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Atayde v. Napa State Hospital

United States District Court, E.D. California

May 25, 2017

LUCY ATAYDE, individually and as successor in interest of decedent RICHARD MICHAEL RAMIREZ Plaintiff,
NAPA STATE HOSPITAL, et al., Defendants.


         This matter came before the court on December 6, 2016, for hearing of defendants' motions to dismiss pursuant to Rule 12(b)(6) of the Federal Rules of Civil Procedure. (Doc. Nos. 76, 78.) Attorney Michael Haddad appeared on behalf of plaintiff Lucy Atayde, successor in interest of decedent Richard Michael Ramirez. Deputy Attorney General Krista Dunzweiler appeared on behalf of defendants Napa State Hospital (“NSH”), Dolly Matteucci, and Dana White (the “state defendants”). Attorney Jerome Varanini appeared on behalf of defendant Merced County. Attorney Jemma Saunders appeared on behalf of California Forensic Medical Group Inc. (“CFMG”), Taylor Fithian, Deborah Mandujano, Corina Denning, Sean Ryan, Tom Cavallero, Jason Goins, and Heather Goode (the “county defendants”). Following oral argument, defendants' motions were taken under submission. For the reasons stated below, the court will grant in part and denies in part defendants' motions to dismiss.


         On January 5, 2016, plaintiff Lucy Atayde, the mother of decedent Richard Michael Ramirez, filed suit in the U.S. District Court for the Northern District of California against defendants. (Doc. No. 1.) On March 21, 2016, the case was transferred to this district. (Doc. No. 40.) On September 16, 2016, this court granted the state defendants' motion to dismiss and granted in part the county defendants' motion to dismiss. (Doc. No. 63.)

         This action now proceeds on plaintiffs First Amended Complaint (“FAC”), filed October 7, 2016. (Doc. No. 68.) In her FAC, plaintiff raises claims against two major groups of defendants, those affiliated with the Napa State Hospital (“state defendants”), and those affiliated with the Merced County jail (“county defendants”). (Doc. No. 68.) Plaintiff alleges seven causes of action: (i) claims under 42 U.S.C. § 1983 against defendants Fithian, Goode, Ryan, Denning, Cavallaro, Goins, Mandujano, and White for violation of decedent's Fourth and Fourteenth Amendment rights to adequate mental health treatment, and for violation of plaintiff s First Amendment right to familial association; (ii) claims under § 1983 against defendants Matteucci, Merced County, CFMG, and policy-making officials of each organization, for supervisory and municipal liability; (iii) claims under the California Bane Act, codified at California Civil Code § 52.1; (iv) claims under the Americans with Disabilities Act (“ADA”) and the Rehabilitation Act of 1973 (“RA”) against defendants Merced County, NSH, and CFMG; (v) claims under California Government Code § 845.6 against defendants White, NSH, the County, and Goins; (vi) negligence claims against defendants Cavallero, Goins, and Merced County; and (vii) negligence per se claims against defendants Cavallero, Goins, and Merced County. (Id.)

         In her FAC, plaintiff alleges the following facts. On December 15, 2014, decedent-a twenty seven year-old man suffering from severe psychosis-committed suicide while in the custody of the Merced County Sheriffs Department. (Doc. No. 68 at 29, ¶ 102.) Decedent committed suicide after being held in pre-trial detention for nearly four months. (Id.) The following events led to decedent's suicide.

         Decedent was arrested and booked into Merced County Jail on August 23, 2014. (Id. at 10, ¶ 26.) On August 29, 2014, the Merced County Superior Court suspended the criminal proceedings against decedent due to concerns that he was not mentally competent to stand trial and referred him to Dr. Phillip Hamm, Ph.D., for an evaluation pursuant to California Penal Code § 1368. (Id. at 10, ¶ 28.)

         Decedent exhibited signs of mental illness while held at Merced County jail, reportedly hearing voices and experiencing major mood changes. (Id. at 11-13, ¶¶ 34-38.) On two separate occasions in early September of 2014, decedent was placed in safety cells because of his behavior. (Id. at 13-14, ¶¶ 39-44.) After each of these instances, decedent was released without the initiation of a treatment plan or other follow-up action. (Id.) Decedent was given only two telepsychiatric consultations while incarcerated at the Merced County jail. (Id. at 12-13, ¶ 38.) On September 5, 2014, defendant Heather Goode, M.D., met with decedent and wrote him a prescription for an antipsychotic medication. (Id. at 12-13, ¶ 38.) However, defendant Goode did not draft a treatment plan or diagnose decedent as suffering from psychosis. (Id.) On September 15, 2014, defendant Cora Denning, R.N., conducted a separate assessment of decedent, and found him to have a clear and normal thought process. (Id. at 14-15, ¶ 48.) Decedent was scheduled for another consultation on September 22, 2014, but this appointment was canceled due to a scheduling conflict and was never rescheduled. (Id. at 15, ¶ 49.)

