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Giles v. Reyes

United States District Court, N.D. California

August 31, 2017

OSSIE GILES, Plaintiff,
D. REYES, et al., Defendants.


          YVONNE GONZALEZ ROGERS, United States District Judge

         I. BACKGROUND

         Plaintiff 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.[1] 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.

         In an 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 follows:

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.

         The 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.

         Plaintiff has also filed a motion for a preliminary injunction, to which Defendants have filed a response. Dkts. 28, 35.

         For the reasons stated below, Plaintiff's motion for a preliminary injunction is DENIED, and Defendants' motion for summary judgment is GRANTED.


         Plaintiff 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.

         A. Standard of Review

         The 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.

         Federal 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).

         B. Defendants' Arguments

         In 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.

         1. Standard of Review

         First, 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.

         2. Irreparable Injury

         Defendants 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[2] of the lumbar spine, CT[3] 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[4] 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. ¶ 35.
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.

         3. Conclusion

         Based 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.


         A. Factual Background[5]

         1. The Parties

         At the 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.

         2. Plaintiff's Version

         Plaintiff 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.

         Plaintiff 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].” Id.

         Plaintiff 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)[6] on April 17, 2014[7] 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.

         On May 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 transfer.” Id.

         Finally, 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.

         3. Defendants' Version

         a. Treatment By Defendant Reyes

         On 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 ...

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