Smith v. Santa Cruz County

Background

Tamario Smith’s co-successors-in-interest, Felicia Smith and Michael Warren-Smith, sued Santa Cruz County, James Hart, Wellpath, LLC, Gerald Lazar, and others. The complaint asserted claims under 42 U.S.C. § 1983, California wrongful-death law, the Americans with Disabilities Act, the Rehabilitation Act, and California negligence law. This order addressed only Gerald Lazar’s individual liability.

Smith was held before trial at the Santa Cruz County jail. The complaint alleged that he had severe schizophrenia and psychosis, had been found incompetent to stand trial, and had a history of low blood sodium. Lazar, identified as the jail’s only psychiatrist during Smith’s custody, prescribed psychiatric medications without first ordering routine blood tests or reviewing Smith’s medical history and court records. The complaint alleged that Lazar later prescribed the same medications again without a follow-up interview or other monitoring. Smith died on May 10, 2020, from hyponatremia and choking on his vomit while unmonitored in solitary confinement.

Legal standard

Lazar moved to dismiss under Federal Rule of Civil Procedure 12(b)(6), which tests whether a complaint states a legally sufficient claim, and moved to strike portions of the complaint under Rule 12(f). At the dismissal stage, the court generally accepts well-pleaded factual allegations as true and asks whether they plausibly support relief.

Section 1983 claims

The court applied the Ninth Circuit’s objective deliberate-indifference standard for a pretrial detainee’s medical-care claim under the Fourteenth Amendment. The plaintiffs had to allege that Lazar intentionally made a decision about Smith’s confinement conditions, that the decision created a substantial risk of serious harm, that Lazar failed to take reasonable available measures to reduce that risk even though the danger would have been apparent to a reasonable official, and that this failure caused Smith’s injury. The court noted that this standard requires more than negligence but less than subjective intent.

The court found the allegations sufficient. According to the complaint, Lazar decided to prescribe and re-prescribe psychiatric medications; prescribing them without blood work, medical-history review, or proper monitoring allegedly created a substantial risk of hyponatremia and death; and the alleged danger was apparent from Smith’s severe schizophrenia, worsening mental-health symptoms, and the alleged medical literature linking the medication to hyponatremia. The court also found that the complaint adequately alleged causation. It therefore denied Lazar’s motion to dismiss the Section 1983 claims. The discussion states that claims 1 through 5 met the pleading standard, while the conclusion lists claims 1, 2, 3, 4, 9, and 10 as claims for which dismissal was denied.

Americans with Disabilities Act and Rehabilitation Act claims

The court held that the complaint did not adequately allege that Lazar failed to provide or accommodate services because of Smith’s disability. The plaintiffs alleged that Smith had a disability and was denied appropriate mental-health services, but the court found that they offered only conclusory statements connecting the alleged denial to his disability. The court granted Lazar’s motion to dismiss the ADA and Rehabilitation Act claims, identified in the conclusion as claims 11 and 12, with leave to amend.

Punitive damages

The court declined to require compliance with California Code of Civil Procedure section 425.13, which concerns pleading punitive damages in certain professional-negligence actions. It also declined to strike or dismiss the punitive-damages request. The court explained that punitive damages were a requested remedy rather than an independent claim and that the rules invoked by Lazar did not provide the requested vehicle for removing that remedy at this stage. The court therefore denied Lazar’s request to strike the punitive-damages request.

Motion to strike

The plaintiffs agreed to remove Lazar’s name from claims 5 and 8 because those claims concerned municipal liability and Lazar was sued in his individual capacity. The court granted Lazar’s request to strike his name from those claims.

Lazar also argued that several Section 1983 claims and the state-law negligence and wrongful-death claims were redundant because they arose from the same conduct. The court rejected that argument, explaining that a plaintiff may plead alternative claims and that claims are not redundant merely because they share factual allegations. In the discussion, the court denied the request to strike claims 1, 3, 4, and 9. In its conclusion, however, the court stated that it denied the request to strike claims 1, 3, 4, and 10.

Disposition

The order granted in part and denied in part Lazar’s motion to dismiss and strike. It granted dismissal of claims 11 and 12 with leave to amend and granted the request to strike Lazar’s name from claims 5 and 8. It denied dismissal of the claims listed in the conclusion as claims 1, 2, 3, 4, 9, and 10, denied the request to strike punitive damages, and denied the request to strike the claims listed in the conclusion as claims 1, 3, 4, and 10. The court directed that any amended complaint be filed by December 22, 2023.