Smith v. Fu

Background

Jason Smith, a California inmate, brought this civil-rights action under 42 U.S.C. § 1983 against medical staff at the Correctional Training Facility. The complaint proceeded on an Eighth Amendment claim alleging deliberate indifference to serious medical needs. Smith initially included a First Amendment claim, but that claim was stricken after he chose to proceed only on the Eighth Amendment claim.

The order addresses Dr. Law Fu, M. Votaw, and S. Posson. Dr. Rachel Ross had not been served, and Dr. Mark Kowall’s separate motions were addressed in another order.

Methadone taper

Smith had received methadone for chronic right-shoulder pain. He signed a pain-treatment agreement stating that he would not use non-prescribed mood-altering drugs while taking methadone and acknowledging that a positive drug test could lead to a methadone taper and discontinuation. A May 21, 2018 urine test was positive for cannabis or marijuana. Smith argued that the result could have been a false positive caused by other medications.

Fu saw Smith once, on July 29, 2018, while covering an extra shift. Fu ordered a two-week taper from Smith’s 15-milligram daily dose: 10 milligrams daily for seven days, followed by 5 milligrams daily for seven days. Fu offered Tylenol with codeine as an alternative, but Smith said he was allergic to codeine. Fu noted that Smith would follow up with his primary care provider for other pain treatment. Smith’s methadone taper ended on August 12, 2018, and he later had follow-up appointments with other physicians involving alternative pain treatments.

Smith claimed that Fu discontinued methadone in retaliation for Smith’s refusal to sign a liability waiver related to an orthopedic procedure. Smith also claimed that the taper was abrupt and that he was not given adequate medication for pain or opioid withdrawal.

Health-care appeal

Smith submitted a health-care appeal on August 15, 2018, complaining about being removed from methadone. Nurse Chua, who was not a defendant, determined that the appeal should not be expedited. Votaw screened the appeal and forwarded it to the appropriate medical staff; the court found no evidence that she had authority over Chua’s decision or participated in Smith’s medical care.

Posson prepared the institutional-level response to the appeal. Based on the medical records, Posson concluded that the methadone taper was connected to Smith’s positive marijuana test and pain-treatment agreement, that Smith had follow-up care planned, and that no additional intervention was needed. Smith also faulted Posson for not addressing physical therapy, but the court found that Smith’s health-care appeal did not request physical therapy.

Legal standard

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. The court must view the evidence in the light most favorable to the nonmoving party, but that party must identify evidence from which a reasonable jury could rule in its favor.

To establish deliberate indifference under the Eighth Amendment, a prisoner must show both an objectively serious medical need and that the defendant knew of and disregarded a substantial risk of serious harm. Negligence, a disagreement over medical treatment, or a difference of opinion between a prisoner and medical providers is not enough by itself.

Court’s analysis

As to Votaw, the court held that the evidence showed only that she forwarded Smith’s appeal after Nurse Chua determined that it should not be expedited. Smith provided no evidence that Votaw did more or had authority to override Chua. The court therefore found no evidence that Votaw acted with deliberate indifference.

As to Fu, the court assumed for purposes of its analysis that Fu ordered the taper. It held that the positive marijuana test and the pain-treatment agreement gave Fu a reasonable basis for discontinuing methadone. The court also found that Fu tapered the medication over two weeks rather than stopping it abruptly, offered an alternative medication, and knew Smith would receive follow-up care. Smith provided no evidence that Fu actually knew of and disregarded a substantial risk of serious harm. The court characterized any failure by Fu to recognize such a risk as, at most, negligence, which does not establish an Eighth Amendment violation.

The court also rejected Smith’s retaliation allegation against Fu. It found the allegation conclusory and found no evidence that Fu knew about Smith’s refusal to sign the liability waiver before Smith described it during the July 29 appointment, or that Fu had a reason to retaliate over the waiver. The court further held that disagreement about the length or manner of the taper did not establish a claim under § 1983.

As to Posson, the court held that the records showed a positive marijuana test, a violation of the pain-treatment agreement, a planned follow-up with Smith’s primary care provider, and three later appointments addressing alternative pain treatment. The court found no evidence that Posson knew of and disregarded a substantial risk of serious harm. It also held that Posson could not have been deliberately indifferent for failing to address physical therapy because Smith’s health-care appeal did not mention that request.

Disposition

The court granted Fu, Votaw, and Posson’s motion for summary judgment. It dismissed the Eighth Amendment deliberate-indifference claims against them with prejudice and directed the Clerk to terminate those defendants from the action. The order terminated Docket No. 29.