Reyes v. Sayre et al

Filing 38

ORDER GRANTING DEFENDANTS' ( 27 , 30 , 31 , 32 ) MOTIONS FOR SUMMARY JUDGMENT. ***Civil Case Terminated.*** Signed by Judge Claudia Wilken on 9/8/2014. (Attachments: # 1 Certificate/Proof of Service)(ndr, COURT STAFF) (Filed on 9/8/2014)

Download PDF
1 2 3 IN THE UNITED STATES DISTRICT COURT 4 FOR THE NORTHERN DISTRICT OF CALIFORNIA 5 6 7 GABRIEL RALPH REYES, 8 Plaintiff, 9 v. Case No.: C 13-0620 CW (PR) ORDER GRANTING DEFENDANTS' MOTIONS FOR SUMMARY JUDGMENT Doc. nos. 27, 30-32 10 United States District Court For the Northern District of California MICHAEL SAYRE, MD, et al., 11 Defendants. 12 13 14 Plaintiff Gabriel Ralph Reyes, a state prisoner currently incarcerated at California State Prison——Sacramento, filed this 15 pro se civil rights action pursuant to 42 U.S.C. § 1983, alleging 16 constitutional violations by four individuals employed at Pelican 17 Bay State Prison (PBSP), where he was previously incarcerated. 18 Specifically, Plaintiff claims that a fourteen-day discontinuance 19 of Tylenol #3, which caused him to have withdrawal symptoms, 20 constitutes deliberate indifference to his serious medical needs. 21 Defendants filed four separate motions for summary judgment, which 22 are fully briefed. 23 motions for summary judgment are GRANTED. 24 25 For the reasons discussed below, Defendants’ BACKGROUND The following facts are from Plaintiff’s verified complaint 26 and opposition and the parties' declarations and exhibits. 27 where noted, the facts are undisputed. 28 Except 1 I. Dr. Williams 2 Plaintiff suffers from several chronic medical conditions, 3 including chronic pain. 4 his chronic pain, Plaintiff has been prescribed both narcotic and 5 non-narcotic medications and a pain patch. 6 2009, Defendant Dr. Claire Williams, who was Plaintiff's primary 7 care provider (PCP), prescribed for Plaintiff's pain Tylenol #3 8 with Codeine, two tablets twice a day. 9 United States District Court For the Northern District of California 10 11 Williams Decl. ¶ 6; Reyes Decl. ¶ 2. Id. For Since April 21, Id. ¶ 10. Codeine is an opioid that has a moderate potential for addiction. Id., Ex. G (California Prison Health Care Services 2009 Pain Management Guidelines) at 16. On August 30, 2009, Plaintiff received a medical consultation 12 with a pain management specialist, Dr. Capitano. Williams Decl. 13 ¶ 8. Dr. Capitano recommended that Plaintiff be prescribed 14 Trileptal, a non-narcotic pain medication, starting at 50 mg to a 15 maximum of 600 mg per day. 16 17 18 Id. On October 23, 2009, Dr. Williams reviewed Dr. Capitano's recommendations and added Trileptal, 50 mg a day, to Plaintiff's pain regimen. Id. ¶ 9. Dr. Williams continued to see Plaintiff for follow-up visits and increased the 19 dosage of the Trileptal because Plaintiff reported that the lower 20 dosage was not helping his pain. 21 Id. ¶¶ 10-13. On April 2, 2010, Dr. Williams again examined Plaintiff. Id. 22 ¶ 14. 23 learned that the California Department of Corrections and 24 Rehabilitation (CDCR) had modified its statewide chronic pain 25 medication protocol in an effort to curb the overuse of narcotic 26 medications by inmates. 27 the use of narcotic medications, such as Tylenol #3, and 28 substituting non-narcotic pain medications when medically Dr. Williams states that, prior to Plaintiff's visit, she Id. The new protocol involved limiting 2 1 appropriate. 2 increased Plaintiff's Trileptal to 400 mg three times a day for 3 pain control, cancelled his prescription for Tylenol #3 and 4 scheduled a follow-up visit in two weeks. 5 Dr. Williams' medical note for this visit states, "The use of Tyl. 6 #3 was discontinued by Sacramento so he is here for an alternate 7 treatment plan." 8 disputes that there was such a new pain management protocol 9 United States District Court For the Northern District of California 10 11 12 Id. In accordance with this protocol, Dr. Williams Id.; Reyes Decl. ¶ 11. Williams Decl., Ex. A at 453. Plaintiff because Dr. Williams does not submit it as evidence. Plaintiff states that, at his April 2, 2010 follow-up visit, Dr. Williams told him that she was decreasing his Tylenol #3 pursuant to orders from Dr. Sayre, who, at that time, was Chief Medical Officer (CMO) at PBSP. Reyes Opp. ¶ 9. Plaintiff states 13 that he told Dr. Williams that he needed Tylenol #3 to manage his 14 chronic pain and that his current regimen of medications was the 15 best he had experienced. 