United States District Court, N.D. California
ORDER DENYING PLAINTIFF'S MOTION FOR PRELIMINARY
INJUNCTION; AND GRANTING DEFENDANTS' MOTION FOR SUMMARY
GONZALEZ ROGERS, United States District Judge
Ossie Giles, a state prisoner currently incarcerated at San
Quentin State Prison (“SQSP”), has filed a
pro se civil rights complaint under 42 U.S.C. §
1983. Plaintiff, who claimed he suffered from severe back
pain, alleged that Defendants from California State Prison -
Solano (“CSP-Solano”) failed to give him
treatment for his back pain while he was housed there from
2006 until the date he was transferred to SQSP on December 8,
2009. Dkt. 1 at 3-4. Plaintiff also alleged that Defendants at
SQSP continued to deny him treatment for his back pain after
he was transferred there. Id. at 4-7. Plaintiff
claimed that in April of 2014 he could no longer walk, and he
had to undergo emergency back surgery on May 20, 2014.
Id. at 8-9. Plaintiff named the following Defendants
at SQSP: Doctors D. Reyes and J. Espinoza; and Chief Medical
Officer (“CMO”) E. Tootell. He also named the
following Defendants at CSP-Solano: Doctors B. Naki, T. Tran
and Yuen Chen. Plaintiff seeks monetary damages.
Order dated March 28, 2016, the Court summarized the facts
relating to the constitutional violations alleged by
Plaintiff and found that he stated a cognizable claim, as
Plaintiff alleges that he suffers from serious medical needs,
specifically his severe back pain. Dkt. 1 at 3-8. Plaintiff
claims that Defendants Reyes, Espinoza and Tootell were
deliberately indifferent to his serious medical needs for
failing to provide him treatment for his back pain from the
time he was transferred to SQSP on December 8, 2009 until he
had to receive emergency back surgery on May 20, 2014.
Id. at 5-8. Liberally construed, Plaintiff's
allegations relating to the aforementioned actions state a
cognizable claim for deliberate indifference to his serious
medical needs against Defendants Reyes, Espinoza and Tootell.
Dkt. 8 at 3. The Court ordered service of the complaint on
Defendants Reyes, Espinoza and Tootell. Plaintiff's
claims relating to all problems during his incarceration at
CSP-Solano against Defendants Naki, Tran and Chen were
dismissed without prejudice to Plaintiff refiling them in a
new civil rights action in the United States District Court
for the Eastern District of California.
remaining parties from SQSP-Defendants Reyes, Espinoza and
Tootell (hereinafter “Defendants”)- are presently
before the Court on their Motion for Summary Judgment on the
grounds that Defendants Reyes's and Espinoza's
treatment of Plaintiff's back pain: (1) did not amount to
deliberate indifference of his serious medical needs; and (2)
was within the standard of medical care. Dkt. 30 at 2.
Defendants also claim that “[a]t no time relevant to
plaintiff's lawsuit did [Defendant] Tootell in any way
diagnos[e] or treat plantiff.” Id. at 11.
Thus, Defendants argue that Plaintiff has not made a causal
link between Defendant Tootell and the violation of his
constitutional rights. Id. Plaintiff has filed an
opposition to Defendants' motion, and Defendants have
filed a reply. Dkts. 33, 34.
has also filed a motion for a preliminary injunction, to
which Defendants have filed a response. Dkts. 28, 35.
reasons stated below, Plaintiff's motion for a
preliminary injunction is DENIED, and Defendants' motion
for summary judgment is GRANTED.
PLAINTIFF'S MOTION FOR PRELIMINARY INJUNCTION
has filed a request for a preliminary injunction concerning
medical treatment needed to “alleviate [his] daily pain
and suffering.” Dkt. 28 at 1. Specifically, Plaintiff
seeks an injunction requiring Defendants to move forward with
further diagnostic testing that was originally suggested
during a consultation with a “neuro specialist”
(i.e., neurosurgery consultant) from University of
California-San Francisco (“UCSF”) named Dr.
Wadhwa (a non-party) on October 29, 2015. See Id.
Defendants have filed an opposition to his motion. Dkt. 35.
Standard of Review
PLRA restricts the power of the district court to grant
prospective relief in any action involving prison conditions.
See 18 U.S.C. § 3626(a); Oluwa v.
Gomez, 133 F.3d 1237, 1239 (9th Cir. 1998). Section
3626(a)(2) applies specifically to preliminary injunctive
relief. See 18 U.S.C. § 3626(a)(2). In civil
actions with respect to prison conditions it permits the
court to enter a temporary restraining order
(“TRO”) or preliminary injunction “to the
extent otherwise authorized by law” but also requires
that such an order “must be narrowly drawn, extend no
further than necessary to correct the harm the court finds
requires preliminary relief, and be the least intrusive means
necessary to correct that harm.” Id.
