DALE A. DROZD, Magistrate Judge.
Plaintiff is a state prisoner proceeding pro se with a civil rights action seeking relief under 42 U.S.C. § 1983. This matter is before the court on a motion for summary judgment brought pursuant to Rule 56 of the Federal Rules of Plaintiff has filed an opposition to the motion, and defendant has filed a reply. For the reasons discussed below, the court will recommend that defendant's motion for summary judgment be granted.
Plaintiff is proceeding on an amended complaint. Therein, he alleges that defendant Dr. Traquina created, approved, and continued a policy of denying plaintiff and other inmates suffering from hypertension the blood pressure checks their doctors had ordered during prison lock-down periods from May 2010 through November 2011 in violation of the Eighth Amendment. In terms of relief, plaintiff requests damages and injunctive relief. (Am. Compl. at 5 & Attach. & Exs.)
Plaintiff commenced this action in November 2010. The court screened plaintiff's complaint and determined that service was appropriate with respect to defendant Dr. Traquina. (Doc. No. 7) On June 24, 2011, defendant Dr. Traquina filed a motion to dismiss the complaint for failure to state a cognizable claim for relief. (Doc. No. 13) On January 20, 2012, the undersigned issued findings and recommendations, recommending that defendant's motion to dismiss be granted. (Doc. No. 22) On March 29, 2012, the assigned district judge adopted the findings and recommendations in full and entered judgment on the same day. (Doc. Nos. 25 & 26)
Plaintiff appealed, and the U.S. Court of Appeals for the Ninth Circuit affirmed in part, vacated in part, and remanded the case back to this court. (Doc. No. 31) The Ninth Circuit found that it was not "absolutely clear" that plaintiff could not cure deficiencies of his claim that defendant Dr. Traquina was responsible for an institutional policy or practice of failing to provide blood pressure screenings to inmates when the prison was on lockdown. (
On remand, this court granted plaintiff leave to file an amended complaint only with respect to his claim that defendant Dr. Traquina was responsible for an institutional policy of failing to provide blood pressure screening to inmates when the prison was on lockdown. (Doc. No. 34) Thereafter, plaintiff filed his amended complaint, and defendant filed an answer. (Doc. Nos. 35 & 37) On April 30, 2013, the court issued a discovery and scheduling order, and on October 18, 2013, defendant Dr. Traquina filed the pending motion for summary judgment. (Doc. Nos. 38 & 41)
Summary judgment is appropriate when the moving party "shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." Fed. R. Civ. P. 56(a).
Under summary judgment practice, the moving party "initially bears the burden of proving the absence of a genuine issue of material fact."
If the moving party meets its initial responsibility, the burden then shifts to the opposing party to establish that a genuine issue as to any material fact actually does exist.
"In evaluating the evidence to determine whether there is a genuine issue of fact," the court draws "all reasonable inferences supported by the evidence in favor of the non-moving party."
The Civil Rights Act under which this action was filed provides as follows:
42 U.S.C. § 1983. The statute requires that there be an actual connection or link between the actions of the defendants and the deprivation alleged to have been suffered by plaintiff.
Moreover, supervisory personnel are generally not liable under § 1983 for the actions of their employees under a theory of
The unnecessary and wanton infliction of pain constitutes cruel and unusual punishment prohibited by the Eighth Amendment.
If a prisoner's Eighth Amendment claim arises in the medical care context, the prisoner must allege and prove "acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs."
A medical need is serious "if the failure to treat the prisoner's condition could result in further significant injury or the `unnecessary and wanton infliction of pain.'"
If a prisoner establishes the existence of a serious medical need, he must then show that prison officials responded to the serious medical need with deliberate indifference.
Delays in providing medical care may manifest deliberate indifference.
Finally, mere differences of opinion between a prisoner and prison medical staff or between medical professionals as to the proper course of treatment for a medical condition do not give rise to a § 1983 claim.
Counsel on behalf of defendant Dr. Traquina has moved for summary judgment on plaintiff's inadequate medical care claim on the grounds that the evidence submitted establishes that defendant Dr. Traquina was not deliberately indifferent to plaintiff's serious medical needs. (Def.'s Mem. of P. & A. at 7-9.) Based on all of the evidence presented in connection with the pending motion for summary judgment, and for the reasons stated below, the undersigned concludes that defendant Dr. Traquina is entitled to summary judgment in his favor with respect to this claim.