         Decedent refused to take his prescribed medications during his time at the jail. (Id. at 16, ¶ 56.) In response to his refusal, county employees and agents merely signed release of liability forms on decedent's behalf. (Id. at 16, ¶ 56.) Decedent never signed these release forms himself. (Id.)

         On September 22, 2014, Dr. Hamm issued his court-ordered report on decedent. (Id. at 15-16, ¶¶ 51-53.) The report stated that decedent likely suffered from Psychotic Disorder NOS (not otherwise specified) and was not able to understand the nature and purpose of the proceedings against him. (Id.) On September 26, 2014, Merced County Superior Court adopted Dr. Hamm's report and declared decedent incompetent to stand trial. (Id. at 15-17, ¶¶ 51-60.) The court also ordered a placement report to be submitted by October 15, 2014 and scheduled a report hearing for October 17, 2014. (Id. at 17, ¶ 60.)

         During the period of time leading up to the report hearing, decedent engaged in a series of self-harming behaviors. (Id. at 18-21, ¶¶ 61-76.) On September 27, 2014, while housed in segregated lockdown, decedent began to strike the walls and door of his cell, causing his hand to swell and bruise. (Id. at 18, ¶ 61.) On September 29, 2014, decedent attempted to commit suicide by hanging himself with a t-shirt. (Id. at 18, ¶ 64.) On October 5, 2014, decedent again attempted suicide by choking himself with his own hands. (Id. at 19, ¶ 70.) In response to each suicide attempt, decedent was placed in a safety cell-generally for a period of two days-and given an updated prescription. (Id. at 19-20, ¶¶ 67, 69, 73, 75.) However, decedent continued to refuse his medications, and county staff continued to fail to develop a treatment plan. (Id. at 16-21, ¶¶ 56, 63, 69, 75-76.)

         On October 24, 2014, the Merced County Superior Court ordered decedent to be committed to the trial competency program at defendant NSH, or another appropriate facility, pursuant to California Penal Code § 1370. (Id. at 22, ¶ 79.) In its order, the court specifically noted that if decedent's mental disorder “is not treated with antipsychotic medication, it is probable that serious harm to the physical or mental health of the patient will result.” (Id.) Both county and state defendants were given notice of this order. (Id.)

         NSH completed a pre-admission evaluation of decedent and approved him for admission. (Id. at 20, ¶ 74.) On October 9, 2014, defendant White, a nurse employed by defendant NSH, wrote a letter stating that decedent would be admitted upon receipt of seven specific court documents. (Id.) Defendant NSH received these documents before October 31, 2014. (Id. at 24, ¶ 86.) However, decedent was never transferred to NSH. (Id. at 20, 24-26, ¶¶ 74, 86.) Plaintiff alleges that decedent was not transferred either because the state defendants actively denied decedent's admission to NSH, or because the county defendants failed to transport and deliver decedent to NSH as ordered. (Id.)

         Between October and December of 2014, decedent continued to engage in self-harming behavior. He was placed in a safety cell on three separate occasions during this period-on November 28, 2014, December 5, 2014, and December 14, 2014-and each time was released after a period of observation. (Id. at 26-29, ¶¶ 91, 94, 101.) On December 15, 2014, after being placed in a segregated cell, decedent committed suicide by hanging himself. (Id. at 29, ¶ 102.)

         Defendants Merced County, Cavallero, and Goins filed a motion to dismiss plaintiffs FAC on October 21, 2016. (Doc. No. 76.) State defendants filed a separate motion to dismiss on the same date. (Doc. No. 78.) On November 22, 2016, plaintiff filed oppositions to defendants' motions to dismiss, one of which was amended on November 30, 2016. (Doc. Nos. 80, 81, 84.) County defendants filed their reply on November 26, 2016, and state defendants filed their reply on November 30, 2016. (Doc. Nos. 82, 83.)


         The purpose of a motion to dismiss brought pursuant to Rule 12(b)(6) is to test the legal sufficiency of the complaint. N. Star Int'l v. Ariz. Corp. Comm 'n, 720 F.2d 578, 581 (9th Cir. 1983). “Dismissal can be based on the lack of a cognizable legal theory or the absence of sufficient facts alleged under a cognizable legal theory.” Balistreri v. Pacifica Police Dep t , 901 F.2d 696, 699 (9th Cir. 1990). A claim for relief 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). Though Rule 8(a) does not require detailed factual allegations, a plaintiff is required to allege “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); Ashcroft v. Iqbal, 556 U.S. 662, 677-78 (2009). “A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Iqbal, 556 U.S. at 678.

