Jonathan Eric Rivera v. Madonna Malari

• Court: District Court, D. Arizona
• Decided: May 27, 2026
• Docket: 2:23-cv-02185
• Status: Unknown

Opinion

1 WO KAB 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA 8 9 Jonathan Eric Rivera, No. CV-23-02185-PHX-MTL (MTM) 10 Plaintiff, 11 v. ORDER 12 Madonna Malari, 13 Defendant.

14 15 Plaintiff Jonathan Eric Rivera, who is currently confined in the Arizona State Prison 16 Complex-Lewis, brought this civil rights action under 42 U.S.C. § 1983. Defendant moves 17 for summary judgment. (Doc. 65.) Plaintiff was informed of his rights and obligations to 18 respond pursuant to Rand v. Rowland, 154 F.3d 952, 962 (9th Cir. 1998) (en banc) 19 (Doc. 67), and he opposes the Motion. (Doc. 74.) The Motion is fully briefed. (Doc. 75.) 20 I. Background 21 On screening under 28 U.S.C. § 1915A(a), the Court determined that Plaintiff stated 22 a Fourteenth Amendment medical care claim against Defendant Malari, a doctor Plaintiff 23 saw at the Watkins Jail, based on Plaintiff’s allegations that she refused to provide Plaintiff 24 treatment for eye, leg, and tailbone problems. (Docs. 9, 28.) The Court dismissed the 25 remaining claims and Defendants. (Id.) 26 II. Summary Judgment Standard 27 A court must grant summary judgment “if the movant shows that there is no genuine 28 dispute as to any material fact and the movant is entitled to judgment as a matter of law.” 1 Fed. R. Civ. P. 56(a); see also Celotex Corp. v. Catrett, 477 U.S. 317, 322-23 (1986). The 2 movant bears the initial responsibility of presenting the basis for its motion and identifying 3 those portions of the record, together with affidavits, if any, that it believes demonstrate 4 the absence of a genuine issue of material fact. Celotex, 477 U.S. at 323. 5 If the movant fails to carry its initial burden of production, the nonmovant need not 6 produce anything. Nissan Fire & Marine Ins. Co., Ltd. v. Fritz Co., Inc., 210 F.3d 1099, 7 1102-03 (9th Cir. 2000). But if the movant meets its initial responsibility, the burden shifts 8 to the nonmovant to demonstrate the existence of a factual dispute and that the fact in 9 contention is material, i.e., a fact that might affect the outcome of the suit under the 10 governing law, and that the dispute is genuine, i.e., the evidence is such that a reasonable 11 jury could return a verdict for the nonmovant. Anderson v. Liberty Lobby, Inc., 477 U.S. 12 242, 248, 250 (1986); see Triton Energy Corp. v. Square D. Co., 68 F.3d 1216, 1221 (9th 13 Cir. 1995). The nonmovant need not establish a material issue of fact conclusively in its 14 favor, First Nat’l Bank of Ariz. v. Cities Serv. Co., 391 U.S. 253, 288-89 (1968); however, 15 it must “come forward with specific facts showing that there is a genuine issue for trial.” 16 Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986) (internal 17 citation omitted); see Fed. R. Civ. P. 56(c)(1). 18 At summary judgment, the judge’s function is not to weigh the evidence and 19 determine the truth but to determine whether there is a genuine issue for trial. Anderson, 20 477 U.S. at 249. In its analysis, the court must believe the nonmovant’s evidence and draw 21 all inferences in the nonmovant’s favor. Id. at 255. The court need consider only the cited 22 materials, but it may consider any other materials in the record. Fed. R. Civ. P. 56(c)(3). 23 III. Facts1 24 Plaintiff saw Dr. Malari in the medical clinic at the Maricopa County Sheriff’s 25 Office on September 5, 2023. (Doc. 66 ¶ 1.) The medical record from the visit reflects 26 that Plaintiff requested compression socks for right leg swelling, reported eye floaters 27 28 1 Plaintiff seeks to supplement his response to include an additional medical record (Doc. 76). Plaintiff’s Motion will be granted. 