MORRISON C. ENGLAND, Jr., Chief District Judge.
Through this consolidated proceeding, Plaintiff Sandipkumar Tandel ("Plaintiff") alleges that his civil rights were violated during two separate detentions at the Sacramento County Main Jail ("the Jail") from February 7, 2007 to May 20, 2007, and from March 23, 2010 to May 10, 2010. Presently before the Court is a Motion for Summary Judgment brought on behalf of all remaining named Defendants in this action except for Defendant Chris Smith, M.D., whose counsel filed a separate Motion for Summary Judgment on his behalf.
Plaintiff's first and second causes of action allege violations of the Fourteenth Amendment to the United States Constitution, against both supervisory and medical defendants, pursuant to 42 U.S.C. § 1983. Then, in his third through fifth claims, Plaintiff asserts so-called
This is a complicated case involving numerous claims, multiple defendants, a rare disease, and two separate periods of incarceration.
On February 7, 2007, Plaintiff was arrested and incarcerated at the Sacramento County Main Jail ("the Jail") as a pre-trial detainee. Thereafter, on April 27, 2007, he suffered a head injury as a result of an altercation with two other inmates. Defendants' Statement of Undisputed Fact ("SUF"), No. 56. In addition to a laceration above his right eye, Plaintiff complained of a slight headache but no dizziness, nausea, or vomiting.
The day after returning from urgent care, Plaintiff complained of ongoing headaches when he was evaluated by a nurse. Two days later, on April 30, 2007, Plaintiff continued to complain of headaches when evaluated by Dr. Asa Hambly. Defendants contend, however, that Plaintiff made no complaints regarding the need for ongoing medical care during the following two weeks, from May 1, 2007 to May 12, 2007.
On May 13, 2007, after alerting custodial staff during an hourly cell check that he was having head pain, Plaintiff was seen by registered nurse Henry Carl. SUF at Nos. 75, 77. Plaintiff reported headaches for the past four days, but did not complain about his vision or pain involving his eyes.
On or about May 14, 2007, Plaintiff again sought medical attention on a walk-in basis, complaining of headaches, sensitivity to light, and a nasal drip.
Pl.'s Ex. 8.
On May 17, 2007, Plaintiff collapsed while taking a shower when he lost control of his legs. SUF at No. 93. Plaintiff claims he yelled for help for 30 minutes or more (Pl.'s Ex. 25 at129:1-14) and eventually, since he was unable to get up, had to put on his underwear, pants and shirt by "rolling around the floor."
After Plaintiff was taken by wheelchair for evaluation, he told Nurse Carl about his unexplained loss of use of his extremities and collapse. SUF at Nos. 98-99. Plaintiff alleges that Carl failed to conduct an adequate medical assessment of a patient with an apparent spinal cord injury or neurological disorder, although Carl's chart notes indicate that Plaintiff's lower extremity reflexes were positive and that Plaintiff was able to take his shoes off.
On May 18, 2007, Plaintiff had a sudden and acute loss of vision in his left eye and started noticing that he was unable to move his lower extremities. He was also suffering from urinary retention and constipation, and found he could not control his bladder and bowels. Pl.'s Ex. 2 at ¶¶ 32-33, 39; Smith MSJ, Ex. H, ECF No. 136-12 at 241-46; Defs.' Ex. 1 at 113-14. According to Plaintiff, he repeatedly rang the emergency bell to summon help and informed the officers on duty that his legs did not work, that he could not urinate, and that he was going blind, but was told to stop using the call button and that "this was not going to kill me." Pl.'s Ex 2 at ¶¶ 32-35, 39. On May 19th, after Plaintiff claims to have repeatedly used the call button to frantically request help,
Then, on May 20th, Plaintiff again activated the call button in his cell, telling custody staff that he was in severe pain and had lost consciousness. SUF at No. 113. Plaintiff was transported by wheelchair to the Jail's infirmary and, when initially examined by Nurse Carl, stated his "legs don't work."
At the time of Dr. Smith's examination at 12:30 p.m. on May 20th, Plaintiff's only complaint, consistent with what he told Nurse Carl that morning, was that his legs "didn't work." Dr. Smith conducted a physical and neurological examination of Plaintiff that included both his upper and lower extremities. He found no neurological defects or other abnormalities consistent with Plaintiff's claim that his legs did not work, and accordingly concluded that there was no reason why Plaintiff could not ambulate.
