(PC) Huffman v. Batra ( 2020 )

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 EASTERN DISTRICT OF CALIFORNIA 10 11 WILLIAM RAY HUFFMAN, Case No. 1:19-cv-00655-BAM (PC) 12 Plaintiff, ORDER FINDING PLAINTIFF MAY PROCEED ON COGNIZABLE CLAIMS 13 v. Doc. 13 14 BATRA, et al., 15 Defendants. 16 17 18 Plaintiff William Ray Huffman (“Plaintiff”) is a civil detainee appearing pro se in this 19 civil rights action pursuant to 42 U.S.C. § 1983. Individuals detained pursuant to California 20 Welfare and Institutions Code § 6600 et seq. are civil detainees and are not prisoners within the 21 meaning of the Prison Litigation Reform Act. Page v. Torrey, 201 F.3d 1136, 1140 (9th Cir. 22 2000). Plaintiff’s amended complaint is currently before the Court for screening. (ECF No. 13.) 23 I. Screening Requirement and Standard 24 The Court is required to screen complaints brought by pro se plaintiffs seeking relief 25 against a governmental entity and/or against an officer or employee of a governmental entity. 28 26 U.S.C. § 1915A(a). Plaintiff’s complaint, or any portion thereof, is subject to dismissal if it is 27 frivolous or malicious, if it fails to state a claim upon which relief may be granted, or if it seeks 28 1 monetary relief from a defendant who is immune from such relief. 28 U.S.C. §§ 1915A(b); 2 1915(e)(2)(B)(ii). 3 A complaint must contain “a short and plain statement of the claim showing that the 4 pleader is entitled to relief . . . .” Fed. R. Civ. P. 8(a)(2). Detailed factual allegations are not 5 required, but “[t]hreadbare recitals of the elements of a cause of action, supported by mere 6 conclusory statements, do not suffice.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Bell 7 Atlantic Corp. v. Twombly, 550 U.S. 544, 555 (2007)). While a plaintiff’s allegations are taken as 8 true, courts “are not required to indulge unwarranted inferences.” Doe I v. Wal-Mart Stores, Inc., 9 572 F.3d 677, 681 (9th Cir. 2009) (internal quotation marks and citation omitted). 10 To survive screening, Plaintiff’s claims must be facially plausible, which requires 11 sufficient factual detail to allow the Court to reasonably infer that each named defendant is liable 12 for the misconduct alleged. Iqbal, 556 U.S. at 678 (quotation marks omitted); Moss v. U.S. Secret 13 Serv., 572 F.3d 962, 969 (9th Cir. 2009). The sheer possibility that a defendant acted unlawfully 14 is not sufficient, and mere consistency with liability falls short of satisfying the plausibility 15 standard. Iqbal, 556 U.S. at 678 (quotation marks omitted); Moss, 572 F.3d at 969. 16 II. Plaintiff’s Allegations 17 Plaintiff is currently housed at Coalinga State Hospital in Coalinga, CA. Plaintiff alleges 18 that the events at issue took place at the Coalinga State Hospital (“Coalinga”). Plaintiff names the 19 following defendants: (1) Sanjeev Batra, M.D.; (2) Robert Winthrow, M.D., Director of Medical 20 at Department of State Hospitals; and (3) Jonthan Hamerick, M.D., Chief Physician and Surgeon. 21 Plaintiff alleges that 30 years ago he had his left hip totally replaced. In April 2017, the 22 hip started to squeak and cause great pain. He had two to three x-rays done at Coalinga in April 23 and May 2017. A May 22, 2017 CT pelvis radiology report stated that there is a lateral superior 24 migration of the femoral component, which is now articulating with the bony acetabular roof and 25 is no longer centered with the acetabular cup and “recommended referral to the orthopedic 26 surgery for potential revision.” 27 On July 15, 2017, Plaintiff was in pain and taken to the Urgent Care Room and was seen 28 by Defendant Sanjeev Batra, M.D. Dr. Batra said there is nothing wrong with Plaintiff and that 1 Plaintiff was just seeking pain medication. He said that the prosthetic is out of alignment and the 2 joint needs to be pushed back into place. Dr Batra caused more pain than Plaintiff had been 3 experiencing. Dr. Batra pushed Plaintiff’s leg up so hard that the hip is now broken and shattered 4 into several pieces. 