Richi Orlando Briones v. James Dzurenda, et al.

• Court: District Court, D. Nevada
• Decided: June 3, 2026
• Docket: 2:23-cv-00417
• Status: Unknown

Opinion

1 UNITED STATES DISTRICT COURT 2 DISTRICT OF NEVADA 3 RICHI ORLANDO BRIONES, Case No.: 2:23-cv-00417-APG-DJA

4 Plaintiff Order (1) Granting Plaintiff’s Motion for a Preliminary Injunction, (2) Denying 5 v. Plaintiff’s Motion for a Temporary Restraining Order, (3) Denying 6 JAMES DZURDENDA, et al., Defendants’ Motion for Referral to a Settlement Conference Without Prejudice, 7 Defendants and (4) Striking Plaintiff’s Pro Se Motions

8 [ECF Nos. 94, 95, 106, 111, 112] 9

10 Richi Briones is a prisoner at High Desert State Prison (HDSP) in Indian Springs, 11 Nevada, serving two life sentences without the possibility of parole for two murders. ECF Nos. 12 45 at 5, 15; 96-1 at 2-3. He entered a plea of guilty but mentally ill pursuant to Nevada Revised 13 Statutes § 174.063, and in his judgment of conviction, the Nevada state court ordered that he 14 receive treatment for his mental illness during his incarceration. ECF No. 96-1 at 2-3. 15 Briones is diagnosed with several mental illnesses, including schizoaffective disorder 16 (bipolar type), post-traumatic stress disorder, anxiety, and an unspecified major neurocognitive 17 disorder. ECF No. 98-1 at 15. A psychiatrist described his schizoaffective disorder as a “severe, 18 chronic psychiatric illness” that leads to “severe symptoms of psychosis consisting of severe 19 paranoid delusions and escalating severe command auditory and visual hallucinations.” Id. at 13- 20 14. His mental health history includes multiple suicide attempts and in-patient psychiatric 21 hospitalizations. One hospitalization occurred in late 2016 because he poured lighter fluid on 22 himself and planned to walk into traffic and set himself on fire. Id. at 13. He was hospitalized 23 again in 2017 for acute psychosis with suicidal and homicidal ideations, and 11 days after he was 1 discharged, he was arrested for the two murders to which he pleaded guilty. Id. Further, he has 2 an arachnoid cyst in his brain that has enlarged over time and may contribute to his psychosis 3 and the impaired control of his behavior. ECF No. 98-7 at 3-5. 4 While incarcerated, Briones began receiving a low dose of medication called Geodon

5 (also called ziprasidone) to treat his psychosis in 2020. Id. at 8, 12-13. Soon after, Briones 6 indicated his medication dosage was not effective. Id. at 13. But when he complained to the 7 Nevada Department of Corrections (NDOC) psychiatrist, defendant Dr. Wade Exum, Dr. Exum 8 described Briones as “med-seeking” and refused to increase his dosage. Id. A psychiatrist 9 retained by Briones to review his treatment noted that his current dose of Geodon is “very low” 10 and that, because NDOC does not allow him to take it with food, his body is not absorbing much 11 of the medication. Id. at 9. 12 Briones filed grievances over several years related to complaints of inadequate 13 psychiatric care and medication. In one, he asked that the NDOC medical team review his prior 14 medical records and prescribe him psychiatric medication he had received in the past. ECF No.

15 107-3 at 3-4, 8-9. That grievance was denied. Id. at 6-7. In another, he complained that he had 16 “not received medically necessary or appropriate treatment for [his] various mental illnesses” 17 and that “staff ignore [his] requests.” ECF No. 107-4 at 11, 13. That grievance was also denied, 18 where the NDOC staff noted in 2023 that Briones had been receiving ziprasidone “continuously 19 since initially ordered.” Id. at 8. In many grievances, he cited back to his mentally ill plea to 20 justify seeking different medication that will address his mental illnesses. Id. at 13; ECF Nos. 21 107-3 at 12; 107-5 at 11. 22 As of December 2022, Briones reported experiencing visual and auditory hallucinations 23 due to his psychosis despite receiving Geodon for almost three years. ECF No. 98-7 at 10. The 1 visual hallucinations were of “poorly-formed shadow-like objects that move about in his 2 peripheral vision.” Id. The auditory hallucinations were loud, derogatory human voices that 3 threatened him harm and were “nearly constant” while he was awake. Id. He began wearing 4 earphones playing music or television at maximum volume to try and drown them out. Id.