Rule of Civil Procedure 65 sets forth the procedure for
issuance of a preliminary injunction or TRO. The standard for
issuing a TRO is similar to that required for a preliminary
injunction. See L.A. Unified Sch. Dist. v. United States
Dist. Court, 650 F.2d 1004, 1008 (9th Cir. 1981)
(Ferguson, J., dissenting). “A plaintiff seeking a
preliminary injunction must establish that he is likely to
succeed on the merits, that he is likely to suffer
irreparable harm in the absence of preliminary relief, that
the balance of equities tips in his favor, and that an
injunction is in the public interest.” Winter v.
Natural Resources Defense Council, Inc., 555 U.S. 7, 20
(2008). This standard replaces the previous tests for
preliminary injunctions that had been used in the Ninth
Circuit. Am. Trucking Associations, Inc. v. Los
Angeles, 559 F.3d 1046, 1052 (9th Cir. 2009).
conjunction with their opposition to the request for a
preliminary injunction, Defendants rely on the declaration
Defendant Espinoza that had been filed in support of their
motion for summary judgment. In reliance upon this document,
Defendants argue that Plaintiff does not meet the standard
for preliminary injunctive relief.
Standard of Review
Plaintiff must established probable success on the merits
with respect to his claim of deliberate indifference to his
serious medical needs. Specifically, he must establish that
Defendants have acted with a sufficiently culpable state of
mind, that is, knowingly disregarding an excessive risk to
inmate health. See Farmer v. Brennan, 511 U.S. 825,
837 (1994). In support of their argument that Plaintiff has
not met his burden, Defendants rely upon Plaintiff's
medical records, which reveal as follows:
. . . after Dr. Wadhaw's consultation and nine months of
chronic care follow up, it because clear that the right leg
pain and symptoms, which prompted plaintiff's referral to
Dr. Wadhwa, were in fact due to plaintiff's chronic
ulcers and not his spine. Accordingly, the diagnostic tests
suggested by Dr. Wadhwa were not ordered.
Dkt. 35 at 1. As such, it seems that Defendants are arguing
that Plaintiff will not likely be successful on the merits of
his deliberate indifference to medical care lawsuit.
also seem to maintain that Plaintiff cannot show irreparable
injury justifying the relief sought in the form of ordering
medical staff to perform the diagnostic tests suggested by
Dr. Wadhwa. Dkt. 35 at 1-4. In their opposition to the
request for a preliminary injunction, Defendants show that
Plaintiff's medical evidence indicated that he received
appropriate pain management and medical care during the time
he received follow-up care from prison medical staff after
his October 29, 2015 consultation with Dr. Wadhwa, who
suggested “a new MRI of the lumbar spine, CT of the lumbar
spine and dynamic lumbar x-rays.” Id. (citing
Espinoza Decl. ¶ 27, Ex. A). Defendants then list an
explanation of Plaintiff's follow up care, which has been
summarized by the Court as follows:
November 5, 2015, - Chronic care follow up with Defendant
Espinoza, who suggested for Plaintiff to be classified as a
Disability Impaired Level Terrain (“DLT”) and
transferred to a level terrain facility. While Plaintiff was
initially resistant to such a suggestion, he agreed and was
“designated as ADA code DLT.” Plaintiff would be
transferred to another institution immediately, and therefore
Defendant Espinoza discussed with Plaintiff that he would be
given a follow-up appointment with a new neurosurgeon at his
new facility. Espinoza Decl. ¶ 28.
January 12, 2016 - Plaintiff submitted a Health Care Service
Request Form inquiring why his MRI, CT scan and dynamic
lumbar x-rays had not yet been ordered as suggested by Dr.
Wadhwa. Id. ¶ 32.
January 14, 2016 - Chronic care follow up with Defendant
Espinoza regarding skin lesions that had appeared three weeks
ago. A biopsy was performed and Plaintiff was given
prednisone. When Plaintiff inquired about his MRI, CR scan
and dynamic lumbar x-rays, Defendant Espinoza explained that
Plaintiff would soon be leaving SQSP for a level terrain
facility where he would defer to the new neurosurgeon if any
further imaging was indicated. Defendant Espinoza also noted
that Plaintiff had a recent MRI on August 11, 2015, .
Plaintiff was on a medical hold due to his dermatology issue,
and he indicated he preferred to stay at SQSP until his
lesions were resolved. Id. ¶ 13.
January 28, 2016 - Another chronic care follow up with
Defendant Espinoza regarding skin lesions. Plaintiff stated
that the lesions were getting better and he was not in pain
today. Defendant Espinoza discussed Plaintiff's
neurosurgery follow up, which was pending until his transfer.
Plaintiff requested to keep his medical hold until his
lesions had significantly resolved, and said that it was
alright holding off on his neurosurgery follow up. He claimed
that his pain had decreased and mobility issues had improved
in the last four to five weeks. Plaintiff was then referred
to see a local dermatologist. Id. ¶ 34.
May 2, 2016 - Plaintiff refused to be seen by Defendant
Espinoza for another chronic care follow up. Id.
