stating that “[w]ithdrawal is a serious and potentially 5 deadly medical condition, with symptoms including seizures, hallucinations, agitation and 6 increased blood pressure.”
How later courts described this case
- stating that “[w]ithdrawal is a serious and potentially 5 deadly medical condition, with symptoms including seizures, hallucinations, agitation and 6 increased blood pressure.”
- “[A] judge may dismiss [in forma pauperis] claims which are based on indisputably 18 meritless legal theories or whose factual contentions are clearly baseless.”
Written by the judges who cited it.
The opinion
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8 UNITED STATES DISTRICT COURT
9 FOR THE EASTERN DISTRICT OF CALIFORNIA
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11 LARRY WILLIAM CORTINAS, No. 2:23-cv-00285-CKD P
12 Plaintiff,
13 v. ORDER
14 N. IKEGBU, et al.,
15 Defendants.
16
17 Plaintiff is a state prisoner and is proceeding without counsel. Plaintiff seeks relief
18 pursuant to 42 U.S.C. § 1983 and requested leave to proceed in forma pauperis pursuant to 28
19 U.S.C. § 1915. This proceeding was referred to this court pursuant to 28 U.S.C. § 636(b)(1) and
20 Local Rule 302.
21 Plaintiff submitted a declaration that makes the showing required by 28 U.S.C. § 1915(a).
22 Accordingly, the request to proceed in forma pauperis is granted.
23 Plaintiff is required to pay the statutory filing fee of $350.00 for this action. 28 U.S.C.
24 §§ 1914(a), 1915(b)(1). By this order, plaintiff is assessed an initial partial filing fee in
25 accordance with the provisions of 28 U.S.C. § 1915(b)(1). By separate order, the court will direct
26 the appropriate agency to collect the initial partial filing fee from plaintiff’s trust account and
27 forward it to the Clerk of the Court. Thereafter, plaintiff will be obligated to make monthly
28 payments of twenty percent of the preceding month’s income credited to plaintiff’s prison trust
1 account. These payments will be forwarded by the appropriate agency to the Clerk of the Court
2 each time the amount in plaintiff’s account exceeds $10.00, until the filing fee is paid in full. 28
3 U.S.C. § 1915(b)(2).
4 I. Screening Requirement
5 The court is required to screen complaints brought by prisoners seeking relief against a
6 governmental entity or officer or employee of a governmental entity. 28 U.S.C. § 1915A(a). The
7 court must dismiss a complaint or portion thereof if the prisoner raised claims that are legally
8 “frivolous or malicious,” that fail to state a claim upon which relief may be granted, or that seek
9 monetary relief from a defendant who is immune from such relief. 28 U.S.C. § 1915A(b)(1), (2).
10 A claim is legally frivolous when it lacks an arguable basis either in law or in fact.
11 Neitzke v. Williams, 490 U.S. 319, 325 (1989); Franklin v. Murphy, 745 F.2d 1221, 1227-28 (9th
12 Cir. 1984). The court may, therefore, dismiss a claim as frivolous when it is based on an
13 indisputably meritless legal theory or where the factual contentions are clearly baseless. Neitzke,
14 490 U.S. at 327. The critical inquiry is whether a constitutional claim, however inartfully
15 pleaded, has an arguable legal and factual basis. See Jackson v. Arizona, 885 F.2d 639, 640 (9th
16 Cir. 1989), superseded by statute as stated in Lopez v. Smith, 203 F.3d 1122, 1130-31 (9th Cir.
17 2000) (“[A] judge may dismiss [in forma pauperis] claims which are based on indisputably
18 meritless legal theories or whose factual contentions are clearly baseless.”); Franklin, 745 F.2d at
19 1227.
20 Rule 8(a)(2) of the Federal Rules of Civil Procedure “requires only ‘a short and plain
21 statement of the claim showing that the pleader is entitled to relief,’ in order to ‘give the
22 defendant fair notice of what the . . . claim is and the grounds upon which it rests.’” Bell Atlantic
23 Corp. v. Twombly, 550 U.S. 544, 555 (2007) (quoting Conley v. Gibson, 355 U.S. 41, 47 (1957)).
24 In order to survive dismissal for failure to state a claim, a complaint must contain more than “a
25 formulaic recitation of the elements of a cause of action;” it must contain factual allegations
26 sufficient “to raise a right to relief above the speculative level.” Id. However, “[s]pecific facts
27 are not necessary; the statement [of facts] need only ‘give the defendant fair notice of what the . .