About eight hours after Dr. Smith's examination, Plaintiff was observed sitting on the floor of his cell, and told custodial staff that he could not move due to constipation.
At the time of his initial evaluation in the Emergency Room, Plaintiff identified "very vague" symptomatology to the examining physician, J. Douglas Kirk, M.D., including some left eye blindness along with a generalized weakness in his legs that had progressed into paralysis of the lower extremities. The admission note describes Plaintiff's urine and bowel retention as consistent with being unable to urinate or defecate for the past three days. Smith MSJ, Ex. H, ECF No. 136-12 at 241-46. The lower extremity weakness, however, appeared to resolve after persistent testing of Plaintiff's strength, and the blindness in Plaintiff's left eye also resolved in the course of Dr. Kirk's initial examination. These discrepancies caused Dr. Kirk to note inconsistencies in Plaintiff's presentation of physical signs and symptoms. SUF at No. 139.
Plaintiff's symptomatology initially continued to baffle his attending doctors at UCD, which included infectious disease specialists, critical care specialists, and neurologists (
Ultimately, given the nature and severity of his condition, Plaintiff was released from incarceration in 2007. Although his disease process was inactive, Plaintiff nonetheless suffered from chronic pain as a result of the neurological damage he sustained, requiring appropriate pain medication and physical therapy. Pl.'s Ex. 13 at 23:22-24:8; Defs.' Ex. 39 at 1366-68. Plaintiff eventually became capable of managing his bowels without regular accidents. His family provided constant nursing care to ensure that he was clean and not sitting or lying in his own feces, and further ensured that no pressure sores were developing. Pl.'s Ex 24 at 37:6-22; Ex. 4 at ¶¶ 14-16; Ex. 2 at ¶ 49).
In 2009, Plaintiff filed a lawsuit against the County and a number of individual defendants under 42 U.S.C. § 1983 alleging his civil rights' violations during the 2007 detention. (
In 2010, Plaintiff went to the Stanford Neuroimmunology Clinic for a second opinion concerning his condition. As a result of Stanford's assessment, Plaintiff's diagnosis was changed to Neuromyelitis Optica ("NMO") as opposed to ADEM.
On March 23, 2010, Plaintiff was again arrested and detained as a pretrial detainee at the Jail, this time for purchasing ammunition in violation of the terms of his release. At the time of his 2010 arrest, Plaintiff required a wheelchair and was unable to move from the nipple line down. Plaintiff's medical record also allegedly indicates that, during the 2010 detention, all Defendants were aware of Plaintiff's serious neurologic autoimmune disease and that Plaintiff required appropriate treatment. After he was booked, a nurse practitioner, Defendant Agnes Felicano, noted Plaintiff's need for catheters and wrote an order for four. She also wrote an order authorizing him to keep a urinal with him at all times. While Felicano offered Plaintiff Ultram to manage pain, he refused it.
On March 25, 2010, Plaintiff allegedly threatened suicide and admitted that the reason he purchased ammunition was to effectuate a suicide attempt in the wake of his NMO diagnosis.
On April 7, 2010, Plaintiff was inexplicably transferred out of the medical unit and into the general population section of the Jail. Defs.' Ex. 2 at 2237. Plaintiff claims this move decreased his access to medical care during a time when his symptoms were worsening.
On April 9, 2010, Plaintiff complained to Dr. Sabha of a burning sensation on the tip of his penis during urination and pressure sores on his inner knees.
Although Dr. Sabha purportedly increased the dosage of Plaintiff's pain medication (
It is undisputed that late on the evening of April 11th, Plaintiff activated his emergency intercom and complained of pain with catheterization. SUF at No. 208. A supervising registered nurse, Charles Munn, responded when custody staff notified him of Plaintiff's complaint. Munn provided narcotic pain medication and transferred to the Jail's medical unit for observation and further testing.
On April 22, 2010, Plaintiff was seen by Defendant Susan Kroner, a registered nurse. He complained of burning pain, rated as a 9 on a scale of 1 to 10, in his left knee, and for the first time stated that for the previous two weeks he had been experiencing blurry vision involving the left eye.