May 3, 2016 - Defendant Espinoza discussed Plaintiff's
lesions with Dr. Mohebali at Kentfield Wound Care, and they
decided to start Plaintiff on antibiotics. Defendant Espinoza
made arrangements for Plaintiff to be seen in the clinic to
discuss the plan with him and to order the recommended
antibiotics. Plaintiff initially refused to be seen, but
later agreed to speak with Defendant Espinoza but explained
that he was upset because he was not given narcotics for his
right leg ulcers. Id. ¶ 36.
July 5, 2016 - Plaintiff was examined at Kentfield Wound Care
and UCSF dermatology, where he was receiving treatment for
his chronic leg ulcers (which have slowly improved).
Plaintiff reported that his back pain and related symptoms
have continued to improve significantly and that he was
walking the lower yard without any issue. Plaintiff refused
to be seen by Defendant Espinoza, who continued to
communicate with the specialists and coordinated
Plaintiff's treatment with Kentfield Wound Care and UCSF.
Defendant Espinoza claims that “[i]t became clear that
the right leg pain and symptoms which prompted
[Plaintiff's] referral to the second neurosurgeon, Dr.
Wadhwa, were in fact due to his skin condition (his lesion[s]
showed up shortly thereafter) and not his spine.”
Id. ¶ 37.
Id. (footnotes added). Based on the above findings,
the diagnostics tests suggested by Dr. Wadhwa were not
ordered. Id. at 4.
on the supporting evidence set forth by Defendants, the Court
finds that Plaintiff does not meet the requirements for
preliminary injunctive relief pending disposition of his
claims. Moreover, based on the record at this point, the
Court cannot say that he has shown probable success with
respect to his remaining allegations of deliberate
indifference. Accordingly, the request for a preliminary
injunction is DENIED. Dkt. 28.
MOTION FOR SUMMARY JUDGMENT
time of the events set forth in his complaint, Plaintiff was
a state prisoner who was incarcerated at SQSP. See
Dkt. 1 at 1; Dkt. 38-1 at 1. Also during the time frame at
issue, Defendants Reyes and Espinoza were Primary Care
Physicians (“PCPs”) at SQSP. Reyes Decl. ¶
1; Espinoza Decl. ¶ 1. Finally, as mentioned above,
Defendant Tootell was the CMO at SQSP. Dkt 1 at 2.
claims that he was transferred to SQSP on December 8, 2009.
Dkt. 1 at 4. He mentioned his back issues at his health
assessment upon his arrival at SQSP. Id.
claims that at his initial consultation with Defendant Reyes,
he requested a lower bunk due to his back pain. Id.
at 5. Plaintiff claims that Defendant Reyes told Plaintiff
that he “needed to do core strengthening for [his] back
pain.” Id. Plaintiff claims he explained that
he had previously had an MRI, which “showed [his] L-4
and L-5 [were] messed up.” Id. Plaintiff
claims that his medical records arrived at SQSP four months
after his transfer, and they “showed [his] back issues
like [he] had been saying all alon[g], yet [Defendant Reyes]
did nothing to accommodate [him] . . . .” Id.
at 6. Plaintiff claims that his “condition exacerbated
because of [Defendant Reyes's] negligen[ce].”
claims that he “started seeing [Defendant] Espinoza and
other doctor[s] ¶ 2014.” Id. at 7. He
states that “the medical care they provided [for his]
back issues amounted to no medical care at all.”
Id. at 7. Plaintiff claims that he was admitted to
the Outpatient Housing Unit (CDCR's equivalent to an
infirmary) on April 17, 2014 because he could no longer
walk and required a wheelchair to move around. Id.
at 7-8, 23. However, Plaintiff claims that Defendant Espinoza
should have made the decision to have Plaintiff admitted at
the Outpatient Housing Unit (“OHU”) on an
earlier date. Id. at 8.
Plaintiff claims that he was admitted at the OHU from April
17, 2014 until July 16, 2014, and that he needed a wheelchair
because he could not walk. Id.
20, 2014, Plaintiff claims that he underwent “urgent
emergency back surgery” by Dr. T. Mampalan (a
non-party). Id. However, Plaintiff claims that he
initially “thought [he] was getting better but [he
went] through the same issues with medical as [he] did prior
to [his] back surgery.” Id. at 8-9. Plaintiff
claims that Defendant Espinoza “assured [him] that if
[his] MRI showed a negative finding she'd refer [him] to
a different neurosurgeon for [a] second opinion.”
Id. at 9. However, Plaintiff claims that
“every time [he] ask[s] about that or any other
accommodation [Defendant Espinoza] interjects the threat of
Plaintiff points out that Defendant Tootell is the CMO at
SQSP, but she “does nothing to assert her authority to
approve or arrange any accommodations in a timely
fashion.” Id. at 10.
Treatment By Defendant Reyes
March 3, 2010, Defendant Reyes examined Plaintiff for the
first time after his December 8, 2009 transfer from
CSP-Solano. Reyes Decl. ¶ 4. Plaintiff's main
complaint was low back pain, which persisted for over four
years. Id. Plaintiff claims he could do his daily
activities without problems and had “good overall
function.” Id. Plaintiff walked with a normal
steady gait and was able to get up from sitting without