KENDALL J. NEWMAN, Magistrate Judge.
Plaintiff is a state prisoner, proceeding without counsel, with a civil rights action pursuant to 42 U.S.C. § 1983. Pending before the court is defendants' motion for summary judgment. (ECF No. 73.) For the following reasons, further briefing is ordered as to plaintiff's claim alleging that the decisions by defendants Street and Awatani to change plaintiff's seizure medication violated the Eighth Amendment.
Plaintiff alleges that when he arrived at Deuel Vocational Institution ("DVI"), defendants Street and Awatani changed his seizure medication. (ECF No. 15 at 7.) Plaintiff alleges that prior to being housed at DVI, he had been taking Dilantin, Gabapentin (aka Neurontin), and Phenobarbital for seizures. (
The parties do not dispute that when plaintiff arrived at DVI on April 30, 2013, from the Shasta County Jail, he had prescriptions for Dilantin, Gabapentin and Phenobarbital. The parties do not dispute that Dilantin and Phenobarbital had been prescribed to treat plaintiff's seizure disorder. While defendants claim that Gabapentin was not previously prescribed for seizures,
The parties do not dispute that on May 9, 2013, nine days after plaintiff arrived at DVI, defendant Street tapered off plaintiff's Phenobarbital prescription, replacing it with Tegretol, and continued plaintiff's Dilantin prescription. The parties do not dispute that on May 9, 2013. defendant Street also tapered off plaintiff's Gabapentin prescription.
The parties do not dispute that on June 3, 2013, approximately four weeks after plaintiff arrived at DVI, defendant Awatani refused plaintiff's request to reinstate Gabapentin. The parties do not dispute that on July 8, 2013, approximately nine weeks after plaintiff arrived at DVI, defendant Awatani refused plaintiff's request to reinstate Phenobarbital and Gabapentin, in part, because they were non-formulary.
The parties do not dispute that plaintiff suffered seizures on July 14, 2013, and July 23, 2013.
Defendants argue that they did not act with deliberate indifference to plaintiff's serious medical needs when they changed plaintiff's seizure medications because in his first three months at DVI, plaintiff did not report any seizures, which indicated that the prescribed medications were effective and there was no reason to change them or to seek approval for non-formulary drugs.
Defendants also argue that their decisions not to prescribe Gabapentin and Phenobarbital were supported by other medical evidence, including a normal EEG and plaintiff's later diagnosis of pseudo-seizures. Defendants' summary judgment motion contains no expert evidence describing or explaining pseudo-seizures, or the treatment for this condition. In his previously submitted declaration, Dr. Fox describes pseudo-seizures, but does not state that this condition does not require the prescription of anti-seizure drugs. (ECF No. 14-1 at 4.)
Defendants' summary judgment contains no expert evidence specifically stating that the combinations of anti-seizure drugs plaintiff was prescribed in place of Gabapentin and Phenobarbital, specifically Keppra and Dilantin, were adequate to treat his seizure disorder. Defendants' declarations do not specifically address the effectiveness of the other drugs compared to Gabapentin and Phenobarbital. In his declaration, Dr. Fox states that Keppra and Dilantin, taken together, are equally as effective in treating plaintiff's seizure disorder as Gabapentin and Phenobarbital. (
In his November 14, 2013 report prepared after plaintiff transferred to Pleasant Valley State Prison ("PVSP"), Dr. Chakatos rejected plaintiff's request for Gabapentin and Phenobartibal, and found that Dilantin, aka phenytoin, was adequate to treat plaintiff's seizures. While this statement may address plaintiff's claim challenging the effectiveness of Dilantin and Tegretol, it does not address the effectiveness of Keppra and Tegretol, which plaintiff was prescribed by defendants just days before his first seizure.
Because plaintiff had two seizures in July after defendants discontinued the two medications he alleged were effective in treating his seizure disorder, for the reasons discussed above, the undersigned cannot find that defendants have demonstrated that they did not act with deliberate indifference when they replaced Gabapentin and Phenobarbital with other anti-seizure drugs. Expert evidence regarding the effectiveness of the drug combinations prescribed in place of Gabapentin and Phenobarbital is required for the undersigned to evaluate the subjective component of deliberate indifference. Neither party has provided any expert evidence on this point. Accordingly, the parties are directed to file further briefing, including expert evidence such as the declarations by appropriate experts, regarding the effectiveness of the combinations of the anti-seizure drugs defendants' prescribed in comparison to Gabapentin and Phenobarbital.
Accordingly, IT IS HEREBY ORDERED that within fourteen days of the date of this order, the parties shall file the further briefing described above.