5 In July 2017, Plaintiff was taken to Receiving and Release and had another CT Pelvis 6 without I.V. Contrast done on his left hip. On July 18, Plaintiff was taken to see N. Birrell Smith, 7 MD, Orthopedic Surgeon. Dr. Smith assessed Plaintiff x-ray as follows: “the x ray represents 8 catastrophic failure of acetabular component with long term chronic dislocation which has created 9 false acetabulum. This will need referral to a center such as Stanford or UCLA for complex 10 revision total hip surgery.” 11 On July 21, 2017, Plaintiff was taken to Community Regional Medical Center. Plaintiff’s 12 discharge instruction state: “Mr. Hoffman as a chronic dislocation of his left hip prosthesis. It is 13 too high risk to attempt reduction. He will need revision of this prosthesis by orthopedic hip 14 specialist. Mr. Huffman should remain non-weight bearing on the left lower extremity until 15 cleared by ortho. . .” 16 August 6, 2017, Plaintiff returned to Fresno Emergency room and the records indicate, 17 “You have a fracture and dislocation in your hip. Our orthopedic consults feel you would be best 18 served by following up with the surgeon at Stanford as you will require complex revision with 19 involved surgical planning on an outpatient basis.” On August 9, 2017, Manavjeet Singh Sidhu, 20 M.D. submitted his orthopedic surgery clinic note on the imaging of Plaintiff: “Acetabular cup 21 loose with broken screw. Prosthetic femoral head dislocated, this is chronic because it can be 22 seen that the femoral head is now articulating in the pseud acetabulum.” 23 Plaintiff alleges Plaintiff’s hip is in the same condition and he has not been taken to other 24 appointments that have been recommended by Dr. Smith or by the Fresno Emergency 25 Department. Plaintiff alleges he has exhausted his administrative remedies. He alleges Defendant 26 Robert Withrow, M.D., Director of Medical Department at Department of State Hospital- 27 Coalinga, and Jonathan Hamrick, M.D., Chief Physician and Surgeon at Department of State 28 Hospitals-Coalinga are responsible for not allowing Plaintiff to go out to other medical 1 appointments to see an orthopedic specialist who deals with hip replacement. These doctors are 2 the two individuals who could allow referrals to out-side medical appointments, but have not allowed 3 Plaintiff. Dr. Withdrow stated that DSH-C will continue to consult outside medical facilities in an 4 effort to secure a contract for specialized orthopedic surgery. Yet, Plaintiff has not gone to other 5 outside medical appointments other than Dr. Smith and appointments at Community Regional 6 Medical Center in Fresno. Dr. Smith said that Plaintiff will need a referral to a center such as 7 Stanford or UCLA for complex revision total hip surgery and Dr. Sidhu agreed with Dr. Smith 8 that Plaintiff need a higher level of care. Plaintiff includes as an Exhibit to the complaint a 9 response from the Department of State Hospital, Office of Human Rights in Sacramento which 10 stated, “[S]everal health care facilities have declined your request for reconstructive surgery. 11 Being an estimated 8-hour surgery, your age and state of health would make this surgery risky.” 12 Plaintiff alleges that no doctor that Plaintiff saw or consulted ever said that the surgery was 8 13 hours, or mentioned Plaintiff’s age or that the surgery was “risky.” Plaintiff asked for these 14 reports that say the surgery is risky, or that his age mattered, and he has not received any and 15 believes these records are false. Plaintiff should have been taken to other facilities for medical 16 assessment. 17 Plaintiff seeks compensatory and punitive damages. 18 III. Discussion 19 A. Deliberate Medical Indifference Claims 20 As a civil detainee, Plaintiff’s right to medical care is protected by the substantive 21 component of the Due Process Clause of the Fourteenth Amendment. See Youngberg v. Romeo, 22 457 U.S. 307, 315 (1982). Under this provision of the constitution, a detainee plaintiff is “entitled 23 to more considerate treatment and conditions of confinement than criminals whose conditions of 24 confinement are designed to punish.” Jones v. Blanas, 393 F.3d 918, 931 (9th Cir. 2004) (quoting 25 Youngberg, 457 U.S. at 321–22). Thus, to avoid liability, a defendant’s medical decisions 26 regarding the plaintiff’s treatment must be supported by “professional judgment.” Youngberg, 27 457 U.S. at 321; see also Robinson v. Sziebert, 740 Fed.App’x. 614, 615 (9th Cir. 2018) (noting 28 Fourteenth Amendment professional judgment standard applies to civil detainees). A defendant 1 fails to use professional judgment when her decision is “such a substantial departure from 2 accepted professional judgment, practice, or standards as to demonstrate that [she] did not base 3 [her] decision on such a judgment.” Youngberg, 457 U.S. at 323. 