1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 FOR THE EASTERN DISTRICT OF CALIFORNIA 10 11 TIMOTHY D. WILKINS, No. 2:24-cv-03135-DJC-CKD P 12 Plaintiff, 13 v. ORDER 14 D. SMITH, et al., 15 Defendants. 16 17 Plaintiff, a state prisoner proceeding pro se, brings this civil rights action 18 pursuant to 42 U.S.C. § 1983. The matter was referred to a United States Magistrate 19 Judge pursuant to the Eastern District of California’s Local Rule 302. On July 8, 2025, 20 the Magistrate Judge filed Findings and Recommendations, which were served on 21 Plaintiff and which contained notice that Plaintiff could file objections within the time 22 stated therein. (ECF No. 21.) Plaintiff filed timely objections to the Findings and 23 Recommendations. (ECF No. 22.) 24 In accordance with 28 U.S.C. § 636(b)(1) and Local Rule 304(f), this Court has 25 conducted a de novo review of this case. Having carefully reviewed the entire file, the 26 Court finds the majority of the findings and recommendations supported by the 27 record and proper analysis. Accordingly, the Court will adopt the Findings and 28 Recommendations in part. 1 However, the Court respectfully declines to adopt the Magistrate Judge’s 2 recommendation to dismiss Plaintiff’s claim predicated on the delay of referral to a 3 specialist or adequate treatment for Plaintiff’s gastroenterological symptoms. 4 Deliberate indifference to a prisoner’s serious medical needs constitutes cruel 5 and unusual punishment in violation of the Eighth Amendment. Estelle v. Gamble, 6 429 U.S. 97, 104 (1976). This type of claim has both an objective and subjective 7 component. Colwell v. Bannister, 763 F.3d 1060, 1066 (9th Cir. 2014). First, to meet 8 the objective prong of this standard, a plaintiff must establish that they have a serious 9 medical need. Estelle, 429 U.S. at 104. “Such a need exists if failure to treat the injury 10 or condition could result in further significant injury or cause the unnecessary and 11 wanton infliction of pain.” Colwell, 429 U.S. at 1066 (internal quotation marks 12 omitted). The existence of “chronic and substantial pain” can indicate the plaintiff has 13 a serious medical need. Russell v. Lumitap, 31 F.4th 729, 739 (9th Cir. 2022). Second, 14 a “prison official is deliberately indifferent under the subjective element of the test 15 only if the official knows of and disregards an excessive risk to inmate health and 16 safety.” Colwell, 429 U.S. at 1066 (internal quotation marks omitted). The “official 17 must both be aware of facts from which the inference could be drawn that a 18 substantial risk of serious harm exists” and “must also draw the inference.” Farmer v. 19 Brennan, 511 U.S. 825, 837 (1994). 20 Mere delay of medical treatment, “without more, is insufficient to state a claim 21 of deliberate medical indifference.” Shapley v. Nev. Bd. of State Prison Comm’rs, 766 22 F.2d 404, 407 (9th Cir. 1985). However, delay of medical care can violate the Eighth 23 Amendment if the delay caused “significant harm” and “Defendants should have 24 known this to be the case.” Hallett v. Morgan, 296 F.3d 732, 746 (9th Cir. 2002). 25 The Magistrate Judge recommended dismissal based on the determination 26 that Plaintiff failed to adequately plead both that delay of care constituted deliberate 27 indifference and that this delay caused significant harm. However, the Court finds 28 1 Plaintiff’s Fourth Amended Complaint (“FAC”) sufficiently stated a claim of deliberate 2 indifference to Plaintiff’s serious medical need. 3 First, Plaintiff has sufficiently alleged the existence of a serious medical need. 4 Plaintiff’s allegations of recurring gastroenterological symptoms, including “black 5 stools,” “severe stomach pain,” “weight loss,” ongoing internal bleeding causing 6 anemia, nausea, and vomiting indicate Plaintiff had a serious medical need. (FAC 7 (ECF 19) at 4–6; FAC, Attach. 