prisoner alleging deliberate indifference 27 based on delay in treatment must show delay led to further injury
How later courts described this case
- prisoner alleging deliberate indifference 27 based on delay in treatment must show delay led to further injury
- “A pro se litigant must be given leave 24 to amend his or her complaint, and some notice of its deficiencies, unless it is absolutely clear that 25 the deficiencies of the complaint could not be cured by amendment”
Written by the judges who cited it.
The opinion
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8 UNITED STATES DISTRICT COURT
9 EASTERN DISTRICT OF CALIFORNIA
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11 RONALD WILLIAM WARD, Case No. 1:21-cv-00929-KES-SKO (PC)
12 Plaintiff, FINDINGS AND RECOMMENDATIONS TO
DISMISS CERTAIN CLAIMS FOLLOWING
13 v.
SCREENING
14 S. BATRA, et al.,
(Doc. 31)
15 Defendants.
14-DAY OBJECTION PERIOD
16
17 Plaintiff Ronald William Ward is a civil detainee proceeding pro se and in forma pauperis
18 in this civil rights action pursuant to 42 U.S.C. § 1983.
19 I. BACKGROUND
20 On November 14, 2023, after screening Plaintiff’s second amended complaint, the Court
21 issued “Findings and Recommendations to Dismiss this Action for Failure to State a Claim Upon
22 Which Relief Can Be Granted.” (Doc. 27.) Following objections by Plaintiff in which he
23 apologized “for his errors in following” instructions, the Court issued its “Order Vacating
24 Findings and Recommendations to Dismiss for a Failure to State a Claim Upon Which Relief Can
25 Be Granted; Order Directing Clerk of the Court to File Third Amended Complaint.” (Doc. 30.)
26 The Court now screens Plaintiff’s third amended complaint.
27 //
1 II. SCREENING REQUIREMENT
2 The Court is required to screen complaints brought by prisoners seeking relief against a
3 governmental entity or an officer or employee of a governmental entity. 28 U.S.C. § 1915A(a).
4 The Court must dismiss a complaint or portion thereof if the complaint is frivolous or malicious,
5 fails to state a claim upon which relief may be granted, or seeks monetary relief from a defendant
6 who is immune from such relief. 28 U.S.C. § 1915A(b). The Court should dismiss a complaint if
7 it lacks a cognizable legal theory or fails to allege sufficient facts to support a cognizable legal
8 theory. See Balistreri v. Pacifica Police Dep’t, 901 F.2d 696, 699 (9th Cir. 1990).
9 III. PLEADING REQUIREMENTS
10 A. Federal Rule of Civil Procedure 8(a)
11 “Rule 8(a)’s simplified pleading standard applies to all civil actions, with limited
12 exceptions.” Swierkiewicz v. Sorema N.A., 534 U.S. 506, 513 (2002). A complaint must contain
13 “a short and plain statement of the claims showing that the pleader is entitled to relief.” Fed. R.
14 Civ. P. 8(a)(2). “Such a statement must simply give the defendant fair notice of what the
15 plaintiff’s claim is and the grounds upon which it rests.” Swierkiewicz, 534 U.S. at 512 (internal
16 quotation marks & citation omitted).
17 Detailed factual allegations are not required, but “[t]hreadbare recitals of the elements of a
18 cause of action, supported by mere conclusory statements, do not suffice.” Ashcroft v. Iqbal, 556
19 U.S. 662, 678 (2009) (citing Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007)). Plaintiff must
20 set forth “sufficient factual matter, accepted as true, to ‘state a claim that is plausible on its face.’”
21 Id. (quoting Twombly, 550 U.S. at 570). Factual allegations are accepted as true, but legal
22 conclusions are not. Id. (citing Twombly, 550 U.S. at 555).