28 . claim is and the grounds upon which it rests.’” Erickson v. Pardus, 551 U.S. 89, 93 (2007)
1 (quoting Bell Atlantic Corp., 550 U.S. at 555) (citations and internal quotations marks omitted).
2 In reviewing a complaint under this standard, the court must accept as true the allegations of the
3 complaint in question, id., and construe the pleading in the light most favorable to the plaintiff.
4 Scheuer v. Rhodes, 416 U.S. 232, 236 (1974), overruled on other grounds, Davis v. Scherer, 468
5 U.S. 183 (1984).
6 II. Allegations in the Complaint
7 At all times relevant to the allegations in the complaint, plaintiff was an inmate at the
8 California Medical Facility (“CMF”). Plaintiff sues four health care officials employed at CMF
9 as well as the Chief Appeals Officer for California Correctional Health Care Services.
10 In his first claim for relief, plaintiff alleges that defendants Ikegbu, Osman, and Patterson
11 have deliberately delayed and denied him needed surgery and pain medication since January 7,
12 2022. In support of this claim, plaintiff attaches a medical report from Dr. Moris Senegor of San
13 Joaquin General Hospital who recommended cervical disc arthroplastic surgery for plaintiff
14 following his examination on November 15, 2021. ECF No. 1 at 13-15. In a follow-up exam on
15 March 14, 2022, Dr. Senegor continued to recommend this same surgery as well as an increase in
16 plaintiff’s morphine dose and the addition of baclofen to his pain management regimen. ECF No.
17 1 at 9-11. Defendants Ikegbu, Osman, and Patterson did not obtain any contrary medical
18 opinions nor did they personally examine plaintiff before they denied him these necessary
19 medical services. Plaintiff further alleges that defendant Haile denied him a follow-up visit with
20 Dr. Senegor and also reduced and then entirely stopped his morphine and baclofen prescriptions
21 for pain contrary to the specialist’s recommended treatment. Plaintiff contends that defendant
22 Gates failed to correct any of these actions when responding to plaintiff’s health care grievances.
23 In his second claim for relief, plaintiff alleges that defendants Ikegbu, Osman, Gates, and
24 Patterson refused to submit Dr. Senegor’s report to medical headquarters to get approval for the
25 recommended surgery. ECF No. 1 at 6. Defendants failed to act in order to keep plaintiff in
26 constant pain so that he would commit suicide and thereby end all of his litigation against CDCR.
27 ECF No. 1 at 6. According to plaintiff, this amounted to retaliation.
28 As a result of defendants’ failure to treat plaintiff in accordance with Dr. Senegor’s
1 reports, plaintiff has suffered increased pain, a loss of bowel functions, and he can no longer walk
2 or write. By way of relief, plaintiff seeks compensatory and punitive damages.
3 III. Legal Standards
4 The following legal standards are being provided to plaintiff based on his pro se status as
5 well as the nature of the allegations in his complaint.
6 A. Linkage
7 The civil rights statute requires that there be an actual connection or link between the
8 actions of the defendants and the deprivation alleged to have been suffered by plaintiff. See
9 Monell v. Department of Social Services, 436 U.S. 658 (1978); Rizzo v. Goode, 423 U.S. 362
10 (1976). The Ninth Circuit has held that “[a] person ‘subjects' another to the deprivation of a
11 constitutional right, within the meaning of section 1983, if he does an affirmative act, participates
12 in another's affirmative acts or omits to perform an act which he is legally required to do that
13 causes the deprivation of which complaint is made.” Johnson v. Duffy, 588 F.2d 740, 743 (9th
14 Cir. 1978) (citation omitted). In order to state a claim for relief under section 1983, plaintiff must
15 link each named defendant with some affirmative act or omission that demonstrates a violation of
16 plaintiff's federal rights.
17 B. Deliberate Indifference to a Serious Medical Need
18 Denial or delay of medical care for a prisoner’s serious medical needs may constitute a
19 violation of the prisoner’s Eighth and Fourteenth Amendment rights. Estelle v. Gamble, 429 U.S.
20 97, 104-05 (1976). An individual is liable for such a violation only when the individual is
21 deliberately indifferent to a prisoner’s serious medical needs. Id.; see Jett v. Penner, 439 F.3d
22 1091, 1096 (9th Cir. 2006); Hallett v. Morgan, 296 F.3d 732, 744 (9th Cir. 2002); Lopez v.
