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Estate of Sandoval v. County of San Diego

United States District Court, S.D. California

August 5, 2016

COUNTY OF SAN DIEGO, a Public Entity; SAN DIEGO COUNTY JAIL, a Public Entity; and DOES 1-100, Defendants.



         Pending before the Court are Defendants Romeo De Guzman, Maria Llamado, and Dana Harris's motion to dismiss Plaintiffs' First Amended Complaint ("FAC"). Defendants argue that Plaintiffs' claims fail to state a claim upon which relief can be granted under Federal Rules of Civil Procedure 12(b)(6) and are time barred under California Government Code § 945.6. Defendants also contend that Plaintiffs have failed to put the individual nurses on notice. For the following reasons, the Court denies the motion to dismiss.


         On February 22, 2014 Ronnie Paul Sandoval was arrested for possession of a controlled substance and violating his parole. (FAC ¶ 15). He was then taken into police custody and transferred to the San Diego Central Jail. (FAC ¶¶ 16, 18). As Mr. Sandoval was being processed, Plaintiffs allege he was observed "shaking, " "sweating profusely, " and being "disoriented." (FAC ¶ 16).[2] Approximately an hour later a prison official, Deputy Chavez, observed he "was still sweating a lot and appeared to be very tired and disoriented." (FAC ¶ 20). Plaintiffs allege that it was around this time a fellow inmate also alerted prison deputies to Mr. Sandoval's poor condition-that he was "shaking violently and was losing pallor." (FAC ¶ 20). The prison deputies proceeded to take Mr. Sandoval to the Medical Obervation Unit for "further medical examination" around 4:47 p.m. (FAC ¶ 21).

         Upon being admitted to the Medical Obervaiton Unit Plaintiffs allege that one of the defendants, nurse DeGuzman, was explicitly informed that Mr. Sandoval was "diabetic, sweating profusely, and disoriented." (Pls.' Opp'n at 3). Despite possessing this information about Mr. Sandoval's medical condition, Plaintiffs allege that Mr. Sandoval was not given any medical attention, or even checked on, for the next eight hours. (FAC ¶ 22). "Literally no one entered the threshold of his door until nearly 1:00 a.m. on February 23, 2014." (FAC ¶ 22). Plaintiffs also allege that in addition to receiving no medical treatment for his symptoms during this time, Mr. Sandoval was provided neither food nor water. (FAC ¶ 29).

         At 12:32 a.m. a deputy approached the medical cell, got no response from Mr. Sandoval, and took no action. (FAC ¶ 23). It was not until approximately 12:52 a.m. on February 23, 2014 that Mr. Sandoval was provided any medical care. (FAC ¶ 25).

         Plaintiffs additionally allege deficiencies in the care that was eventually provided. (FAC ¶ 25). It took Defendants ten miniutes to call an EMT after witnessing Mr. Sandoval have a seizure. (FAC ¶ 27). Plaintiffs allege, in addition to waiting ten minutes, calling an EMT rather then paramedics violated the County's "Code Blue" policy. (FAC ¶ 27). Defendants also waited thirty minutes to advise a supervisor of Mr. Sandoval's condition and after being ordered by the supervisor to call paramedics because EMTs were inadequate, Defendants still refused to call paramedics. (FAC ¶ 27). During this time Plaintiffs also allege that Defendants got into an argument with Deputy Andrade over the need to call paramedics. (Pls.' Opp'n at 4). Deputy Andrade was a trained EMT and understood that given Mr. Sandoval's unresponsive state, EMTs would be unable to transport him. (Pls.' Opp'n at 4). Plaintiffs allege that despite the Deputy imploring the nurses to call the paramedics they still refused. (Pls.' Opp'n at 4). When EMTs arrived they informed the nurses that they could not transport Mr. Sandoval and that paramedics were needed. (FAC ¶ 27). The paramedics did not arrive until around 1:42 a.m, which was approximately an hour after Mr. Sandoval's seizure. (FAC ¶ 27). When paramedics were trying to transfer Mr. Sandoval to the gurney, Mr. Sandoval went into respiratory arrest. (FAC ¶ 27). He was declared dead at 2:11 a.m. (FAC ¶ 27).


         To avoid a Rule 12(b)(6) dismissal, a complaint need not contain detailed factual allegations; rather, it must plead "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). The Court must "construe the facts from Plaintiffs' complaint, which we must deem to be true, in the light most favorable to them." Marceau v. Blackfeet Hous. Authority, 540 F.3d 916, 919 (9th Cir. 2008). The Court may not dismiss a complaint "when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Twombly, 550 U.S. at 556).

         I. Sufficiency of Allegations

         Defendants assert that the Plaintiffs have failed to plead "deliberate indifference." "Deliberate indifference to serious medical needs of prisoners constitutes the 'unnecessary and wanton infliction of pain, ' proscribed by the Eighth Amendment." Estelle v. Gamble, 429 U.S. 97, 104 (1976) (quoting Gregg v. Georgia, 428 U.S. 153, 173 (1976)). A determination of deliberate indifference involves an examination of two elements:

"First, the plaintiff must show a serious medical need by demonstrating that failure to treat a prisoner's condition could result in further significant injury or the unnecessary and wanton infliction of pain. Second, the plaintiff must show the defendant's response to the need was deliberately indifferent. This second prong ... is satisfied by showing (a) a purposeful act or failure to respond to a prisoner's pain or possible medical need and (b) harm caused by the indifference."

Akhtar v. Mesa, 698 F.3d 1202, 1213 (9th Cir. 2012) (quoting Jett v. Penner, 439 F.3d 1091 (9th Cir. 2006). "Indifference 'may appear when prison officials deny, delay or intentionally interfere with medical treatment'." Jett, 439 F.3d at 1096 (quoting Hutchinson v. United States, 838 F.2d 390, 392 (9th Cir. 1988)). However, "an accident, although it may produce added anguish, is not on that basis alone to be characterized as wanton infliction of unnecessary pain" sufficient to demonstrate deliberate indifference. Estelle, 429 U.S. at 105. A defendant must purposefully ignore or fail to respond to a prisoner's early pain or possible medical need in order for deliberate indifference to be established. McGukin v. Smith, 91A F.2d 1050, 1060 (9th Cir. 1986) (overruled on other grounds by WMX Tech. Inc. v. Miller, 104 F.3d 133 (9th Cir. 1997); see also Tyler v. Smith, 458 Fed.Appx. 597 (9th Cir. 2011) (finding that a prisoner who had undergone knee surgery stated a claim against the prison official for deliberate indifference under the Eighth Amendment by alleging that the prison official had delayed referral to an orthopedist despite knowing of the prionser's knee pain).

         Plaintiffs have pleaded facts that if true, could satisfy the "deliberate indifference" standard. In their FAC, Plaintiffs alleged that the deputies were notified as to the gravity of Mr. Sandoval's condition, sweating substantially, "shaking violently and was losing pallor." By the time Mr. Sandoval reached the Medical Waiting Room Defendant DeGuzman was fully informed that Mr. Sandoval was "feeling ill, sweating profusely, disoriented and diabetic." Nevertheless, Plaintiffs allege that Mr. Sandoval went unseen for the next eight hours despite being transferred for medical care and showing signs he needed medical care. It is also alleged that Defendants Llamado and Harris ignored a deputy's direction that he needed skilled paramedics rather than less skilled EMTs. (FAC ¶ 27). Plaintiffs have sufficiently alleged Mr. Sandoval's medical need was serious and Defendants "den[ied], delay[ed], ...

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