1 associated with ocular migraine, muscle twitching in his eyelids, lips, left upper arm, and 2 left lower leg, occurring three times a week, lasting from a few seconds to a few minutes 3 associated with increased anxiety levels, tailbone pain on and off, worse when sitting, and 4 that his right leg may be longer than his left leg, causing hip and pelvic discomfort when 5 sitting. (Doc. 66-4 at 137-138; Doc. 66 ¶ 2; Doc. 74 at 1.) Dr. Malari physically examined 6 Plaintiff’s tailbone and didn’t find a palpable mass at the low back/sacrum/tailbone during 7 the examination. (Doc. 66 ¶ 10.)2 Plaintiff asserts that he bent over the table, and Dr. 8 Malari gently touched the top of his left buttock and said she did not see anything and he 9 responded, it is on his bone, and she then said “where?” and Plaintiff told her where and 10 she touched his lower back and said she did not feel anything, but Plaintiff believed she 11 did not want to touch near his anus where Plaintiff felt the pain. (Doc. 1 at 8.) Dr. Malari 12 asserts that she did not find any tenderness during the examination, and Plaintiff asserts 13 that this was only because she did not touch the correct spot. (Doc. 66 ¶ 11; Doc. 74 at 9- 14 10 ¶ 11.) 15 Dr. Malari noted that Plaintiff appeared anxious without acute respiratory distress; 16 his eyes, nose, and mouth were normal; she did not observe muscle twitching in Plaintiff’s 17 face, arm or leg; his heartrate was normal; his lungs were clear; his abdomen was soft, 18 19 nontender, distended; he had no visible rash, lower extremity edema, or obvious leg length 20 discrepancies; he had a normal and stable gait and no gross abnormalities or palpable mass 21 in Plaintiff’s low back/sacrum/tailbone. (Doc. 66-4 at 137-138.) Dr. Malari advised 22 Plaintiff to elevate his legs when he notices edema and told him he can wear TED hose if 23 needed, stated she would prescribe him 400 mg ibuprofen as needed for migraines, advised 24 him to monitor symptoms of twitching, which were not present on exam and made a note 25 26 2 In his Controverting Statement of Facts, Plaintiff states “Per Malari’s Declaration 27 #29 she did a physical exam on Plaintiff. In Declaration #30 she states she examines a patient not the Plaintiff’s exam the same way because she did not describe Plaintiff’s exam 28 or perform it the same way.” (Doc. 74 at 9 ¶ 10.) The nature of Plaintiff’s dispute is not clear to the Court. 1 to check creatine phosphokinase (CPK),3 noted that Plaintiff had been seen by psych for 2 anxiety and agreed that Plaintiff should be on medications for anxiety, but deferred to 3 “psych orders,” reassured Plaintiff that his tailbone felt normal, but advised him to monitor 4 symptoms, and concluded no further workup was needed regarding Plaintiff’s leg length 5 discrepancy. (Id. at 138.) Dr. Malari later decided against ordering ibuprofen because 6 Plaintiff had an ongoing prescription for acetaminophen, which she concluded was safer 7 than ibuprofen for a patient with hypertension and a cardiac condition. (Doc. 66-5 ¶ 17.) 8 IV. Discussion 9 Defendant asserts that she is entitled to summary judgment because there is no 10 evidence that Plaintiff was at substantial risk of serious harm or that her treatment decisions 11 were objectively unreasonable under the circumstances. 12 a. Legal Standard 13 “[C]laims for violations of the right to adequate medical care ‘brought by pretrial 14 detainees against individual defendants under the Fourteenth Amendment’ must be 15 evaluated under an objective deliberate indifference standard.” Gordon v. Cnty. of Orange, 16 888 F.3d 1118, 1124-25 (9th Cir. 2018) (quoting Castro v. Cnty. of Los Angeles, 833 F.3d 17 1060, 1070 (9th Cir. 2016)). To state a medical care claim, a pretrial detainee must show 18 (i) the defendant made an intentional decision with respect to the conditions under which the plaintiff was confined; (ii) those 19 conditions put the plaintiff at substantial risk of suffering serious harm; (iii) the defendant did not take reasonable 20 available measures to abate that risk, even though a reasonable 21 official in the circumstances would have appreciated the high degree of risk involved—making the consequences of the 22 defendant’s conduct obvious; and (iv) by not taking such measures, the defendant caused the plaintiff’s injuries. 23 Id. at 1125. “With respect to the third element, the defendant’s conduct must be objectively 24 unreasonable, a test that will necessarily ‘turn[] on the facts and circumstances of each 25 particular case.’” Castro, 833 F.3d at 1071 (quoting Kingsley v. Hendrickson, 576 U.S. 26

