Paz v. State of Idaho et al

Filing 24

SUCCESSIVE REVIEW ORDERBY SCREENING JUDGE - IT IS ORDERED that Plaintiffs case is DISMISSED with prejudice. Signed by Judge David C. Nye. (caused to be mailed to non Registered Participants at the addresses listed on the Notice of Electronic Filing (NEF) by (lm)

UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF IDAHO
FEDERICO PAZ,
Case No. 1:21-cv-00201-DCN
Plaintiff,
SUCCESSIVE REVIEW ORDER
BY SCREENING JUDGE

v.
STATE OF IDAHO, WARDEN
ALBERTO RAMIREZ,
PSYCHIATRIST SCOTT ELIASON,
MS. L. WATSON, NICOLE MENEAR,
and IMSI PSYCHIATRIC SERVICES,
Defendants.

To assist in the screening of the Second Amended Complaint in this case (Dkt. 16),
the Court ordered Defendant Scott Eliason to provide a Martinez report to address
Plaintiff’s allegations that he is being denied medications for psychiatric and other serious
medical conditions. Dkt. 17. Dr. Eliason has filed his report with a declaration and over
900 pages of Plaintiff’s medical and mental health records. Dkts. 20 to 20-6. Plaintiff has
filed a response. Dkt. 22. After reviewing the entire recording in this matter, the Court
concludes that Plaintiff has failed to state a claim upon which relief can be granted, that
further amendment would be futile, and that the Complaint will be dismissed with
prejudice.
1. Screening Requirement
The Court must screen complaints filed by prisoners seeking relief against the

SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 1

government or its representatives to determine whether summary dismissal is appropriate.
The Court must dismiss a complaint or any portion thereof that states a frivolous or
malicious claim, fails to state a claim upon which relief may be granted, or seeks monetary
relief from a defendant who is immune from such relief. 28 U.S.C. §§ 1915(e)(2)(B) &
1915A(b).
In Martinez v. Aaron, 570 F.2d 317 (10th Cir. 1978), the trial court ordered (before
answer) that prison officials conduct an investigation of the incident which was the subject
of a prisoner complaint and file a report with the court to enable it to decide the
jurisdictional issues and make a screening determination under § 1915. Id. at 319. The
Ninth Circuit approved the use of Martinez reports in In re Arizona, 528 F.3d 652, 659 (9th
Cir. 2008).
The Court construed Plaintiff’s Complaint as stating Eighth Amendment deliberate
indifference claims for failure to provide adequate medical and mental health treatment.
The Eighth Amendment to the United States Constitution protects prisoners against cruel
and unusual punishment. To state a claim under the Eighth Amendment, Plaintiff must
state facts showing that he is “incarcerated under conditions posing a substantial risk of
serious harm” as a result of Defendants’ actions—which is analyzed under an objective
standard. Farmer v. Brennan, 511 U.S. 825, 834 (1994) (internal quotation marks omitted).
Plaintiff must also allege facts showing that Defendants were deliberately indifferent to his
needs—analyzed under a subjective standard.
As to the objective standard, the Supreme Court has explained that, “[b]ecause
society does not expect that prisoners will have unqualified access to health care, deliberate
SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 2

indifference to medical needs amounts to an Eighth Amendment violation only if those
needs are ‘serious.’” Hudson v. McMillian, 503 U.S. 1, 9 (1992).
As to the subjective factor, to violate the Eighth Amendment, a prison official must
act in a manner that amounts to deliberate indifference, which is “more than ordinary lack
of due care for the prisoner’s interests or safety,” but “something less than acts or omissions
for the very purpose of causing harm or with knowledge that harm will result.” Farmer,
511 U.S. at 835.
Differences in judgment between an inmate and prison medical personnel regarding
appropriate medical diagnosis and treatment are not enough to establish a deliberate
indifference claim. See Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir. 1989). Medical
negligence or malpractice alone will not support a claim for relief under the Eighth
Amendment. Broughton v. Cutter Lab, 622 F.2d 458, 460 (9th Cir. 1980).
2. Discussion
Dr. Eliason provides extensive medical records and a detailed declaration. Both of
these tools aid in the screening of the pleadings. Dr. Eliason is a board-certified psychiatrist
and a “Certified Correctional Healthcare Professional.” He is both a medical doctor and a
mental health provider. Dr. Eliason has treated many patients diagnosed with paranoid
schizophrenia and antisocial personality disorder and knows the standard of care for
treating those conditions. He has been Plaintiff’s treating psychiatrist since about 2010.
Dkt. 20-1, pp. 1-3.
Plaintiff has been diagnosed with “paranoid schizophrenia and antisocial
personality disorder, to a severe degree.” Id., p. 3. Plaintiff could become violent if not
SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 3

treated with appropriate medications. Id., pp. 6-7. The medical records support these
medical opinions. See Dkts. 20-2 to 20-6.
To treat these mental health conditions, Dr. Eliason prescribed an antipsychotic,
haloperidol decanoate (“haloperidol”), for Plaintiff in 2010, and that prescription continues
today. Since about May 2019, Plaintiff has received his haloperidol via long-acting
injection, administered every four weeks and has been compliant with taking the
medication. Id., p. 3.
A.