5 Briones also was experiencing symptoms due to his post-traumatic stress disorder 6 (PTSD) in December 2022. He reported to a psychiatrist that he had trauma-related nightmares 7 almost every night. Id. at 12. These issues traced back years. In 2021 he filed a grievance 8 because the treatment for his PTSD was not preventing flashbacks and nightmares that kept him 9 from sleeping. ECF No. 107-3 at 8, 10. The psychiatrist retained by Briones noted that the only 10 PTSD treatment Briones was receiving was a medication called Prazosin, which the psychiatrist 11 claimed the Food and Drug Administration has not approved to treat PTSD. ECF No. 98-7 at 11. 12 Despite Briones’ on-going symptoms, he argues there was no reevaluation of his 13 psychiatric treatment, which the defendants do not dispute. ECF No. 95 at 6. The defendants 14 also do not dispute that NDOC no longer has a full-time psychiatrist on staff, nor has it

15 contracted with an outside psychiatrist to provide treatment to inmates since August 2025. Id. at 16 7-8. 17 Briones sued the defendants, who are various NDOC officials. He filed an amended 18 complaint on November 7, 2024, alleging that HDSP officials’ deliberate indifference and failure 19 to provide him with adequate psychiatric health care and medication violates the Eighth 20 Amendment. ECF No. 45 at 22-23. In March 2025, the parties entered a stipulation where they 21 agreed an outside psychiatrist would evaluate Briones to determine whether his medication 22 needed to be changed. ECF No. 58 at 2. 23 1 Briones alleges, and the defendants do not dispute, that this appointment with the outside 2 psychiatrist never occurred. ECF No. 95 at 8. In recent months, his mother reports that Briones 3 talks only about his delusions during their phone calls, unlike earlier in his incarceration when he 4 was “sometimes able to have normal conversations.” ECF Nos. 96-2 at 2; 96-3 at 2. Briones’

5 attorney met with him in April 2026 and also noted that his paranoid and delusional beliefs were 6 more pronounced “to the point where it was difficult to have a normal conversation about his 7 lawsuit.” ECF No. 108-1 at 2. Briones told his attorney he destroyed his electronic tablet 8 because cartels and government agencies monitoring him were posting messages on it. Id. 9 Briones now moves for a temporary restraining order or preliminary injunction on his 10 inadequate psychiatric care claim against the HDSP defendants. He seeks several forms of 11 equitable relief. He requests that a licensed psychiatrist evaluate him and recommend treatment, 12 and that the psychiatrist be able to review Briones’ medical file, his mentally ill plea, and the 13 psychiatric report in support of that plea. He asks that the treatment plan be provided to all 14 NDOC providers, to his counsel, and be placed in his medical file, and that NDOC follow the

15 plan. He requests that NDOC prioritize hiring or contracting with a licensed psychiatrist. 16 Finally, pending a psychiatric evaluation, Briones asks that he be housed at the Mental Health 17 Unit at Northern Nevada Correctional Center and that he remain there until a psychiatrist or 18 psychologist determines such care is no longer necessary. 19 The defendants oppose the motions, arguing that Briones has not exhausted his 20 administrative remedies under the Prison Litigation Reform Act (PLRA). They also argue that 21 he has failed to show imminent irreparable harm, and that the balance of equities and public 22 interest favor them. They also move to refer this case to a settlement conference. 23 1 Because Briones satisfies the requirements for a preliminary injunction, and because the 2 defendants have not shown a likelihood of success on their PLRA affirmative defense, I grant the 3 preliminary injunction. I order that the defendants hire or contract with a psychiatrist to evaluate 4 Briones and develop a new treatment plan for him. I further order the defendants to comply with