First, the court finds that defendant Dr. Traquina has borne the initial responsibility of coming forward with evidence demonstrating that no reasonable juror could conclude that he was deliberately indifferent to plaintiff's serious medical needs in violation of the Eighth Amendment. Defendant Dr. Traquina has submitted a statement of undisputed facts supported by declarations signed under penalty of perjury by defendant Dr. Traquina and Dr. Pfile. Defendant's statement of undisputed facts is also supported by citations to a transcript of plaintiff's deposition and to plaintiff's medical records. The evidence submitted by the defendant in support of his motion for summary judgment establishes the following.
At all relevant times to this suit, plaintiff was an inmate at California State Prison, Solano ("CSP-Solano"), and defendant Dr. Traquina was the Chief Medical Officer ("CMO") at CSP-Solano. At all relevant times, Dr. Ashley Pfile was plaintiff's primary care physician at CSP-Solano. (Def.'s SUDF 1-2 & 6, Pfile Decl., Pl.'s Dep.)
On March 5, 2010, Dr. Pfile saw plaintiff. At that time plaintiff complained of episodes of chest pressure, palpitations, and near syncope (fainting) beginning six weeks earlier. Dr. Pfile prepared a Physician Request for Services for plaintiff to receive a cardiology evaluation. On March 25, 2010, Dr. Dassah, a cardiologist, evaluated plaintiff. Plaintiff's examination by Dr. Dassah was unremarkable. Plaintiff reported that his symptoms had ceased and had not returned. Dr. Dassah recommended that plaintiff undergo a treadmill test at CSP-Solano. Plaintiff subsequently underwent an Exercise Tolerance Test ("ETT") or Stress Test on a treadmill at CSP-Solano. His results from that test were found to be within normal limits. (Def.'s SUDF 8-9, Pfile Decl.)
On May 10, 2010, plaintiff returned to CSP-Solano from an ophthalmology appointment outside the institution. He reported to the Triage and Treatment Area ("TTA") of CSP-Solano on that date complaining of chest pains. Dr. Rallos diagnosed plaintiff as suffering from hypertension and prescribed him enalapril to control his blood pressure. Dr. Rallos advised plaintiff to monitor his blood pressure three times a week and to follow-up with his primary care provider. (Def.'s SUDF 4, Pfile Decl., Pl.'s Dep.)
Three days later, on May 13, 2010, plaintiff reported to the CSP-Solano annex clinic complaining of dizziness and elevated blood pressure. He was transported within the facility to the TTA, where his prescription dosage of enalapril was increased and he was monitored until his blood pressure readings returned to within normal limits. Plaintiff was also given a prescription for hydrochlorothiazide at that time to control his blood pressure. (Def.'s SUDF 5, Pfile Decl., Pl.'s Dep.)
On May 20, 2010, Dr. Pfile saw plaintiff again. She continued plaintiff's prescription for hydrochlorothiazide as his primary treatment for his hypertension, discontinued the enalapril, and advised plaintiff to monitor his blood pressure twice a week. Plaintiff also received a card during that visit on which to record his blood pressure readings. (Def.'s SUDF 6-7, Pfile Decl., Pl.'s Dep.)
On July 2, 2010, plaintiff had a follow-up doctor visit for his hypertension. He did not present with any complaints or symptoms at this appointment, and the monitoring of his blood pressure revealed that it was staying within normal limits. On July 16, 2010, Dr. Pfile noted that plaintiff's hypertension was under excellent control with medication. (Def.'s SUDF 10-11, Pfile Decl.)
On October 27, 2010, Dr. Pfile saw plaintiff for complaints of some dizziness, stomach cramping, and shoulder pain. Plaintiff's blood pressure readings indicated that his hypertension was under excellent control with hydrochlorothiazide, and the rest of plaintiff's cardiac work-up results were within normal limits. Plaintiff's prescription for hydrochlorothiazide was modified because that medication can be the cause of dizziness. By November 29, 2010, plaintiff's dizziness had improved significantly with the reduction of the hydrochlororthiazide dosage. At that time plaintiff's blood pressure readings indicated continued excellent control of his hypertension. (Def.'s SUDF 12-13, Pfile Decl.) As of February 25, 2011, plaintiff's blood pressure readings indicated continued excellent control of his hypertension with only minor modifications to his prescribed medication.