16 17 18 Reyes Decl. ¶ 12. Plaintiff also reminded Dr. Williams that he had been taking a high dose of Tylenol #3 for a long time and, because of this, he was worried about withdrawal symptoms and requested that she slowly reduce the 19 Tylenol #3. 20 replied, "I'm sorry, my hands are tied. 21 I have an email from him ordering me to cancel your medication," 22 and also said that she was not going to give Plaintiff anything 23 for withdrawal symptoms because, "that's the consequences of long 24 term use of Narcotic Pain Medication, now your [sic] just going to 25 have to pay the Piper." Id. ¶ 13. According to Plaintiff, Dr. Williams The CMO is in charge. . . Id. ¶¶ 13, 15. 26 In her declaration, Dr. Williams states that the reason she 27 discontinued Plaintiff's Tylenol #3 was because of the new state 28 protocol, but she does not specifically dispute Plaintiff's 3 1 statements that she said Dr. Sayre ordered her to discontinue 2 Plaintiff's Tylenol #3 or that she told Plaintiff that withdrawal 3 symptoms were the consequences of his use of Tylenol #3. 4 Decl. ¶ 14. 5 Williams Immediately after Dr. Williams discontinued Plaintiff's 6 Tylenol #3, Plaintiff experienced pain and withdrawal symptoms 7 such as muscle cramps, loss of appetite, vomiting, severe 8 diarrhea, hallucinations, loss of sleep and hot and cold flashes. 9 United States District Court For the Northern District of California 10 11 12 Reyes Decl. ¶ 20. fourteen days. Plaintiff suffered like this for approximately Id. ¶ 23. physically and mentally. Plaintiff lost weight and was exhausted Id. After forty-eight hours of suffering from withdrawal symptoms, Plaintiff submitted a health care request form seeking 13 medical help. Id. ¶ 17. In response to this request, on April 5, 14 2010, Plaintiff was seen by Registered Nurse (RN) Heather 15 Williams. 16 17 18 Id. ¶ 19. RN Williams noted that Plaintiff looked strange and stated, "Reyes, are you OK? Can you sit up?" Williams left the room to consult with Dr. Adams. RN Williams' Progress Notes. Id. RN Id. at Ex. G., When RN Williams returned, she 19 prescribed medication for Plaintiff's nausea and regular Tylenol 20 for Plaintiff's fever and pain. 21 two-day prescription, which did not help his symptoms. 22 Id. ¶ 19. Plaintiff received a Id. On April 16, 2010, fourteen days after Dr. Williams 23 discontinued Plaintiff's Tylenol #3 prescription, Dr. Williams saw 24 Plaintiff again and re-prescribed Tylenol #3. 25 According to Plaintiff, Dr. Williams stated, "It was a mistake to 26 take you off your medication the way that it was done." 27 night, Plaintiff received the same dosage of Tylenol #3 he had 28 been receiving before Dr. Williams discontinued it. 4 Id. ¶ 24. Id. Id. That 1 Dr. Williams states that, when she saw Plaintiff on April 16, 2 2010 for a follow-up visit, he told her that his chronic pain was 3 not adequately controlled, that he was experiencing pain in his 4 upper back and arms and decreased sensation in his right 5 fingertips and that the increase in Trileptal had not helped him. 6 Williams Decl. ¶ 15. 7 did not observe any adverse effects from the discontinuance of 8 Tylenol #3 for two weeks but, given Plaintiff's indication that he 9 United States District Court For the Northern District of California 10 11 12 Dr. Williams states that, clinically, she was in pain, she decreased his Trileptal to 200 mg a day and restarted him on Tylenol #3. Id. In her medical progress note, Dr. Williams wrote, "The restrictions on Tyl. #3 have been lifted and it is now up to the PCP if he wants to use it for long term pain so I will decrease his Trileptal back to 200 mg . . . and 13 restart his Tyl. #3 at two BID." Id., Ex. A at 487. 14 Dr. Williams states that, based upon her examination of 15 Plaintiff, his clinical presentations, her review of his record 16 17 18 19 and the nature of his chronic pain symptoms, the medical care he received for his chronic pain complaints was proper and appropriate. Id. ¶ 16. II. Medical Guidelines 20 In support of his claims, Plaintiff submits the 2009 Pain 21 Management Guidelines from the State of California Prison Health 22 Care Services. 