4 In determining whether a defendant has met his constitutional obligations, decisions made 5 by the appropriate professional are entitled to a presumption of correctness. Youngberg, 457 U.S. 6 at 324. “[T]he Constitution only requires that the courts make certain that professional judgment 7 in fact was exercised. It is not appropriate for the courts to specify which of several professionally 8 acceptable choices should have been made.” Id. at 321. Liability will be imposed only when the 9 medical decision “is such a substantial departure from accepted professional judgment, practice, 10 or standards as to demonstrate that the person responsible actually did not base the decision on 11 such a judgment.” Id. at 323. 12 At the pleading stage and considering the facts in light most favorable to Plaintiff, Plaintiff’s 13 allegations suggest that Dr. Batra’s actions departed from accepted professional judgment, practice or 14 standards for the care provided on July 15, 2017. 15 B. Supervisory Liability 16 Plaintiff asserts a claim against Dr. Withrow and Defendant Hamerick for failing to refer 17 Plaintiff for replacement hip surgery. Plaintiff alleges that they are responsible for authorizing all 18 surgeries and for not allowing Plaintiff to go to medical appointments to see an orthopedic 19 specialist who deals with hip replacements. 20 Supervisory personnel may not be held liable under section 1983 for the actions of 21 subordinate employees based on respondeat superior, or vicarious liability. Crowley v. Bannister, 22 734 F.3d 967, 977 (9th Cir. 2013); accord Lemire v. California Dep’t of Corr. and Rehab., 726 23 F.3d 1062, 1074-75 (9th Cir. 2013); Lacey v. Maricopa County, 693 F.3d 896, 915-16 (9th Cir. 24 2012) (en banc). “A supervisor may be liable only if (1) he or she is personally involved in the 25 constitutional deprivation, or (2) there is a sufficient causal connection between the supervisor’s 26 wrongful conduct and the constitutional violation.” Crowley, 734 F.3d at 977 (citing Snow v. 27 McDaniel, 681 F.3d 978, 989 (9th Cir. 2012)) (internal quotation marks omitted); accord Lemire, 28 726 F.3d at 1074-75; Lacey, 693 F.3d at 915-16. “Under the latter theory, supervisory liability 1 exists even without overt personal participation in the offensive act if supervisory officials 2 implement a policy so deficient that the policy itself is a repudiation of constitutional rights and is 3 the moving force of a constitutional violation.” Crowley, 734 F.3d at 977 (citing Hansen v. Black, 4 885 F.2d 642, 646 (9th Cir. 1989)) (internal quotation marks omitted). 5 Plaintiff alleges that Dr. Withrow and Defendant Hamerick were personally involved in 6 denial of his medical care. He alleges that they alone must sign off on a referral and have refused 7 to do so, despite the medical records indicating that he needs a higher level of care to correct his 8 hip medical issue. Plaintiff alleges, by inference, that these 2 supervisor defendants would not 9 refer him out for further treatment because of costs associated with the care. See Jett v. Penner, 10 439 F.3d 1091, 1098 (9th Cir. 2006) (supervisor may be liable for deliberate indifference to a 11 serious medical need if he or she fails to respond to a prisoner's request for help 12 Plaintiff’s documentary evidence attached to the complaint consists of medical records 13 and his medical appeals and responses to his medical appeals. (ECF No. Exh. A-Q.) The Court 14 may consider exhibits attached to the pleading and incorporated by reference, but is not required 15 to blindly accept conclusory allegations, unwarranted factual deductions, or unreasonable 16 inferences. See Petrie v. Electronic Game Card, Inc., 761 F.3d 959, 964 n.6 (9th Cir. 2014); 17 Sprewell v. Golden State Warriors, 266 F.3d 979, 988 (9th Cir. 2001); see also Fed. R. Civ. P. 18 10(c). Nor is the Court required to accept as true allegations that are contradicted by the exhibits 19 attached to the complaint. Sprewell, 266 F.3d at 988. 