5 that treatment plan. Accordingly, I deny his motion for a temporary restraining order as moot. I 6 also deny the defendants’ motion for a referral to a settlement conference without prejudice. 7 Finally, I strike Briones’ pro se motions because he is represented by counsel. 8 I. BRIONES MOTION FOR A PRELIMINARY INJUNCTION 9 To obtain a preliminary injunction, a plaintiff must demonstrate: (1) a likelihood of 10 success on the merits, (2) a likelihood of irreparable harm, (3) the balance of hardships favors the 11 plaintiff, and (4) an injunction is in the public interest. Winter v. Natural Res. Def. Council, Inc., 12 555 U.S. 7, 20 (2008). 13 Because Briones seeks to compel the defendants to act prior to final judgment, he seeks a 14 mandatory injunction. Doe v. Synder, 28 F.4th 103, 111 (9th Cir. 2022). To receive a mandatory

15 injunction, he “must establish that the law and the facts clearly favor [his] position, not simply 16 that [he] is likely to succeed.” Garcia v. Google, Inc., 786 F.3d 733, 740 (9th Cir. 2015) (en 17 banc) (emphasis omitted). “In general, mandatory injunctions are not granted unless extreme or 18 very serious damage will result.” Doe, 28 F.4th at 111 (quotation omitted). 19 / / / / 20 / / / / 21 / / / / 22 / / / / 23 / / / / 1 A. Briones has established that the law and the facts clearly favor his position. 2 1. Briones has established that the law and the facts clearly favor the position that the 3 HDSP defendants are not providing adequate psychiatric care under the Eighth 4 Amendment.

5 The government is obligated “to provide medical care for those whom it is punishing by 6 incarceration.” Estelle v. Gamble, 429 U.S. 97, 103 (1976). “[D]eliberate indifference to serious 7 medical needs of prisoners” violates the Eighth Amendment’s prohibition on cruel and unusual 8 punishment. Id. at 104. To establish a claim for deliberate indifference to serious medical needs, 9 a plaintiff must show (1) a “serious medical need by demonstrating that failure to treat a 10 prisoner’s condition could result in further significant injury or the unnecessary and wanton 11 infliction of pain,” and (2) the defendant was subjectively “deliberately indifferent” to the need. 12 Jett v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006) (quotations omitted). This second prong 13 requires that the defendant knew of and disregarded “an excessive risk to inmate health or 14 safety.” Farmer v. Brennan, 511 U.S. 825, 837 (1994).

15 Broadly, the defendants do not challenge that the law and the facts favor Briones’ 16 position on both prongs of his Eighth Amendment claim, which constitutes consent that I rule for 17 him. LR 7-2(d). And on the merits of Briones’ arguments, the law and the facts also clearly 18 favor his position. 19 Briones has shown that he has a serious medical need and meets the first prong of his 20 Eighth Amendment claim. He provided psychiatric reports diagnosing him with schizophrenic 21 disorder, PTSD, and anxiety. ECF Nos. 98-1 at 15; 98-7 at 7, 10. In the past, when these mental 22 illnesses went untreated, he attempted suicide. Both his attorney and his mother have reported 23 1 that his delusions have become more pronounced recently, such that it is much more difficult for 2 him to talk about anything else. 3 Briones also satisfies the second prong. Several documents show that the defendants 4 knew that Briones needed but was not receiving sufficient care for his psychiatric conditions.

5 His mental health guilty plea identified that Briones has mental illnesses and ordered that he 6 receive psychiatric treatment. Briones has submitted several grievances to the defendants 7 referencing that he is not receiving the proper psychiatric medication, contravening his mental 8 health guilty plea. ECF Nos. 107-4 at 5-7, 10, 13; 107-5 at 4, 7-8, 11. The defendants do not 9 contest that Briones’ current psychiatric treatment plan and medication create a risk to his health 10 and that they have not changed the plan despite that risk. See Stewart v. Aranas, 32 F.4th 1192, 11 1194 (9th Cir. 2022) (stating that “continuation of the same treatment in the face of obvious 12 failure” is deliberate indifference); Porretti v. Dzurenda, 11 F.4th 1037, 1043, 1049 (9th Cir. 13 2021) (finding an inmate had shown a likelihood of success on an Eighth Amendment inadequate 14 medical care claim where the prison stopped providing psychiatric medication as prescribed by

