Cleon Neal Jones v. Dr Ajmel Sangha MD et al

Filing 19

ORDER Granting In Part and Denying In Part 12 Motion to Dismiss Plaintiff's First Amended Complaint as to Defendant Sangha. The Defendant's Motion to Dismiss Plaintiff's First Amended Complaint as to Defendant Sangha is Granted as to suit against the Defendant in his official capacity and Denied as to suit against the Defendant in his individual capacity. Signed by Judge Gonzalo P. Curiel on 9/16/2015. (All non-registered users served via U.S. Mail Service)(srm)

1
2
3
4
5
6
7
8

UNITED STATES DISTRICT COURT

9

SOUTHERN DISTRICT OF CALIFORNIA

10

CLEON NEAL JONES,

11
12
13
14
15

v.

CASE NO. 3:14-cv-2828-GPC-PCL
Plaintiff,

GRANTING IN PART AND
DENYING IN PART MOTION TO
DISMISS PLAINTIFF’S FIRST
AMENDED COMPLAINT AS TO
DEFENDANT SANGHA

DR. AJMEL SANGHA, M.D.; K.
WYATT, RN; DR IRENE PULIDO,
M.D.,

[ECF No. 12]

Defendant.

16
17

Cleon Neal Jones (“Plaintiff”) is a prisoner currently incarcerated at Centinela

18 State Prison (“CEN”) located in Imperial, California, and is proceeding pro se and in
19 this civil action pursuant to 42 U.S.C. § 1983. Am. Compl. 1, ECF No. 6. Defendants
20 are medical officials employed at CEN. Id. at 2. Jones claims Defendants acted with
21 deliberate indifference to his serious medical needs in violation of the Eighth
22 Amendment, by delaying treatment of complications resulting from Jones’ cataract
23 removal, with the result that Jones experienced “permanent vision loss” in his right eye.
24 Id. at 3. He seeks $300,000 in general and punitive damages. Id. at 7.
25

Defendant Dr. Ajmel Sangha (“Defendant”) has filed a Motion to Dismiss

26 Plaintiff’s First Amended Complaint as to Defendant Sangha, pursuant to Fed. R. Civ.
27 P. 12(b)(6), on the grounds that Jones has failed to plead facts sufficient to state a cause
28

1

1 of action for deliberate indifference against Dr. Sangha. Mot. Dismiss 2, ECF No. 12.
2 Dr. Sangha also argues that he cannot be sued in his official capacity in a § 1983
3 action. Id. Jones filed a Response. ECF No. 17. Dr. Sangha filed a Reply. ECF No. 18.
4

Based on the briefing and the applicable law, the Court GRANTS IN PART and

5 DENIES IN PART Defendant’s Motion to Dismiss the First Amended Complaint as
6 to Defendant Sangha.
7 I.

Factual Background

8

Jones alleges that he received a cataract removal surgery on June 6, 2013. Am.

9 Compl. 3. Subsequently, on September 2, 2013, he informed Defendant K. Wyatt, a
10 registered nurse, that he had “suddenly” experienced “loss [of] vision in [his] right
11 eye.” Id. Nurse Wyatt “reviewed [plaintiff’s] medical record and saw that [he] had
12 cataract removal surgery” on June 6, 2013. Id. The next day, Nurse Wyatt informed Dr.
13 Sangha, CEN’s Chief Medical Officer, of the “injury.” Id.
14

Dr. Sangha then ordered a “routine evaluation” to take place “eleven days later”

15 on September 13, 2013. Id. During the evaluation on September 13, 2013, Defendant
16 Irene Pulido, a “Facility Optometrist,” “reviewed [Plaintiff’s] record, saw that [he] had
17 [cataract] surgery on June 6, 2013, did an examination, . . . [and] order[ed] a follow up
18 for second opinion by Doctor Sangha.” Id. This “follow up” “took place on November
19 14, 2013.” Id.
20

Jones received “surgery to reattach [the] retina” three months later, on February

21 11, 2014. Id. Jones alleges that after the surgery, the surgeon who reattached Jones’
22 retina, “Dr. Mozayan Isfani Arash,” told him that he “would have perm[a]nent vision
23 loss in [his] right eye, because the best time to save [his] sight was 48 hours after [he
24 first] notice[d] vision loss.” Id.
25 II.