27 3 CPK is a muscle enzyme, and testing would show whether a patient had myalgias 28 or muscle dysfunction. (Doc. 66 ¶ 32.) Plaintiff later received the CPK test per Defendant’s order and it was normal. (Doc. 66 ¶ 33.) 1 389, 397 (2015); Graham v. Connor, 490 U.S. 386, 396 (1989)). 2 The “‘mere lack of due care by a state official’ does not deprive an individual of 3 life, liberty, or property under the Fourteenth Amendment.” Castro, 833 F.3d at 1071 4 (quoting Daniels v. Williams, 474 U.S. 327, 330-31 (1986)). A plaintiff must “prove more 5 than negligence but less than subjective intent—something akin to reckless disregard.” Id. 6 A mere delay in medical care, without more, is insufficient to state a claim against prison 7 officials for deliberate indifference. See Shapley v. Nev. Bd. of State Prison Comm’rs, 766 8 F.2d 404, 407 (9th Cir. 1985). 9 b. Discussion 10 With regard to the tailbone pain, Defendant asserts that there is no evidence that her 11 examination of Plaintiff and conclusion that his tailbone pain did not require treatment at 12 that time put Plaintiff at substantial risk of serious harm. In Response, Plaintiff asserts that 13 Dr. Malari was reckless in her treatment of him because she did not order an MRI for his 14 tailbone even though Plaintiff had previously reported tailbone pain to other providers and 15 Plaintiff continued to have tailbone pain after his visit with Dr. Malari. 16 Here, there is no evidence that Dr. Malari’s conclusion that Plaintiff did not require 17 treatment at that time for his tailbone pain put him at substantial risk of serious harm. Dr. 18 Malari attempted to examine Plaintiff and did not find obvious evidence of the cause of 19 Plaintiff’s tailbone pain. Dr. Malari asserts that treatment for tailbone pain when there is 20 no recent trauma or injury is to avoid sitting in the same position for too long or to change 21 position to relieve pressure on the tailbone. (Doc. 66 ¶ 49.) Although Plaintiff asserts that 22 Dr. Malari’s examination of his tailbone was inadequate, an inadequate exam may support 23 a negligence claim, but it is insufficient to rise to the level of reckless disregard, and 24 Plaintiff fails to show that the inadequate exam subjected him to a substantial risk of 25 serious harm. 26 With regard to ocular migraines/floaters, Defendant asserts that there is no evidence 27 that she put Plaintiff at substantial risk of serious harm by allowing him to continue to use 28 acetaminophen for his ocular migraines and there is no evidence that any other treatment 1 was warranted or necessary. In Response, Plaintiff asserts that Malari did not treat him 2 with “any kind of pain meds” and she should have ordered an MRI with and without 3 contrast. (Doc. 74 at 5.) Defendant asserts that ocular migraines are generally managed 4 by controlling exposure to triggers and over-the-counter pain medication. (Doc. 65 at 9.) 5 Plaintiff’s assertion that Dr. Malari should have ordered an MRI is unsupported. 6 The evidence shows that Dr. Malari considered Plaintiff’s complaints, initially decided that 7 ibuprofen could help Plaintiff, but later concluded that ibuprofen was contraindicated for 8 Plaintiff and he could use his ongoing Acetaminophen prescription. Although there is no 9 evidence that Dr. Malari communicated her Acetaminophen decision to Plaintiff, there is 10 no evidence that this failure to communicate placed Plaintiff at substantial risk of serious 11 harm or that Plaintiff lacked the ability to follow-up. 12 With regard to muscle twitching, Defendant asserts that ordering CPK testing to rule 13 out evidence of muscular dysfunction and telling Plaintiff to continue monitoring when she 14 observed no evidence of twitching did not place Plaintiff at a substantial risk of suffering 15 serious harm. Plaintiff did not respond to this argument, and there is no evidence in the 16 record that Dr. Malari’s decisions regarding Plaintiff’s reports of muscle twitching put 17 Plaintiff at substantial risk of suffering serious harm. 18 With regard to leg complaints, Defendant asserts that leg length disparity does not 19 require treatment if it does not affect the patient’s weight and she did not observe Plaintiff 20 to have a leg length disparity, Plaintiff received TED hose to help with his lower extremity 21 edema, and canvas shoes are not medically necessary for treating lower extremity edema 22 or peripheral venous insufficiency. In Response, Plaintiff asserts that Defendant should 23 have measured his legs, monitored for edema, and after his appointment, he received the 24 wrong size of TED hose, and was not given the correct size for 8 months. 25 Plaintiff has not shown that Dr. Malari’s failure to provide treatment for his leg 26 length disparity caused a substantial risk of serious harm and has not shown that her failure 27 to observe swelling and instruction to continue monitoring caused a substantial risk of 28 serous harm. Although Plaintiff argues that a nurse prescribed him TED hose a few days 1 | after his appointment with Malari, and he never received that hose, Plaintiff produces no evidence that Dr. Malari knew Plaintiff did not receive his hose or acted in a way that 3| caused him to suffer a substantial risk of serious harm. 4 For the foregoing reasons, Defendant’s Motion for Summary Judgment will be granted. 6| ITIS ORDERED: 7 (1) The reference to the Magistrate Judge is withdrawn as to Defendant’s 8 | Motion for Summary Judgment (Doc. 65), Plaintiff's Motion to Submit Supplementary 9| Evidence to Plaintiff's Response to Summary Judgment (Doc. 76), and Plaintiff's Motion 10 | to Request Status Update (Doc. 78). 1] (2) Plaintiff's Motion to Submit Supplementary Evidence to □□□□□□□□□□□ 12) Response to Summary Judgment (Doc. 76) is granted. 13 (3) Defendant’s Motion for Summary Judgment (Doc. 65) is granted, and the action is terminated with prejudice. The Clerk of Court must enter judgment accordingly. 15 (4) Plaintiff's Motion to Request Status Update (Doc. 78) is denied as moot. 16 Dated this 26th day of May, 2026. 17 Wichadl T. Hbhurdle Michael T. Liburdi 20 United States District Judge 21 22 23 24 25 26 27 28