15 the inmate’s doctor prior to his incarceration). They also do not counter Briones’ expert’s report 16 that his current treatment for his psychosis and PTSD is inadequate, nor do they provide their 17 own expert report that states his current treatment is adequate. Cf. Poretti, 11 F.4th at 1048 18 (noting that a plaintiff fails to demonstrate deliberate indifference when his medical expert has a 19 “mere disagreement of medical opinion” with the defendants’ expert). Additionally, they 20 stipulated over a year ago to have an outside psychiatrist evaluate Briones, which they have 21 failed to schedule, showing knowledge and disregard of his health risk. Therefore, Briones has 22 established that the law and the facts clearly favor his position. 23 1 2. The defendants have not shown a likelihood of success on their affirmative defense of 2 PLRA exhaustion. 3 Nonetheless, the defendants oppose granting a preliminary injunction because they argue 4 Briones has not exhausted his administrative remedies under the PLRA. PLRA exhaustion is an

5 affirmative defense. Jones v. Bock, 549 U.S. 199, 211 (2007). When the non-moving party raises 6 an affirmative defense in opposition to a motion to a preliminary injunction, “once the moving 7 party has carried its burden of showing a likelihood of success on the merits, the burden shifts to 8 the non-moving party to show a likelihood that its affirmative defense will succeed.” Disney 9 Enters., Inc. v. VidAngel, Inc., 869 F.3d 848, 856 (9th Cir. 2017). 10 The PLRA requires that an inmate exhaust all “administrative remedies as are available” 11 before bringing a claim related to prison conditions. 42 U.S.C. § 1997e(a). “Exhaustion must be 12 ‘proper.’ This means that a grievant must use all steps the prison holds out, enabling the prison to 13 reach the merits of the issue.” Griffin v. Arpaio, 557 F.3d 1117, 1119 (9th Cir. 2009) (quoting 14 Woodford v. Ngo, 548 U.S. 81, 90 (2006)). Thus, the inmate must comply “with an agency's

15 deadlines and other critical procedural rules because no adjudicative system can function 16 effectively without imposing some orderly structure on the course of its proceedings.” Woodford, 17 548 U.S. at 90-91. “The level of detail in an administrative grievance necessary to properly 18 exhaust a claim is determined by the prison’s applicable grievance procedures.” Morton v. Hall, 19 599 F.3d 942, 946 (9th Cir. 2010) (citing Jones, 549 U.S. at 218). The date the operative 20 complaint was filed controls the PLRA exhaustion analysis. Saddozai v. Davis, 35 F.4th 705, 21 706, 710 (9th Cir. 2022). 22 NDOC’s grievance process is governed by Nevada’s Administrative Regulation (AR) 23 740, effective April 28, 2022. ECF No. 107-1 at 2. That process has three levels through which 1 the inmate must proceed to exhaust his administrative remedies: an Informal Grievance, a First 2 Level appeal, and a Second Level appeal. Id. at 11-16. The grievance must “factually 3 demonstrate a loss or harm.” Id. at 4. This is insufficient guidance as to the factual specificity 4 required in a grievance, so an NDOC inmate’s grievance is properly specific if it “puts the prison

5 on adequate notice of the problem for which the prisoner seeks redress.” Sapp v. Kimbrell, 623 6 F.3d 813, 824 (9th Cir. 2010); Malone v. Janssen Biotech, Inc., No. 2:22-cv-01089-APG-DJA, 7 2024 WL 2028010, at *2 (D. Nev. May 5, 2024). 8 Because PLRA exhaustion is an affirmative defense, “the defendant’s burden is to prove 9 that there was an available administrative remedy, and that the prisoner did not exhaust that 10 available remedy.” Albino v. Baca, 747 F.3d 1162, 1172 (9th Cir. 2014) (en banc). “Once the 11 defendant has carried that burden, . . . the burden shifts to the prisoner to come forward with 12 evidence showing that there is something in his particular case that made the existing and 13 generally available administrative remedies effectively unavailable to him.” Id. 14 The defendants identify only one grievance Briones fully exhausted related to his medical

15 issues by the time he filed his amended complaint on November 7, 2024. Briones received a 16 response to his Level 2 appeal of Grievance 2006-31-54000 (Grievance ‘000) on June 4, 2024. 17 ECF No. 107-8 at 2. Briones does not dispute this is his only fully exhausted grievance. But 18 Grievance ‘000 does not mention his mental illnesses or his psychiatric treatment. Id. at 3, 6-7, 9, 19 11. In Grievance ‘000, Briones states he is not receiving proper treatment for his arachnoid cyst 20 in his brain, high blood pressure, or his back pain. Id. This does not put the defendants on 21 adequate notice of the problem he seeks to redress in this motion, that he is not receiving proper 22 psychiatric care for his mental illnesses. 23 1 The burden thus shifts to Briones. He responds that NDOC’s administrative procedures 2 did not provide him with an available avenue for relief. “A prisoner need not exhaust remedies if 3 they are not ‘available.’” Ross v. Blake, 578 U.S. 632, 636 (2016). “If prison officials screen out 4 an inmate’s appeals for improper reasons, the inmate cannot pursue the necessary sequence of