Standard of Review

26

A Rule 12(b)(6) dismissal may be based on either a “‘lack of a cognizable legal

27 theory’ or ‘the absence of sufficient facts alleged under a cognizable legal theory.’”
28

2

1 Johnson v. Riverside Healthcare System, LP, 534 F.3d 1116, 1121–22 (9th Cir. 2008)
2 (quoting Balistreri v. Pacifica Police Dep’t, 901 F.2d 696, 699 (9th Cir. 1990)).
3

“To survive a motion to dismiss, a complaint must contain sufficient factual

4 matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’”
5 Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550
6 U.S. 544, 570 (2007)). “A claim has facial plausibility when the plaintiff pleads factual
7 content that allows the court to draw the reasonable inference that the defendant is
8 liable for the misconduct alleged.” Id. at 679 (citing Twombly, 550 U.S. at 556).
9 “Threadbare recitals of the elements of a cause of action, supported by mere conclusory
10 statements, do not suffice.” Iqbal, 556 U.S. at 678; Twombly, 550 U.S. at 555 (noting
11 that on a motion to dismiss the court is“not bound to accept as true a legal conclusion
12 couched as a factual allegation.”). “The pleading standard . . . does not require ‘detailed
13 factual

allegations,’

but

it

demands

more

than

an

unadorned,

the

14 defendant-unlawfully-harmed-me accusation.” Iqbal, 556 U.S. at 678 (citations
15 omitted).
16

In analyzing a pleading, the Court sets conclusory factual allegations aside,

17 accepts all non-conclusory factual allegations as true, and determines whether those
18 nonconclusory factual allegations accepted as true state a claim for relief that is
19 plausible on its face. Iqbal, 556 U.S. at 676–84; Turner v. City & Cty. of San
20 Francisco, 788 F.3d 1206, 1210 (9th Cir. 2015) (noting that “conclusory allegations
21 of law and unwarranted inferences are insufficient to avoid a Rule 12(b)(6) dismissal.”)
22 (internal quotation marks and citation omitted). And while “[t]he plausibility standard
23 is not akin to a probability requirement,” it does “ask[] for more than a sheer possibility
24 that a defendant has acted unlawfully.” Iqbal, 556 U.S. at 678 (internal quotation marks
25 and citation omitted). In determining plausibility, the Court is permitted “to draw on
26 its judicial experience and common sense.” Id. at 679.
27
28

Nevertheless, claims asserted by pro se petitioners, “however inartfully pleaded,”
3

1 are held “to less stringent standards than formal pleadings drafted by lawyers.” Haines
2 v. Kerner, 404 U.S. 519–20 (1972). Thus, courts “continue to construe pro se filings
3 liberally when evaluating them under Iqbal.” Hebbe v. Pliler, 627 F.3d 338, 342 & n.7
4 (9th Cir. 2010) (citing Bretz v. Kelman, 773 F.2d 1026, 1027 n.1 (9th Cir. 1985)
5 (noting that courts “have an obligation where the petitioner is pro se, particularly in
6 civil rights cases, to construe the pleadings liberally and to afford the petitioner the
7 benefit of any doubt.”)).
8 III.

Eighth Amendment Deliberate Indifference Claim

9

A.

10

General Legal Standard

The Eighth Amendment prohibits punishment that involves the “unnecessary and

11 wanton infliction of pain.” Estelle v. Gamble, 429 U.S. 97, 103 (1976) (quoting Gregg
12 v. Georgia, 428 U.S. 153, 173 (1976)). This principle “establish[ed] the government’s
13 obligation to provide medical care for those whom it is punishing by incarceration.” Id.
14 The Supreme Court has noted that “[a]n inmate must rely on prison authorities to treat
15 his medical needs; if the authorities fail to do so, those needs will not be met.” Id.; West
16 v. Atkins, 487 U.S. 42, 54–55 (1988).
17

Prison officials violate a prisoner’s Eighth Amendment right to be free from

18 cruel and unusual punishment if they are deliberately indifferent to the prisoner’s
19 serious medical needs. Estelle, 429 U.S. at 106 (1976); Hunt v. Dental Dep’t, 865 F.2d
20 198, 200 (9th Cir. 1989). “Regardless of how evidenced, deliberate indifference to a
21 prisoner’s serious illness or injury state a cause of action under § 1983,” including
22 when this “indifference is manifested by prison doctors in their response to the
23 prisoner’s needs.” Estelle, 429 U.S. at 104–05 (footnotes omitted).
24

A “serious” medical need exists if the failure to treat a prisoner’s condition could

25 result in further significant injury or the “unnecessary and wanton infliction of pain.”
26 Id. at 104. Thus, the “existence of an injury that a reasonable doctor or patient would
27 find important and worthy of comment or treatment; the presence of a medical
28

4

1 condition that significantly affects an individual’s daily activities; or the existence of
2 chronic and substantial pain are examples of indications that a prisoner has a ‘serious’
3 need for medical treatment.” McGuckin v. Smith, 974 F.2d 1050, 1059–60 (9th Cir.
4 1992), overrruled on other grounds by WMX Techs., Inc. v. Miller, 104 F.3d 1133 (9th
5 Cir. 1997) (en banc); Lopez v. Smith, 203 F.3d 1122, 1131–32 (9th Cir. 2000); see also
6 Doty v. County of Lassen, 37 F.3d 540, 546 (9th Cir. 1994).
7

“The requirement of deliberate indifference is less stringent in cases involving

8 a prisoner’s medical needs than in other cases involving harm to incarcerated
9 individuals, because ‘[t]he State’s responsibility to provide inmates with medical care
10 ordinarily does not conflict with competing administrative concerns.’” McGuckin v.
11 Smith, 974 F.2d at 1060 (quoting Hudson v. McMillian, 503 U.S. 1, 6 (1992)
12 (contrasting failure to attend to serious medical needs with the use of force during
13 prison disturbances)).
14

B.