20 Each of the medical reports indicate that Plaintiff’s hip would need specialized care and 21 higher level of care such that the physicians consulted recommended that Plaintiff would need to 22 go to Stanford Medical Center or UCLA. (See ECF No.13, Exh. B, p.15) In response to 23 Plaintiff’s appeals, Plaintiff was told that he has not been referred for surgery because no higher 24 level of care facility was willing to take on his surgery. On December 12, 2017, Plaintiff’s case 25 was referred to the Orthopedic Department at University of California, San Francisco and to the 26 Orthopedic Department at Loma Linda University Medical Center. (Exh. H, p.34.) On May 17, 27 2018, Plaintiff was told by a representative of Coalinga that no orthopedic department had agreed 28 to take his case but that the Department of State Hospitals-Coalinga “will continue to consult 1 outside medical facility in an effort to secure a contract for specialized orthopedic surgery.” 2 (ECF No. 13, Exh. K, p. 40.) On May 29, 2018, The California Office of Patients’ Rights, to 3 which Plaintiff had complained, responded to Plaintiff, noting that in November 2017, his case 4 was referred to Loma Linda Medical Center for review.1 Finally, on July 30, 2018, the third level 5 of response to Plaintiff’s medical appeal indicated that “several healthcare facilities have declined 6 your request for reconstructive surgery. Being as estimated 8-hour surgery, your age and state of 7 health would make this surgery risky.” (Exh. O p. 49.) Plaintiff’s appeal was then closed. 8 Plaintiff alleges that Dr. Withrow and Defendant Hamerick did not explore options despite 9 Plaintiff’s pain and immobility. Plaintiff alleges that he was told that he needed specialized case 10 and that referral to Stanford would be an option, yet he has not been referred for consultation 11 there by either Dr. Withrow or Defendant Hamerick. In addition, Plaintiff alleges that no such 12 documentation exists regarding referral to “several” other health care facilities or for the 13 purported denial based on “estimated 8-hour surgery, your age and state of health would make 14 this surgery risky.” Plaintiff alleges that no such records exist, and these statements are false and 15 he was not referred out and was never referred to Stanford, as his medical records say he should 16 be to correct his injury. At the pleading stage, and considering the facts in light most favorable to 17 Plaintiff, Plaintiff has stated a cognizable claim against Defendants Withrow and Hamerick. 18 IV. Conclusion and Order 19 For the reason stated, the Court finds that Plaintiff has stated a cognizable claim against 20 Defendants Batra, Withrow and Hamerick for denial of medical care in violation of the substantive 21 component of the Due Process Clause of the Fourteenth Amendment. 22 Accordingly, it is HEREBY ORDERED as follows: 23 1. This action shall proceed on Plaintiff’s first amended complaint, filed on January 21, 24 2020 (ECF No. 13), against Defendants Batra, Withrow and Hamerick for denial of 25 1 A full copy of Exhibit L was not included in the First Amended Complaint. Based upon Exhibit L, included with the original complaint, the California Office of Patients’ Rights, to which 26 Plaintiff had informed Plaintiff that “three health care facilities have reviewed his case. None of 27 them agreed to proceed with reconstruction surgery, apparently due to damage that has been done to your hip.” (See ECF No. 1, Exh. L) Plaintiff was also told that another medical group was 28 contacted about his case but the Department of State Hospitals-Coalinga was awaiting a response. 1 medical care in violation of the substantive component of the Due Process Clause of the 2 Fourteenth Amendment; and 3 2. A separate order will issue regarding service of the complaint. 4 IT IS SO ORDERED. 5 6 Dated: June 15, 2020 /s/ Barbara A. McAuliffe _ UNITED STATES MAGISTRATE JUDGE 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28