From March 26, 2011, until April 2, 2011, plaintiff was hospitalized at San Joaquin General Hospital for a syncopal episode attributed to his prescription eye drops and pneumonia. That hospitalization was not attributable to plaintiff's hypertension. (Def.'s SUDF 14-15, Pfile Decl., Pl.'s Dep.)
Plaintiff was seen at least monthly by doctors for follow-up appointments from April until November 2011, regarding all of his medical conditions, including his hypertension. Plaintiff's blood pressure readings continued to indicate fair to excellent control of his hypertension with the prescribed medication. (Def.'s SUDF 16, Pfile Decl., Pl.'s Dep.)
According to Dr. Pfile, plaintiff's hypertension was well controlled with medication as Dr. Pfile and other medical professionals regularly evaluated his hypertension condition during plaintiff's routine medical appointments. There is no indication in plaintiff's medical records that he suffered any injury or experienced any complications due to a lack of blood pressure readings. On November 22, 2011, plaintiff transferred from CSP-Solano to San Quentin State Prison. (Def.'s SUDF 17-20, Pfile Decl., Pl.'s Dep.)
Plaintiff admitted during his deposition in this case that he does not know what dates he was unable to monitor his blood pressure nor how many times he believes his blood pressure was not taken when it supposedly should have been taken. Plaintiff acknowledged that if he experienced any light-headedness or dizziness that he associated with elevated blood pressure, he could request to see someone in the TTA of CSP-Solano by going "man-down," even when his housing unit was on modified program or lockdown or on holidays. Plaintiff also conceded that he never filled out a Request for Health Care Services to have his blood pressure checked during any modified programming or lockdown when he was not able to freely walk to the annex clinic to have his blood pressure checked. Plaintiff also admitted that he never requested a ducat to go to the annex clinic or for an escort to the annex clinic during any modified program or lockdown when he was not able to freely walk to the annex clinic to have his blood pressure checked. (Def.'s SUDF 20-24, Traquina Decl., Pl.'s Dep.)
According to defendant Dr. Traquina, there simply was no policy at CSP-Solano to preclude, delay, or otherwise prevent inmates with a history of hypertension from having medical professionals monitor their blood pressure. Defendant Dr. Traquina declares that he has never met or treated plaintiff. (Def.'s SUDF 25-26, Traquina Decl., Pl.'s Dep.)
Given the evidence submitted by defendant Dr. Traquina in support of the pending motion for summary judgment, the burden shifts to plaintiff to establish the existence of a genuine issue of material fact with respect to his inadequate medical care claim. On defendant's motion for summary judgment, the court is required to believe plaintiff's evidence and draw all reasonable inferences from the evidence before the court in plaintiff's favor. The court has reviewed plaintiff's amended complaint and his opposition to defendant's motion. Drawing all reasonable inferences from the evidence in plaintiff's favor, the court concludes that plaintiff has not submitted sufficient evidence on summary judgment to create a genuine issue of material fact with respect to his claim that defendant Dr. Traquina violated his rights under the Eighth Amendment.
As noted above, it is clear that a defendant can be held liable as supervisor "if there exists either (1) his or her personal involvement in the constitutional deprivation; or (2) a sufficient causal connection between the supervisor's wrongful conduct and the constitutional violation."
In this case, plaintiff contends that defendant Dr. Traquina intentionally made sure, either through a policy or practice, that nursing staff was not available to conduct blood pressure checks during modified programming or lockdown periods and on holidays at CSP-Solano. (Pl.'s SDF in Opp'n to Def.'s Mot. for Summ. J. at 4.) Plaintiff has not, however, submitted any evidence of an official policy or practice of prohibiting nursing staff from conducting blood pressure checks during these times or occasions. Although plaintiff declares that the nurses at CSP-Solano would not check his blood pressure during modified programming or lockdown periods and on holidays, his allegations are based on his limited experience alone and do not establish that defendant Dr. Traquina created, implemented, or authorized an actual policy or practice to this effect.