23 indicates, "Physical dependence is a common feature of opioids, 24 corticosteroids, barbiturates, benzodiazepines and anti- 25 hypertensive's," and that "physical dependence is easily managed 26 by gradually tapering the drug if it is no longer needed." 27 at 8. 28 tapering of drugs that no longer meet treatment goals. Reyes Decl., Ex. G. Plaintiff cites page 8, which Ex. G Plaintiff points to other guidelines which urge the 5 See e.g., 1 Ex. G at 13, 24, 36 ("If a patient has been on a significant dose 2 of opioid for more than a couple of weeks, when discontinuing 3 consider short taper of opioid to avoid withdrawal symptoms."). 4 The guidelines indicate that Codeine has a moderate addiction 5 potential. 6 III. Dr. Sayre Id. at 16. 7 Plaintiff states that, on April 2, 2010, Dr. Sayre, in his 8 role as CMO, instructed Dr. Williams to discontinue Plaintiff's 9 United States District Court For the Northern District of California 10 11 12 Tylenol #3. Reyes Decl. ¶¶ 13-15. Dr. Sayre declares that he did not participate in Dr. Williams' April 2, 2010 decision to discontinue Plaintiff's Tylenol #3 and that he was not involved in Dr. Williams' decision to restart Plaintiff on Tylenol #3 two weeks later. Sayre Decl. ¶ 10. 13 IV. J. Torrance 14 On April 4, 2010, Plaintiff submitted an Inmate Health Care 15 Appeal Form (602 appeal) seeking relief from the pain and 16 17 18 withdrawal symptoms he was experiencing. Reyes Decl. ¶ 32. J. Torrance, a Licensed Vocational Nurse, and the Medical Appeal Coordinator, screened out Plaintiff's 602 appeal on the ground 19 that it was duplicative of two previous 602 appeals Plaintiff had 20 filed. 21 Id. Torrance cites the California Code of Regulations to explain 22 that she can screen out a 602 appeal if it "duplicates an inmate's 23 previous appeal upon which a decision has been rendered or is 24 pending." 25 Regulations (CCR), tit. 15, § 3084.6(c)(2)). 26 regulation providing that a 602 appeal can be screened out if "the 27 appeal issue or complaint emphasis has been changed . . . to the 28 the extent that the issue is entirely new, and the required lower Torrance Decl. ¶ 5 (citing California Code of 6 She cites another 1 levels of review and assessment have been circumvented." 2 (citing CCR, tit. 15, § 3084.6(b)(16)). Id. 3 Torrance states that, on April 4, 2010, Plaintiff submitted 4 his 602 appeal about the cancellation of his Tylenol #3 in which 5 he requested that he (1) be given relief; (2) be given proper pain 6 medication; (3) be given a written explanation of why the Tylenol 7 #3 had been cancelled; and (4) be compensated for his pain and 8 suffering. 9 United States District Court For the Northern District of California 10 11 12 Id. ¶ 6. On April 12, 2014, Torrance reviewed Plaintiff's 602 appeal. Id. ¶ 7. She noted that Plaintiff's 602 appeal history included two prior 602 appeals, filed on September 8, 2008 and December 17, 2009, where he also complained that he was dissatisfied with his chronic pain management medication. ¶ 8. Id. Torrance determined that Plaintiff's April 2010 appeal, 13 which sought changes to his chronic pain medication, was 14 duplicative of his prior 602 appeals and screened it out on that 15 basis. 16 17 18 Id. ¶ 12. On April 15, 2010, Plaintiff resubmitted his April 4, 2010 602 appeal, contending it was not duplicative. Id. ¶ 13. Torrance noted Plaintiff's additional grounds for relief about his 19 need for medication to counteract his withdrawal symptoms, and 20 determined that it was a change in emphasis and a new issue in his 21 appeal. Torrance screened out Plaintiff's amended appeal on this 22 ground. Id. 23 On April 21, 2010, Plaintiff again resubmitted his April 4, 24 2010 appeal and Torrance advised Plaintiff that he must present 25 the new issues in a separate 602 appeal form. 26 Id. ¶ 14. Plaintiff states that Torrance knew that this was the only 27 602 appeal that Plaintiff submitted regarding his withdrawal 28 symptoms between April 2 and April 4, 2010 and, thus, it was 7 1 impossible for Torrance to think that it was a duplicate of any 2 other 602 appeal. 