         In determining whether a complaint states a claim on which relief may be granted, the court accepts as true the allegations in the complaint and construes the allegations in the light most favorable to the plaintiff. Hishon v. King & Spalding, 467 U.S. 69, 73 (1984); Love v. United States, 915 F.2d 1242, 1245 (9th Cir. 1989). It is inappropriate to assume that the plaintiff “can prove facts which it has not alleged or that the defendants have violated the . . . laws in ways that have not been alleged.” Associated Gen. Contractors of Cal, Inc. v. Cal State Council of Carpenters, 459 U.S. 519, 526 (1983).


         In their motions to dismiss, both the state and county defendants argue that plaintiffs FAC does not cure the defects of the original complaint, and should be dismissed for the same reasons the court previously articulated in its September 16, 2016 order. (See Doc. No. 63.) Defendants collectively make four arguments: (i) plaintiffs § 1983 claims are inadequately pled with respect to both the state and county defendants; (ii) plaintiffs § 1983 claim for municipal liability against Merced County fails under federal pleading standards; (iii) plaintiffs ADA and RA claims fail because the FAC does not allege that defendants discriminated against decedent on the basis of disability; and (iv) plaintiffs claims against the state defendants under California Government Code §§ 845.6 and 815 fail because decedent was not in custody of NSH at the time of his death, and because the state defendants are immune from suit under state law and the Eleventh Amendment. (Doc. Nos. 76, 78.)

         The court considers each of defendants' arguments in turn below.

         I. Claims under 42 U.S.C. § 1983

         Both state and county defendants first move to dismiss plaintiffs § 1983 claims for violation of the Fourteenth Amendment, arguing that the factual allegations of plaintiff s FAC are insufficient to state a claim for a violation of the decedent's constitutional rights, and are inadequate to support claims against defendants White, Matteucci, or Goins.

         The Civil Rights Act under which this action was filed provides as follows:

Every person who, under color of [state law] . . . subjects, or causes to be subjected, any citizen of the United States . . . to the deprivation of any rights, privileges, or immunities secured by the Constitution . . . shall be liable to the party injured in an action at law, suit in equity, or other proper proceeding for redress.

42 U.S.C. § 1983. To make out a valid claim under § 1983, a plaintiff must allege and eventually prove that: (i) the conduct complained of was committed by a person acting under color of state law; (ii) this conduct deprived a person of constitutional rights; and (iii) there is an actual connection or link between the actions of the defendants and the deprivation allegedly suffered by decedent. See Parratt v. Taylor, 451 U.S. 527, 535 (1981); Monell v. Dep't of Soc. Servs., 436 U.S. 658, 690-695 (1978); Rizzo v. Goode, 423 U.S. 362, 370-371 (1976). “A person ‘subjects' another to the deprivation of a constitutional right, within the meaning of § 1983, if he does an affirmative act, participates in another's affirmative acts or omits to perform an act which he is legally required to do that causes the deprivation of which complaint is made.” Lacey v. Maricopa County, 693 F.3d 896, 915 (9th Cir. 2012) (quoting Johnson v. Duffy, 588 F.2d 740, 743 (9th Cir. 1978)).

         Supervisory personnel are generally not liable under § 1983 for the actions of their employees under a theory of respondeat superior and, therefore, when a named defendant holds a supervisorial position, the causal link between him or her and the claimed constitutional violation must be specifically alleged. See Fayle v. Stapley, 607 F.2d 858, 862 (9th Cir. 1979); Mosher v. Saalfeld, 589 F.2d 438, 441 (9th Cir. 1978). Vague and conclusory allegations concerning the involvement of official personnel in civil rights violations are not sufficient. See Ivey v. Board of Regents, 673 F.2d 266, 268 (9th Cir. 1982).

         A. Deliberate Indifference Claims

         Defendants argue that plaintiff has not adequately pled a § 1983 claim based on deliberate indifference against either the state or county defendants. (Doc. No. 78-1 at 17-18.)

