1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 EASTERN DISTRICT OF CALIFORNIA 10 11 ARAM SARUKHANYAN, No. 1:24-cv-01091-JLT-SAB (PC) 12 Plaintiff, ORDER DIRECTING CLERK OF COURT TO RANDOMLY ASSIGN A DISTRICT JUDGE 13 v. TO THIS ACTION 14 DOROTHEA BERRY, et al., FINDINGS AND RECOMMENDATIONS RECOMMENDING DISMISSAL OF ACTION 15 Defendants. (ECF Nos. 18, 19) 16 17 Plaintiff is proceeding pro se and in forma pauperis in this action filed pursuant to 42 18 U.S.C. § 1983. 19 Plaintiff’s complaint in this action was filed on September 13, 2024. (ECF No. 1.) 20 On November 15, 2024, the Court screened the complaint, found that Plaintiff failed to 21 state a cognizable claim for relief, and granted Plaintiff thirty days to file an amended complaint. 22 (ECF No. 10.) 23 Plaintiff filed a first amended complaint on January 30, 2025. (ECF No. 15.) On June 10, 24 2025, the Court screened the first amended complaint, found no cognizable claims for relief, and 25 granted Plaintiff one final opportunity to amend the complaint. (ECF No. 18.) 26 Plaintiff failed to file an amended complaint or otherwise respond to the June 10, 2025 27 order. Therefore, on July 22, 2025, the Court issued an order for Plaintiff to show cause why the 28 1 action should not be dismissed. (ECF No. 19.) Plaintiff has failed to respond to the order to 2 show cause and the time to do so has now passed. Thus, the operative complaint before the Court 3 is the second amended complaint, which as explained below, fails to state a cognizable claim for 4 relief and dismissal of the action is warranted. 5 I. 6 SCREENING REQUIREMENT 7 The Court is required to screen complaints brought by prisoners seeking relief against a 8 governmental entity or officer or employee of a governmental entity. 28 U.S.C. § 1915A(a). The 9 Court must dismiss a complaint or portion thereof if the prisoner has raised claims that are legally 10 “frivolous or malicious,” that “fail[] to state a claim on which relief may be granted,” or that “seek[] 11 monetary relief against a defendant who is immune from such relief.” 28 U.S.C. § 1915(e)(2)(B); 12 see also 28 U.S.C. § 1915A(b). 13 A complaint must contain “a short and plain statement of the claim showing that the pleader 14 is entitled to relief. . . .” Fed. R. Civ. P. 8(a)(2). Detailed factual allegations are not required, but 15 “[t]hreadbare recitals of the elements of a cause of action, supported by mere conclusory statements, 16 do not suffice.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Bell Atlantic Corp. v. Twombly, 17 550 U.S. 544, 555 (2007)). Moreover, Plaintiff must demonstrate that each defendant personally 18 participated in the deprivation of Plaintiff’s rights. Jones v. Williams, 297 F.3d 930, 934 (9th Cir. 19 2002). 20 Prisoners proceeding pro se in civil rights actions are entitled to have their pleadings 21 liberally construed and to have any doubt resolved in their favor. Wilhelm v. Rotman, 680 F.3d 22 1113, 1121 (9th Cir. 2012) (citations omitted). To survive screening, Plaintiff’s claims must be 23 facially plausible, which requires sufficient factual detail to allow the Court to reasonably infer that 24 each named defendant is liable for the misconduct alleged. Iqbal, 556 U.S. at 678-79; Moss v. U.S. 25 Secret Service, 572 F.3d 962, 969 (9th Cir. 2009). The “sheer possibility that a defendant has acted 26 unlawfully” is not sufficient, and “facts that are ‘merely consistent with’ a defendant’s liability” 27 falls short of satisfying the plausibility standard. Iqbal, 556 U.S. at 678; Moss, 572 F.3d at 969. 28 /// 1 II. 2 SUMMARY OF ALLEGATIONS 3 The Court accepts Plaintiff’s allegations in the complaint as true only for the purpose of the 4 screening requirement under 28 U.S.C. § 1915. 5 In 2011, prior to Plaintiff’s incarceration, he suffered a gunshot wound to his face and had 6 complex facial reconstruction surgery by Dr. Gravely. Metal places, wires, and screws were used 7 to reconstruct Plaintiff’s face and head. After the surgery, Plaintiff had no complaints of severe 8 ear pain, infection, facial swelling, inability to breathe through nostrils, and continuous high 9 pressure inside ears. 10 On June 24, 2019, while at Substance Abuse Treatment Facility and State Prison, 11 Corcoran (SATF), dental surgeon, Dr. Germanos, informed Plaintiff that teeth numbers 10, 12, 12 and 13 were small in size and needed to be removed. Dr. Germanos did not inform Plaintiff that 13 these teeth were anchor points for the maxillary hardware which was placed during his facial 14 reconstruction surgery. 