Li v. Contra Costa County, 3:16-cv-02861

Background

Plaintiff Andy Li, a federal pretrial detainee at Contra Costa County's Martinez Detention Facility, alleged deliberate indifference to serious medical needs related to delayed optometry care and denial of pain medication.
On Jan 14, 2016 Li's Snellen test showed uncorrected vision of 20/100 (20/40 with borrowed glasses); he was referred to county optometry on Jan 15, 2016 but did not receive an optometry exam until Feb 17, 2017 (~13 months).
Li filed grievances and requests complaining of eye pain, headaches, and difficulty seeing; medical staff repeatedly explained long clinic wait times and advised commissary purchase of OTC analgesics; there is no evidence Li attempted to buy commissary analgesics.
After an inmate altercation on Nov 30, 2016 Li suffered acute ocular trauma and was treated in the hospital; subsequent ophthalmology/optometry follow-ups occurred and new prescription glasses were ordered in Feb 2017.
Defendants who appeared: County of Contra Costa, Health Services Administrator Samuel Rosales, and nurse Harjinder Dhanoa. Three other defendants (nurses Joy Kick, Felisa, and Dr. Dennis McBride) were never served and were dismissed without prejudice.
The court construed Li as a pretrial detainee, applied Fourteenth Amendment standards (using the Castro objective deliberate-indifference framework), and allowed amendment to assert a Monell claim for a policy/practice of delayed optometry appointments.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
1) Monell liability for delayed optometry appointments	Contra Costa had a de facto policy/practice of long delays causing Li to be deprived of needed corrective vision and suffer pain	County: waits due to an "impacted" county optometry clinic and resource constraints; no unconstitutional policy	Denied summary judgment for County on the Monell claim; triable issue exists that policy/practice of long delays violated Li's Fourteenth Amendment rights
2) Individual liability of Health Services Administrator Rosales for delay	Rosales knew of long waits, responded to grievance without action and oversaw policies that accepted delays	Rosales: merely described system constraints and long wait times; not deliberately indifferent	Denied summary judgment as to Rosales on optometry-delay claim; triable issue whether his conduct/policy role was the moving force
3) Denial of pain medication (claims vs. County, Rosales, Dhanoa)	Li: nurses/administrators refused to provide pain relief for eye pain and headaches	Defendants: policy directed inmates to buy OTC meds from commissary; indigent inmates can be provided OTC meds; no evidence Li tried to buy meds; complaints did not show a serious medical need	Granted summary judgment for County, Rosales, and Dhanoa on pain-medication claims; no genuine issue of deliberate indifference
4) Unserved defendants and case management	N/A (procedural)	N/A	Nurses Joy Kick and Felisa and Dr. McBride dismissed without prejudice for failure to effect service; case referred to Pro Se Prisoner Mediation Program

Key Cases Cited

Monell v. Dep't of Soc. Servs., 436 U.S. 658 (municipal liability requires a policy, practice, or custom)
Castro v. County of Los Angeles, 833 F.3d 1060 (9th Cir.) (objective deliberate-indifference standard for pretrial detainees)
McGuckin v. Smith, 974 F.2d 1050 (9th Cir.) (delays in treatment can support § 1983 medical claims)
Farmer v. Brennan, 511 U.S. 825 (deliberate indifference requires awareness and disregard of substantial risk)
Celotex Corp. v. Catrett, 477 U.S. 317 (summary judgment standard and burden shifting)
Connick v. Thompson, 563 U.S. 51 (official municipal policy/practice concepts)
Jett v. Penner, 439 F.3d 1091 (9th Cir.) (serious medical need standard guidance)