Moreover, even if the court assumes for the sake of argument that defendant Dr. Traquina had a policy or practice that prohibited nursing staff from monitoring the blood pressure of inmates during modified program, lockdowns, and on holidays, plaintiff has not submitted any evidence of a causal connection between any such policy or practice on the one hand and a constitutional injury he suffered on the other hand. See Starr, 652 F.3d at 1207;
As an initial matter, plaintiff testified during his deposition that he could not even recall when he was denied a blood pressure check or how many times such a denial occurred. When defense counsel pressed plaintiff and asked if he was denied a blood pressure check more than ten or more than twenty times, plaintiff responded, "Between May 10th [2010] and November 2011, may have been seven or eight." (Pl.'s Dep. at 53) In his opposition to defendant's pending motion for summary judgment, plaintiff clarifies that he learned through defendant's responses to his discovery requests that prison officials put CSP-Solano on lockdown on the following Mondays and Thursdays when he presumably would have monitored his blood pressure: May 24, 2010, May 27, 2010, June 17, 2010, June 21, 2010, July 12, 2010, August 19, 2010, and March 2, 2011. Plaintiff contends that the following holidays also fell on Mondays and Thursdays: Labor Day, Veteran's Day, Christmas Eve, New Year's Eve. (Pl.'s Opp'n to Def.'s Mot. for Summ. J. at 6.) Plaintiff argues that on these dates he could not monitor his blood pressure and as a result suffered "mini strokes" and that he could have lost his left eye and his life. In this regard, plaintiff maintains that his blood pressure was never under control while he was at CSP-Solano, and had his blood pressure been checked on the dates that CSP-Solano was on lockdown and on those specified holidays, his doctor could have made a proper determination as to the blood pressure medication he needed to adequately control his hypertension. (Pl.'s SDF in Opp'n to Def.'s Mot. for Summ. J. at 3.)
Plaintiff's contentions, however, are purely speculative. Plaintiff is not a medical expert and, therefore, he may not offer his own opinion as to whether defendant Dr. Traquina's purported policy caused his alleged injuries. Certainly by merely expressing his conclusory and speculative opinions plaintiff fails to create a genuine issue of material fact.
Moreover, plaintiff acknowledged during his own deposition that no medical professional has told him that the lack of blood pressure checks he complains of here caused him any actual harm. In relevant part, plaintiff testified at deposition as follows:
(Pl.'s Dep. at 58.)
Thus, even assuming that plaintiff did not receive blood pressure checks on the dates he has listed because of the purported policy or practice instituted by defendant Traquina, plaintiff has come forward with no evidence to show that his alleged inability to monitor his blood pressure on those dates was the actual or proximate cause of any injury which he suffered.
Finally, the court observes that this is not a case where plaintiff repeatedly requested medical care which prison officials denied him.
For all of the foregoing reasons, the court finds that based upon the evidence presented in connection with the pending motion for summary judgment no reasonable juror could conclude that defendant Dr. Traquina was deliberately indifferent to plaintiff's serious medical needs.
Accordingly, defendant Dr. Traquina is entitled to summary judgment in his favor with respect to plaintiff's claim that that Traquina was responsible for an institutional policy or practice of failing to provide blood pressure screenings to inmates when the prison was on lockdown status in violation of plaintiff's rights under the Eighth Amendment.
Accordingly, IT IS HEREBY RECOMMENDED that:
1. Defendant Dr. Traquina's motion for summary judgment (Doc. No. 41) be granted; and
2. This action be closed.
These findings and recommendations are submitted to the United States District Judge assigned to the case, pursuant to the provisions of 28 U.S.C. § 636(b)(l). Within fourteen days after being served with these findings and recommendations, any party may file written objections with the court and serve a copy on all parties. Such a document should be captioned "Objections to Magistrate Judge's Findings and Recommendations." Any response to the objections shall be filed and served within seven days after service of the objections. The parties are advised that failure to file objections within the specified time may waive the right to appeal the District Court's order.