On April 23rd, Plaintiff was again seen by Dr. Sabha. In addition to continuing to identify penile pain, Plaintiff further reported generalized pain in his legs and back, as well as vision changes.
According to Defendants, Plaintiff was also evaluated by Dr. Bauer on five occasions, between April 27, 2010 and May 4, 2010 for management of his chronic pain.
On May 4, 2010, Plaintiff was also seen by Dr. Sotak. He complained of a double vision episode that had resolved, as well as muscle stiffness and weight loss, apparently because of Plaintiff declining to eat some of his food because of religious preferences. Dr. Sotak prescribed high-calorie liquids, along with physical therapy.
On May 9, 2010, Plaintiff was seen by Dr. Bauer and reported both headaches and pain in his right eye for three days. Because Dr. Bauer's exam showed Plaintiff's eye movements to be intact, and because Bauer believed that Plaintiff's headaches were potentially attributable to an increased morphine dosage, he discontinued MS Contin (morphine) and restarted Norco.
After being admitted to the Medical Center, an MRI confirmed the presence of neuritis in Plaintiff's right optic nerve.
Plaintiff alleges that medical Defendants' deliberate indifference resulted in and/or increased the acuteness of his new attack and accelerated the recurrence of his disease. Plaintiff claims this resulted in irreversible damage to new areas of myelin, causing cumulative and permanent disfigurement and disability, as well as decreasing Plaintiff's future opportunity for rehabilitation and his overall life expectancy.
The Federal Rules of Civil Procedure provide for summary judgment when "the movant 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);
Rule 56 also allows a court to grant summary judgment on part of a claim or defense, known as partial summary judgment.
In a summary judgment motion, the moving party always bears the initial responsibility of informing the court of the basis for the motion and identifying the portions in the record "which it believes demonstrate the absence of a genuine issue of material fact."
In attempting to establish the existence or non-existence of a genuine factual dispute, the party must support its assertion by\
Fed. R. Civ. P. 56(c)(1). 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.
In resolving a summary judgment motion, the evidence of the opposing party is to be believed, and all reasonable inferences that may be drawn from the facts placed before the court must be drawn in favor of the opposing party.
Under 42 U.S.C. § 1983, an individual like Plaintiff may sue "[e]very person who, under color of [law] subjects" him "to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws." For an inmate to bring a valid § 1983 claim against a prison official, Plaintiff must first "objectively show that he was deprived of something serious.
Individual capacity suits "seek to impose individual liability upon a government officer for actions taken under color of state law."
Under § 1983, government officials acting as supervisors may be liable under certain circumstances. "[W]hen a supervisor is found liable based on deliberate indifference, the supervisor is being held liable for his or her own culpable action or inaction, not held vicariously liable for the culpable action or inaction of his or her subordinates."
A supervisor's physical presence is not required for supervisory liability.
As a pretrial detainee at the time of his incarceration in 2007, Plaintiff was entitled to be free of cruel and unusual punishment under the Due Process Clause of the Fourteenth Amendment.
The Due Process Clause requires that "persons in custody have the established right to not have officials remain deliberately indifferent to their serious medical needs."
Plaintiff can satisfy the "serious medical need" prong by demonstrating that "failure to treat [his] condition could result in further significant injury or the unnecessary and wanton infliction of pain."
The Court finds that Plaintiff alleges sufficient facts to make a plausible showing that his medical need was serious. During both his 2007 and 2010 incarcerations, Plaintiff contends he suffered from neurological issues that made him partially paralyzed and unable to walk. Obviously, such a development would have affected Plaintiff's daily activities to the extent that a reasonable doctor would find such symptoms noteworthy.
The next issue for the Court is whether a defendant was deliberately indifferent to plaintiff's serious medical need. In
"The indifference to medical needs must be substantial; a constitutional violation is not established by negligence or `an inadvertent failure to provide adequate medical care.'"
Finally, deliberate indifference also contains a causal component. Mere delay in receiving medical treatment, without more, does not constitute "deliberate indifference," unless the plaintiff can show that the delay caused serious harm to the plaintiff.
With these standards in mind, we now look to the two individuals against whom Plaintiff continues to claim deliberate indifference during the course of his 2007 incarceration.