23 Smith, 203 F.3d 1122, 1131-32 (9th Cir. 2000).
24 In the Ninth Circuit, the test for deliberate indifference consists of two parts. Jett, 439
25 F.3d at 1096, citing McGuckin v. Smith, 974 F.2d 1050 (9th Cir. 1991), overruled on other
26 grounds by WMX Techs., Inc. v. Miller, 104 F.3d 1133 (9th Cir. 1997) (en banc). First, the
27 plaintiff must show a “serious medical need” by demonstrating that “failure to treat a prisoner’s
28 condition could result in further significant injury or the ‘unnecessary and wanton infliction of
1 pain.’” Id., citing Estelle, 429 U.S. at 104. Drug withdrawal constitutes a serious medical need
2 requiring appropriate medical care under the Eighth Amendment. See Pajas v. Cty. of Monterey,
3 2016 WL 3648686, at *10 (N.D. Cal. July 8, 2016); see also Hernandez v. Cty. of Monterey, 110
4 F.Supp.3d 929, 948 (N.D. Cal. 2015) (stating that “[w]ithdrawal is a serious and potentially
5 deadly medical condition, with symptoms including seizures, hallucinations, agitation and
6 increased blood pressure.”); Foelker v. Outagamie Cty., 394 F.3d 510, 513 (7th Cir. 2005)
7 (finding opiate withdrawal amounts to a serious medical need). Other “[e]xamples of serious
8 medical needs include ‘[t]he existence of an injury that a reasonable doctor or patient would find
9 important and worthy of comment or treatment; the presence of a medical condition that
10 significantly affects an individual’s daily activities; or the existence of chronic and substantial
11 pain.’” Lopez, 203 F. 3d at 1131-1132, citing McGuckin, 974 F.2d at 1059-60.
12 Second, the plaintiff must show the defendant’s response to the need was deliberately
13 indifferent. Jett, 439 F.3d at 1096. This second prong is satisfied by showing (a) a purposeful act
14 or failure to respond to a prisoner’s pain or possible medical need and (b) harm caused by the
15 indifference. Id. Under this standard, the prison official must not only “be aware of facts from
16 which the inference could be drawn that a substantial risk of serious harm exists,” but that person
17 “must also draw the inference.” Farmer v. Brennan, 511 U.S. 825, 837 (1994). This “subjective
18 approach” focuses only “on what a defendant’s mental attitude actually was.” Id. at 839. A
19 showing of merely negligent medical care is not enough to establish a constitutional violation.
20 Frost v. Agnos, 152 F.3d 1124, 1130 (9th Cir. 1998), citing Estelle, 429 U.S. at 105-106. A
21 difference of opinion about the proper course of treatment is not deliberate indifference, nor does
22 a dispute between a prisoner and prison officials over the necessity for or extent of medical
23 treatment amount to a constitutional violation. See, e.g., Toguchi v. Chung, 391 F.3d 1051, 1058
24 (9th Cir. 2004); Sanchez v. Vild, 891 F.2d 240, 242 (9th Cir. 1989). Furthermore, mere delay of
25 medical treatment, “without more, is insufficient to state a claim of deliberate medical
26 indifference.” Shapley v. Nev. Bd. of State Prison Comm’rs, 766 F.2d 404, 407 (9th Cir. 1985).
27 Where a prisoner alleges that delay of medical treatment evinces deliberate indifference, the
28 prisoner must show that the delay caused “significant harm and that Defendants should have
1 known this to be the case.” Hallett, 296 F.3d at 745-46; see McGuckin, 974 F.2d at 1060.
2 C. Inmate Grievances
3 The existence of a prison grievance procedure establishes a procedural right only and
4 “does not confer any substantive right upon the inmates.” Buckley v. Barlow, 997 F.2d 494, 495
5 (8th Cir. 1993) (citation omitted); see also Ramirez v. Galaza, 334 F.3d 850, 860 (9th Cir. 2003)
6 (no liberty interest in processing of appeals because no entitlement to a specific grievance
7 procedure). This means that a prison official’s action in reviewing an inmate grievance cannot
8 serve as a basis for liability under Section 1983. Buckley, 997 F.2d at 495. “Only persons who
9 cause or participate in the violations are responsible. Ruling against a prisoner on an
10 administrative complaint does not cause or contribute to the violation. A guard who stands and
11 watches while another guard beats a prisoner violates the Constitution; a guard who rejects an
12 administrative complaint about a completed act of misconduct does not.” George v. Smith, 507
