious medical needs of a prisoner. Farmer v. Brennan, 511 U.S. 825, 828

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(1994). To establish an Eighth Amendment violation, a plaintiff must satisfy

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both an objective standard – that the deprivation was serious enough to constitute

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cruel and unusual punishment – and a subjective standard – deliberate

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indifference. Snow v. McDaniel, 681 F.3d 978, 985 (9th Cir. 2012). To meet the

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objective standard, the denial of a plaintiff’s serious medical need must result in

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the “‘unnecessary and wanton infliction of pain.’” Id. (quoting Estelle v.

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Gamble, 429 U.S. 97, 104 (1976)). To meet the subjective standard of deliberate

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indifference, a prison official must know that a prisoner faces a substantial risk of

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serious harm and disregard that risk by failing to take reasonable steps to abate it.

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Farmer, 511 U.S. at 837.

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Negligence cannot establish liability under the Eighth Amendment. Id. at
835-36 n.4. An “official’s failure to alleviate a significant risk that he should

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have perceived but did not . . . cannot under our cases be condemned as the

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infliction of punishment.” Id. at 838. Instead, “the official’s conduct must have

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been ‘wanton,’ which turns not upon its effect on the prisoner, but rather, upon

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the constraints facing the official.” Frost v. Agnos, 152 F.3d 1124, 1128 (9th Cir.

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1998) (citing Wilson v. Seiter, 501 U.S. 294, 302-03 (1991)). Prison officials

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violate their constitutional obligation only by “intentionally denying or delaying

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access to medical care.” Estelle, 429 U.S. at 104-05.

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A showing of nothing more than a difference of medical opinion as to the

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need to pursue one course of treatment over another is generally insufficient to

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establish deliberate indifference. Toguchi v. Chung, 391 F.3d 1051, 1058 (9th

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Cir. 2004). To prevail on a claim involving choices between alternative courses

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of treatment, a prisoner-plaintiff must show that the course of treatment the

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doctor-defendants chose was medically unacceptable under the circumstances

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and that they chose this course in conscious disregard of an excessive risk to

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plaintiff’s health. Id.

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Defendant claims he is entitled to summary judgment because, even when

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viewed in the light most favorable to Plaintiff, the evidence in the record does not

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show that he was deliberately indifferent to Plaintiff’s medical needs. The Court

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agrees. In view of the undisputed evidence in the record, no reasonable jury

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could find that Defendant consciously disregarded Plaintiff’s condition by failing

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to take reasonable steps to abate the risks. See Farmer, 511 U.S. at 837.

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The record shows that after Plaintiff’s surgery on August 18, 2010,

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Defendant noted that the intraocular lens was in a good position and there was

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some corneal swelling due to the surgery. Stamper Decl. ¶ 6g. Visual acuity in

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Plaintiff’s left eye was 20/70 and intraocular pressure was normal. Id.

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Defendant instructed Plaintiff to use antibiotic drops for his eye, and Pred-Forte

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drops for the corneal swelling. Id. Defendant also directed Plaintiff to return for

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a follow-up in one week. Id. Plaintiff failed to return until more than one year

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later on December 1, 2011. Id. ¶ 6j. Plaintiff asserts that when he did not return

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after one week, Defendant should have checked to see why Plaintiff did not

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return. Opp. at 1. Plaintiff believes that it was Defendant’s duty to ensure that

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Plaintiff returned for a follow-up. Id. at 2. However, Plaintiff provides no

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evidence supporting his assertion. Nor does Plaintiff provide evidence showing

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that he attempted to set up or request a follow-up appointment. Even assuming

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that Defendant had some duty of care to follow-up with Plaintiff, there is no

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evidence suggesting that Defendant failed to do so while knowing that Plaintiff

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faced a substantial risk of serious harm and disregarding that risk by failing to

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take reasonable steps to abate it. See Farmer, 511 U.S. at 837. Plaintiff’s

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assertion that Defendant’s surgeries resulted in Plaintiff’s being blind in his left

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eye is not supported by the record. At most, even assuming that Defendant’s

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surgeries caused Plaintiff’s sight in his left eye to deteriorate, Plaintiff’s claim is

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one of negligence rather than deliberate indifference. There is no evidence that

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Defendant intentionally delayed or denied Plaintiff access to medical care.

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Rather, the record makes clear that each time Defendant examined

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Plaintiff, Defendant considered Plaintiff’s concerns, identified the problems and

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took reasonable steps to abate them by treating them. Plaintiff argues that when

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he first saw Defendant, Plaintiff requested that Defendant retrieve the lens that

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was ordered for him by the ophthalmologist at Solano State Prison. Supp. Opp.

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at 3. Plaintiff alleges that Defendant refused to do so, and stated that he would

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make the lens himself. Id. However, the record shows that Defendant used the

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same premium intraocular lens in Plaintiff’s right eye for Plaintiff’s left eye.

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Stamper Decl. ¶ 7b. Plaintiff provides no evidence to support his implication that

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Defendant’s failure to use the previously made lens was less than reasonable,

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much less that it was due to deliberate indifference.

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They day after the first surgery, Defendant saw Plaintiff and observed that

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the left eye lens was in a good position and the vision test showed 20/70.