15 Between June 24 to June 27, 2019, a three-member dental authorization review committee 16 approved the removal undermining Dr. Gravely’s expertise, who placed the hardware there for a 17 purpose. 18 On June 27, 2019, Plaintiff was taken to SATF treatment center for the removal of teeth 19 by the oral surgeon, Dr. Berry. Dr. Berry did not inform Plaintiff that these teeth were anchor 20 points for the maxillary hardware which was placed during facial reconstruction. Plaintiff did not 21 give consent to Dr. Germanos or Dr. Berry to remove the original implant out of his mouth. Both 22 doctors refused to consult Dr. Gravely or his complex medical history. 23 Drs. Germans and Berry intentionally caused Plaintiff unnecessary and wanton infliction 24 of pain and suffering. Their actions caused Plaintiff to suffer ear pain, facial swelling, sleepless 25 nights, and chronic maxillary sinusitis resulting in obstruction of nostrils. 26 On June 30, 2019, Plaintiff submitted a medical request form stating his mouth was 27 swollen after the removal of the three teeth and he was in severe pain. 28 On August 13, 2019, Plaintiff saw registered nurse Ratliff for his ear pain. After 1 examination, Ratliff noticed swelling and Plaintiff was prescribed an antibiotic by Dr. Kim R. 2 On September 11, 2019, Plaintiff returned to the medical clinic complaining of extreme 3 pain in his left ear radiating to the surrounding area. Plaintiff was again prescribed antibiotics. 4 On June 5, 2020, Plaintiff returned to the clinic and saw physician assistant David Oberst 5 for left ear pain and swelling. Oberst prescribed ear drops and Ibuprofen. 6 On June 7, 2020, Plaintiff returned to the clinic complaining that the ear drops were 7 causing more pain and ringing in his left ear. Plaintiff requested to see an ear-nose-and throat, 8 (ENT) specialist which was denied by Dr. Davydov who prescribed antibiotics. 9 On June 23, 2020, Plaintiff again saw Oberst for right ear pain and swelling. Plaintiff 10 requested to see an ENT for the ongoing ear pain and swelling. Plaintiff stated the pain was 11 increasing and radiating around the ear. Oberst denied Plaintiff’s request and again prescribed ear 12 drops. 13 On June 26, 2020, Plaintiff again returned to the clinic complaining that the ear drops 14 were causing more pain and asked for an ENT consultation. Dr. Davydov denied Plaintiff’s 15 request and prescribed different ear drops. 16 On July 7, 2020, Plaintiff submitted a sick call slip informing medical staff that his left ear 17 pain had returned, and the prescribed ear drops and antibiotics were not resolving the root cause 18 of his pain. 19 On July 14, 2020, Plaintiff again saw Dr. Davydov for left ear pain who prescribed ear 20 drops, despite Plaintiff informing him ear drops were not effective. 21 On September 6, 2020, Plaintiff complained of extreme pain behind his left ear which was 22 hindering his daily activities due to loss of balance. Plaintiff was simply advised to continue 23 using Ibuprofen. Plaintiff submitted an inmate appeal requesting face to face ENT consultation 24 for repetitive ear pain and swelling for over a year. 25 On November 4, 2020, Plaintiff received a response to his inmate appeal which falsely 26 stated that the ear drops showed improvement and the ENT request was denied. 27 On November 23, 2020, Plaintiff filed an appeal requesting a face-to-face ENT 28 consultation. 1 On January 8, 2021, Plaintiff saw Dr. Scharffenberg for reoccurring ear pain and 2 requested to see an ENT. Dr. Scharffenberg prescribed antibiotics and denied the ENT referral. 