2 at 26); see Hutchins v. Johal, No. 1:15-cv-01537-DAD- 8 HBK, 2021 WL 4690597, at *7 (E.D. Cal. Oct. 7, 2021), report and recommendation 9 adopted, No. 1:15-cv-01537-DAD-HBK P, 2021 WL 6051696 (E.D. Cal. Dec. 21, 10 2021), aff'd sub nom. Hutchins v. Lockyer, No. 22-15036, 2023 WL 2674368 (9th Cir. 11 Mar. 29, 2023) (holding reasonable jury could find plaintiff’s “stomach pain, nausea” 12 and “chronic pain” constitute a serious medical need for purposes of Eighth 13 Amendment claim); see also Russell, 31 F.4th at 739 (explaining that “chronic and 14 substantial pain” can indicate the existence of a serious medical need for Eighth 15 Amendment purposes). 16 Second, Plaintiff sufficiently pled that Drs. Saukhla and Satter were deliberately 17 indifferent to this need as they knew of his pain and failed to ensure he timely 18 received the referrals and treatments they themselves prescribed. The FAC alleges 19 Drs. Saukhla and Satter were aware of these symptoms because Plaintiff reported 20 them during medical visits with each doctor. In December of 2023, Plaintiff reported 21 his symptoms to Dr. Satter, and Dr. Satter submitted a “High Priority” request for 22 gastroenterology and a colonoscopy procedure. (FAC, Attach. 5 at 38.) However, 23 Plaintiff alleges Dr. Satter then canceled the prescribed referral, and Plaintiff did not 24 receive the recommended appointments for six months. (FAC ¶¶ 5–6.) Similarly, 25 Plaintiff alleges reporting these symptoms to Dr. Saukhla for six months and 26 “plead[ing] with him for help and an EGD and colonoscopy.” (FAC ¶¶ 7, 10.) Plaintiff 27 alleges that, in March of 2024, after Plaintiff again reported his symptoms to Dr. 28 Saukhla, Dr. Saukhla referred Plaintiff for an EGD procedure. (FAC ¶ 6.) Dr. Saukhla 1 allegedly canceled this referral three days later. (Id.) By alleging these doctors knew 2 of Plaintiff’s ongoing pain and prevented Plaintiff from timely receiving either their 3 prescribed treatments or the benefit of their referrals for at least six months after their 4 initial recommendation, Plaintiff has stated a claim of deliberate indifference. See 5 Sandoval v. County of San Diego, 985 F.3d 657, 680 (9th Cir. 2021) (explaining that “a 6 prison official who is aware that an inmate is suffering from a serious acute medical 7 condition violates the Constitution when he stands idly by rather than responding with 8 reasonable diligence to treat the condition”). 9 Third, Plaintiff has satisfied the requirement that the delay in medical care 10 inflicted harm as Plaintiff continued to suffer pain during this six-month delay. Pain 11 can constitute harm sufficient to render the delay of medical care a constitutional 12 violation. See Tyler v. Smith, 458 F. App'x 597, 598 (9th Cir. 2011) (reversing dismissal 13 of Eighth Amendment claim where Plaintiff alleged facts to show that Defendant was 14 aware of Plaintiff’s pain and delayed in referring Plaintiff to a specialist). As a result of 15 the delay in care, Plaintiff alleges he was “forced to endure severe pain.” (FAC at 3.) 16 Therefore, as the delay of care allegedly resulted in Plaintiff suffering ongoing pain, 17 Plaintiff has stated a claim of deliberate indifference to medical need in violation of the 18 Eighth Amendment. 19 As the Magistrate Judge did not consider the sufficiency of Plaintiff’s state law 20 claims due to anticipated lack of supplemental jurisdiction, this Court takes no 21 position on these claims.
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1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 FOR THE EASTERN DISTRICT OF CALIFORNIA 10 11 TIMOTHY D. WILKINS, No. 2:24-cv-03135-DJC-CKD P 12 Plaintiff, 13 v. ORDER 14 D. SMITH, et al., 15 Defendants. 16 17 Plaintiff, a state prisoner proceeding pro se, brings this civil rights action 18 pursuant to 42 U.S.C. § 1983. The matter was referred to a United States Magistrate 19 Judge pursuant to the Eastern District of California’s Local Rule 302. On July 8, 2025, 20 the Magistrate Judge filed Findings and Recommendations, which were served on 21 Plaintiff and which contained notice that Plaintiff could file objections within the time 22 stated therein. (ECF No. 21.) Plaintiff filed timely objections to the Findings and 23 Recommendations. (ECF No. 22.) 