13 F.3d 605, 609-10 (7th Cir. 2007) (citations omitted).
14 D. Retaliation
15 “Within the prison context, a viable claim of First Amendment retaliation entails five
16 basic elements: (1) An assertion that a state actor took some adverse action against an inmate (2)
17 because of (3) that prisoner's protected conduct, and that such action (4) chilled the inmate's
18 exercise of his First Amendment rights, and (5) the action did not reasonably advance a legitimate
19 correctional goal. Rhodes v. Robinson, 408 F.3d 559 567-68 (9th Cir. 2005) (citations omitted).
20 Filing an inmate grievance is a protected action under the First Amendment. Bruce v. Ylst, 351
21 F.3d 1283, 1288 (9th Cir. 2003). The plaintiff bears the burden of pleading and proving the
22 absence of legitimate correctional goals for the conduct of which he complains. Pratt v. Rowland,
23 65 F.3d 802, 806 (9th Cir. 1995).
24 Also, in order to state a claim for retaliation, plaintiff must point to facts indicating a
25 causal connection between the adverse action and the protected conduct. Watison v. Carter, 668
26 F.3d 1108, 1114 (9th Cir. 2012).
27 E. Civil Conspiracy
28 To state a claim for conspiracy under 42 U.S.C. § 1983, plaintiff must plead specific facts
1 showing an agreement or meeting of minds between the defendants to violate his constitutional
2 rights. Woodrum v. Woodward Cty., 866 F.2d 1121, 1126 (9th Cir. 1989). Plaintiff must also
3 show how an actual deprivation of his constitutional rights resulted from the alleged conspiracy.
4 Id. “‘To be liable, each participant in the conspiracy need not know the exact details of the plan,
5 but each participant must at least share the common objective of the conspiracy.’” Franklin v.
6 Fox, 312 F.3d 423, 441 (9th Cir. 2002) (quoting United Steel Workers of Am. V. Phelps Dodge
7 Corp., 865 F.2d 1539, 1541 (9th Cir. 1989)).
8 IV. Analysis
9 The court has reviewed plaintiff’s complaint and, for the limited purposes of § 1915A
10 screening, finds that it states a cognizable claim Eighth Amendment deliberate indifference claim
11 against defendants Ikegbu, Osman, Patterson, and Haile. See 28 U.S.C. § 1915A. However, the
12 court finds that the complaint does not state a cognizable claim against defendant Gates as the
13 appeals officer who responded to plaintiff’s health care grievance. See George v. Smith, 507 F.3d
14 605, 609-10 (7th Cir. 2007). Additionally, plaintiff’s passing reference to a civil conspiracy
15 amongst the defendants is entirely conclusory. Plaintiff has not alleged any specific facts
16 showing an agreement or meeting of the minds between the defendants to violate his
17 constitutional rights. Woodrum v. Woodward Cty., 866 F.2d 1121, 1126 (9th Cir. 1989). As a
18 result, the court finds that the conspiracy allegations fail to state a cognizable claim against
19 defendants. Based on these deficiencies with the remaining claims and defendant, plaintiff may
20 choose to proceed immediately on the Eighth Amendment deliberate indifference claims against
21 defendants Ikegbu, Osman, Patterson, and Haile, or he may attempt to cure these defects by filing
22 a first amended complaint. See Lopez v. Smith, 203 F.3d 1122, 1126–27 (9th Cir. 2000) (en banc)
23 (finding that district courts must afford pro se litigants an opportunity to amend to correct any
24 deficiency in their complaints). If plaintiff elects to proceed against defendants Ikegbu, Osman,
25 Patterson, and Haile, the court will construe plaintiff’s election as consent to dismiss defendant
26 Gates as well as the purported conspiracy claims without prejudice pursuant to Rule 41(a) of the
27 Federal Rules of Civil Procedure.
28 /////
1 V. Leave to Amend
2 If plaintiff chooses to amend the complaint, plaintiff must demonstrate how the conditions
3 complained of have resulted in a deprivation of plaintiff’s constitutional rights. See Ellis v.
4 Cassidy, 625 F.2d 227 (9th Cir. 1980). Also, in his amended complaint, plaintiff must allege in
5 specific terms how each named defendant is involved. There can be no liability under 42 U.S.C.