23 The Court construes pleadings of pro se prisoners liberally and affords them the benefit of
24 any doubt. Hebbe v. Pliler, 627 F.3d 338, 342 (9th Cir. 2010) (citation omitted). However, “the
25 liberal pleading standard . . . applies only to a plaintiff’s factual allegations,” not his legal
26 theories. Neitzke v. Williams, 490 U.S. 319, 330 n.9 (1989). Furthermore, “a liberal interpretation
27 of a civil rights complaint may not supply essential elements of the claim that were not initially
1 quotation marks & citation omitted), and courts “are not required to indulge unwarranted
2 inferences.” Doe I v. Wal-Mart Stores, Inc., 572 F.3d 677, 681 (9th Cir. 2009) (internal quotation
3 marks & citation omitted). The “sheer possibility that a defendant has acted unlawfully” is not
4 sufficient to state a cognizable claim, and “facts that are merely consistent with a defendant’s
5 liability” fall short. Iqbal, 556 U.S. at 678 (internal quotation marks & citation omitted).
6 B. Linkage and Causation
7 Section 1983 provides a cause of action for the violation of constitutional or other federal
8 rights by persons acting under color of state law. See 42 U.S.C. § 1983. To state a claim under
9 section 1983, a plaintiff must show a causal connection or link between the actions of the
10 defendants and the deprivation alleged to have been suffered by the plaintiff. See Rizzo v. Goode,
11 423 U.S. 362, 373-75 (1976). The Ninth Circuit has held that “[a] person ‘subjects’ another to the
12 deprivation of a constitutional right, within the meaning of section 1983, if he does an affirmative
13 act, participates in another’s affirmative acts, or omits to perform an act which he is legal required
14 to do that causes the deprivation of which complaint is made.” Johnson v. Duffy, 588 F.2d 740,
15 743 (9th Cir. 1978) (citation omitted).
16 IV. DISCUSSION
17 A. Plaintiff’s Third Amended Complaint
18 Plaintiff names Sanjeev Batra, an osteopathic physician and surgeon at Coalinga State
19 Hospital, as Defendant in this action. (Doc. 31 at 1-2.) Plaintiff includes 36 pages of
20 correspondence, complaint forms, health care directives, and health care related documentation,
21 as Exhibit A (id. at 9-45), and 3 pages of what appear to be notices directed to officials at
22 Coalinga State Hospital advising them of the filing of this action as Exhibit B (id. at 52-54), in
23 support of his complaint. Plaintiff seeks to have “Doctor Batra fired as a State of California
24 doctor and his [licenses] to treat patients in the United States of America stripped for as he lives.”
25 (Id. at 46.) Plaintiff also seeks Medi-Cal and Medi-Care benefits “for life,” his legal fees and
26 costs, and compensatory damages of $8,500,000 and punitive damages totaling $204,000,000,
27 plus any interest. (Id. at 47.) Finally, Plaintiff requests “permission to notify Doctor Batra, and the
1 courts permission to place a [lien] against the Department of State Hospital-Coalinga’s bond.”
2 (Id.)
3 B. Plaintiff’s Factual Allegations1
4 Plaintiff contends that on August 28, 2020, Defendant Batra informed him that blood test
5 results revealed Plaintiff had “thickening of the blood.” (Doc. 31 at 6.) Plaintiff states he had
6 complained of numbness and a tingling sensation in both feet that worsened later in the day. (Id.)
7 Plaintiff contends the doctor “completely ignored” Plaintiff’s inquiry about “why his left foot was
8 discoloring.” (Id.) On November 14, 2020, Plaintiff began experiencing excruciating stabbing
9 pain in his feet. (Id.) Despite being on the sick call list until November 20 or 21, 2020, Plaintiff
10 was unable to see Batra. (Id.) On November 27, 2020, a licensed psychiatric technician “verified
11 the worsening of [his] serious medical condition,” noting Plaintiff’s entire left foot “was turning
12 purple and black and blue and the big and little toe had turned completely black.” (Id.) Plaintiff
13 was provided a wheelchair. (Id.) That same date, Batra was notified of Plaintiff’s condition, but
14 refused to see Plaintiff. (Id.) Plaintiff alleges he complained of excruciating pain and an inability
15 to eat, sleep, or walk to psychiatric technicians, and was again ignored by Batra. (Id.) He states
16 Batra refused to see him on December 5, 2020. (Id.) Plaintiff alleges that on December 8, 2020,
17 another licensed psychiatric technician “became loudly verbally aggressive towards” Batra,
18 demanding the doctor immediately examine Plaintiff’s left foot. (Id.) Plaintiff states Batra
19 “presumed [he] was malingering.” (Id. at 7.) Plaintiff alleges Batra could have examined his left
20 foot with a stethoscope to listen to the affected area, “easily [verifying] the lack of blood flow,” or
21 ordered an ultrasound, that would have saved Plaintiff from amputation. (Id.)