24 In accordance with 28 U.S.C. § 636(b)(1) and Local Rule 304(f), this Court has 25 conducted a de novo review of this case. Having carefully reviewed the entire file, the 26 Court finds the majority of the findings and recommendations supported by the 27 record and proper analysis. Accordingly, the Court will adopt the Findings and 28 Recommendations in part. 1 However, the Court respectfully declines to adopt the Magistrate Judge’s 2 recommendation to dismiss Plaintiff’s claim predicated on the delay of referral to a 3 specialist or adequate treatment for Plaintiff’s gastroenterological symptoms. 4 Deliberate indifference to a prisoner’s serious medical needs constitutes cruel 5 and unusual punishment in violation of the Eighth Amendment. Estelle v. Gamble, 6 429 U.S. 97, 104 (1976). This type of claim has both an objective and subjective 7 component. Colwell v. Bannister, 763 F.3d 1060, 1066 (9th Cir. 2014). First, to meet 8 the objective prong of this standard, a plaintiff must establish that they have a serious 9 medical need. Estelle, 429 U.S. at 104. “Such a need exists if failure to treat the injury 10 or condition could result in further significant injury or cause the unnecessary and 11 wanton infliction of pain.” Colwell, 429 U.S. at 1066 (internal quotation marks 12 omitted). The existence of “chronic and substantial pain” can indicate the plaintiff has 13 a serious medical need. Russell v. Lumitap, 31 F.4th 729, 739 (9th Cir. 2022). Second, 14 a “prison official is deliberately indifferent under the subjective element of the test 15 only if the official knows of and disregards an excessive risk to inmate health and 16 safety.” Colwell, 429 U.S. at 1066 (internal quotation marks omitted). The “official 17 must both be aware of facts from which the inference could be drawn that a 18 substantial risk of serious harm exists” and “must also draw the inference.” Farmer v. 19 Brennan, 511 U.S. 825, 837 (1994). 20 Mere delay of medical treatment, “without more, is insufficient to state a claim 21 of deliberate medical indifference.” Shapley v. Nev. Bd. of State Prison Comm’rs, 766 22 F.2d 404, 407 (9th Cir. 1985). However, delay of medical care can violate the Eighth 23 Amendment if the delay caused “significant harm” and “Defendants should have 24 known this to be the case.” Hallett v. Morgan, 296 F.3d 732, 746 (9th Cir. 2002). 25 The Magistrate Judge recommended dismissal based on the determination 26 that Plaintiff failed to adequately plead both that delay of care constituted deliberate 27 indifference and that this delay caused significant harm. However, the Court finds 28 1 Plaintiff’s Fourth Amended Complaint (“FAC”) sufficiently stated a claim of deliberate 2 indifference to Plaintiff’s serious medical need. 3 First, Plaintiff has sufficiently alleged the existence of a serious medical need. 4 Plaintiff’s allegations of recurring gastroenterological symptoms, including “black 5 stools,” “severe stomach pain,” “weight loss,” ongoing internal bleeding causing 6 anemia, nausea, and vomiting indicate Plaintiff had a serious medical need. (FAC 7 (ECF 19) at 4–6; FAC, Attach. 2 at 26); see Hutchins v. Johal, No. 1:15-cv-01537-DAD- 8 HBK, 2021 WL 4690597, at *7 (E.D. Cal. Oct. 7, 2021), report and recommendation 9 adopted, No. 1:15-cv-01537-DAD-HBK P, 2021 WL 6051696 (E.D. Cal. Dec. 21, 10 2021), aff'd sub nom. Hutchins v. Lockyer, No. 22-15036, 2023 WL 2674368 (9th Cir. 11 Mar. 29, 2023) (holding reasonable jury could find plaintiff’s “stomach pain, nausea” 12 and “chronic pain” constitute a serious medical need for purposes of Eighth 13 Amendment claim); see also Russell, 31 F.4th at 739 (explaining that “chronic and 14 substantial pain” can indicate the existence of a serious medical need for Eighth 15 Amendment purposes). 