John McGinness was the elected Sheriff of Sacramento County throughout the course of both of Plaintiff's incarcerations. As Sheriff, McGuinness is ultimately responsible for the Jail's operation. Plaintiff alleges that McGinness was "aware of longstanding and well-documented deficiencies in the Jail through the findings of Sacramento Grand Jury investigations related to the overcrowding and understaffing of the jail and the overall deficiencies in the main jail medical care delivery system." Pl.'s Opp'n at 32:2-7. The Grand Jury's 2005-06 report reported pervasive understaffing of medical and custody staff resulting in a denial of access to medical care. Pl.'s Ex. 47. McGinness was copied on the County's initial responses, dated August 7, 2006, thereby putting him on notice of the subject deficiencies. Pl.'s Ex. 49 at 4. Significantly, too, in a
The County itself ordered an audit of Jail operations by Joseph A. Brann and Associates. The Brann Report similarly revealed widespread deficiencies, including an unusually high percentage of grievances regarding medical care, the lack of a system ensuring that inmate medical complaints were routinely reviewed, and insufficient staffing levels.
As indicated above, supervisory liability under 42 U.S.C. § 1983 can attach if a sufficient causal connection exists between the supervisor's conduct and the constitutional violation.
Here, as enumerated above, Plaintiff claims his use of the call button to summon custodial staff and request medical care was repeatedly ignored; indeed, the housing logs themselves contain no mention of many of the complaints made by Plaintiff despite the fact that custodial staff should have documented all such requests. Additionally, when Plaintiff collapsed in the shower on May 17, 2007, his requests for help went unheeded for more than 30 minutes, and the responding deputy failed to even file an incident report in contravention of Jail policy, a shortcoming that led to his formal discipline. Two days later, custodial staff went so far as to lock down Plaintiff's entire pod for what is alleged to have been Plaintiff's excess use of the call button for aid.
Given McGinness' prior knowledge of understaffing at the jail and the effect that it had on needed medical care, as revealed by the Grand Jury's 2005-06 Report and the subsequent Brann Report, as well as the fact that Plaintiff's subsequent incarceration contains allegations of ongoing impediments to seeking medical assistance, this Court concludes that factual issues exist that preclude summary adjudication as to Sheriff McGinness for the First Claim for Relief. These factual issues extend both to the extent of McGinness' knowledge about understaffing and lack of access to medical care at the Jail, and to whether those shortcomings exacerbated Plaintiff's condition.
Defendant Ann Marie Boylan was Chief of Correctional Health Services at the Jail during both of Plaintiff's incarcerations, and as such was responsible for managing the delivery of medical and mental health services to county jail inmates. She did not assume that position, however, until January of 2007, less than a month before Tandel was jailed on February 7, 2007. Unlike McGinness, there is no evidence that she participated in the Grand Jury investigation and subsequent 2006 Brann Report, which is not surprising since that predated her tenure as Chief of Correctional Health Services. Accordingly, the Court finds Plaintiff has presented no facts showing deliberate indifference on Boylan's part during his 2007 incarceration. Boylan is therefore entitled to summary adjudication as to Plaintiff's First Claim for Relief.
As indicated above, given his status as a pretrial detainee during the 2007 incarceration, Plaintiff's First Claim for Relief alleges a Fourteenth Amendment against supervisory Defendants as a result of that incarceration. Although Plaintiff has failed to allege his conviction status during the subsequent 2010 incarceration, he alleges both Eighth and Fourteenth Amendment violations against all remaining individual defendants as a result of the events of 2010. The protections afforded by the Eighth Amendment's prohibition against cruel and unusual punishment inures to the benefit of post-conviction prisoners. The issue of whether the Fourteenth or the Eighth Amendment applies in analyzing the viability of the Second Claim for Relief, however, is largely academic since the Ninth Circuit has held that pretrial detainees' rights under the Fourteenth Amendment are comparable to prisoner's rights under the Eighth Amendment. The same deliberate indifference standard applies under either scenario.