5 appeals, and administrative remedies are therefore plainly unavailable.” Sapp, 623 F.3d at 823. 6 “To fall within this exception, . . . the inmate must establish (1) that he actually filed a grievance 7 or grievances that, if pursued through all levels of administrative appeals, would have sufficed to 8 exhaust the claim that he seeks to pursue in federal court, and (2) that prison officials screened 9 his grievance or grievances for reasons inconsistent with or unsupported by applicable 10 regulations.” Id. at 823-24. 11 There is an “inherent tension” here because the defendants bear the burden of showing a 12 likelihood of success on the merits of their affirmative defense, yet within that merits 13 determination Briones bears the burden of establishing the exception to the affirmative defense. 14 See California Chamber of Com. v. Council for Educ. & Rsch. on Toxics, 29 F.4th 468, 477 (9th

15 Cir. 2022). But “the burdens at the preliminary injunction stage track the burdens at trial.” 16 Gonzales v. O Centro Espirita Beneficente Uniao do Vegetal, 546 U.S. 418, 429 (2006). 17 Therefore, to succeed on his motion for a preliminary injunction under this exception, Briones 18 must establish that the law and facts clearly favor the position that the prison’s administrative 19 appeals process was unavailable to him because NDOC officials improperly screened his 20 grievances. Two grievances meet this burden: Grievance 2006-31-53573 (Grievance ‘573) and 21 Grievance 2006-31-53819 (Grievance ‘819). 22 / / / / 23 / / / / 1 i. The law and facts clearly favor the position that Grievances ‘573 and ‘819 put 2 the defendants on notice of Briones’ inadequate psychiatric care claim. 3 For a grievance to sufficiently exhaust a claim that a prisoner now pursues in federal 4 court, it must “put[] the prison on adequate notice of the problem for which the prisoner seeks

5 redress.” Sapp, 623 F.3d at 824. Grievance ‘573 alerted the defendants that Briones claimed he 6 was not receiving the psychiatric care he needed despite his mentally ill plea. He stated that 7 “since [he] entered the custody of NDOC, [he] [has] not received medically necessary or 8 appropriate treatment for [his] various mental illness” and further references his “mental health 9 issues” and “mentally ill plea” throughout the grievance. ECF No. 107-4 at 5, 10, 17. 10 NDOC’s response to Grievance ‘573 shows that it knew this grievance was tied to 11 Briones’ psychiatric medication. A prison’s response to a grievance is evidence that the prison 12 was on notice of the alleged deprivation. See Reyes v. Smith, 810 F.3d 654, 659 (9th Cir. 2016). 13 In Reyes, a prisoner sued members of the prison’s Pain Management Committee over their 14 decision to deny him morphine. Id. at 656. The prisoner’s grievances did not mention the Pain

15 Management Committee and only referred to the prescribing doctor’s denial of morphine. Id. at 16 658. But the prison’s responses cited the Pain Management Committee’s decision when denying 17 the prisoner’s grievances, so the Ninth Circuit held that the grievance satisfied the PLRA 18 exhaustion requirement for a suit against the Pain Management Committee members because the 19 prison had “full notice of the alleged deprivation.” Id. at 659. 20 Here, NDOC’s response to Grievance ‘573 noted how the court ordered that Briones 21 receive mental health treatment, that he had multiple visits from mental health providers, and 22 listed four “[p]sychiatric medications” he has “been given continuously since ordered.” ECF No. 23 1 107-4 at 8. Thus, NDOC had full notice of Briones’ claim that he was not given proper 2 medication and treatment to address his psychiatric conditions. 3 For similar reasons, Grievance ‘819 also put the defendants on notice of his claim. 4 Grievance ‘819 raises issues of “missing medication” for Briones’ “mood” despite a court order