3 On February 25, 2021, Plaintiff received the denial of his appeal to see an ENT. The 4 actions in denying Plaintiff’s request to see an ENT by Edwards and Gates demonstrates careless 5 disregard to Plaintiff’s serious medical needs. The appeals coordinators were informed about 6 reoccurring ear swelling, pain, and infection, and that Plaintiff’s condition was worsening due to 7 the pain spreading around the ear. They were also informed that the current treatment with ear 8 drops and antibiotics were ineffective and still denied the pleas by falsely stating that ear drops 9 showed improvement. 10 In March and April 2021, Plaintiff discovered that in addition to the three teeth being 11 removed, the maxillary hardware was also removed. 12 On April 13, 2021, Plaintiff again complained of increasing ear pain, stating his condition 13 started on June 27, 2019, with the removal of maxillary hardware. Plaintiff was advised to use 14 Ibuprofen. 15 On April 21, 2021, Plaintiff again complained that the ear pain continued and it felt like 16 there was liquid inside his ears. 17 Oberst, Dr. Davydov, and Dr. Scharffenberg continued ineffectively treating Plaintiff with 18 ear drops, antibiotics, and Ibuprofen, despite his condition worsening. Their failure to refer 19 Plaintiff to see a specialist face to face for reoccurring ear pain, swelling, and infection was 20 medically unacceptable under the circumstances. The ear and swelling was a sufficiently obvious 21 risk that a reasonable physician would have noticed. Their failure to refer in order to save money 22 led to further significant injury causing chronic sinusitis and inability to breathe through nostrils. 23 On September 8, 2021, Plaintiff again submitted a medical request form complaining of 24 ear pain and pressure. 25 On November 7, 2022, Plaintiff went “man down” due to extreme pain and numbness on 26 the left side of his face. Plaintiff informed medical staff of pain and he was taken to Adventist 27 Health Hospital. A CT scan of Plaintiff’s sinuses was taken which found “mucosal thickening of 28 left sinus and sinus wall partially absent.” 1 On November 9, 2022, Plaintiff was taken to the triage and treatment area because of 2 extreme pain on the left side of his face. On this same date, Plaintiff submitted an “urgent” 3 appeal for pain on his face after removal of maxillary implant from his mouth. Plaintiff requested 4 the metal plate to be placed back to restore normal functioning of sinuses. 5 On November 10, 2022, Plaintiff again saw Oberst who prescribed antibiotics and denied 6 ENT referral, despite Plaintiff’s medical condition. CDCR is refusing to spend money to provide 7 adequate and much needed health care. 8 On January 23, 2023, Plaintiff informed SATF medical staff via medical request form that 9 was still suffering severe facial and ear pain. On this same date, Plaintiff received a response, 10 stating: “Chronic pain and inflammation of face noted and your health care does not meet urgent 11 criteria.” Nothing is mentioned about the removal of maxillary hardware that Plaintiff addressed 12 in his request. 13 On February 11, 2023, Plaintiff visited an ENT who prescribed antibiotics and nasal 14 spray. 15 On March 30, 2023, Plaintiff revisited the ENT for follow-up who placed a request for CT 16 scan of sinuses due to the continued symptoms after maximal dose of antibiotics. 17 On May 5, 2023, Plaintiff is finally taken to Adventist Health Hospital for a second time 18 for CT scan. 19 On May 16, 2023, Plaintiff received his inmate appeal response, stating: “SATF medical 20 staff are promptly addressing your medical concerns. The issue of facial surgery is a duplicate 21 and was addressed in 602 Tracking #22001604.” Barerjee is refusing to address the removal of 22 maxillary hardware and concealed the unauthorized removal with false statement. 23 On May 17, 2023, Plaintiff saw Dr. Scharffenberg who assured that the CT scan images 24 taken on May 5, 2023 would be sent to the ENT for examination. 25 On July 17, 2023, Plaintiff visited the ENT to discuss CT scan results, but the doctor 26 stated the CT images were not sent and she could not discuss anything. Plaintiff believes the 27 failure to send the CT images was a deliberate delay tactic. 28 On August 25, 2023, Plaintiff saw Dr. Scharffenberg who blamed the delay on the CDCR 1 system, even though he can make the delivery and appointment priority. 