15

Dr. Sangha does not dispute that Jones’ alleged loss of vision amounted to a

Analysis

16 serious medical need. See, e.g., Cowell v. Bannister, 763 F.3d 1060, 1067 (9th Cir.
17 2014) (noting that “blindness in one eye,” as well as “less severe losses of vision” such
18 as “needed eyeglasses for double vision and loss of depth perception” have been
19 considered serious medical needs by the federal courts (citing Koehl v. Dalsheim, 85
20 F.3d 86,88 (2d Cir. 1996))); Singleton v. Lopez, 577 Fed. Appx. 733, 735–36 (9th Cir.
21 2014) (concluding that “eye pain and swelling” and resulting “vision loss” constituted
22 a serious medical need). Instead, Dr. Sangha argues that his actions did not rise to the
23 level of deliberate indifference. Mot. Dismiss 6, ECF No. 12.
24

Before deliberate indifference can be established, Jones must show that (1) Dr.

25 Sangha “purposefully ignore[d] or failed to respond to [his] pain or possible medical
26 need,” McGuckin, 974 F.2d at 1060; see also Farmer v. Brennan, 511 U.S. 825, 826
27 (1994) (noting “subjective” component of deliberate indifference test); Wilson v. Seiter,
28

5

1 501 U.S. 294, 302 (1991) (“In order to show deliberate indifference, an inmate must
2 allege sufficient facts to indicate that prison officials acted with a culpable state of
3 mind.”); and (2) the delay in treatment was harmful, McGuckin, 974 F.2d at 1060
4 (noting that while the harm caused by delay need not necessarily be “substantial,” “a
5 finding that the inmate was seriously harmed by the defendant’s action or inaction
6 tends to provide additional support to a claim that the defendant was ‘deliberately
7 indifferent’ to the prisoner’s medical needs”).
8

First, Dr. Sangha argues that his first order, on September 3, 2013, for a “routine

9 evaluation” of Jones by an optometrist to occur eleven days later, shows that he
10 “reacted promptly and appropriately” to Jones’ September 2, 2013 complaint of vision
11 loss to Nurse Wyatt. Mot. Dismiss 6. Second, he argues that as to the November 14,
12 2013 “follow up,” and subsequent surgery on February 11, 2014, “[t]here is no
13 allegation that Dr. Sangha had control over or anything to do with the scheduling of the
14 surgery,” and that “[e]ven if it were alleged that Dr. Sangha had some measure of
15 control over the scheduling of the surgery, the timing of the surgery does not indicate
16 deliberate indifference by Dr. Sangha.” Id.
17

Dr. Sangha may be right that he had no control over or anything to do with the

18 scheduling of the surgery. However, “construing the pleadings liberally and . . .
19 afford[ing] the petitioner the benefit of any doubt,” Bretz, 773 F.2d at 1027 n.1, Jones
20 has pled factual allegations that allow this Court to draw “reasonable inference[s]” that
21 both the above criteria are met, Iqbal, 556 U.S. at 679.
22

First, Jones alleges that Nurse Wyatt informed Dr. Sangha of his sudden vision

23 loss on September 3, 2013, and that Jones’ medical records indicated that he had
24 previously had cataract surgery on June 6, 2013. Am. Compl. 3. Dr. Sangha responded
25 by ordering a “routine evaluation” that would not take place until “eleven days later.”
26 Id. However, Jones alleges that following the surgery, the operating doctor informed
27 him that he would experience “permanent vision loss” because his eye problems were
28

6

1 not addressed within “48 hours” after he initially noticed vision loss. Id. Thus, under
2 the facts alleged, the Court can reasonably infer that Dr. Sangha’s decision to schedule
3 Jones for a “routine evaluation” eleven days later, rather than having him examined
4 earlier, was harmful to Jones.
5