3 opportunities to review, investigate and assess Plaintiff's 4 medical situation and, in each instance, she chose to disregard 5 Plaintiff's suffering, even after Plaintiff explained it to her. 6 Id. 7 V. J. Walker United States District Court For the Northern District of California 10 11 12 Plaintiff states that Torrance had three J. Walker was Chief of the Office of the Third Level Appeals- 8 9 Id. Health Care (OTLA) from July 1, 2009 to December 4, 2010 and is currently retired. Walker Decl. ¶ 1. As Chief of the OTLA, Walker was responsible for overseeing the review of Health Care Appeals at the third level of review and responded to inmate appeals after the inmate's specific institution had responded to 13 the appeal at the second level of review. Id. ¶ 3. Decisions at 14 the third level of review were approved by Walker or by a 15 designated manager within the OTLA. 16 17 18 Id. Walker notes that Plaintiff's April 4, 2010 602 appeal was screened out three times at Plaintiff's prison as duplicative of previous appeals and that Plaintiff appealed this decision to the 19 OTLA. 20 appeal, agreed it was duplicative of his previous appeals and also 21 screened it out as not complying with CCR, title 15, section 22 3084.3(c)(2). 23 his printed name, as Chief of the OTLA, appears on the OTLA 24 decision, the review of Plaintiff's appeal was performed by an 25 OTLA Associate Health Program Advisor, whose signature appears on 26 the OTLA's decision. 27 28 Id. ¶ 11. On May 18, 2010, the OTLA reviewed Plaintiff's Id., Ex. A at 893. Id.1 Walker declares that, although Walker declares that he was not 1 The OTLA decision appears to be signed by D. Sanchez, for J. Walker, Chief. Walker Decl., Ex. A at 893. 8 1 involved in the decision regarding Plaintiff's 602 appeal and that 2 he was not aware, prior to being served with this lawsuit, that 3 Plaintiff had submitted a 602 appeal. Id. 4 Plaintiff states that Walker's name on the Third Level 5 Screen-Out Form indicates that she was the person signing off on 6 the decision to screen out his appeal and, thus, denied him the 7 medical care he needed. 8 Walker was aware of the pain management guidelines that instructed 9 United States District Court For the Northern District of California 10 11 Reyes Decl. ¶ 35. Plaintiff states that the tapering of narcotic medications and, thus, she was aware of Plaintiff's suffering and did nothing to relieve it. Opp. ¶¶ 15-16. DISCUSSION 12 I. Motion for Summary Judgment 13 A. Legal Standard 14 Summary judgment is only proper where the pleadings, 15 discovery, and affidavits show there is “no genuine issue as to 16 17 18 any material fact and that the moving party is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). Material facts are those which may affect the outcome of the case. 19 Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). 20 dispute as to a material fact is genuine if the evidence is such 21 that a reasonable jury could return a verdict for the nonmoving 22 party. 23 A Id. The court will grant summary judgment “against a party who 24 fails to make a showing sufficient to establish the existence of 25 an element essential to that party’s case, and on which that party 26 will bear the burden of proof at trial.” 27 Catrett, 477 U.S. 317, 322-23 (1986). 28 initial burden of identifying those portions of the record that 9 Celotex Corp. v. The moving party bears the 1 demonstrate the absence of a genuine issue of material fact. 2 burden then shifts to the nonmoving party to “go beyond the 3 pleadings, and by his own affidavits, or by the ‘depositions, 4 answers to interrogatories, or admissions on file,’ designate 5 ‘specific facts showing that there is a genuine issue for trial.’” 6 Id. at 324. 7 8 9 United States District Court For the Northern District of California 10 11 12 The In considering a motion for summary judgment, the court must review the evidence in the light most favorable to the nonmoving party. Leslie v. Grupo ICA, 198 F.3d 1152, 1158 (9th Cir. 1999). The court’s function on a summary judgment motion is not to make credibility determinations or weigh conflicting evidence with respect to a disputed material fact. T.W. Elec. Serv. v. Pacific Elec. Contractors Ass’n, 809 F.2d 626, 630 (9th Cir. 1987). 