2 On October 18, 2023, Plaintiff met with Chief Medical Executive (CEO), Dr. Ugwueze 3 and explained his serious medical condition. Plaintiff requested to see Dr. Gravely, his 4 reconstruction surgery for consultation but the request was denied. 5 On October 23, 2023, Plaintiff is finally able to discuss the CT images with ENT, Dr. 6 Pieper. The ENT diagnosis was left maxillary sinusitis and refused to comment about the 7 maxillary hardware that was removed from Plaintiff’s mouth. Dr. Pieper offered to enter through 8 Plaintiff’s nostrils and make a hole on the sinus cavity. Dr. Pieper also placed referral for the 9 Plaintiff to see Dr. Gravely, reconstruction surgeon. 10 On November 9, 2023, Plaintiff meets supervisory dentist, Dr. Edwards and requests to 11 see Dr. Gravely. Dr. Edwards denies the request stating, “it will cost a lot of money to transport 12 the Plaintiff to Pasadena.” 13 Plaintiff’s injuries have been knowingly allowed to worsen to a life-threatening condition. 14 Defendants Barerjee, Gates, Edwards, and Ugwueze refused to restore Plaintiff’s sinus cavity to 15 its original state before June 27, 2019. Their failure and denial to provide meaningful and 16 effective care to save money has caused Plaintiff unnecessary pain and risk of dying. 17 Dr. Edwards and Dr. Ugwueze refused to restore Plaintiff’s sinus cavity to its original 18 state before June 27, 2019. Instead, they recommended less expensive and easier treatment to 19 reduce the symptoms without curing the root cause of the medical problem. 20 On November 30, 2023, Plaintiff visits Dr. Thompson for tooth filling procedure. 21 On December 28, 2023, Plaintiff returns to Dr. Thompson for inability to breathe through 22 his right nostril. Plaintiff informed that his right nostril felt “stuffy” after the tooth filling 23 procedure. Plaintiff wants to know if the extended drilling and grinding of the tooth during the 24 procedure damaged his sinus cavity lining. 25 Dr. Thompson explained the difficulty breathing was possibly coincidental due to chronic 26 sinusitis. 27 On January 10, 2024, Plaintiff was seen by physician assistant, Mbadugha for inability to 28 breathe through his right nostril. Mbadugha stated he cannot do anything because his boss dr. 1 Ugwueze is the one who makes the decision. Mbadugha refused to treat Plaintiff. 2 On January 15, 2024, Plaintiff submitted another inmate appeal for the inability to breath. 3 On April 23, 2024, Plaintiff saw Dr. Ugwueze and informed him that his condition was 4 consistently getting worse. Dr. Ugwueze denied help to Plaintiff. 5 On May 3, 2024, Plaintiff sees nurse practitioner Hunt for inability to breathe through his 6 right nostril. Plaintiff also requested a second opinion ENT consultation. 7 In late June 2024, Plaintiff requested the dental record review for dental extraction 8 consent forms. Upon review of the dental records, Plaintiff discovered that consent for extraction 9 document signed on June 27, 2019, had been deceitfully altered. Sometime in mid-July 2024, 10 Plaintiff filed a second inmate appeal stating that somebody altered a state legal document by 11 adding extra words without Plaintiff’s knowledge. 12 On July 11, 2024, Plaintiff saw a nurse for discomfort due to obstructed nostrils. 13 On August 15, 2024, after more than three months of waiting for a second opinion from 14 an ENT specialist, Plaintiff’s appointment was cancelled by SATF without Plaintiff’s consent. 15 On this same date, Plaintiff saw nurse Hunt for progressive hearing loss. 16 In early September 2024, Plaintiff received medical progress notes for May 3 and August 17 5, 2024, visits with Hunt. Plaintiff discovered that Hunt falsified Plaintiff’s conversations during 18 his visits. Hunt stated that Plaintiff’s medical condition was the same, deliberately hiding the 19 worsening symptoms. 20 On October 25, 2024, Plaintiff went to the clinic for a doctor visit. However, upon seeing 21 Hurt, Plaintiff requested to see another doctor. That same day, Hurt retaliated against Plaintiff by 22 falsely stating in the medical records that he was argumentative and uncooperative with the staff. 23 Plaintiff filed a health care grievance against Hurt for retaliation. 