DEBORAH BARNES, Magistrate Judge.
Plaintiff is a state prisoner proceeding pro se and in forma pauperis with a civil rights action under 42 U.S.C. § 1983. Plaintiff contends defendant Jahangiri was deliberately indifferent to plaintiff's serious medical needs in violation of the Eighth Amendment when he did not take appropriate measures after plaintiff threatened to commit suicide. Before the court is defendant's motion for summary judgment and plaintiff's motions to amend his complaint, for a jury trial, and for the appointment of counsel. For the reasons set forth below, the court will recommend defendant's motion be granted and plaintiff's motions be denied.
Plaintiff alleges that on August 28, 2014, while incarcerated at the California Health Care Facility ("CHCF") a nurse claimed that plaintiff had threatened to kill her. The following day plaintiff was brought to a meeting of the IDTT,
Plaintiff filed his complaint here on December 14, 2015. (ECF No. 1.) He identified Jahangiri and CHCF as defendants. On screening, the court found plaintiff stated a cognizable Eighth Amendment deliberate indifference claim against Jahangiri and dismissed the claim against CHCF. (ECF No. 11.)
After the parties conducted discovery, defendant Jahangiri filed a motion for summary judgment on June 27, 2017. (ECF No. 61.) Plaintiff filed three documents in opposition (ECF Nos. 68, 68-1, 69) and defendant filed a reply (ECF No. 71).
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."
When the non-moving party bears the burden of proof at trial, "the moving party need only prove that there is an absence of evidence to support the nonmoving party's case."
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.
However, a complaint that is submitted in substantial compliance with the form prescribed in 28 U.S.C. § 1746 is a "verified complaint" and may serve as an opposing affidavit under Rule 56 as long as its allegations arise from personal knowledge and contain specific facts admissible into evidence.
The opposing party must demonstrate that the fact in contention is material, i.e., a fact that might affect the outcome of the suit under the governing law, see
To show the existence of a factual dispute, the opposing party need not establish a material issue of fact conclusively in its favor. It is sufficient that "the claimed factual dispute be shown to require a jury or judge to resolve the parties' differing versions of the truth at trial."
"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 the plaintiff.
Supervisory personnel are generally not liable under § 1983 for the actions of their employees under a theory of respondeat superior and, therefore, when a named defendant holds a supervisorial position, the causal link between him and the claimed constitutional violation must be specifically alleged.
The Eighth Amendment prohibits the infliction of "cruel and unusual punishments." U.S. Const. amend. VIII. The unnecessary and wanton infliction of pain constitutes cruel and unusual punishment prohibited by the Eighth Amendment.
What is needed to show unnecessary and wanton infliction of pain "varies according to the nature of the alleged constitutional violation."
For an Eighth Amendment claim arising in the context of medical care, 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.
Before it can be said that a prisoner's civil rights have been abridged with regard to medical care, "the indifference to his medical needs must be substantial. Mere `indifference,' `negligence,' or `medical malpractice' will not support this cause of action."
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.
Defendant filed a Statement of Undisputed Facts ("DSUF") as required by Local Rule 260(a). (ECF No. 61-2.) Plaintiff submitted two filings in opposition to defendant's motion. Plaintiff's first filing is an opposition brief. (ECF No. 69.) In the second filing, plaintiff responds to each of the undisputed facts identified by defendant. (ECF No. 68 at 5-10.) In addition, plaintiff provides his declaration. (ECF No. 68-1.) In his reply brief, defendant objects to plaintiff's statement of disputed facts because, while plaintiff attaches exhibits to both of his filings, plaintiff does not explicitly identify evidence to support his contentions. (
The events at issue occurred while plaintiff was incarcerated at CHCF. Defendant Dr. Jahangiri is a psychiatrist employed by California's Department of State Hospitals. (DSUF #1.
Prior to August 13, 2014, plaintiff was on Discretionary Program Status ("DPS") at CHCF. (DSUF #6.) On DPS, plaintiff's activities were limited to his room and he had special staffing. (
Jahangiri next saw plaintiff on August 18, 2014. (DSUF #15.) At that time, plaintiff had been placed back on DPS due to an incident on August 15 when he got angry at staff and punched a door with a hand he had recently fractured. (DSUF #16.) At the August 18 appointment, plaintiff was again moved to Stage 1 from DPS in light of his sustained compliance with unit routine. (DSUF #20.)
Jahangiri next saw plaintiff at his IDTT meeting on August 28, 2014 at 9:55 a.m. (DSUF #21.) Plaintiff was back on DPS due to reports that he threatened to kill a staff member, incessantly banged his door, and yelled profanities and racial slurs at staff. (DSUF #22.) At that meeting, plaintiff expressed anger at staff, particularly staff who wrote him up. (DSUF #25.) Plaintiff was informed at that time that he would be discharged from CHCF to an Enhanced Outpatient Program at CDCR. (DSUF #33.) It is undisputed that plaintiff was upset then, and continues to be upset, that he has not received sex offender treatment and, in particular, that he has not been transferred to Atascadero or Coalinga State Hospitals for that treatment.
In his declaration, Dr. Jahangiri describes what he found in his examination of plaintiff at the August 28 meeting. (Jahangiri Decl., ¶ 10.c.) Jahangiri found plaintiff to be "calm and cooperative but argumentative and self-advocating." He noted that plaintiff expressed no suicidality. Dr. Jahangiri ordered a continuation of plaintiff's medication and that plaintiff have staggered safety checks every ten minutes. (DSUF #36.) He ordered the staggered safety checks based on plaintiff's DPS status and his oppositional attitude during the IDTT meeting. (DSUF #40.) In addition, Jahangiri felt it would be prudent to prevent any impulsive self-harm. (DSUF #41.) Ten-minute staggered rounds are performed by staff members other than those who are assigned to conduct welfare checks every fifteen minutes. (DSUF #37.) The purpose of staggered checks is to observe the patient at random, unpredictable intervals no longer than ten minutes apart (i.e. ten minutes; then two minutes then six minutes, etc.). (DSUF #38.) Staggered rounds are in addition to the fifteen-minute rounds, not in lieu of them. (DSUF #39.)
