CAROLYN K. DELANEY, Magistrate Judge.
Plaintiff, an inmate in custody of the California Department of Corrections and Rehabilitation ("CDCR"), proceeds pro se with a civil rights complaint filed pursuant to 41 U.S.C. § 1983. (Dkt. No. 1.) Defendants have moved for summary judgment. (Dkt. No. 54, 55). Plaintiff opposes the motion. (Dkt. Nos. 57, 58, 60.) Defendants did not file a reply.
Plaintiff alleges in his complaint that on January 7, 2008, defendants Miranda, Davis and Robinson arrived at Doctors Medical Center in Modesto to transport him back to Mule Creek State Prison (MCSP) three days after plaintiff's spinal surgery. (Dkt. No. 1 at 6.
Plaintiff proceeds with claims for damages under the Eighth Amendment and under the Americans with Disabilities Act ("ADA") against defendants Miranda, Davis, Robinson, Martel, Subia, Williams, Smith and Cate. (ECF No. 9 at 3-4.)
Defendants assert in their motion for summary judgment that plaintiff's Eighth Amendment claims fail because he cannot show that prison officials denied, delayed, or otherwise interfered with his access to medical care, cannot show that there are customs or policies in place for transporting inmates in a way designed to inflict unreasonable and unnecessary pain and suffering, and cannot show that defendants failed to properly train the transport officers. Defendants further argue plaintiff's ADA claim fails because he has not shown that he is a qualified individual under the ADA. Defendants further assert they are entitled to qualified immunity. (Dkt. No. 54 at 3.)
On November 20, 2012, contemporaneously with defendants' motion for summary judgment, plaintiff was advised of the requirements for opposing a motion pursuant to Rule 56 of the Federal Rules of Civil Procedure. (Dkt. No. 56.)
Summary judgment is appropriate when it is demonstrated 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). A party asserting that a fact cannot be disputed must support the assertion by "citing to particular parts of materials in the record, including depositions, documents, electronically stored information, affidavits or declarations, stipulations (including those made for purposes of the motion only), admissions, interrogatory answers, or other materials...." Fed. R. Civ. P. 56(c)(1)(A).
Summary judgment should be entered, after adequate time for discovery and upon motion, against a party who fails to make a showing sufficient to establish the existence of an element essential to that party's case, and on which that party will bear the burden of proof at trial.
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 the endeavor to establish 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 resolving the summary judgment motion, the evidence of the opposing party is to be believed.
"[T]he unnecessary and wanton infliction of pain constitutes cruel and unusual punishment forbidden by the Eighth Amendment."
In order to be liable, an official must know of and disregard an excessive risk to inmate health or safety.
"While... deliberate indifference entails something more than mere negligence, the cases are also clear that it is satisfied by something less than acts or omissions for the very purpose of causing harm or with knowledge that harm will result."
For purposes of resolving this motion, the following facts are either undisputed by the parties, or, upon review of the evidence submitted, have been deemed undisputed.
At all times relevant to this action, plaintiff was a state prisoner in CDCR's custody housed at MCSP. (Defendant's Undisputed Fact ("DUF") 1.) Plaintiff has an escape history, which is documented on his classification chronos as an escape from work furlough in February 1988. (DUF 2.) At all times relevant, defendants were employed by CDCR in the following capacities: M. Cate was the Secretary of the CDCR; M. Martel and R. Subia were Wardens at MCSP; B. Williams was the Health Care Manager at MCSP; C. Smith was the Chief Medical Officer at MCSP; T. Miranda, M. Robinson, and P. Davis were Correctional/Transportation Officers working out of MCSP. (DUF 3.)
On November 5, 2007, plaintiff was transported to Pacific Regional Neurosurgery for a consultation with Dr. Remington. (DUF 4.) Plaintiff had a history of low back and right leg pain that had been bothering him for about a year and a half. (
On January 2, 2008, plaintiff was transported to the McHenry Medical Group in Modesto for a preoperative examination, and the following day, on to Doctor's Medical Center for surgery. (DUF 5.) Dr. Remington again discussed with plaintiff the surgery, the risks associated with surgery, and other treatment options. (DUF 6.) It was Dr. Remington's opinion that plaintiff would benefit from the surgery. (Def. Ex. B, p.8.) Plaintiff indicated that he understood the risks associated with the surgery, and opted to proceed in spite of the risks. (DUF 6.)