24 III. 25 DISCUSSION 26 A. Deliberate Indifference to Serious Medical Condition 27 Plaintiff complains of medical conditions stemming from 2019 to 2024-approximatley 5 28 years. 1 Deliberate indifference to the serious medical needs of an incarcerated person constitutes 2 cruel and unusual punishment in violation of the Eighth Amendment. See Estelle v. Gamble, 429 3 U.S. 97, 104 (1976). To maintain an Eighth Amendment claim premised on prison medical 4 treatment, the prisoner must show that officials were deliberately indifferent to his medical needs. 5 A finding of “deliberate indifference” involves an examination of two elements: the seriousness of 6 the plaintiff's medical need (determined objectively) and the nature of the defendant's response 7 (determined by defendant's subjective state of mind). See McGuckin v. Smith, 974 F.2d 1050, 8 1059 (9th Cir.1992), overruled on other grounds, WMX Technologies, Inc. v. Miller, 104 F.3d 9 1133, 1136 (9th Cir. 1997) (en banc). On the objective prong, a “serious” medical need exists if 10 the failure to treat “could result in further significant injury” or the “unnecessary and wanton 11 infliction of pain.” Colwell v. Bannister, 763 F.3d 1060, 1066 (9th Cir. 2014). On the subjective 12 prong, a prison official must know of and disregard a serious risk of harm. Farmer v. Brennan, 511 13 U.S. 825, 837 (1994). Such indifference may appear when a prison official intentionally denies or 14 delays care, or intentionally interferes with treatment once prescribed. Estelle, 429 U.S. at 104-05. 15 If, however, the official failed to recognize a risk to the plaintiff—that is, the official 16 “should have been aware” of a risk, but in fact was not—the official has not violated the Eighth 17 Amendment. Sandoval v. Cnty. of San Diego, 985 F.3d 657, 668 (9th Cir. 2021) (emphasis in 18 original). That is because deliberate indifference is a higher standard than medical malpractice. 19 Thus, a difference of opinion between medical professionals—or between the plaintiff and 20 defendant—generally does not amount to deliberate indifference. See Toguchi v. Chung, 391 F.3d 21 1051, 1057 (9th Cir. 2004). An argument that more should have been done to diagnose or treat a 22 condition generally reflects such differences of opinion and not deliberate indifference. Estelle, 23 429 U.S. at 107. To prevail on a claim involving choices between alternative courses of treatment, 24 a plaintiff must show that the chosen course “was medically unacceptable under the 25 circumstances,” and was chosen “in conscious disregard of an excessive risk” to the plaintiff's 26 health. Hamby v. Hammond, 821 F.3d 1085, 1092 (9th Cir. 2016). 27 Neither will an “inadvertent failure to provide medical care” sustain a claim, Estelle, 429 28 U.S. at 105, or even gross negligence, Lemire v. California Dep’t of Corr. & Rehab., 726 F.3d 1 1062, 1082 (9th Cir. 2013). Misdiagnosis alone is not a basis for a claim of deliberate medical 2 indifference. Wilhelm v. Rotman, 680 F.3d 1113, 1123 (9th Cir. 2012). A delay in treatment, 3 without more, is likewise insufficient to state a claim. Shapley v. Nevada Bd. of State Prison 4 Comm’rs, 766 F.2d 404, 407 (9th Cir. 1985). It is only when an official both recognizes and 5 disregards a risk of substantial harm that a claim for deliberate indifference exists. Peralta v. 6 Dillard, 744 F.3d 1076, 1086 (9th Cir. 2014) (en banc). A plaintiff must also demonstrate harm 7 from the official’s conduct. Jett v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006). And the 8 defendant’s actions must have been both an actual and proximate cause of this harm. Lemire, 726 9 F.3d at 1074. 10 Here, Plaintiff’s allegations span over a period of approximately 5 years-from June 2019 11 to August 2024. Plaintiff initially contends that he did not consent to the removal of his original 12 implant by Doctors Germanos and Berry; however, Plaintiff fails to demonstrate that the implant 13 removal was “medically unacceptable under the circumstances” and that Defendants chose it “in 14 conscious disregard of an excessive risk to plaintiff's health.” Jackson v. McIntosh, 90 F.3d 330, 15 332 (9th Cir. 1996); Toguchi, 391 F.3d at 1058. It is clear that Plaintiff consented to the removal 16 of teeth numbers 10, 12, and 13. Thus, this is not a situation where Plaintiff withheld consent and 17 medical professional nonetheless forced him to undergo treatment despite Plaintiff’s objections. 