United States District Court, N.D. California
DAVID C. PATKINS, Plaintiff,
TRAN, et al., Defendants.
ORDER GRANTING DEFENDANTS' MOTION FOR SUMMARY
JUDGMENT DOCKET NO. 23
M. CHEN UNITED STATES DISTRICT JUDGE.
pro se prisoner's civil rights action, David
Patkins contends that four prison dentists were deliberately
indifferent in their responses to his complaints about his
dental bridge. Defendants have filed a motion for summary
judgment, which Mr. Patkins has opposed. For the reasons
discussed below, Defendants' motion for summary judgment
will be granted and judgment entered against Mr. Patkins.
dental bridge may be used to deal with missing teeth. The
teeth at the end of a bridge are called the abutment teeth.
The bridge may be cemented to those abutment teeth and covers
the gap where the teeth between those abutment teeth are
case concerns four dentists' responses to Mr.
Patkins' requests for services on his dental bridge. The
following facts are undisputed unless otherwise noted.
Dental Care For The Bridge
events and omissions giving rise to Mr. Patkins'
complaint occurred in 2014 through late 2015. At the relevant
time, Mr. Patkins was an inmate at the Correctional Training
Facility (CTF) in Soledad, California. Also at the relevant
time, Dr. Tran, Dr. Babienco, Dr. Chang, and Dr. Kamminga
were dentists providing dental care to inmates at CTF.
Patkins received a dental bridge in 1998, covering a
four-tooth area from his top right central incisor (i.e.,
tooth # 8) to his top left canine tooth (i.e., tooth # 11).
(Docket No. 26 at 2.) The incisor and the canine were the
abutment teeth on his bridge, and his bridge covered the gap
where two teeth were missing between the abutment teeth.
2007, the margin where the bridge met tooth # 8 was patched
with a composite filling. (Docket No. 26 at 12; Dental 0015,
15 years and one patch job, the bridge developed problems,
loosening at first and later fully detaching.
March 4, 2014, Mr. Patkins submitted a request for care
because “one post” on his bridge was loose.
March 17, 2014, a nondefendant dentist saw Mr. Patkins, and
noted that Mr. Patkins' bridge had no mobility but that
the spaces between his gum and his abutment teeth were probed
to pocket depths of 333/434. The gum depths pertain to the
periodontal health of a tooth and those numbers reflect
“moderate bone loss, ” according to dentist Dr.
Uy. (Docket No. 23-1 at 3; Dental 0056-57.)
April 3, 2014, Dr. Babienco attempted to detach the bridge to
recement it, but one side of it remained fastened so the
bridge could not be detached for recementing. (Docket No. 26
22, 2014, Mr. Patkins submitted a request for periodontal
treatment. One or two nondefendant dentists did the
periodontal care (i.e., scaling and root planing) in two
sessions, on May 22 and in mid-June 2014. (Docket No. 23-1 at
3; Dental 0056, 0058, 0061, 0067; Docket No. 26 at 2, 13.)
According to Mr. Patkins, at the second session, the
nondefendant dentist told him his abutment teeth were
“'strong and healthy.'” (Docket No. 26 at
10, 2014, Mr. Patkins requested care because his bridge had
fully detached. (Dental 0062.) When the bridge detached, the
exposed abutment teeth became highly sensitive to hot and
cold temperatures in food, liquid and weather; and caused
pain and headaches. (Docket No. 26 at 2-3.)
18, 2014, Dr. Tran noted on Mr. Patkins' treatment plan
that the bridge needed to be recemented, but he did not see
Mr. Patkins that day. (Docket No. 26 at 13.) On July 2, 2014,
Dr. Tran recemented the bridge. (Dental 0066, 0068.)
According to Mr. Patkins, before she recemented the bridge,
Dr. Tran stated that the bridge did not fit right. (Docket
No. 26 at 4.) Also according to Mr. Patkins, Dr. Tran said
that dentists at CTF do not cement bridges and she proposed
extracting the abutment teeth. (Id.; Docket No. 20
at 8.) Mr. Patkins' teeth were not extracted.
31, 2014, Mr. Patkins submitted a request for care because
his bridge had loosened on about July 15, and his abutment
teeth were highly sensitive. He noted that “maybe an
outside expert is appropriate.” (Dental 0069.)
Tran saw Mr. Patkins on August 6, 2014. Dr. Tran wrote that
the bridge was not loose but that there was exposed enamel at
the crown margin of tooth # 11. She again suggested tooth
extraction. (Docket No. 23-1 at 3; Dental 0073.)
August 19 or 20, 2014, Dr. Babienco interviewed Mr. Patkins
in connection with an inmate appeal. Dr. Babienco made a note
to recement the bridge. (Dental 0074.)
September 5, 2014, Dr. Chang recemented the bridge using
Duralon cement. Dr. Chang told Mr. Patkins that the bridge
may loosen again. (Dental 0076 (“inf. pt. that prep of
#8-11 FPD is too tapered & may loosen again.”))
October 4, 2014, Mr. Patkins submitted a request for care
because his bridge had detached. He requested an
“outside expert [to] properly cement [his]
bridge.” (Dental 0077.)
Babienco saw him on October 9, 2014, and advised Mr. Patkins
that he would be given a ducat for an appointment to have a
dentist recement the bridge. Dr. Babienco's note appears
to state “ducat for recementation of bridge, if
clinician [?] determines bridge cannot be recement[ed] then
the issue is completed.” (Dental 0082.) Mr. Patkins
states that Dr. Babienco told Mr. Patkins he could
“wait till [his] life sentence is over before [he
would] get a proper cementing” of the bridge.”
(Docket No. 20 at 14.) Mr. Patkins alleges that Dr. Babienco
“permanently banned plaintiff from dental
services” (id.), but this apparently was
hyperbole by either the dentist or patient because Mr.
Patkins continued to receive care from Dr. Babienco and other
October 20, 2014, Dr. Chang recemented the bridge. Mr.
Patkins signed a refusal to have teeth # 8 and # 11
extracted. Dr. Chang told him that the refusal may lead to
pain and/or swelling, and to submit a form 7362 to request
dental care. (Dental 0085.)
November 7, 2014, Dr. Uy (a nondefendant who was a
supervising dentist at CTF) examined Mr. Patkins. Dr. Uy
discussed with Mr. Patkins the possibility that
teeth-grinding during sleep was causing additional problems
with the bridge, and prescribed a night guard for Mr.
Patkins' teeth. Dr. Uy also noted a slight gap between
the bridge and the gum line. (Docket No. 23-1 at 4; Dental
0093.) Mr. Patkins told Dr. Uy that the gap was “filler
sealed for those 15 years--until dentist Tran worked it off
at the 7-2-14 recementing.” (Docket No. 20 at 15.) Mr.
Patkins denies that he grinds his teeth.
Patkins was fitted for a dental guard on November 17, 2014,
and, when the night guard mold was removed, the bridge came
out with it. Dr. Chang recemented the bridge that day.
(Docket No. 20 at 16.) Mr. Patkins refused the night guard
the next week. (Dental 0095.)
February 2, 2015, Mr. Patkins requested care for the bridge
that had again detached. (Dental 0096.)
Babienco recemented the bridge using Duralon cement on
February 11, 2015. (Dental 0099.)
29, 2015, Mr. Patkins requested care for the bridge that had