Dr. Remington performed the surgery, placing transpedicular screws at the L4 and L5 levels. (DUF 7.) Plaintiff tolerated the procedure well and there were no complications. (
Plaintiff was discharged from Doctor's Medical Center on January 7, 2008. (DUF 11.) Plaintiff requested to be released with a front wheel walker (FWW) and additional pain medication. (
Plaintiff's discharge orders stated that he was to keep the incision clean and dry from sweat and water, towel dry after shower, and not to scrub the incision. (DUF 13.) The discharge orders further stated plaintiff was not to twist, bend, lift more than ten pounds, or sit more than ten minutes at a time, and he was to take short walks several times a day. (
When an inmate is released from a hospital, members of the CDCR transportation team receive a "hospital kit," including a copy of the inmate's discharge orders. (DUF 16.) The transportation team also receives all pertinent information from on duty medical staff. (
Proper restraint equipment must be used during medical transport unless the inmate's physical condition precludes the use of restraints. (DUF 17.) Such an exemption must be authorized by the institution's Health Care Manager (HCM) and a concurrence must be obtained from the correctional captain or watch commander. (
The transportation team for plaintiff's transport back to MCSP consisted of transportation officers Miranda, Robinson and Davis. (DUF 15.) Miranda and Robinson were in the transport van during the ride back to MCSP and Davis was in the escort vehicle. (
The transportation took approximately an hour. (PDF 36.) Two other inmates were present in the van. (PDF 9.) At one point, plaintiff advised the transportation officers that he was nauseous, and they pulled over to the side of the road, stopped the van, and gave him a sick bag. (DUF 22.) When the transport arrived at MCSP, medical staff assisted in removing plaintiff from the van. (DUF 24.) Plaintiff was then helped into a wheelchair and taken to the triage and treatment area, as per procedure. (DUF 25.) Upon removing his shirt, plaintiff saw that his shirt was soaked with bodily fluids and blood that leaked from the sutures in his back. (PDF 18.)
Plaintiff had several follow-up appointments with Dr. Remington. (DUF 25.) On February 11, 2008, plaintiff was seen for his first follow-up appointment by Dr. Remington, who dictated subsequent to the appointment that plaintiff had a "rough postoperative course," that he "was sent home too soon," and that he "stayed in a wheelchair probably for too long" after surgery. (Def. Ex. B, p.23.)
After a second follow-up appointment on April 7, 2008, Dr. Remington dictated that plaintiff had told him that he fell off the seat during the transport back to MCSP. (DUF 27.) Plaintiff was not feeling pain as often as he was before the surgery, but his recovery was slow. (
Following a third visit on August 13, 2008, Dr. Remington dictated:
(Def. Ex. B. p.26.)
Following a fourth postoperative visit on December 15, 2008, Dr. Remington dictated that plaintiff was having "severe pain" into his tail bone and into the butt cheek and is "suffering so bad, he would consider a second surgery." (Def. Ex. B p.27.)
Plaintiff's expert, James E. Daly, D.O, M.S., is a retired Doctor of Osteopathy and Master of Science. (Plaintiff's Disputable Facts ("PDF") 39.) Dr. Daly states of plaintiff's status as of March 3, 2012:
(PDF 40, 41.)
Dr. Daly states that the lumbar operation plaintiff underwent entails a very extensive procedure and requires careful rehabilitation. (PDF 45.) The use of Dynasis screws to attach the body of the vertebra to each other require some six weeks to become ossified to the bone; during that period of time the duration and extent of activities are restricted. (
After thorough review of the records and plaintiff's present medical presentation, it is Daly's opinion that plaintiff's "present failed back syndrome, with atrophic muscular neuropathy extensively in the right hip, lower leg and foot," and to a lesser extent involvement of his left side, "resulted from unsecured sitting position while in transit for forty-five minutes to one hour while in transit from Doctor's Hospital to Mule Creek State Prison." (PDF 39, 57.)