18 Plaintiff, at most, disputes the scope of his consent. Stated differently, Plaintiff disputes the 19 method of treatment, but as stated above, a prisoner’s disagreement with a medical professional 20 over the appropriate course of treatment does not demonstrate that the medical professional has 21 acted with deliberate indifference to the Plaintiff’s serious medical needs by following a 22 particular course of treatment. That Plaintiff had a bad outcome following the surgical procedure 23 in removing his original implant is not sufficient to show that Defendants were deliberately 24 indifferent. See Cunningham v. UCSF Spine Center, No. C-13-1978 EMC (pr), 2013 WL 25 5539311, at *3 (N.D. Cal. Oct. 8, 2013) (“That a surgery has potential complications or cannot be 26 performed with guaranteed perfect results does not mean that a doctor who performs the surgery 27 does so with deliberate indifference, or even negligence.”); Torrey v. Lovett, No. 2:12-cv-1457 28 JAM CKD P, 2013 WL 269043, at *2 (E.D. Cal. Jan. 23, 2013) (plaintiff’s allegation that his 1 knee surgery was “botched” was “exactly the kind of negligence claim that is not cognizable 2 under § 1983”). Further, Plaintiff claims that doctors simply provided antibiotics, ear drops, 3 and/or Ibuprofen; however, Plaintiff fails to demonstrate that these doctors purposely ignored or 4 failed to respond to Plaintiff’s pain or medical needs. Toguchi, 391 F.3d at 1058. The claim that 5 medical professional should have provided Plaintiff with additional or different treatment, is a 6 classic example of a matter for medical judgment and does not impose liability under the Eighth 7 Amendment. Adams v. Poag, 61 F.3d 1537, 1545 (11th Cir.1995) (quoting Estelle, 429 U.S. at 8 107). 9 Plaintiff further contends that he was repeatedly denied a referral to an ENT specialist. 10 However, Plaintiff fails to set forth sufficient facts to demonstrate that such referral was necessary 11 under the circumstances or that any need was obvious to any medical professional. Indeed, when 12 Plaintiff saw an ENT specialist on August 12, 2021, the specialist noted there was nothing he 13 could do. (ECF No. 1 at 11.) Plaintiff further acknowledges that he saw an ENT specialist again 14 on February 11, 2023, and he was prescribed antibiotics and nasal spray, as was prescribed by 15 prior medical professionals. (Id. at 12.) 16 With respect to Plaintiff’s claim that Edwards and Gates denied his inmate grievances for 17 referral to an ENT specialist, prison administrators cannot willfully turn a blind eye to 18 constitutional violations being committed by subordinates. See Jett, 439 F.3d at 1098 (prison 19 administrators “are liable for deliberate indifference when they knowingly fail to respond to an 20 inmate's requests for help” (citations omitted)). Therefore, an individual who denies an inmate 21 appeal and who had the authority and opportunity to prevent an ongoing constitutional violation 22 could potentially be subject to liability if the individual knew about an existing or impending 23 violation and failed to prevent it. Id. However, Plaintiff’s allegations fail to state a claim for relief 24 because he has failed to demonstrate that any medical professional acted with deliberate 25 indifference to any constitutional violation such that they could have intervened. 26 Further, Plaintiff’s complaint fails to state a claim based on allegations of a false medical 27 report. The creation of false evidence, standing alone, is not actionable under § 1983. See 28 Hernandez v. Johnston, 833 F.2d 1316, 1319 (9th Cir. 1987) (independent right to accurate prison 1 record has not been recognized); Martin v. Pfeiffer, No. 1:22-CV-00889 AWI BAM PC, 2022 WL 2 4345686, at *8 (E.D. Cal. Sept. 19, 2022) (no cognizable claim for a false medical report), report 3 and recommendation adopted, No. 1:22-CV-00889 AWI BAM PC, 2022 WL 17406535 (E.D. Cal. 4 Dec. 2, 2022); Sanford v. Eaton, No. 1:20-CV-00792 BAM (PC), 2021 WL 1172911, at *7 (E.D. 5 Cal. Mar. 29, 2021) (denying a claim alleging falsified medical report and statements made by 6 Plaintiff), denying to adopt on other grounds, Sanford v. Eaton, No. 1:20-CV00792-JLT 7 BAM(PC), 2022 WL 168530, at *2 (E.D. Cal. Jan. 19, 2022). 