At some point after the August 28 meeting and before plaintiff was discovered injured, plaintiff broke a piece of metal off of a wrist brace he was wearing. (Transcript of Plt.'s Mar. 23, 2017 Depo. ("Plt.'s Depo.") at 38.) Plaintiff had been given the brace after he punched a door and broke his hand about three weeks earlier. (
Plaintiff was found in his cell with a wound to his neck at 2:24 a.m. on August 30, 2014. (DSUF #42.) During the over 40 hours between the August 28 IDTT meeting, and the discovery of plaintiff's injury, plaintiff was seen hundreds of times by numerous staff members. First, he was seen 258 times by staff as part of the staggered safety checks. (DSUF #43.) None of the staff notes show any activities by plaintiff indicative of self-injury. (DSUF #44.) Second, plaintiff was seen 161 times on the regular fifteen-minute welfare checks. (DSUF #46.) Third, registered nurses made contact with plaintiff nine times. (DSUF #48.) The notes of those contacts do not reflect any self-injurious intent by plaintiff. (
The one material fact in dispute is whether plaintiff informed Jahangiri that he intended to attempt suicide. According to plaintiff, he informed Jahangiri that he intended to do so as soon as he returned to his cell. (Compl. (ECF No. 1 at 3); Plt.'s Depo. at 24.) According to Jahangiri, plaintiff "expressed no suicidal ideation during his IDTT meeting on 8/28/14." (Jahangiri Decl., ¶ 10.)
Plaintiff contends Jahangiri exhibited deliberate indifference when he failed to institute more restrictive measures after plaintiff threatened suicide at the August 28 IDTT meeting. Plaintiff claims Jahangiri should have had plaintiff "removed in handcuffs, placed in a F[e]rguson gown, and put in a room stripped of all contraband for his safety." (Compl. (ECF No. 1 at 3).) Jahangiri argues first that plaintiff did not express any suicidal ideations at the August 28 meeting and also that the measures he ordered show that he did not exhibit deliberate indifference to foreseeable risks to plaintiff.
Considering the facts in the light most favorable to plaintiff, the court will assume plaintiff did, in fact, tell Jahangiri at the August 28 IDTT meeting that he intended to commit suicide when he returned to his cell. The court then examines Jahangiri's conduct in response. It is clear that plaintiff's behavior at the August 28 IDTT meeting gave Jahangiri cause for concern. Jahangiri initiated much more frequent welfare checks. Plaintiff does not contest that he was checked on by staff over 400 times in a little over 40 hours. Rather than being indifferent to plaintiff's care, Jahangiri, based on his knowledge of plaintiff's medical history, his prior examinations of plaintiff, and his observations of plaintiff during the August 28 meeting, determined that plaintiff required a higher level of monitoring for self-injurious behavior.
Plaintiff argues that Jahangiri should have instituted certain procedures as soon as plaintiff stated that he intended to commit suicide. However, plaintiff provides no evidence to support an argument that these procedures were medically necessary. Plaintiff does not show that the actions Jahangiri took were medically unsound or unreasonable, much less that they demonstrate Jahangiri acted with deliberate indifference.
In addition, plaintiff's suicide attempt occurred over 40 hours after Jahangiri saw plaintiff. During that time, Jahangiri had no reason to think the measures he had put in place were not effective. He received no reports from the staff members performing frequent welfare checks and delivering medications or from the nursing staff who had nine contact visits with plaintiff that plaintiff was in imminent danger of harming himself.
The 40-hour time period that elapsed between the August 28 meeting and plaintiff's self-injurious behavior also defeats a finding of causation. Plaintiff did not immediately attempt suicide as he contends he threatened to do at the August 28 meeting. Rather, a good deal of time elapsed during which plaintiff had interactions with many staff members who provided him medications, escorted him to the dayroom, and checked on his welfare during nursing contact visits. It cannot be said that plaintiff's actions taken 40 hours after he allegedly made the statement to Jahangiri were reasonably foreseeable in this situation.
The Eighth Amendment standard is a high one — plaintiff must show more than "negligence" or "medical malpractice."
Section 945.4 of the Government Claims Act provides that
Cal. Gov't Code § 945.4 (emphasis added). Section 950.6 provides that
Cal. Gov't Code § 950.6 (emphasis added).
The claims-presentation requirement "constitutes an element of any cause of action arising under the Government Claims Act."
Plaintiff does not contest defendant's assertion that he failed to file a claim with the Government Claims Board. (Plt.'s Depo. at 50; ECF No. 69 at 3.) Further, he provides no basis to excuse compliance with the claim filing requirement. Accordingly, plaintiff fails to state a cognizable state-law cause of action.
In his motion to file an amended complaint, plaintiff simply states that he has a witness to testify at trial and wishes to add a request for compensatory relief. (ECF No. 77.) Because these "amendments" do not change the court's analysis herein, plaintiff's motion should be denied. Plaintiff's motion for a jury trial (ECF No. 78) should be denied as moot. Finally, plaintiff moves for the appointment of counsel because he "may not have been proficient with the legalities of this case." (ECF No. 78.) For the reasons stated in the court's denial of plaintiff's prior request for counsel, plaintiff's current motion should be denied as well. (
Accordingly, IT IS HEREBY RECOMMENDED that:
These findings and recommendations will be 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. The 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 result in waiver of the right to appeal the district court's order.