The main dispute in this case is whether the manner of plaintiff's transport back to MCSP interfered with his recovery. In particular, the parties dispute whether plaintiff's discharge orders, which indicated that he was being discharged in a wheelchair rather than a gurney, but also ordered that he not sit for more than 10 minutes at a time, meant that he must be transported in a supine position rather than a seated position. (DUF 19; PDF 46-49.) The parties dispute whether the transport officers were unable to secure plaintiff with a seatbelt on the bench seat in the van due to severe swelling of his back from the surgery. (PDF 10, 34.) The parties dispute whether, during the transport, plaintiff slid or fell off the bench and lay twisted in a trapped position between the cage wall and the seat. (PDF 11.) The parties dispute whether plaintiff screamed out in pain asking for help, which defendants did not provide. (PDF 11, 13, 35.) The parties dispute whether plaintiff remained in the twisted, trapped position while the transportation team stopped the van to give him a sick bag, but did not right him, after which transport continued with plaintiff stuck in that position for the duration of the transport. (PDF 11.)
As an initial matter, it is clear that plaintiff's post-surgical medical needs qualify as a serious medical need. Citing plaintiff's deposition testimony, defendants argue, first, that plaintiff has "repudiated" his allegation in his complaint that he fell from the seat to the floor of the van during transport from the hospital to MCSP. (ECF No. 54 at 7.) Plaintiff testified in his deposition:
(Def. Ex. E [Pl. Depo, p. 50.]) Defendants' argument that plaintiff has repudiated his allegation is not persuasive as a factual dispute exists as to whether plaintiff slid off the bench seat into a twisted position during the transport and whether that occurred due to his not being restrained by a seat belt, possibly in combination with other factors. Just a few days prior, plaintiff underwent a major surgery and was under doctor's orders not to twist, bend, lift more than ten pounds, or sit more than ten minutes at a time. Plaintiff's hands were restrained and he was seated on a bench seat in the transport van. He has submitted evidence in the form of his own sworn declaration and the sworn declaration of another inmate present that his seatbelt was not fastened by the transportation team due to swelling from the surgery, that he slid off the bench into a painful, twisted position, and that the transportation team left him there even upon stopping the van to give him a sick bag, for the remainder of the transport.
The transportation team's duties included receiving a copy of the inmate's discharge orders, ensuring that plaintiff was properly seated, and ensuring that plaintiff was secured with a seat belt. While the failure to secure an inmate with a seatbelt would not normally show deliberate indifference standing alone, transporting a post-surgical inmate under orders not to twist, bend, or sit for more than 10 minutes at a time on a bench seat unrestrained by a seatbelt for an hour long transport could reasonably be said to be in disregard of a known and excessive risk to the prisoner's health and safety, particularly in light of plaintiff's tendered evidence that he fell off the seat into a twisted position in which he was left for the remainder of the transport despite screaming out for help. Under these circumstances, plaintiff has put forth evidence sufficient to create a triable issue of fact as to whether these defendants were aware of facts from which the inference could be drawn that a substantial risk of serious harm to his health or safety existed and whether they drew the inference, yet failed to change the course of action.
Defendants argue that although plaintiff alleges that he was screaming in pain, defendants Miranda and Robinson did not hear him scream and did not believe that plaintiff was in acute distress. (ECF No. 54 at 7.) The court notes that Miranda has submitted a declaration to this effect; Robinson has not. Regardless, plaintiff's evidence creates a disputed issue of fact in this regard. As for Davis, the third member of the transportation team, defendants argue that he was in the car following the van and never heard or saw plaintiff's complaints of pain. (
Defendants next argue that plaintiff cannot show that the defendants' alleged actions resulted in any harm. (ECF No. 54 at 8.) However, as set forth, plaintiff has submitted evidence in the form of an opinion of Dr. James E. Daly., D.O., M.S., that plaintiff's "present failed back syndrome, with atrophic muscular neuropathy extensively in the right hip, lower leg and foot," and to a lesser extent involvement of his left side, "resulted from unsecured sitting position while in transit for forty-five minutes to one hour while in transit from Doctor's Hospital to Mule Creek State Prison. For purposes of this motion, plaintiff's evidence in this regard is essentially undisputed, as defendants contend only that Dr. Remington did not indicate that the manner of transport caused plaintiff further injuries; in other words, Dr. Remington did not express an opinion. Plaintiff's evidence that substantial harm resulted provides additional support for the his claim that defendants were deliberately indifferent to his needs.