5 and his “mentally ill plea.” ECF No. 107-5 at 4, 7-8, 11, 19. In response, NDOC noted his 6 prescriptions of the four psychiatric medications listed in its response to Grievance ‘573 and that 7 they had “all been renewed and are current.” Id. at 5. Therefore, Briones has established that the 8 law and the facts clearly favor the position that Grievances ‘573 and ‘819 would have been 9 sufficient to exhaust his administrative appeals for his inadequate psychiatric care claim against 10 the HDSP defendants. 11 ii. The law and the facts clearly favor the position that Grievances ‘573 and ‘819 12 were improperly screened. 13 As relevant to PLRA exhaustion, Grievances ‘573 and ‘819 followed identical procedural 14 pathways. Briones first filed an Informal Grievance, which was denied on the merits. ECF Nos.

15 107-4 at 14-15, 17; 107-5 at 9, 11, 13. Briones then filed a First Level Grievance, which was 16 also denied on the merits. ECF Nos. 107-4 at 8, 11, 13; 107-5 at 5, 7-8. Finally, Briones filed a 17 Second Level Grievance, which was not denied on the merits but “rejected” due to procedural 18 deficiencies. ECF No. 107-4 at 2, 5-6; 107-5 at 2,1 4. Grievances ‘573 and ‘819 were rejected on 19

20 1 The rejection of Grievance ‘819 is listed as a rejection for a “Level 1” Grievance. ECF No. 107-5 at 2. This is NDOC’s second reply to the First Level Grievance to Grievance ‘819. On 21 the record before me, this appears to be a typographical error and should instead be a rejection for Briones’ Level 2 Grievance of Grievance ‘819. The rejection was issued after Briones 22 received a response on his First Level Grievance and submitted his Second Level Grievance. NDOC denied his First Level Grievance on August 1, 2023. Id. at 5. Briones signed his Second 23 Level Grievance on October 19, 2023. Id. at 4. NDOC then issued its rejection of Grievance ‘819 on November 2, 2023. Id. at 2. The defendants provided no other documents issued by NDOC after Briones’ signed his Second Level Grievance, so the November 2 rejection is likely 1 February 21, 2024 and November 2, 2023, respectively, before Briones filed his amended 2 complaint. ECF Nos. 107-4 at 2; 107-5 at 2. The listed justifications for both rejections were 3 identical: 4 Missing Documents: Per AR 740.08 number 4D(5), all documentation and factual allegations available to the Offender must be submitted at this level with the 5 grievance. You have failed to attach all prior submitted documents to support your claim. 6 Instructions: Please correct and resubmit on a new Grievance . . . [and] attach all 7 previously submitted documents including prior submitted grievance(s), attach proof of claim and Official Response(s) under this grievance number, the prior 8 DOC 3098 Improper Grievance Memo(s) and/or prior responses under this grievance number, and all attachments so that this can be fully researched. 9

10 ECF Nos. 107-4 at 2 (emphasis omitted); 107-5 at 2 (emphasis omitted). 11 The law and the facts clearly favor the position that these two grievances were 12 improperly screened. The regulation listed for the rejection, AR 740.08 number 4D(5), does not 13 exist. See ECF No. 107-1 at 11-13. But there is an AR 740.08(4)(D) and an AR 740.08(5). Id. at 14 12. AR 740.08(4)(D) is irrelevant to these grievances because it discusses the timeline for filing 15 grievances relating to sexual abuse and disability discrimination claims. Id. 16 AR 740.08(5) appears to be the regulation the prison official was attempting to cite. It 17 states that “[a]ll documentation and factual allegations available to the offender must be 18 submitted at this level with the grievance.” Id. The “level” this regulation refers to is not the 19 Second Level, the level of Briones’ grievances that the rejections addressed. The “level” under 20 AR 740.08(5) refers to the Informal Level because AR 740.08 deals only with regulations 21 relating to the Informal Grievances. Id. at 11. AR 740.10 is the section of the NDOC regulations 22