22 Plaintiff contends that on December 8, 2020, Batra “yielded to [] demands,” looked at
23 Plaintiff’s left foot and “gasped and immediately said [Plaintiff needed to be transported to”
24 Community Regional Medical Center (CRMC) in Fresno. (Doc. 31 at 4, 5.) Doctors examined
25 Plaintiff’s left foot, ran tests, and recommended amputation of his left leg at the knee. (Id. at 5.)
26 Plaintiff states those doctors were in a race to save his left foot. (Id.) The treating physician at
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1 Although the facts were not asserted in chronological order, the Court has attempted to summarize the
1 CRMC informed Plaintiff that to save his life, his left leg had to be amputated “from the shin
2 down” due to the onset of “gangrene caused by the lack of blood flow” and clotting. (Id.)
3 Plaintiff states that Batra’s actions amount to cruel and unusual punishment and
4 intentional deliberate indifference to serious medical needs. (Doc. 31 at 5.) Plaintiff contends
5 Batra refused to examine his left foot for days, “until it exacerbated to such a putrid state it had to
6 be amputated” to save his life. (Id.) Plaintiff states the lingering pain was torture. (Id.)
7 Plaintiff identifies his injuries as “left leg amputated from left shin down, unnecessary
8 extreme pain and suffering and lingering torture for over 180 days.” (Doc. 31 at 48.)
9 C. Plaintiff’s Claims
10 The Court construes Plaintiff’s third amended complaint to assert an Eighth Amendment
11 deliberate indifference to serious medical needs claim.
12 Prison officials violate the Eighth Amendment if they are “deliberate[ly] indifferen[t] to [a
13 prisoner’s] serious medical needs.” Estelle v. Gamble, 429 U.S. 97, 104 (1976). “A medical need
14 is serious if failure to treat it will result in ‘“significant injury or the unnecessary and wanton
15 infliction of pain.”’” Peralta v. Dillard, 744 F.3d 1076, 1081-82 (9th Cir. 2014) (quoting Jett v.
16 Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) (quoting McGuckin v. Smith, 974 F.2d 1050, 1059
17 (9th Cir. 1992), overruled on other grounds by WMX Techs., Inc. v. Miller, 104 F.3d 1133 (9th
18 Cir. 1997) (en banc)).
19 To maintain an Eighth Amendment claim based on medical care in prison, a plaintiff must
20 first “show a serious medical need by demonstrating that failure to treat a prisoner’s condition
21 could result in further significant injury or the unnecessary and wanton infliction of pain. Second,
22 the plaintiff must show the defendants’ response to the need was deliberately indifferent.”
23 Wilhelm v. Rotman, 680 F.3d 1113, 1122 (9th Cir. 2012) (quoting Jett, 439 F.3d at 1096
24 (quotation marks omitted)).
25 As to the first prong, indications of a serious medical need “include the existence of an
26 injury that a reasonable doctor or patient would find important and worthy of comment or
27 treatment; the presence of a medical condition that significantly affects an individual’s daily
1 1066 (9th Cir. 2014) (citation & internal quotation marks omitted); accord Wilhelm, 680 F.3d at
2 1122; Lopez v. Smith, 203 F.3d 1122, 1131 (9th Cir. 2000) (“Examples of serious medical needs
3 include ‘[t]he existence of an injury that a reasonable doctor or patient would find important and
4 worthy of comment or treatment; the presence of a medical condition that significantly affects an
5 individual’s daily activities; or the existence of chronic and substantial pain”).