The remaining individual defendants against who Plaintiff alleges deliberate indifference during his 2010 incarceration had three different connections to Plaintiff's care. First, Drs. Bauer, Sahba and Sotok, and Nurse Kroner and Nurse Practitioner Felicano, are all medical professionals and were involved in Plaintiff's care in that context. Second, Officers Jacoby and Medeiros were custodial staff. Finally, the liability of Defendants McGinness, Boylan, and Iwasa, if any, derives only from their supervisorial positions. Each of these groups of defendants will now be addressed.
Aside from allegedly suggesting that Plaintiff reuse the straight catheters he was provided (a claim not borne out by Plaintiff's medical chart),
Plaintiff fares no better in his claims against Drs. Sahba and Sotok, the remaining two physician defendants in his Second Claim for Relief. Plaintiff's chart indicates Dr. Sahba initially saw him on March 25, 2010, after he had threatened suicide. Although Plaintiff takes issue with the suicide precautions Dr. Sahba took, her chart note reflects a concern about Plaintiff's ability to transfer from his mattress to his wheelchair and indicates she followed up with two other physicians about that concern. The fact that she felt it was "too risky" under the circumstances to permit clothing and a different kind of bed does not equate with deliberate indifference. Nor does Dr. Sahba's examination on April 9th, when she prescribed ointment for Plaintiff's pressure sores, and ordered urinalysis and other testing to see whether Plaintiff's complaints of penile pain were related to a sexually transmitted disease, suggest anything approaching deliberate indifference. Finally, when Plaintiff saw Dr. Sahba a third and final time on April 22, 2007, she referred him to an ophthalmologist and a neurologist given his reports of continuing leg and back pain, as well as vision issues. She also ordered follow-up urinalysis. Again, the fact that Dr. Sahba examined Plaintiff and recommended treatment for what she observed does not show deliberate indifference. The fact that Dr. Sabha, and other jail medical personnel, did not immediately recognize symptomatology suggesting either ADEM or NMO cannot be deliberate indifference given the rarity of those conditions and the fact that neurological specialists at the U.C. Davis Medical Center had difficulty in properly diagnosing Plaintiff's condition.
The care provided by Dr. Sotak leads the Court to the same conclusion. Although it appears that Dr. Sotak, as the Jail's Medical Director, may have generally reviewed Plaintiff''s chart and concurred with the recommendation to place him on suicide watch under certain precautions, he saw Plaintiff only twice. At the time of the first visit on May 4, 2010, Dr. Sotak prescribed high calorie liquids along with physical therapy in response to Plaintiff's claims of weight loss (apparently exacerbated by his religious preference regarding food), as well as physical therapy.
With respect to Susan Kroner and Agnes Felicano, both nurses are sued in their individual capacities under §1983 as a result of Plaintiff's 2010 incarceration. All Nurse Practitioner Felicano did, immediately following Plaintiff's booking in 2010, was to prescribe an order for four catheters and an order authorizing him to keep a urinal with him at all times. By no means does that minimal, and seemingly innocuous, interaction and treatment show deliberate indifference. Significantly, although Plaintiff claims he wanted eight catheters a day, his chart contains no complaint thereafter that four were insufficient and Plaintiff testified at deposition that he was using about four on a daily basis. SUF at No. 201. Finally, Nurse Kroner saw Plaintiff just once, on April 22, 2010, when Plaintiff stated he had been experiencing blurry vision involving the left eye for the previous two weeks. According to her note, because Kroner observed that the vision in Plaintiff's right eye was better than his left, she referred him to be seen by a physician the following day. While Plaintiff claims that she should have sought more immediate care, there was no indication that her decision to have a doctor examine Plaintiff the following day was so below the applicable standard of care so as to constitute deliberate indifference. Again, it was not deliberately indifferent for a nurse like Kroner to have failed to appreciate symptoms potentially suggesting the recurrence of a rare neurological disease like NMO.