13 A district court may consider only admissible evidence in 14 ruling on a motion for summary judgment. Fed. R. Civ. P. 15 56(c); Orr v. Bank of America, 285 F.3d 764, 773 (9th Cir. 2002). 16 17 18 19 A verified complaint may be used as an opposing affidavit under Rule 56, as long as it is based on personal knowledge and sets forth specific facts admissible in evidence. Schroeder v. McDonald, 55 F.3d 454, 460 & nn.10-11 (9th Cir. 1995). 20 B. Deliberate Indifference to Serious Medical Needs 21 Plaintiff argues Defendants were deliberately indifferent to 22 his serious medical needs by completely discontinuing his Tylenol 23 #3 prescription for fourteen days without tapering it off to 24 prevent him from experiencing withdrawal symptoms. 25 Defendants were also deliberately indifferent by failing to 26 prescribe any treatment for his withdrawal symptoms. 27 28 10 He argues that 1 2 1. Deliberate Indifference Legal Standard Deliberate indifference to serious medical needs violates the 3 Eighth Amendment’s proscription against cruel and unusual 4 punishment. 5 v. Smith, 974 F.2d 1050, 1059 (9th Cir. 1992), overruled on other 6 grounds, WMX Technologies, Inc. v. Miller, 104 F.3d 1133, 1136 7 (9th Cir. 1997) (en banc). 8 indifference” involves an examination of two elements: the 9 United States District Court For the Northern District of California 10 11 12 Estelle v. Gamble, 429 U.S. 97, 104 (1976); McGuckin A determination of “deliberate seriousness of the prisoner’s medical need and the nature of the defendant’s response to that need. McGuckin, 974 F.2d at 1059. A serious medical need exists if the failure to treat a prisoner’s condition could result in further significant injury or the unnecessary and wanton infliction of pain. Id. The existence 13 of an injury that a reasonable doctor or patient would find 14 important and worthy of comment or treatment, the presence of a 15 medical condition that significantly affects an individual’s daily 16 17 18 activities, or the existence of chronic and substantial pain are examples of indications that a prisoner has a serious need for medical treatment. Id. at 1059-60. 19 A prison official is deliberately indifferent if he knows a 20 prisoner faces a substantial risk of serious harm and disregards 21 that risk by failing to take reasonable steps to abate it. 22 v. Brennan, 511 U.S. 825, 837 (1994)(equating the standard with 23 that of criminal recklessness). 24 “be aware of facts from which the inference could be drawn that a 25 substantial risk of serious harm exists,” but he “must also draw 26 the inference.” 27 established, therefore, there must be a purposeful act or failure Id. Farmer The prison official must not only In order for deliberate indifference to be 28 11 1 to act on the part of the defendant and resulting harm. 2 974 F.2d at 1060. McGuckin, Deliberate indifference may be shown when prison officials 3 4 deny, delay, or intentionally interfere with medical treatment, or 5 it may be shown in the way in which they provide medical care. 6 Id. at 1062. 7 patient and prison medical authorities regarding treatment, nor a 8 difference of medical opinion as to the need to pursue one course 9 United States District Court For the Northern District of California 10 11 12 Neither a difference of opinion between a prisoner- of treatment over another is sufficient to establish deliberate indifference. 2004). Toguchi v. Chung, 391 F.3d 1051, 1059-61 (9th Cir. In order to prevail on a claim involving choices between alternative courses of treatment, a plaintiff must show that the course of treatment the doctors chose was medically unacceptable 13 under the circumstances, and they chose this course in conscious 14 disregard of an excessive risk to the plaintiff’s health. Id. at 15 1058. 16 17 18 19 A claim of mere negligence related to medical problems is insufficient to state a deliberate indifference claim. Id.; Franklin v. Oregon, 662 F.2d 1337, 1344 (9th Cir. 1981). 2. Analysis Defendants do not argue that Plaintiff does not have a 20 serious medical need for treatment for his chronic pain. 21 they argue that the discontinuance of his Tylenol #3 prescription 22 for fourteen days does not constitute deliberate indifference. 