16 Second, Plaintiff sufficiently pled that Drs. Saukhla and Satter were deliberately 17 indifferent to this need as they knew of his pain and failed to ensure he timely 18 received the referrals and treatments they themselves prescribed. The FAC alleges 19 Drs. Saukhla and Satter were aware of these symptoms because Plaintiff reported 20 them during medical visits with each doctor. In December of 2023, Plaintiff reported 21 his symptoms to Dr. Satter, and Dr. Satter submitted a “High Priority” request for 22 gastroenterology and a colonoscopy procedure. (FAC, Attach. 5 at 38.) However, 23 Plaintiff alleges Dr. Satter then canceled the prescribed referral, and Plaintiff did not 24 receive the recommended appointments for six months. (FAC ¶¶ 5–6.) Similarly, 25 Plaintiff alleges reporting these symptoms to Dr. Saukhla for six months and 26 “plead[ing] with him for help and an EGD and colonoscopy.” (FAC ¶¶ 7, 10.) Plaintiff 27 alleges that, in March of 2024, after Plaintiff again reported his symptoms to Dr. 28 Saukhla, Dr. Saukhla referred Plaintiff for an EGD procedure. (FAC ¶ 6.) Dr. Saukhla 1 allegedly canceled this referral three days later. (Id.) By alleging these doctors knew 2 of Plaintiff’s ongoing pain and prevented Plaintiff from timely receiving either their 3 prescribed treatments or the benefit of their referrals for at least six months after their 4 initial recommendation, Plaintiff has stated a claim of deliberate indifference. See 5 Sandoval v. County of San Diego, 985 F.3d 657, 680 (9th Cir. 2021) (explaining that “a 6 prison official who is aware that an inmate is suffering from a serious acute medical 7 condition violates the Constitution when he stands idly by rather than responding with 8 reasonable diligence to treat the condition”). 9 Third, Plaintiff has satisfied the requirement that the delay in medical care 10 inflicted harm as Plaintiff continued to suffer pain during this six-month delay. Pain 11 can constitute harm sufficient to render the delay of medical care a constitutional 12 violation. See Tyler v. Smith, 458 F. App'x 597, 598 (9th Cir. 2011) (reversing dismissal 13 of Eighth Amendment claim where Plaintiff alleged facts to show that Defendant was 14 aware of Plaintiff’s pain and delayed in referring Plaintiff to a specialist). As a result of 15 the delay in care, Plaintiff alleges he was “forced to endure severe pain.” (FAC at 3.) 16 Therefore, as the delay of care allegedly resulted in Plaintiff suffering ongoing pain, 17 Plaintiff has stated a claim of deliberate indifference to medical need in violation of the 18 Eighth Amendment. 19 As the Magistrate Judge did not consider the sufficiency of Plaintiff’s state law 20 claims due to anticipated lack of supplemental jurisdiction, this Court takes no 21 position on these claims. This Court returns these claims to the Magistrate Judge for 22 further screening. 23 ACCORDINGLY, IT IS HEREBY ORDERED that: 24 1. The Court adopts in part and declines to adopt in part the Findings and 25 Recommendations (ECF No. 21); 26 a. The Court adopts as to Plaintiff’s Eighth Amendment claim regarding 27 back surgery against Dr. Saukhla and Jannet Ilagan. 28 1 b. The Court adopts as to Plaintiff's claim of conspiracy against Drs. 2 Satter, Saukhla, and Denigris, and Jannet llagan. 3 c. The Court adopts as to Plaintiff's Motion for Preliminary Injunction. 4 d. The Court declines to adopt as to Plaintiffs’ Eighth Amendment claim 5 against Drs. Satter and Saukhla as to Plaintiff's gastroenterological 6 symptoms. Plaintiff has stated a cognizable Eighth Amendment claim 7 against these Defendants predicated on the delay of referral to a 8 specialist and adequate treatment for Plaintiff's gastroenterological 9 symptoms. 10 2. Plaintiff's Eighth Amendment claims as to back surgery and conspiracy are 11 dismissed without leave to amend. 12 3. Plaintiff's motion for a preliminary injunction (ECF No. 20) is DENIED; and 13 4. This matter is referred back to the assigned Magistrate Judge for further 14 pretrial proceedings, including screening of Plaintiff's state law claims. 15 16 IT 1S SO ORDERED. 17 | Dated: _October 22, 2025 “Dane J CoD tto— Hon. Daniel alabretta 18 UNITED STATES DISTRICT JUDGE 19 20 21 22 23 | DJC7 - wilkins24v03135,jo 24 25 26 27 28