Failure to Treat Plaintiff’s Tremors

Plaintiff alleges that he suffers from tremors when he takes haloperidol—which is
a known side effect of that medication. Id. Dr. Eliason has prescribed Cogentin and Inderal
in the past to help with the side effects. Plaintiff requested that Dr. Eliason discontinue
these medications. Id. Plaintiff says that these medications did not help the tremors caused
by the haloperidol. Dkt. 22.
To help with the tremors, on June 15, 2022, Plaintiff requested and received a
prescription of ropinirole, which can treat restless leg syndrome, from a non-psychiatric
provider at the prison. However, after Plaintiff began taking ropinirole, Dr. Eliason
received reports that Plaintiff had begun exhibiting behavior consistent with possible
worsening psychosis. Dkt. 20-1, p. 6. Dr. Eliason was aware that worsening psychosis can
be a side effect of ropinirole. Accordingly, Dr. Eliason immediately discontinued
Plaintiff’s ropinirole medication. Thereafter, Plaintiff’s mental health conditions seemed
to improve. Id., p. 6.
Plaintiff’s disagreement with Dr. Eliason over whether he should be able to continue
SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 4

taking a medication that helps his tremors and worsens his psychosis does not form the
factual basis of an Eighth Amendment claim. Nor has Plaintiff provided sufficient
allegations or pointed to evidence in the record showing that he tried the two medications
Dr. Eliason prescribed over a sufficient period of time to reject them as nonhelpful for the
tremors. In addition, the medical records show consistently that Plaintiff does not complain
of any particular problems at his mental health screenings. See Dkts. 20-1 to 20-6. He has
failed to provide sufficient allegations to show that he has an objectively serious medical
need not addressed by Dr. Eliason, or that Dr. Eliason has been deliberately indifferent to
his medical and mental health needs.
B.

Failure to Prescribe Ingrezza Medication for Side Effects

While conversing with Dr. Eliason, Plaintiff explained he had recently seen
commercials for a medication called Ingrezza and expressed an interest in trying that
medication. Dkt. 20-1, pp. 4-5. Ingrezza is a medication specifically prescribed to treat
tardive dyskinesia. Id., p. 5. Tardive dyskinesia is a side effect caused by some medications
that presents as repetitive, jerking movements that occur in the face, neck, and tongue.
Plaintiff did not have tardive dyskinesia per Dr. Eliason’s objective assessment. Thus, Dr.
Eliason did not prescribe Ingrezza for Plaintiff at that time. Id., p.5.
Plaintiff’s disagreement with Dr. Eliason over whether he should be able to take a
drug he saw advertised on television to try to address his tremors, even though it is
specifically prescribed for jerking movements that Plaintiff does not exhibit, does not form
the factual basis of an Eighth Amendment claim. Whether the medication is costly does
not factor into the equation, given that Plaintiff does not exhibit the specific symptoms
SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 5

Ingrezza addresses.
C.

Failure to Prescribe Austeda for Suicidal thoughts, Seriovital for Sleeping
Disorder, Prevegen for Mind Improvement, and Nexium for Heartburn

On June 23, 2021, Plaintiff submitted a Health Service Request (“HSR”) stating, “I
would like to try a new medication that is out for suicidal thoughts.” Dkt. 20-1, p. 4. As a
result of this HSR, medical staff placed Plaintiff on a four-hour suicide watch. Thereafter,
Plaintiff was assessed by a mental health clinician. Although Plaintiff was emotional due
to lack of sleep and slightly frustrated with his incarceration, the clinician released Plaintiff
from suicide watch because he presented as “low risk.” Plaintiff agreed to comply with his
medication, to regulate his sleep patterns, and to address any medication concerns with Dr.
Eliason. Plaintiff was scheduled for three days of post-watch release follow-up
appointments. Id.
The next day, Plaintiff had an appointment with Dr. Eliason. Plaintiff denied any
suicide ideation or self-injurious behaviors. At that time, Plaintiff was compliant with his
haloperidol injections, reported a normal appetite, and explained that things were going
well for him. Id., pp. 4-5.
Plaintiff had a follow-up appointment with Dr. Eliason on July 15, 2021. Id., pp. 56. At this follow-up appointment, Plaintiff reported he was doing well. Id. Although
Plaintiff requested multiple new medications, he denied the necessity for each. Further
assessment by Dr. Eliason indicated there was no need for additional medications. Id. Dr.
Eliason believed Plaintiff was likely shopping for medications out of boredom since he had
no symptoms that would warrant any other medications Plaintiff was requesting. Id.

SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 6

Therefore, Dr. Eliason appropriately continued Plaintiff’s haloperidol injection
prescription and declined Plaintiff’s other unsupported requests. Id.
From July 15, 2021, through September 12, 2021, Plaintiff’s mental health has been
assessed as stable. Plaintiff made no additional supportable complaints in more than ten
separate appointments. Dkt. 20-1, p. 6. On August 17, 2021, Dr. Eliason assessed Plaintiff
after he submitted a HSR stating “I want to change my mental health meds to pills twice
daily, please.” Id. (referencing Corizon_Paz_000686). At that appointment, Plaintiff stated
he was doing well and happy, denied suicidal thoughts, and denied any side effects from
his haloperidol.
Dr. Eliason’s objective assessment of Plaintiff aligned with Plaintiff’s subjective
assessment, meaning he appeared to be doing well. Because Plaintiff was doing well on
the long-acting injection of haloperidol, Dr. Eliason decided that it would not be helpful to
change the method of delivery to pills. This decision was made based on the severity of
Plaintiff’s mental diagnoses (i.e., he has very serious schizophrenia if he is not taking
appropriate medications and could be very violent off his medications), the effectiveness
of his current haloperidol long-acting injection, and his past noncompliance with oral
medications. Id., pp. 6-7.
Overall, Dr. Eliason opined that, though Plaintiff has complained of prescribed
medications intermittently, Plaintiff has also indicated on multiple occasions that he is
satisfied with haloperidol. Plaintiff’s paranoid schizophrenia and antisocial personality
disorder remain stable on haloperidol.
Although Plaintiff has complained to other providers about wanting antidepressant
SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 7

medications, Plaintiff has not exhibited symptoms such that Dr. Eliason would be inclined
to prescribe them. Nevertheless, Dr. Eliason reported that, should Plaintiff request
antidepressants and present to him in a manner consistent with depression, Dr. Eliason
would be open to prescribing appropriate antidepressants under the circumstances. To date,
however, Plaintiff generally presents to Dr. Eliason as stable, bubbly, and enjoyable to
work with, which is not consistent with depression. Id., p.7.
Plaintiff’s vague complaints about not receiving various requested medications do
not state a plausible claim that he is being denied medical or mental health treatment for
serious medical conditions. The record reflects that Dr. Eliason carefully considers
Plaintiff’s requests, but has determined, in his professional opinion, that the additional
medications requested are not warranted or would substantially interfere with Plaintiff’s
treatment for severe mental health conditions that, if left untreated, may cause Plaintiff to
act out in violent ways.
3. Conclusion
Plaintiff has not shown by his allegations or with the supplemental medical records
provided by Defendant that he can meet the objective or subjective standard for stating an
Eighth Amendment claim. As to the objective prong of the Eighth Amendment standard,
the medical records present a picture of a man in his early 60s in relatively good health
despite his severe mental illness challenges, thanks to the care of Dr. Eliason and the prison
medical staff. Plaintiff has not shown that he has objectively serious medical conditions
that require the medications he asserts he is not receiving. The 900 pages of medical records
show that Plaintiff is receiving better care than many Americans who are not incarcerated
SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 8

and who are nevertheless footing the bill for Plaintiff’s excellent mental health care in
prison.
As to the subject prong of the Eighth Amendment standard, Plaintiff has baldly
alleged that Dr. Eliason lies and argues with him, but the medical records show that Dr.
Eliason is an experienced, contemplative provider who is very knowledgeable about
Plaintiff’s severe mental illness and makes decisions according to what he deems best for
Plaintiff in the context of Plaintiff’s severe mental illness. The record reflects that when
Plaintiff presents Dr. Eliason with a new request, Dr. Eliason carefully considers it in light
of Plaintiff’s diagnoses and other medications. No deliberate indifference is evident from
the allegations of the pleadings or the medical records.
4. Opportunity to Amend
The Court now considers whether to allow Plaintiff a third opportunity to amend the
complaint. Amendments to pleadings are governed by Rule 15 of the Federal Rules of Civil
Procedure. That rule states that the Court “should freely give leave when justice so
requires.” Fed. R. Civ. P. 15(a)(2). The Ninth Circuit has explained the reasoning behind
allowing the opportunity to amend:
In exercising its discretion with regard to the amendment of pleadings, a court must
be guided by the underlying purpose of Rule 15—to facilitate decision on the merits rather
than on the pleadings or technicalities. Courts must liberally construe civil rights actions
filed by pro se litigants so as not to close the courthouse doors to those truly in need of
relief. Eldridge v. Block, 832 F.2d 1132, 1135-37 (9th Cir. 1987) A pro se litigant bringing
a civil rights suit must have an opportunity to amend the complaint to overcome
SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 9

deficiencies unless it is clear that those deficiencies cannot be overcome by amendment.
Id. at 1135-36. Although several factors contribute to the analysis of whether a plaintiff
should be allowed an opportunity to amend, futility alone can justify denying such an
opportunity. Johnson v. Buckley, 356 F.3d 1067, 1077 (9th Cir. 2004).
The Court concludes that amendment in this case would be futile. Plaintiff’s
extensive medical records would not help him state a claim on the factual bases alleged in
the second amended complaint. In fact, the opposite is true. Plaintiff’s care does not reflect
any facts that could form the basis of an Eighth Amendment claim. Therefore, the Court
will dismiss the second amended complaint without leave to amend.
ORDER
IT IS ORDERED that Plaintiff’s case is DISMISSED with prejudice.

DATED: August 1, 2022
_________________________
David C. Nye
Chief U.S. District Court Judge

SUCCESSIVE REVIEW ORDER BY SCREENING JUDGE - 10