23 24 Rather, a. Defendant Williams The following facts regarding Plaintiff's claim against Dr. 25 Williams are undisputed: 26 for many chronic ailments, including pain; (2) since April 2009, 27 Dr. Williams' treatment for Plaintiff's pain included Tylenol #3; 28 (3) in August 2009, pain specialist, Dr. Capitano, recommended (1) Dr. Williams was treating Plaintiff 12 1 Trileptal for Plaintiff's pain; (4) on April 2, 2010, Dr. Williams 2 discontinued Plaintiff's prescription for Tylenol #3, increased 3 his prescription for Trileptal and scheduled him for a two-week 4 follow-up visit; (5) Dr. Williams was familiar with the fact that 5 Codeine is an opioid that is moderately addictive and that 6 Plaintiff could experience withdrawal symptoms from its complete 7 discontinuance; (6) on April 5, 2010, Plaintiff told RN Williams 8 that he was suffering from pain, nausea, fever and other 9 United States District Court For the Northern District of California 10 11 12 withdrawal symptoms, and RN Williams consulted with Dr. Adams who prescribed regular Tylenol for Plaintiff's pain and medication for his nausea; and (7) on April 16, 2010, fourteen days after Dr. Williams discontinued Plaintiff's Tylenol #3, she re-prescribed it for him at the original dosage. 13 There are few facts regarding this claim that are disputed. 14 The main one is whether Dr. Williams discontinued Plaintiff's 15 Tylenol #3 on the basis of a new state protocol requiring her to 16 17 18 do so. Dr. Williams' statements in her declaration and her medical notes of her meetings with Plaintiff on April 2 and April 16, 2010, support her claim that the state had issued a new 19 protocol regarding discontinuing narcotic medications like Tylenol 20 #3. 21 submit a copy of the state protocol. 22 summary judgment, Plaintiff's evidence must be taken in the light 23 most favorable to him. 24 the Court assumes that a new state protocol did not exist. 25 However, as Plaintiff points out, Dr. Williams does not On Defendants' motion for Therefore, for purposes of this motion, However, even if a new state protocol did not exist, 26 Plaintiff's evidence has not raised a disputed issue of material 27 fact regarding whether Dr. Williams' treatment constituted 28 deliberate indifference. 13 1 Plaintiff's claim focusses on the fourteen days between April 2 2, 2010, when Dr. Williams' discontinued his Tylenol #3 and 3 increased his Trileptal and April 16, 2010, when she resumed the 4 Tylenol #3 and Trileptal at their previous dosages, during which 5 time Plaintiff experienced withdrawal symptoms. 6 after Dr. Williams discontinued the Tylenol #3, Dr. Adams treated 7 Plaintiff for the withdrawal symptoms. 8 Plaintiff informed Dr. Williams he was experiencing severe pain 9 United States District Court For the Northern District of California 10 11 12 However, two days Twelve days later, when and withdrawal symptoms, she re-instituted his previous pain management regimen. This evidence shows that on April 2, 2010, Dr. Williams was trying another treatment regimen for Plaintiff's pain, just as different pain treatment regimens had been prescribed for him in 13 the past. Along with this change in regimen, she scheduled a 14 follow-up visit in two weeks to evaluate it. When Dr. Williams 15 saw that the new regimen did not work, she immediately 16 17 18 reinstituted the old regimen. Thus, even though the new regimen did not work, the evidence shows that Dr. Williams' goal for the new regimen was to treat Plaintiff's pain in a different way, not 19 to deny, delay or interfere with his treatment or to cause him 20 increased pain. 21 original regimen when she saw the new regimen was not working is 22 further evidence that she intended to treat Plaintiff's pain, not 23 to deny him treatment. 24 That Dr. Williams immediately reinstituted the Furthermore, the fact that Plaintiff wanted the Tylenol #3 to 25 be tapered off rather than discontinued at once means that he had 26 a difference of opinion with Dr. Williams. 27 a claim involving choices of alternate courses of treatment, 28 Plaintiff must show that Dr. Williams' treatment plan was 14 In order to prevail on 1 medically unacceptable and chosen in conscious disregard of an 2 excessive risk to his health. 