         The Fourteenth Amendment provides that “[n]o State shall . . . deprive any person of life, liberty, or property, without due process of law.” U.S. Const. amend. 14 § 1. Fourteenth Amendment protections cover a procedural as well as a substantive sphere, such that they bar certain government actions regardless of the fairness of the procedures used to implement them. Cty. of Sacramento v. Lewis, 523 U.S. 833, 840 (1998). Here, because Mr. Ramirez was a pretrial detainee at the time of the alleged incidents, his right to be free from cruel and unusual punishment is derived from the due process clause of the Fourteenth Amendment rather than the Eighth Amendment. See Bell v. Wolfish, 441 U.S. 520, 535 (1979); Castro v. County of Los Angeles, 833 F.3d 1060, 1067-68 (9th Cir. 2016), cert. denied sub nom. Los Angeles County, Cal v. Castro, __U.S. __, 137 S.Ct. 831 (2017). The duty to protect detainees from suicide is grounded in the substantive liberty interest to adequate medical care.[1] See Simmons v. Navajo County, Ariz., 609 F.3d 1011, 1018 (9th Cir. 2010); Johnson v. Meltzer, 134 F.3d 1393, 1397 (9th Cir. 1998); Schwartz v. Lassen Cty. ex rel. Lassen Cty. Jail (Detention Facility), 838 F.Supp.2d 1045, 1052 (E.D. Cal. 2012). In particular, “persons in custody ha[ve] the established right to not have officials remain deliberately indifferent to their serious medical needs.'” Gibson v. Cty. of Washoe, 290 F.3d 1175, 1187 (9th Cir. 2002) (quoting Carnell v. Grim, 74 F.3d 977, 979 (9th Cir. 1996)), overruled on other grounds by Castro, 833 F.3d at 1076. Moreover, “[i]ncapacitated criminal defendants have liberty interests in freedom from incarceration and in restorative treatment.” Oregon Advocacy Ctr. v. Mink, 322 F.3d 1101, 1121 (9th Cir. 2003). When determining whether failure to provide timely restorative treatment constitutes a violation of the Fourteenth Amendment, courts must balance the detainee's liberty interests against the legitimate interests of the state. Id. (citing Youngberg, 457 U.S. at 321).

         Plaintiffs may claim deliberate indifference under the Fourteenth Amendment[2] by alleging: (i) defendant made an intentional decision with respect to the conditions of plaintiff's confinement; (ii) those conditions exposed plaintiff to a “substantial risk of serious harm”; (iii) defendant did not take reasonable available measures to abate that risk, even though a reasonable officer in the circumstances would have appreciated the high degree of risk involved; and (iv) by not taking those measures, defendant caused plaintiff's injuries. See Castro v. Los Angeles, 833 F.3d 1060, 1068-71 (9th Cir. 2016), cert. denied sub nom. Los Angeles County, Cal. v. Castro, __U.S. __, 137 S.Ct. 831 (2017). Accordingly, when considering a motion to dismiss such a claim, a district court must consider whether the plaintiff has pled sufficient facts to permit the court to infer the plaintiff had a “serious medical need” and a defendant was “deliberately indifferent” to that need. See Jett v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006); see also Simmons, 609 F.3d at 1018 (“[W]e have previously recognized that a heightened suicide risk can present a serious medical need.”). In particular, deliberate indifference may be shown where prison officials or practitioners “deny, delay, or intentionally interfere with medical treatment.” Hutchinson v. United States, 838 F.2d 390, 394 (9th Cir. 1988); see also Estelle v. Gamble, 429 U.S. 97, 104-105 (1976) (finding that delays in providing medical care may show deliberate indifference). Courts “need not defer to the judgment of prison doctors or administrators” in deciding whether there has been deliberate indifference to an inmate's serious medical needs. Snow v. McDaniel, 681 F.3d 978, 985-86 (9th Cir. 2012) (quoting Hunt v. Dental Dep't, 865 F.2d 198, 200 (9th Cir. 1989)). However, mere negligence in diagnosing or treating a medical condition, without more, does not constitute deliberate indifference. See Hunt, 865 F.2d at 200; see also Toguchi v. Chung, 391 F.3d 1051, 1058-60 (9th Cir. 2004).

          i. State defendants White and Matteucci

         The state defendants move to dismiss plaintiff's § 1983 claims against defendants White and Matteucci for deliberate indifference in the provision of medical care in violation of decedent's Fourteenth Amendment rights. (Doc. No. 78-1 at 15-21.) They assert three arguments in this regard. (Id.) First, they argue that defendants White and Matteucci cannot be held liable for their omissions when they were not subject to a duty to transfer decedent from county jail to NSH. (Id. at 15-16.) Second, defendants argue that plaintiff's § 1983 deliberate indifference claim against defendants White and Matteucci is inadequately pled. (Id. at 16-19.) Finally, defendants contend that plaintiff's § 1983 claim against defendants White and Matteucci is barred by qualified immunity. (Doc. No. 78 at 15-18, 20-21.)[3]

         In her opposition, plaintiff argues that defendants White and Matteucci were under a duty to carry out decedent's transfer; that the deliberate indifference claim is adequately alleged under federal pleading standards; and that qualified ...

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