6 As to the second prong, deliberate indifference is “a state of mind more blameworthy than
7 negligence” and “requires ‘more than ordinary lack of due care for the prisoner’s interests or
8 safety.’” Farmer v. Brennan, 511 U.S. 825, 835 (1994) (quoting Whitley v. Albers, 475 U.S. 312,
9 319 (1986)). Deliberate indifference is shown where a prison official “knows that inmates face a
10 substantial risk of serious harm and disregards that risk by failing to take reasonable measures to
11 abate it.” Id. at 847. In medical cases, this requires showing: (a) a purposeful act or failure to
12 respond to a prisoner’s pain or possible medical need and (b) harm caused by the indifference.
13 Wilhelm, 680 F.3d at 1122 (quoting Jett, 439 F.3d at 1096). “A prisoner need not show his harm
14 was substantial; however, such would provide additional support for the inmate’s claim that the
15 defendant was deliberately indifferent to his needs.” Jett, 439 F.3d at 1096, citing McGuckin, 974
16 F.2d at 1060.
17 Deliberate indifference is a high legal standard. Toguchi v. Chung, 391 F.3d 1051, 1060
18 (9th Cir. 2004). “Under this standard, the prison official must not only ‘be aware of the facts from
19 which the inference could be drawn that a substantial risk of serious harm exists,’ but that person
20 ‘must also draw the inference.’” Id. at 1057 (quoting Farmer, 511 U.S. at 837). “‘If a prison
21 official should have been aware of the risk, but was not, then the official has not violated the
22 Eighth Amendment, no matter how severe the risk.’” Id. (quoting Gibson v. County of Washoe,
23 Nevada, 290 F.3d 1175, 1188 (9th Cir. 2002)).
24 To prevail on a deliberate-indifference claim, a plaintiff must also show that harm resulted
25 from a defendant’s wrongful conduct. Wilhelm, 680 F.3d at 1122; see also Jett, 439 F.3d at 1096;
26 Hallett v. Morgan, 296 F.3d 732, 746 (9th Cir. 2002) (prisoner alleging deliberate indifference
27 based on delay in treatment must show delay led to further injury).
1 Amendment claim against Defendant Batra. Plaintiff has identified “the existence of an injury
2 that a reasonable doctor or patient would find important and worthy of comment or treatment.”
3 Colwell, 763 F.3d at 1066. Plaintiff complained of numbness and tingling in his feet, and his feet
4 became painful and “black and blue.” Further, Plaintiff alleges Batra failed to respond to his pain
5 or possible medical need on several occasions, and that as a result, Plaintiff suffered a partial
6 amputation of his left leg because of Batra’s indifference. Wilhelm, 680 F.3d at 1122.
7 To the extent Plaintiff seeks to assert state law claims, he fails to state any cognizable
8 claim. Plaintiff simply lists a series of California Government Code provisions (see Doc. 31 at 49)
9 with no explanation and directs the Court to the factual allegations asserted elsewhere in the third
10 amended complaint. Plaintiff fails to readily identify his state law claims and makes no effort to
11 connect those claims to Batra’s conduct. Iqbal, 556 U.S. at 678 (the “sheer possibility that a
12 defendant has acted unlawfully” is not sufficient to state a cognizable claim, and “facts that are
13 merely consistent with a defendant’s liability” fall short).
14 Moreover, to the extent Plaintiff’s third amended complaint can be construed to bring a
15 state law claim for negligence and/or medical malpractice, he fails to state a claim. The California
16 Government Claims Act requires that a tort claim against a public entity or its employees be
17 presented to the California Victim Compensation and Government Claims Board no more than
18 six months after the cause of action accrues. Cal. Gov't Code §§ 905.2, 910, 911.2, 945.4, 950-
19 950.2. Presentation of a written claim, and action on or rejection of the claim are conditions
20 precedent to suit. State v. Superior Court of Kings County (Bodde), 32 Cal.4th 1234, 1239 (Cal.
21 2004); Shirk v. Vista Unified School District, 42 Cal.4th 201, 209 (2007). The Government
22 Claims Act requires exhaustion of Plaintiff's state law tort claims with the California Victim
23 Compensation and Government Claims Board, and Plaintiff is required to specifically allege
24 compliance in the complaint. Shirk, at 208-09. Here, Plaintiff fails to specifically allege that he
25 complied with the Government Claims Act. See also Figueras v. Gonzalez, No. 1:22-cv-01328-
26 SKO (PC), 2023 WL 11819205, at *3 (E.D. Cal. June 30, 2023) (“The Court’s duty is not to
27 wade through exhibits in an attempt to ascertain Plaintiff’s claims); Davis v. Carlton, No. 2:11-
1 comb through attached exhibits seeking to determine whether a claim possibly could have been
2 stated where the pleading itself does not state a claim”).