NDOC’s reply to it. AR 740 does not provide a way prisoners can submit a second First Level 23 Grievance for the same grievance. See ECF No. 107-1 at 13-16. The only listed method a prisoner can appeal a First Level response is using a Second Level Grievance form. Id. at 15. 1 that establishes the procedures for Second Level Grievances. Id. at 15. AR 740.10 does not state 2 that prisoners must submit other documentation alongside the Second Level grievance itself, 3 such as the prior grievances and responses. See id. at 15-16; cf. Sapp, 623 F.3d at 825-26 (finding 4 that a prison properly screened a grievance for failing to attach a form because the “regulations

5 allow an appeal to be rejected if ‘necessary supporting documents are not attached’” (quoting the 6 prison’s regulations)). In fact, it requires the prison’s Grievance Coordinator to “forward copies 7 of all related documents and the appeal to the respective Deputy Director for review.” Id. at 15. 8 Therefore, the law and the facts clearly favor the position that NDOC’s rejection of his 9 Second Level Grievances for Grievances ‘573 and ‘819 is unsupported by the applicable 10 regulations and thus an improper screening. See Nunez v. Duncan, 591 F.3d 1217, 1225-26 (9th 11 Cir. 2010) (holding that a prisoner’s administrative remedies were unavailable when the prison 12 official denied an intermediate appeal of a grievance by citing the incorrect regulation). 13 Ultimately, Briones has established the law and the facts clearly favor the position that PLRA 14 exhaustion was unavailable for his grievances relating to his psychiatric care.

15 B. Briones has shown a likelihood of irreparable harm. 16 The defendants argue that Briones is not facing imminent threat of irreparable injury. 17 But Briones has shown that the defendants are depriving him psychiatric care in violation his 18 Eighth Amendment rights, and “the deprivation of a prisoner’s constitutional right to adequate 19 medical care is sufficient to establish irreparable harm.” Porretti, 11 F.4th at 1050 (simplified); 20 see Elrod v. Burns, 427 U.S. 347, 373 (1976) (a violation of constitutional rights 21 “unquestionably constitutes irreparable injury”). A psychiatric evaluation from 2023 notes how 22 Briones’ current treatment is inadequate and that he suffers from visual and auditory 23 hallucinations from his psychosis and experiences trauma-related nightmares due to his PTSD. 1 ECF No. 98-7 at 10, 12. Briones also attempted suicide several times prior to his incarceration 2 due to “repeated command auditory hallucinations with suicidal content, and an accompanying 3 urge to escape his increasingly disturbing paranoia and auditory and visual hallucinations,” 4 including one attempt a few months before his arrest. ECF No. 98-1 at 9, 13. “Debilitating

5 symptoms like paranoid delusions [and] auditory hallucinations” along with the risk of suicide 6 constitutes irreparable harm. Porretti, 11 F.4th at 1050 (simplified). These symptoms and 7 increased risk of suicide together qualify as “extreme or very serious damage” to Briones. See 8 Doe, 28 F.4th at 111 (quotation omitted). The defendants have not indicated they will soon be 9 able to replace the psychiatrist that stopped working with NDOC last August or that they are 10 working to schedule an appointment with another psychiatrist to evaluate Briones as required by 11 the parties’ March 2025 stipulation. Without a concrete plan to address Briones’ psychiatric 12 concerns, these on-going mental health risks and symptoms constitute irreparable harm and 13 require injunctive relief. 14 C. The balance of the equities and public interest weigh in favor of Briones.

15 “The third and fourth factors of the preliminary-injunction test–balance of equities and 16 public interest–merge into one inquiry when the government opposes a preliminary injunction.” 17 Porretti, 11 F.4th at 1050. The “balance of equities” concerns the burdens or hardships to 18 Briones compared with the burden on the defendants if I order an injunction. Id. “The ‘public 19 interest’ mostly concerns the injunction’s impact on nonparties rather than parties.” Id 20 (simplified). 21 Granting the preliminary injunction will place some burden on the defendants. Paying an 22 outside psychiatrist to evaluate and develop a treatment plan for Briones imposes costs on 23 NDOC. Transferring Briones to the Mental Health Unit at the Northern Nevada Correctional 1 Center is also a logistical burden. But Briones’ persistent psychotic symptoms outweigh the 2 costs to the defendants to hire another psychiatrist to evaluate him, to potentially follow a new 3 psychiatric treatment plan for Briones, or to transfer him to the Mental Health Unit. See id. 4 Further, the public interest supports an injunction. “The public has an interest in ensuring

