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Archie Cranford v. Letty Avila


September 26, 2011


The opinion of the court was delivered by: Michael J. Seng United States Magistrate Judge


Plaintiff Archie Cranford ("Plaintiff") proceeds pro se and in forma pauperis in this civil rights action pursuant to 42 U.S.C. § 1983. Plaintiff is civilly committed to Coalinga State Hospital as a sexually violent predator. Plaintiff initiated this action on November 13, 2008. (ECF No. 1.) The Court previously screened Plaintiff's Complaint and dismissed it for failure to state a claim, but gave Plaintiff leave to amend. (ECF No. 9.) On December 15, 2010, Plaintiff filed the Amended Complaint which is now before the Court for screening. (ECF No. 10.)


The in forma pauperis statutes provides that "the court shall dismiss the case at any time if the court determines that . . . the action or appeal . . . fails to state a claim upon which relief may be granted." 28 U.S.C. § 1915(e)(2)(B)(ii). A complaint must contain "a short and plain statement of the claim showing that the pleader is entitled to relief . . . ." Fed. R. Civ. P. 8(a)(2). Detailed factual allegations are not required, but "[t]hreadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice," Ashcroft v. Iqbal, 129 S.Ct. 1937, 1949 (2009) (citing Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555 (2007)), and courts "are not required to indulge unwarranted inferences," Doe I v. Wal-Mart Stores, Inc., 572 F.3d 677, 681 (9th Cir. 2009) (internal quotation marks and citation omitted). While factual allegations are accepted as true, legal conclusion are not. Iqbal, 129 S.Ct. at 1949.

Under section 1983, a plaintiff must demonstrate that each defendant personally participated in the deprivation of his rights. Jones v. Williams, 297 F.3d 930, 934 (9th Cir. 2002). This requires the presentation of factual allegations sufficient to state a plausible claim for relief. Iqbal, 129 S.Ct. at 1949-50; Moss v. U.S. Secret Service, 572 F.3d 962, 969 (9th Cir. 2009). The mere possibility of misconduct falls short of meeting this plausibility standard. Iqbal, 129 S.Ct. at 1949-50; Moss, 572 F.3d at 969.


Plaintiff is civilly committed to Coalinga State Hospital as a sexually violent predator. Plaintiff has named Letty Avila, the Unit Supervisor, and Ires Wilkins, RN, as Defendants in this action.

Plaintiff alleges as follows:

On a day in September*fn1 Defendant Avila ordered Defendant Wilkens to remove from Plaintiff nitro-gylcerin tablets which Plaintiff used, with a doctor's permission, to prevent chest pain and heart attacks. Plaintiff has been without this medication at least since that date to the date of filing his initial complaint, November 13, 2008, and perhaps through the date of this Amended Complaint. Plaintiff has had several bouts of chest pain and two heart attacks as a result of his medication being removed from his possession.

Plaintiff asks for a permanent injunction of both "Defendants" employment, compensatory damages, punitive damages, and regular damages.


As the Court previously informed Plaintiff, Section 1983 "provides a cause of action for the 'deprivation of any rights, privileges, or immunities secured by the Constitution and laws' of the United States." Wilder v. Virginia Hosp. Ass'n, 496 U.S. 498, 508 (1990) (quoting 42 U.S.C. § 1983). Section 1983 is not itself a source of substantive rights, but merely provides a method for vindicating federal rights conferred elsewhere. Graham v. Connor, 490 U.S. 386, 393-94 (1989).

Plaintiff alleges that prison officials violated his constitutional rights by failing to provide adequate medical care. Plaintiff is not a prisoner; he is civilly committed to Coalinga State Hospital as a sexually violent predator. "[C]ivil detainees retain greater liberty protections than individuals detained under criminal process, and pre-adjudication detainees retain greater liberty protections than convicted ones . . . ." Jones v. Blanas, 393 F.3d 918, 932 (9th Cir. 2004) (citations omitted). Treatment is presumptively punitive when a civil detainee is confined in conditions identical to, similar to, or more restrictive than his criminal counterparts, and when a pre-adjudication civil detainee is detained under conditions more restrictive than a post-adjudication civil detainee would face. Id. at 932-33.

As a civil detainee, Plaintiff's right to medical care is protected by the substantive component of the Due Process Clause. Youngberg v. Romeo, 457 U.S. 307, 315 (1982). A determination whether Plaintiff's rights were violated requires "balancing of his liberty interests against the relevant state interests." Youngberg, 457 U.S. at 321. Plaintiff is "entitled to more considerate treatment and conditions of confinement than criminals whose conditions of confinement are designed to punish," but the Constitution requires only that courts ensure that professional judgment was exercised. Youngberg, 457 U.S. at 321-22. A "decision, if made by a professional, is presumptively valid; liability may be imposed only when the decision by the professional is such a substantial departure from accepted professional judgment, practice, or standards as to demonstrate that the person responsible actually did not base the decision on such a judgment." Id. at 322-23; compare Clouthier v. County of Contra Costa, 591 F.3d 1232, 1243-44 (9th Cir. 2010) (rejecting the Youngberg standard and applying the deliberate indifference standard to a pretrial detainee's right to medical care, and noting that pretrial detainees, who are confined to ensure presence at trial, are not similarly situated to those civilly committed). Under this "professional judgment" standard, mere negligence or medical malpractice does not violate the Constitution. See Patten v. Nichols, 274 F.3d 829, 842-43 (4th Cir. 2001) (applying Youngberg "professional judgment" standard to a denial of medical care claim by a civilly committed psychiatric patient and holding that more than negligence is required).

The facts alleged in Plaintiff's Amended Complaint fail to address the deficiencies pointed out in the Court's original screening order. Plaintiff does now allege that he suffered chest pain and heart attacks during a not-clearly described period of time. However, he has failed to allege facts showing that Defendants' removal of the medication was a substantial departure from accepted professional judgment, practice, or standards. The original pleading reflected concern on the part of Defendants, who apparently are medical personnel, with whether Plaintiff was aware of the risks of using the medication and whether he was capable of reasonably and reliably self-medicating with it. According to the original pleading, Defendant Wilkens was satisfied, but Defendant Avila was not. In his amended pleading, Plaintiff does not allege that Defendants had any improper or non-penological motive for their actions. The most that could be read into Plaintiff's allegations is that Defendant Avila disagreed with the reported permission given to Plaintiff to self-medicate and that Defendant Wilkens was simply following Defendant Avila's instructions. Even if it were assumed that Defendant's judgment was medically inadvisable, there is nothing in the Complaint to suggest that Defendant's were improperly motivated or guilty of anything except perhaps negligence in removing the tablets. Mere negligence does not suffice under the "professional judgment" standard to state a cognizable claim for inadequate medical care against Defendants.


For the reasons stated above, the Court finds that Plaintiff's Complaint fails to state a claim upon which relief may be granted and, inasmuch as previously noted deficiencies remain, leave to amend would be futile. See Noll v. Carlson, 809 F.2d 1446, 1448-49 (9th Cir. 1987). Accordingly, Plaintiff's Complaint is DISMISSED WITH PREJUDICE for failure to state a claim. The Clerk shall close the case.


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