Plaintiffs allege deliberate indifference against Deputies Stephanie Jacoby and Mark Medeiros given their conduct as housing officers on Plaintiff's ward during the day shift on April 11, 2010. Jacoby and Medeiros allegedly ignored Plaintiff's call button requests for assistance, and further ignored a call request from Plaintiff's neighboring inmate who claims he heard Plaintiff screaming in agony. As enumerated above, Jacoby and Medeiros allegedly informed oncoming night shift personnel that they were having problems with Plaintiff "[y]elling and screaming and causing a problem hitting the button constantly . . ." Pl.'s Ex. 28 at 70:19-71:25. Moreover, the housing logs document none of this although they were required to do so pursuant to Jail policy. Defs.' Ex. 5 at 5380-82. While Jacoby and Medeiros simply claim they were not informed of any medical need on April 11, 2014, there is evidence to the contrary, and that evidence must be presumed true for purposes of summary judgment. If Jacoby and Medeiros repeatedly ignored not only Plaintiff's repeated calls for help, but also similar calls made by a neighboring inmate, those repeated failures raise, at the very least, triable issues of fact that preclude summary judgment on their behalf. Deliberate indifference may be manifested not only by prisoner doctors in their response to prisoner's needs, but also by prison guards "in intentionally denying or delaying access to medical care. . ."
In arguing for summary adjudication as to the Section 1983 deliberate indifference claim against McGinness, Defendants state there "simply is no connection between any alleged injury [arising from the 2010 incarceration] and Sheriff McGinness." Defs.' Mot. at 20:7-8. The Court disagrees. As discussed above with regard to the 2007 incarceration, there is evidence that McGinness was aware of longstanding and well-documented deficiencies in the Jail related to understaffing at the Jail that resulted in a denial of access to medical care. The Sacramento County Grand Jury's 2005-06 Report identified problems in that regard, and a subsequent independent audit of Jail operations confirmed those problems. Moreover, the same deficiencies continued to be brought to McGinness' attention following Plaintiff's 2007 incarceration. A September 2009 audit by the Sacramento County Office of Inspector General similarly revealed that line-level staffing was low and inmate overpopulation was acute. Pl.'s Ex. 53. Defendants' request for summary adjudication as to the Second Claim for Relief against McGinness, which stems from the 2010 incarceration, fails for the same reasons the First Claim for Relief survives against McGinness.
With respect to Defendant Ann Marie Boylan, the Chief of Correctional Health Services at the Jail, there is no evidence that Boylan trained or supervised custodial staff or had any role in promulgating policies or procedures relating to the operation of the custodial staff at the jail. Nor has Plaintiff identified any evidence connecting Boylan with the actions of the remaining custodial defendants involved in the 2010 incarceration, Jacoby and Medeiros.
Mark Iwasa, the final individually named defendant to the Second Claim for Relief, served as Undersheriff and Jail Captain during the 2010 incarceration. Defendants urge the Court to grant summary adjudication as to Iwasa on grounds that Plaintiff has advanced no evidence to support his allegation that Iwasa was aware of and disregarded widespread deficiencies in the delivery of health care at the Jail in 2010. The only specific allegation levied against Iwasa is that both he and Iwasa "worked closely with the Brann auditors in response to the 2005-06 Grand Jury findings," citing Plaintiff's Exhibit 53. That exhibit contains virtually no reference to Iwasa, however, beyond a statement that the consultants had "unrestricted access" to Iwasa and four others during the preparation of their report.
Plaintiff's Third Claim for Relief alleges that the County had a policy, practice, or custom of denying, delaying and interfering with inmate access to medical care. Under § 1983, a municipal entity like Sacramento County may be found liable under such a theory if it facilitates a constitutional violation by "execution of a . . . policy or custom, whether by its lawmakers or by those whose edicts or acts may fairly be said to represent official capacity."
At a very minimum, there is evidence here that Jail staff repeatedly, during both Plaintiff's 2007 and 2010 incarcerations, failed to timely respond to Plaintiff's requests for medical aid. Plaintiff claims he repeatedly depressed his call button for medical aid between May 5, 2007 and May 16, 2007, with virtually no response. The Jail's logs, however, do not document a single complaint until May 13, 2007. Then, on May 17, 2007, after Plaintiff collapsed while taking a shower when he lost control of his legs, he claims he yelled for more than 30 minutes before help finally arrived. The next day, when he repeatedly rang the emergency button for help on grounds that he could neither walk, urinate, or see properly, Plaintiff alleges he was told to stop using the call button. The next day, after Plaintiff claims he repeatedly used the call button to frantically request help, Plaintiff alleges that custodial officers punished the entire pod for Plaintiff's overuse of that button for aid.