Second, Jones alleges that after he was seen by the Facility Optometrist on

6 September 13, 2013, she “order[ed] a follow up for second opinion by Doctor Sangha
7 that took place on November 14, 2013.” Id. Dr. Sangha argues that Jones’ First
8 Amended Complaint “is silent as to when or if Dr. Sangha examined Plaintiff, provided
9 a second opinion, ordered any further examinations or procedures, or engaged in any
10 other act.” Mot. Dismiss 2–3. However, the above language in the First Amended
11 Complaint does suggest that following the initial evaluation on September 13, the
12 Facility Optometrist referred the matter back to Dr. Sangha. Thus, the facts alleged do
13 provided a basis from which the Court could reasonably infer that Dr. Sangha had a
14 continuing role in monitoring Plaintiff’s course of treatment, and thus in the continued
15 delay in treating Plaintiff’s vision loss.
16

“Once th[e]se prerequisites are met, it is up to the factfinder to determine

17 whether or not the defendant was ‘deliberately indifferent’ to the prisoner's medical
18 needs.” McGuckin, 974 F.2d at 1061 (noting that “[a] finding that the defendants’
19 neglect of a prisoner’s condition was an ‘isolated occurrence,’ Wood v. Housewright,
20 900 F.2d 1332, 1334 (9th Cir. 1990), or an ‘isolated exception,’ Toussaint v. McCarthy,
21 801 F.2d 1080, 1111 (9th Cir. 1986), to the defendants’ overall course of treatment of
22 the prisoner ordinarily militates against a finding of deliberate indifference,” while “a
23 finding that the defendant repeatedly failed to treat an inmate properly or that a single
24 failure was egregious strongly suggests that the defendant’s actions were motivated by
25 ‘deliberate indifference’ to the prisoner’s medical needs,” id. at 1060–61 (citations
26 omitted)). Inadequate treatment due to malpractice, or even gross negligence, does not
27 amount to a constitutional violation. Estelle, 429 U.S. at 106; Toguchi v. Chung, 391
28

7

1 F.3d 1051, 1060 (9th Cir. 2004) (“Deliberate indifference is a high legal standard.”
2 (citing Hallett v. Morgan, 296 F.3d 732, 1204 (9th Cir. 2002); Wood, 900 F.2d at
3 1334)). Moreover, differences in judgment between an inmate and prison medical
4 personnel regarding appropriate medical diagnosis and treatment are not enough to
5 establish a deliberate indifference claim. Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir.
6 1989).
7

This is not a case, however, where Jones alleges differences in judgment between

8 Jones and Dr. Sangha as to appropriate medical diagnosis and treatment, but delay in
9 that treatment. In Singleton, plaintiff suffered vision loss after prison medical officials
10 neglected to treat his eye pain and swelling for over a year. Singleton, 577 Fed. Appx.
11 at 736. The Ninth Circuit rejected the argument that this was a case of “differing
12 medical opinions,” concluding that Singleton had stated a claim for deliberate
13 indifference. Id. Similarly, Jones does not allege that Dr. Sangha committed medical
14 malpractice or negligence, but delay in treatment. In cases where prison medical
15 officials have been found to have engaged in behavior that arguably amounted to
16 malpractice or negligence, but not deliberate indifference, prison medical officials were
17 found to be sufficiently “responsive,” even if the medical care provided was less than
18 ideal. See Toguchi, 391 F.3d at 1061; see also Estelle, 429 U.S. at 107 (noting that
19 plaintiff was treated by medical personnel “on 17 occasions spanning a 3-month
20 period”).
21

Thus, Jones has pled facts sufficient to raise more than the “sheer possibility”

22 that Dr. Sangha acted with deliberate indifference. Iqbal, 556 U.S. at 678.
23 IV.

Official Capacity Claim

24

Jones is suing Dr. Sangha both as an individual and in his official capacity. Am.

25 Compl. 2. Dr. Sangha argues that he cannot be sued in his capacity as a state official
26 in a § 1983 action. Mot. Dismiss. 7. State officials cannot be sued in their official
27 capacity in a § 1983 action, Will v. Michigan Dept. of State Police, 491 U.S. 58, 71
28

8

1 (1989), even if they may be held personally liable for damages based upon actions
2 taken in their official capacities, Hafer v. Melo, 520 U.S. 21, 31 (1991).
3

Thus, Dr. Sangha may not be sued in his official capacity in this § 1983 action.

4 V.

Conclusion and Order

5

Based on the foregoing, IT IS HEREBY ORDERED that:

6

1. The Defendant’s Motion to Dismiss Plaintiff’s First Amended Complaint as

7 to Defendant Sangha is GRANTED as to suit against the Defendant in his official
8 capacity.
9

2. The Defendant’s Motion to Dismiss Plaintiff’s First Amended Complaint as

10 to Defendant Sangha is DENIED as to suit against the Defendant in his individual
11 capacity.
12

IT IS SO ORDERED.

13
14 DATED: September 16, 2015
15
16

HON. GONZALO P. CURIEL
United States District Judge

17
18
19
20
21
22
23
24
25
26
27
28

9