Lozano v. County of Santa Clara

Background

The plaintiffs were Lucinda Lozano, Johnny Lozano, Sr., individually and as heir to Johnny Lozano, Jr., and the Estate of Johnny Lozano, Jr. They sued Santa Clara County, former Assistant Sheriff Beliveau, several physicians, and other defendants. The complaint asserted claims under 42 U.S.C. §§ 1983 and 1988 and California law.

The plaintiffs alleged that Johnny Lozano, Jr., who was a pretrial detainee at the Santa Clara County Jail for approximately five years, had chronic heart disease and needed continuing treatment. They alleged that jail medical staff and Valley Medical Center employees delayed or failed to provide medical care, failed to arrange follow-up appointments, provided or withheld medications improperly, delayed hospital treatment, and did not pursue certain transplant or medical-device options. They claimed that this conduct caused serious suffering and contributed to his death.

Claims and legal standards

Claims One and Two were federal civil-rights claims under Section 1983. Claim One alleged deliberate indifference to serious medical needs, and Claim Two alleged failure to protect from harm, both under the Fourteenth Amendment. Claim Three alleged a violation of substantive due process based on the plaintiffs’ parent-child relationship. Claims Four and Five alleged, respectively, failure to furnish or summon medical care and negligent supervision, training, hiring, and retention. Claim Six was a California wrongful-death claim, and Claim Seven was a California negligence claim.

The defendants moved to dismiss under Rule 12(b)(6), which tests whether a complaint states a legally sufficient claim. The court explained that a complaint must include enough factual detail to make liability plausible, not merely possible. For the medical-care claims, the court applied the objective deliberate-indifference standard for pretrial detainees. That standard requires allegations that the defendant intentionally made a decision about the detainee’s conditions, those conditions created a substantial risk of serious harm, the defendant failed to take reasonable available measures despite the obvious risk, and that failure caused injury.

Rulings on Claims Four through Seven

The plaintiffs voluntarily dismissed Claims Four and Five. The court therefore dismissed those claims as to all defendants without prejudice because it could not determine whether amendment would be futile.

The court dismissed Claims Six and Seven as to the County with prejudice after concluding that the plaintiffs had waived their response to the County’s immunity argument. The court dismissed those claims as to the individual doctors with prejudice because the California one-year limitations period for claims against health-care providers had expired. The court rejected the plaintiffs’ arguments that a different limitations period applied or that the Government Claims Act extended or tolled the deadline.

Rulings on Claims One through Three against individual defendants

The court dismissed Claims One, Two, and Three with prejudice as to Smith and Beliveau. The plaintiffs did not respond to the defendants’ arguments concerning those officials, so the court treated the arguments as waived. Because the court found no viable deliberate-indifference claim against them, it also found no conduct that could support a substantive due-process claim based on conscience-shocking conduct.

The court dismissed Claims One, Two, and Three with prejudice as to Dr. Chyorny. It concluded that an alleged threat to discontinue medication, a recommendation for further psychiatric evaluation, and responsibility for medication policies did not plausibly show deliberate indifference. The court characterized the alleged medication error, even if serious, as at most misdiagnosis, malpractice, or gross negligence rather than purposeful disregard of a known risk.

The court dismissed Claims One and Two with prejudice as to Dr. Walsh. It concluded that the allegations about Tylenol instead of Norco, a missed dose, delayed blood draws, delayed hospitalization, and delayed cardiology appointments did not plausibly show that Dr. Walsh purposefully disregarded a serious medical risk or caused substantial harm. The court dismissed Claim Three as to Dr. Walsh without prejudice.

The court dismissed Claims One and Two with prejudice as to Dr. Nekomoto. It found that the allegations showed that he responded to the reported dizziness and swollen eye, even if the plaintiffs disagreed with his treatment choices. The court also dismissed Claim Three with prejudice as to Dr. Nekomoto because the alleged conduct did not rise to the level of conscience-shocking conduct.

The court dismissed Claims One and Two with prejudice as to Dr. Kanakaraj. It found no allegation showing that he was responsible for the delayed device-clinic appointment, and it concluded that substituting Tylenol for Norco and moving Mr. Lozano from the infirmary to medical housing did not plausibly establish deliberate indifference. The court also dismissed Claim Three with prejudice as to Dr. Kanakaraj.

The court dismissed Claims One and Two with prejudice as to Dr. Zhao. It concluded that Dr. Zhao consulted with Stanford doctors before deciding not to pursue a transfer, and that her decisions about transplant evaluation and other treatment options reflected medical judgment rather than purposeful disregard of Mr. Lozano’s needs. The court also dismissed Claim Three with prejudice as to Dr. Zhao.

Rulings on the County’s liability

For the County, the plaintiffs relied on municipal liability under Section 1983. To state that type of claim, they had to plausibly allege a constitutional violation caused by a County policy, custom, or practice that amounted to deliberate indifference and was the moving force behind the injury.

The court dismissed Claims One, Two, and Three as to the County, but granted leave to amend. It found that the complaint did not adequately identify a widespread and well-settled County custom or policy, did not identify similar treatment of other people, and did not allege a sufficient constitutional violation by the individual defendants. The court stated that a viable claim might be possible if the plaintiffs described the alleged widespread conduct and specific policy in greater detail and addressed whether the County’s actions caused the death given the progressive nature of Mr. Lozano’s illness.

Motion to strike and final disposition

The defendants also moved to strike allegations concerning Mr. Lozano’s pain and suffering and requests for exemplary or punitive damages. The court ruled that this motion was moot because the claims and allegations it targeted had been dismissed. The court did not reach the merits of the motion to strike.

The order therefore dismissed Claims Four and Five without prejudice as to all defendants; dismissed Claims Six and Seven with prejudice as to all defendants; dismissed Claims One, Two, and Three with prejudice as to the named individual defendants; dismissed those three claims against the County with leave to amend; and left the motion to strike undecided as moot. Judge Edward M. Chen directed that any amended complaint against the County be filed within 30 days.