Similar problems persisted in 2010, when Plaintiff was reincarcerated. On April 11, 2010, as indicated above, Defendants Jacoby and Medeiros are alleged to have repeatedly ignored Plaintiff's call button requests for help, even when told by another inmate that Plaintiff needed assistance. Additionally, when Plaintiff was placed on suicide watch, he claims he was left to lay naked on a mattress and, in the absence either regular assistance or access to a call button, urinated on himself, could not defecate properly, and developed bed sores.
Given the persistence of these problems over two incarcerations three years apart, this Court believes that Plaintiff has identified a triable issue of fact with respect to the County's custom and practice liability. Also significant in this determination is the fact that the County was on explicit notice, through the 2005-06 Grand Jury Report, the subsequent Brann Report, and an additional 2008 audit by the Sacramento County office of Inspector General, that custodial staffing was insufficient to the point that a denial of access to medical care resulted. Consequently, the Third Claim for Relief, which alleges custom and practice
Plaintiff's Fourth Claim for Relief alleges the County is liable for deliberate indifference to his serious medical needs in both 2007 and 2010 because of its failure to properly train Jail staff. In order to establish liability for failure to train, Plaintiff must show a training policy that amounts to deliberate indifference and must further establish that injury could have been avoided had proper training been provided.
Plaintiff's opposition, in attempting to shore up its
Plaintiff's Fifth Claim for Relief, however, for failure to adequately staff and/or supervise, does not suffer from the same shortcoming. As already discussed above, Plaintiff has identified numerous instances, in both 2007 and 2010, of custodial staff failing to respond to Plaintiff's medical needs, even in the wake of reports and investigations putting Defendant on clear notice of staffing insufficiencies. That is enough to withstand summary judgment as to the Fifth Claim.
To establish a claim under Title II of the ADA, Plaintiff must show (1) that he is an individual with a disability; (2) is otherwise qualified to receive the services and benefits of the public entity's care; and (3) was denied access to those benefits as a result of his disability.
Similarly, to establish a violation of Section 504 of the Rehabilitation Act, Plaintiff must show that he was denied benefits or services solely because of his handicap, and that the program providing the benefit or services receives federal financial assistance.
Plaintiff claims he can meet the requirements for liability under both the ADA and the Rehabilitation Act because he was "denied proper psychiatric and medical care," and did not provide assistance necessary for him to engage in the activities of daily living ("ADLs") with respect to sanitation, eating, and showering. He further alleges that the manner in which he was placed on suicide watch (without clothing and with no ability to urinate or defecate) violated the ADA and the Rehabilitation Act.
Plaintiff's unsupported factual allegation that he was denied proper medical care is not enough to create a triable issue of fact with respect to either the ADA or the Rehabilitation Act. Inadequate treatment or lack of treatment for Plaintiff's medical condition does not in itself suffice to create liability under either statutory scheme.
In sum, Plaintiff has failed to make the requisite factual showing under either the ADA or the Rehabilitation Act, and as such has failed to state a viable claim under either statutory scheme. Defendant County is accordingly entitled to summary adjudication as to the Seventh Claim for Relief.
To establish liability under California Government Code § 845.6, Plaintiff "must establish three elements: (1) the public employee knew or had reason to know of the need (2) for immediate medical care, and (3) failed to summon such care."
Plaintiff names both the County of Sacramento and Deputies Jacoby and Medeiros as defendants to his Ninth Claim. He claims that Jacoby and Medeiros were aware of Tandel's serious medical need and failed to summon medical care. For the reasons already outlined with respect to the § 1983 deliberate indifference liability of Defendants Jacoby and Medeiros as individuals, the same issues that precluded summary judgment as to that claim also prohibit summary adjudication with respect to Defendants' § 845.6 liability. There is evidence that Plaintiff repeatedly depressed his call button without success, and that another inmate housed adjacent to Plaintiff's cell also tried unsuccessfully to summon help after he reportedly heard Plaintiff scream in agony. Those two pieces of evidence, taken together, are enough to preclude summary judgment with regard to California Government Code § 845.6.
Based on the foregoing, Defendants' Motion for Summary Judgment (ECF No. 135) is GRANTED in part and DENIED in part as follows:
IT IS SO ORDERED.