3 D. The Relief Requested
4 As noted above, Plaintiff seeks to have Defendant Batra’s medical license permanently
5 revoked. Plaintiff also seeks “Medi-Cal” and “Medi-Care” coverage for life, and asks for the
6 Court’s permission to place a lien on a bond maintained by the California State Hospital-
7 Coalinga. These remedies are improper.
8 Regarding Plaintiff’s request to have Batra’s medical license revoked, this Court does not
9 have the authority to grant such relief. See, e.g., Cranford v. Eyiuche, No. 1:16-cv-00783-GSA-
10 PC, 2018 WL 3348736, at *3 (E.D. Cal. July 9, 2018) (“The issue whether Defendant Eyiuche
11 should be employed at Coalinga State Hospital is strictly a matter for her employer to determine,
12 not this court”). Nor does this Court have the authority to award or order Medi-Care or Medi-Cal
13 coverage to Plaintiff. See generally, Summers v. Earth Island Institute, 555 U.S. 488, 491-93 (the
14 pendency of an action does not give a court jurisdiction over prison officials in general or over
15 individuals who are not parties to an action). As this Court previously stated in its “Order
16 Denying Plaintiff’s Request Concerning Lien” issued February 4, 2024, “an order such as the one
17 sought by Plaintiff would be inappropriate ….” (Doc. 33 at 2.)
18 E. Granting Further Leave to Amend Would Be Futile
19 If a court finds that a complaint should be dismissed for failure to state a claim, the court
20 has discretion to dismiss with or without leave to amend. Lopez v. Smith, 203 F.3d 1122, 1126–30
21 (9th Cir. 2000) (en banc). Leave to amend should be granted if it appears possible that the defects
22 in the complaint could be corrected, especially if a plaintiff is pro se. Id. at 1130–31; see also
23 Cato v. United States, 70 F.3d 1103, 1106 (9th Cir. 1995) (“A pro se litigant must be given leave
24 to amend his or her complaint, and some notice of its deficiencies, unless it is absolutely clear that
25 the deficiencies of the complaint could not be cured by amendment”). Here, the Court finds
26 granting Plaintiff further leave to amend would be futile.
27 Plaintiff has had several opportunities to present his claims (see Docs. 1 [original
1 leave to amend his earlier complaints to cure the deficiencies identified therein, including the
2 failure to “clearly and concisely explain” the basis for liability and the insufficiency of conclusory
3 allegations. (See Docs. 12 & 27.) It does not appear Plaintiff can cure the deficiencies regarding
4 his state law claims and Plaintiff has had several opportunities to amend.
5 V. CONCLUSION AND RECOMMENDATIONS
6 For the foregoing reasons, the Court RECOMMENDS that:
7 1. This action PROCEED only on Plaintiff’s Eighth Amendment deliberate indifference
8 to serious medical needs claim against Defendant Batra; and
9 2. Any remaining claims in Plaintiff’s third amended complaint be DISMISSED.
10 These Findings and Recommendations will be submitted to the district judge assigned to
11 this case, pursuant to 28 U.S.C. § 636(b)(l). Within 14 days of the date of service of these
12 Findings and Recommendations, a party may file written objections with the Court. The
13 document should be captioned, “Objections to Magistrate Judge’s Findings and
14 Recommendations.” Failure to file objections within the specified time may result in waiver of
15 rights on appeal. Wilkerson v. Wheeler, 772 F.3d 834, 839 (9th Cir. 2014) (citing Baxter v.
16 Sullivan, 923 F.2d 1391, 1394 (9th Cir. 1991)).
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IT IS SO ORDERED.
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19 Dated: October 8, 2024 /s/ Sheila K. Oberto .
UNITED STATES MAGISTRATE JUDGE
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