3 Plaintiff's evidence fails to show this. 4 Plaintiff submits only suggest an opioid like Tylenol #3 should be 5 reduced gradually; they do not require tapering. 6 follow-up visit in two weeks, Dr. Williams ensured that she would 7 be able to evaluate the results of the new regimen very soon after 8 she implemented it, so that if it did not work, she would be able 9 United States District Court For the Northern District of California 10 11 12 to change it, which she did. See Toguchi, 391 F.3d at 1059-61. The medical guidelines By scheduling a As stated above, Dr. Williams' actions demonstrate care and concern for Plaintiff, not deliberate indifference to his pain. For all these reasons, Plaintiff has failed to raise a disputed issue of material fact that Dr. Williams' treatment 13 constituted deliberate indifference to his serious medical needs. 14 Dr. Williams' motion for summary judgment is granted. 15 b. Other Defendants 16 17 18 Plaintiff's claim of deliberate indifference against Dr. Sayre is based upon Plaintiff's statement that Dr. Sayre ordered Dr. Williams to discontinue Plaintiff's Tylenol #3. Even taking 19 Plaintiff's evidence against Dr. Sayre as true, his claim against 20 Dr. Sayre fails because it is predicated upon his claim against 21 Dr. Williams. 22 to discontinue Plaintiff's Tylenol #3 does not constitute 23 deliberate indifference because, in following that order and 24 discontinuing the Tylenol #3, Dr. Williams was not deliberately 25 indifferent to Plaintiff's medical needs. 26 liable for ordering Dr. Williams to implement a medically 27 appropriate treatment plan. 28 judgment is granted. In other words, Dr. Sayre's order to Dr. Williams Dr. Sayre cannot be Dr. Sayre's motion for summary 15 1 Plaintiff's claims for deliberate indifference against J. 2 Torrance and J. Walker fail for the same reason. 3 predicated on the fact that these Defendants did not grant 4 Plaintiff's appeals challenging Dr. Williams' fourteen-day 5 discontinuance of his prescription for Tylenol #3. 6 Williams was not deliberately indifferent to Plaintiff's serious 7 need for chronic pain treatment by discontinuing his prescription 8 of Tylenol #3, Torrance and Walker could not be deliberately 9 United States District Court For the Northern District of California 10 11 12 The claims are Because Dr. indifferent by denying Plaintiff's 602 appeals about Dr. Williams' behavior. Furthermore, Plaintiff's claims against Torrance and Walker fail for another reason. By the time Torrance and Walker denied Plaintiff's appeals about Dr. Williams' behavior, she had re13 prescribed the Tylenol #3 so that there was no behavior for them 14 to remedy. This situation is distinguishable from one in which 15 there is an ongoing medical need and the inmate's appeal requests 16 17 18 a remedy for the ongoing problem. In the latter case liability can be based on the denial of the appeal, just as it could be based on the denial of a verbal request from the inmate. See Jett 19 v. Penner, 439 F.3d 1091, 1098 (9th Cir. 2006) (supervisor may be 20 liable for deliberate indifference to a serious medical need if he 21 or she fails to respond to a prisoner’s request for help). 22 Williams' fourteen-day discontinuance of Plaintiff's prescription 23 for Tylenol #3 was not an ongoing medical need that could result 24 in the officers' liability for denying Plaintiff's appeals. 25 Therefore, Plaintiff's evidence against Torrance and Walker fails 26 to raise a disputed issue of material fact on this ground as well. 27 Torrance and Walker's motions for summary judgment are granted. 28 16 Dr. 1 CONCLUSION 2 For the foregoing reasons, the Court orders as follows: 3 1. Defendants' motions for summary judgment are GRANTED. 4 5 6 Docket nos. 27, 30-32. 2. The Clerk of the Court shall enter a separate judgment, terminate all motions and close the file. 7 3. This order terminates Docket nos. 27, 30-32. 8 IT IS SO ORDERED. 9 United States District Court For the Northern District of California 10 Dated: 9/8/2014 ________________________ CLAUDIA WILKEN UNITED STATES DISTRICT JUDGE 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 17

Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.

Why Is My Information Online?