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Stamper Decl. ¶ 6g. When Plaintiff returned to Defendant on December 1, 2011,

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Plaintiff’s vision test in his left eye showed 20/100 and Plaintiff complained of

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blurred vision. Id. ¶ 6j. Defendant prescribed gasses with corrective lenses and

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instructed Plaintiff to return in six months. Id. Plaintiff returned to Defendant on

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March 1, 2012, and Defendant noted that Plaintiff’s left eye vision remained at

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20/100 but that the lens had shifted. Id. ¶ 6l. As a result, Defendant requested

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that Plaintiff receive a second surgery to re-position or replace the lens. Id.

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Defendant performed the second surgery on April 18, 2012. Id. ¶ 6o. The

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following day, Defendant noted that the lens was in good position. Id. ¶ 6q. One

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week later, Defendant saw Plaintiff and Plaintiff’s left eye vision test was 20/80

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and the lens was in a good position. Id. ¶ 6r. Plaintiff was given eye glasses and

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asked to return in one week. Id.

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On May 3, 2012, Plaintiff returned, and his vision test remained at 20/80

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and Defendant noted the lens position was good. Id. ¶ 6s. Defendant prescribed

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distance glasses. Id. Defendant saw Plaintiff again on May 24, 2012, and July

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27, 2012, at which time Defendant observed that the lens was in a good position,

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and checked Plaintiff’s vision. Id. ¶¶ 6v, 6w. Although instructed to return in

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three months, Plaintiff did not return until October 31, 2013, when Plaintiff again

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complained that his vision was blurry and the glasses were not helping. Id. ¶ 6z.

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As a result, Defendant confirmed that the intraocular lenses were in a good

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position in both eyes, and because Defendant believed that Plaintiff’s eyes were

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blurred due to the vision test, Defendant recommended further testing by optical

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coherence tomography. Id. The test results were negative and revealed a normal

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retina. Id.

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The undisputed facts do not demonstrate that Defendant was deliberately
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indifferent to Plaintiff’s post-surgery complaints. That Plaintiff believes

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Defendant should have done more or done something different appears to be a

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disagreement with Defendant’s chosen course of treatment – to perform cataract

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surgery, readjust Plaintiff’s lens after the first cataract surgery, check Plaintiff’s

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vision and adjust prescriptions for corrective eye glasses. A mere disagreement

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is not enough to establish deliberate indifference. See Franklin v. Oregon, 662

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F.2d 1337, 1344 (9th Cir. 1981).

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Plaintiff has set forth no evidence whatsoever showing that the course of

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treatment Defendant chose was medically unacceptable under the circumstances

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and that Defendant chose this course of treatment in conscious disregard of an

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excessive risk to Plaintiff's health. See Toguchi, 391 F.3d at 1058.
In fact, Dr. Robert Stamper, a board-certified ophthamologist reviewed all

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the pertinent medical records and determined that Defendant’s actions met the

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standard of care ordinarily exercised by prudent ophthalmologists. Stamper Decl.

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¶ 7a. Dr. Stamper stated that Defendant’s operative technique for the first

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surgery was appropriate. Id. ¶ 7b. Dr. Stamper explained that a small break in

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the posterior capsule during the first surgery are a known complication of cataract

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surgery and does not suggest poor technique or negligence. Id. Further, Dr.

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Stamper reviewed Defendant’s actions post-surgery and opined that the treatment

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Defendant provided was proper and within the normal standard of care. Id.

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¶¶ 7c-7h. Plaintiff has not disputed this evidence with any of his own.
In sum, Plaintiff has not demonstrated the existence of a genuine dispute

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of material fact on his claim that Defendant was deliberately indifferent to his

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serious medical needs. Defendant consequently is entitled to summary judgment

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as a matter of law. See Celotex, 477 U.S. at 323.

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C.

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Miscellaneous motions
Plaintiff moves for an independent examination by an optometrist.
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However, Plaintiff’s medical condition is not in dispute. See Fed. R. Civ. P. 35;

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Schlagenhauf v. Holder, 379 U.S. 104, 118-19 (1964). The motion is DENIED.
Plaintiff’s motion for clarification of order is not understandable. Plaintiff

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does not state what he needs clarified. The motion is DENIED.
Plaintiff has also filed motion for discovery, in which he requests records

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of all medical malpractice suits or complaints filed against Defendant. Federal

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Rule of Civil Procedure 56(d) provides that if a party opposing summary

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judgment demonstrates a need for further discovery in order to obtain facts

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essential to justify the party’s opposition, the trial court may deny the motion for

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summary judgment or continue the hearing to allow for such discovery. See Fed.

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R. Civ. P. 56(d); Margolis v. Ryan, 140 F.3d 850, 853 (9th Cir. 1998). In making

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a Rule 56(d) motion, a party opposing summary judgment must make clear “what

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information is sought and how it would preclude summary judgment.” Id. at 853.

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Because Plaintiff has not done so, his motion is DENIED.
CONCLUSION

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For the foregoing reasons, Defendant’s motion for summary judgment

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(dkt. #23) is GRANTED and Plaintiff’s pending motions (dkt. #29, 30, 31) are

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DENIED.
The clerk shall enter judgment in accordance with this order and close the

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file.

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SO ORDERED.

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DATED: June 6, 2014
CHARLES R. BREYER
United States District Judge

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