8 Lastly, Plaintiff’s claim that he was denied medical treatment based on financial concerns, 9 also fails to state a cognizable claim. Plaintiff’s conclusory that Defendants had a financial motive 10 to deny adequate medical care in order to save the prison money, without more, simply “do[es] not 11 allow the court to infer more than the mere possibility of misconduct.” Iqbal, 556 U.S. at 679; 12 Sprewell v. Golden State Warriors, 266 F.3d 979, 988 (9th Cir.) (the court is not required to 13 “accept as true allegations that are merely conclusory, require unwarranted deductions or 14 unreasonable inferences.” ) (internal quotations omitted), amended on other grounds, 275 F.3d 15 1187 (9th Cir.2001); see also Butler v. Kelso, Civil No. 11cv–2884 CAB (RBB), 2013 WL 16 1883233 at *9 (S.D. Cal. May 2, 2013) (the prisoner-plaintiff failed to state a claim for deliberate 17 indifference because he did not provide sufficient factual allegations necessary for the court to 18 accept his conclusion that defendants’ medical decisions were based on the desire to save money). 19 Moreover, Plaintiff’s own allegations acknowledge that he was repeatedly examined and provided 20 some form of treatment. Although he may not have agreed with the treatment provided, a 21 disagreement among an inmate and doctor as to what is appropriate treatment does not give rise to 22 a claim for deliberate indifference. Plaintiff references a single statement made by Dr. Edwards 23 stating, “it will cost a lot of money to transport the Plaintiff to Pasadena.” However, this comment 24 does not state or infer that Plaintiff was denied any and all treatment because of its cost. Plaintiff 25 has failed to provide sufficient factual allegations necessary to allow the Court to accept his 26 ultimate conclusion that a financial strain on the prison led to the decision by multiple Defendants 27 to deny him adequate medical treatment. See Holden v. Hagopian, 978 F.2d 1115, 1121 (9th Cir. 28 1992); see also Sims v. Wexford Health Sources, 635 F. App’x 16, 20 (3d Cir. 2015) (summarily 1 | affirming dismissal of Monell claims against prison medical contractor where plaintiff's 2 | “complaint stated that Wexford had an open practice, policy, or custom of deliberate indifference 3 | in order to save money” and “[h]is statement of facts merely repeated this”); Winslow v. Prison 4 | Health Services, 406 F. App’x 671, 674-75 (3d Cir. 2011) (allegation that plaintiff was harmed by 5 | “policies to save money” is conclusory); Haar v. CFG Health Servs., LLC, No. 22-7595, 2024 WL 6 | 4880349, at *6 (D.N.J. Nov. 25, 2024) (assertion that CFG has “a policy to provide inmates with 7 | as little medical care as possible ... to save money” is too speculative and conclusory to support a 8 | deliberate indifference claim). Accordingly, Plaintiff fails to state a cognizable claim for relief. 9 V. 10 ORDER AND RECOMMENDATION 11 Based on the foregoing, it is HEREBY ORDERED that the Clerk of Court shall randomly 12 | assign a District Judge to this action. 13 Further, it is HEREBY RECOMMENDED that this action be dismissed for failure to state 14 | acognizable claim for relief. 15 This Findings and Recommendation will be submitted to the United States District Judge 16 || assigned to the case, pursuant to the provisions of 28 U.S.C. § 636(b)(1). Within fourteen (14) 17 | days after being served with this Findings and Recommendation, Plaintiff may file written 18 | objections with the Court, limited to 15 pages in length, including exhibits. The document should 19 | be captioned “Objections to Magistrate Judge’s Findings and Recommendation.” Plaintiff is 20 | advised that failure to file objections within the specified time may result in the waiver of rights 21 | onappeal. Wilkerson v. Wheeler, 772 F.3d 834, 838-39 (9th Cir. 2014) (citing Baxter v. 22 | Sullivan, 923 F.2d 1391, 1394 (9th Cir. 1991)). 23 24 IT IS SO ORDERED. OF. ee 25 | Dated: _ August 22, 2025 STANLEY A. BOONE 26 United States Magistrate Judge 27 28 13