Hollis v. Risenhoover

Background

Marvin Glenn Hollis, a California state prisoner proceeding without a lawyer, filed a civil-rights action under 42 U.S.C. § 1983 based on mental-health care he received while housed at Pelican Bay State Prison. The court previously found that his complaint stated a claim under the Eighth Amendment for deliberate indifference to serious medical needs. The opinion states that an earlier motion for summary judgment had already resolved the Eighth Amendment claim against S. Risenhoover and N. Adam. The motions addressed in this order concerned Dr. M. McCall and J. Afdahl.

Hollis claimed that Afdahl falsely reported that he had not swallowed his medication and that Afdahl and McCall conspired to stop his mental-health medications and reduce another medication. He asserted that the medication changes caused depression, anxiety, mood swings, and other symptoms associated with bipolar disorder. He also claimed that he notified the defendants that his symptoms were worsening and that they did nothing.

The record showed that Hollis had been prescribed Lamictal, also called lamotrigine, for bipolar disorder and Buspirone for anxiety. McCall evaluated him on February 2, 2016, questioned whether his symptoms were consistent with bipolar disorder, and questioned whether Lamictal was medically necessary. She also discussed the risk of a potentially fatal rash if Lamictal was taken inconsistently. She initially renewed both prescriptions for 90 days because Hollis was a new patient with an existing diagnosis.

On February 9, 2016, Afdahl reported that Hollis refused to show her his mouth after taking medication. The prison then placed him under Direct Observation Therapy, requiring staff to confirm that he swallowed his medication. Hollis denied that he had failed to take or “cheeked” the medication but acknowledged that he refused to open his mouth for inspection.

On February 10, McCall discontinued Lamictal, citing the reported incident and Hollis’s earlier medication-adherence problems. She ordered that Buspirone be crushed and mixed in water. The opinion states that there was no indication that Hollis failed to receive Buspirone in that form. Hollis disputed McCall’s account, stating that she stopped Lamictal without another examination or discussion, that he experienced adverse effects and increased symptoms, and that she reduced his Buspirone dosage.

Lamictal was later restarted by another psychiatrist on March 29, 2016. The records also showed that Hollis repeatedly refused Lamictal and some Buspirone doses in April and May. He was transferred to the Department of State Hospitals on June 3, 2016.

Legal standard

The court explained that summary judgment is appropriate when the evidence shows no genuine dispute about a material fact and the moving party is entitled to judgment as a matter of law. A fact is material if it could affect the outcome, and a dispute is genuine if a reasonable jury could find for the nonmoving party.

For an Eighth Amendment deliberate-indifference claim involving medical care, a prisoner must show a serious medical need and that officials knew of a substantial risk of serious harm but failed to take reasonable steps to address it. A difference of opinion between a prisoner and medical personnel about treatment is not enough. When the claim concerns competing treatment choices, the prisoner must show that the chosen treatment was medically unacceptable under the circumstances and was selected in conscious disregard of an excessive health risk.

Court’s analysis

The defendants conceded for purposes of their motion that a factual question existed about whether Hollis’s mental-health issues constituted a serious medical need. They argued, however, that the evidence did not show that they knowingly disregarded a substantial risk of serious harm. Hollis filed a cross-motion for summary judgment and argued that the evidence created a factual dispute about deliberate indifference.

The court rejected the claim against McCall. It found that McCall had evaluated Hollis, had substantial psychiatric experience, and had concluded that his symptoms did not clearly support the existing bipolar-disorder diagnosis. The court also found that McCall had an independent safety reason for stopping Lamictal: Hollis’s inconsistent adherence and the associated risk of a potentially fatal rash. In the court’s view, McCall’s decision was a reasonable effort to reduce a health risk, not a conscious disregard of one.

The court stated that even if McCall’s clinical assessment was incorrect, that would at most amount to negligence or medical malpractice, which would not establish deliberate indifference. The fact that another psychiatrist had previously prescribed Lamictal or that Dr. Hutchinson later prescribed it again also did not establish an Eighth Amendment violation. The court further found no evidence that McCall knew the medication changes had worsened Hollis’s mental health and consciously disregarded that risk.

The court also rejected the claim against Afdahl. It found that Afdahl’s documented involvement consisted of the February 9 medication-monitoring incident. Even accepting Hollis’s assertion that Afdahl wrongly accused him of not swallowing his medication, the court concluded that her conduct did not show deliberate indifference. The court found that the incident did not cause Hollis to be denied medication; instead, it led to Direct Observation Therapy intended to ensure that he swallowed the medication. The court also found no evidence that Afdahl knew McCall would discontinue Lamictal or intended that result while aware of a substantial risk of serious harm.

The court found no evidence supporting Hollis’s conspiracy claim. It described a civil conspiracy as an agreement or meeting of the minds to accomplish an unlawful objective and concluded that Hollis’s assertion that the defendants conspired was conclusory and unsupported by evidence. The court likewise found no evidence that Afdahl knew about Hollis’s later mental-health complaints or that McCall knew the medication changes were causing further harm.

Disposition

The court granted M. McCall and J. Afdahl’s motion for summary judgment. It denied Hollis’s cross-motion for summary judgment. The court dismissed with prejudice the Eighth Amendment claims against those defendants. The court also denied Hollis’s request for judicial notice as to the listed case law and the book excerpt because he had not identified indisputable facts that the materials established. The order terminated Docket Nos. 104 and 123.