5 the continued dignity of individuals incarcerated in federal prisons and inherent in that dignity is 6 the recognition of serious medical needs, and their adequate and effective treatment pursuant to 7 the Eighth Amendment’s mandated standard of care.” Id. (simplified). “[I]t is always in the 8 public interest to prevent the violation of a party’s constitutional rights.” Melendres v. Arpaio, 9 695 F.3d 990, 1002 (9th Cir. 2012) (simplified). Additionally, properly treating Briones’ 10 psychiatric diagnoses will decrease the likelihood he will commit acts that harm others. See ECF 11 No. 98-1 at 13 (noting Briones was released from a psychiatric in-patient facility 19 days prior to 12 his arrest for the two murders in 2017 and that Briones was hospitalized for psychosis in 2016 13 after he poured lighter fluid on himself with plans to set himself on fire and walk into traffic). 14 For all these reasons, I grant Briones’ motion for a preliminary injunction, the scope of

15 which is detailed below. 16 II. BRIONES’ MOTION FOR A TEMPORARY RESTRAINING ORDER 17 Briones also moved for a temporary restraining order for the same relief in his motion for 18 a preliminary injunction. I deny that motion as moot as I am granting his motion for preliminary 19 injunction. 20 III. DEFENDANTS’ MOTION FOR A REFERRAL TO A SETTLEMENT 21 CONFERENCE 22 The defendants move to refer this case to a settlement conference before a Magistrate 23 Judge, and Briones opposes. In my experience, settlement conferences are unproductive unless 1 both parties want to participate. Because Briones resists participation here, I deny the motion 2 without prejudice. However, I strongly encourage the parties to discuss resolving the case 3 outside of litigation, even if it does not occur in a formal settlement conference. Additionally, if 4 all parties are now or soon amenable to a settlement conference, they may file a stipulation

5 requesting one. 6 IV. BRIONES’ PRO SE MOTIONS 7 Briones filed two pro se motions despite being represented by counsel. ECF Nos. 111, 8 112. Under Local Rule IA 11-6(a), “once an attorney makes an appearance on behalf of a party, 9 that party may not personally file a document with the court; all filings must thereafter be made 10 by the attorney.” Accordingly, I strike Briones’ two pro se motions. 11 V. CONCLUSION 12 I THEREFORE ORDER that plaintiff Richi Orlando Briones’ motion for a preliminary 13 injunction (ECF No. 95) is GRANTED. 14 I FURTHER ORDER that, by July 6, 2026, the defendants must hire or contract with a

15 psychiatrist who must conduct a comprehensive evaluation of Briones and recommend a course 16 of treatment, which may include medication, referrals to other providers, and regular monitoring 17 of Briones and his medication. If the defendants must transfer him to another unit or prison to 18 have a psychiatrist evaluate Briones, they may. 19 I FURTHER ORDER that the defendants must provide all of Briones’ medical records 20 that they have to the psychiatrist prior to the evaluation. 21 I FURTHER ORDER that Briones’ counsel may provide documents to the defendants 22 that are relevant to Briones’ diagnosis or treatment prior to the evaluation, and the defendants 23 must provide those documents to the psychiatrist before Briones’ evaluation. ] I FURTHER ORDER the defendants to follow the treatment plan prescribed by the psychiatrist. If the defendants can justify a necessary reason to deviate from a portion of the plan, they must adopt a reasonable alternative to that portion. Any such deviation must be reported to Briones’ counsel within 10 days. 5 I FURTHER ORDER the defendants to file the psychiatrist’s report on CM/ECF under seal, provide a copy to Briones’ counsel, and file it in Briones’ NDOC medical file. 7 I FURTHER ORDER the parties to file a Joint Status Report by July 21, 2026 8] confirming they have complied with this order. 9 I FURTHER ORDER that Briones’ motion for a temporary restraining order (ECF No. is DENIED as moot. 11 I FURTHER ORDER that the defendants’ motion for a referral to a settlement conference (ECF No. 106) is DENIED without prejudice. 13 I FURTHER ORDER that Briones’ emergency motions for an immediate restraining order and injunction (ECF Nos. 111, 112) are STRICKEN. 15 DATED this 3rd day of June, 2026. 16 Ge ANDREWP.GORDON. 18 CHIEF UNITED STATES DISTRICT JUDGE

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