6 § 1983 unless there is some affirmative link or connection between a defendant’s actions and the
7 claimed deprivation. Rizzo v. Goode, 423 U.S. 362 (1976). Furthermore, vague and conclusory
8 allegations of official participation in civil rights violations are not sufficient. Ivey v. Board of
9 Regents, 673 F.2d 266, 268 (9th Cir. 1982).
10 Finally, plaintiff is informed that the court cannot refer to a prior pleading in order to
11 make plaintiff’s amended complaint complete. Local Rule 220 requires that an amended
12 complaint be complete in itself without reference to any prior pleading. This is because, as a
13 general rule, an amended complaint supersedes the original complaint. See Loux v. Rhay, 375
14 F.2d 55, 57 (9th Cir. 1967). Once plaintiff files an amended complaint, the original pleading no
15 longer serves any function in the case. Therefore, in an amended complaint, as in an original
16 complaint, each claim and the involvement of each defendant must be sufficiently alleged.
17 V. Plain Language Summary for Pro Se Party
18 The following information is meant to explain this order in plain English and is not
19 intended as legal advice.
20 Some of the allegations in the complaint state claims for relief against the defendants, and
21 some do not. You must decide if you want to (1) proceed immediately on the Eighth Amendment
22 deliberate indifference claims against defendants Ikegbu, Osman, Patterson, and Haile; or, 2)
23 amend the complaint to fix the problems identified in this order with respect to the remaining
24 claims and defendants. Once you decide, you must complete the attached Notice of Election
25 form by checking only one box and returning it to the court.
26 Once the court receives the Notice of Election, it will issue an order telling you what you
27 need to do next. If you do not return this Notice, the court will order service of the complaint
28 only on the claims found cognizable in this screening order and will dismiss the remaining claims
1 | and defendant without prejudice pursuant to Rule 41(a) of the Federal Rules of Civil Procedure.
2 Accordingly, IT IS HEREBY ORDERED that:
3 1. Plaintiffs motion for leave to proceed in forma pauperis (ECF No. 7) is granted.
4 2. Plaintiff is obligated to pay the statutory filing fee of $350.00 for this action. Plaintiff
5 || is assessed an initial partial filing fee in accordance with the provisions of 28 U.S.C.
6 || § 1915(b)(1). All fees shall be collected and paid in accordance with this court’s order to the
7 || Director of the California Department of Corrections and Rehabilitation filed concurrently
8 | herewith.
9 3. Plaintiff has the option to proceed immediately on the Eighth Amendment deliberate
10 || indifference claims against defendants Ikegbu, Osman, Patterson, and Haile. In the alternative,
11 | plaintiff may choose to amend the complaint to fix the deficiencies identified in this order with
12 || respect to the remaining claims and defendant.
13 4. Within 21 days from the date of this order, plaintiff shall complete and return the
14 || attached Notice of Election form notifying the court whether he wants to proceed on the screened
15 || complaint or whether he wants time to file a first amended complaint.
16 5. If plaintiff elects to proceed against defendants Ikegbu, Osman, Patterson, and Haile,
17 || the court will construe plaintiffs election as consent to dismiss defendant Gates as well as the
18 || purported conspiracy claims without prejudice pursuant to Rule 41(a) of the Federal Rules of
19 | Civil Procedure.
20 6. If plaintiff fails to return the attached Notice of Election within the time provided, the
21 || court will construe this failure as consent to dismiss the deficient claims and proceed only on the
22 || cognizable claims identified above.
23 || Dated: May 1, 2023 / hice
fr fA. ?
CAROLYNK.DELANEY
25 UNITED STATES MAGISTRATE JUDGE
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28 12/cort0285.140ption
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8 UNITED STATES DISTRICT COURT
9 FOR THE EASTERN DISTRICT OF CALIFORNIA
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11 LARRY WILLIAM CORTINAS, No. 2:23-cv-00285-CKD
12 Plaintiff,
13 v. NOTICE OF ELECTION
14 N. IKEGBU, et al.,
15 Defendants.
16
17 Check only one option:
18 _____ Plaintiff wants to proceed immediately on the Eighth Amendment deliberate indifference
19 claims against defendants Ikegbu, Osman, Patterson, and Haile. Plaintiff voluntarily dismisses
20 the remaining claims and defendant; or
21 _____ Plaintiff wants time to file a first amended complaint.
22
23 DATED:
24 _______________________________
Plaintiff
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