Defendants next assert there is no evidence that Dr. Smith (Health Care Manager at MCSP) or Dr. Williams (Chief Medical Officer at MCSP) interfered in any way with plaintiff's treatment at the outside hospital, or that they were involved with the timing of his release from the hospital, or that they had any involvement with the manner of his transportation back to the prison. (ECF No. 54 at 8.) Defendants are correct that there is no evidence that Smith or Williams had any involvement with plaintiff's treatment at the hospital or any involvement in determining his release date from the hospital, as the undisputed evidence indicates that Dr. Remington discharged plaintiff from the hospital, albeit "too soon" in his own opinion.
As to transport, plaintiff has alleged that Williams and Smith were responsible for setting the policies and procedures governing medical transports and that it was their personal decision to determine how plaintiff was transported. Plaintiff further contends that MCSP refuses to utilize handicap accessible vehicles despite having been notified of the unconstitutional conditions with medical/handicap transports and that MCSP systematically subjects inmates to inhumane medical transport vehicles, restraints, and procedures. (PDF 67-69.) As support, plaintiff cites to his Exhibit F, which he states is "a large multitude of inmate declarations and Inmate Appeals [602] covering several [years] by inmate/patients; disabled patients, mobility impaired inmates; and post-surgical [inmates] who all suffered wanton and callous infliction of pain, injury due to medical transport vehicles, and restraints used by these defendants." (ECF No. 57 at 18.)
A recurring theme in the declarations and inmate appeals presented in plaintiff's Exhibit F is the use of so-called "Marten cuffs" or "Black Box" hand restraints on medical transports of elderly or disabled MCSP inmates and injuries allegedly sustained therefrom. Many of the declarants state that other prisons do not use these restraints and they believe that MCSP uses them to discourage inmates from seeking outside medical treatment. (
However, it is undisputed that an exemption from normal transportation procedures would have to have been authorized by Smith. Smith has not submitted a declaration explaining why there were no exemptions for plaintiff's transport back to MCSP. While a perfectly valid explanation may exist, such evidence has not been tendered for purposes of this motion. With no evidence in the record on this point, and in light of plaintiff's currently undisputed evidence that he suffered serious injuries from the manner of transport, there is a genuine dispute of material fact for trial as to whether Smith knew of and disregarded an excessive risk to plaintiff's health or safety in regard to the manner of plaintiff's transport from the outside hospital to MCSP.
Defendants next assert that plaintiff has not stated a cognizable claim for failure to properly train staff, or deliberate indifference in setting the policies and procedures governing medical transports, by supervisory personnel defendants Williams, Smith, Cate (CDCR Secretary), Subia (Warden) and Martel (Warden). The undersigned agrees.
Supervisory personnel are generally not liable under § 1983 for the actions of their employees under a theory of respondeat superior. The Ninth Circuit has recently reaffirmed that a supervisory defendant may be held liable under § 1983 only "`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.'"
Here, there is no evidence of deliberate indifference in the failure to train employees by any of the named defendants who are supervisory personnel. Nor is there any evidence that any defendant other than Smith, Miranda, Robinson or Davis caused or participated in the constitutional deprivation allegedly suffered by plaintiff.
Title II of the ADA prohibits "discrimination on the basis of disability" by a public entity.
"To establish a violation of Title II of the ADA, a plaintiff must show that (1) [he] is a qualified individual with a disability; (2) [he] was excluded from participation in or otherwise discriminated against with regard to a public entity's services, programs, or activities[;] and (3) such exclusion or discrimination was by reason of [his] disability."
Here, plaintiff's allegations that he was improperly transported following his surgery do not demonstrate or allow an inference that he was denied some benefit or service based upon a disability. The treatment or lack of treatment for a medical condition does not provide a basis upon which to impose liability under the ADA.
Government officials performing discretionary functions generally are shielded from liability for civil damages insofar as their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known.
The inquiry into whether a right was clearly established "must be taken in light of the specific context of the case, not as a broad general proposition."
The right to "have prison officials not be `deliberately indifferent to serious medical needs'" is a sufficiently particularized right for the purposes of the qualified immunity analysis.
In accordance with the above, IT IS HEREBY RECOMMENDED THAT defendant's motion for summary judgment (Dkt. No. 54) be granted in part and denied in part as follows: granted as to plaintiff's claims under the ADA; granted as to plaintiff's Eighth Amendment claims against defendants Williams, Cate, Subia and Martel; and denied as to plaintiff's Eighth Amendment claims against defendants Miranda, Robinson, Davis and Smith.
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 reply to the objections shall be served and filed within fourteen 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.