Opinion
NOT TO BE PUBLISHED
APPEAL from the Superior Court of San Bernardino County No. RCV077621, Craig S. Kamansky, Judge.
Law Offices of Federico Castelan Sayre, Federico C. Sayre and Ronald Z. Gomez for Plaintiffs and Appellants.
Ruth E. Stringer, County Counsel, and James H. Thebeau, Deputy County Counsel, for Defendants and Respondents.
OPINION
King, J.
I. INTRODUCTION
Plaintiff John Winfrey (Winfrey) allegedly sustained personal injuries and a reonset of a prior but dormant seizure condition after he fell from an upper bunk bed while in custody at the West Valley Detention Center. He sued the County of San Bernardino (County), the San Bernardino County Sheriff’s Department (SBSD), the West Valley Detention Center (WVDC), and numerous employees of WVDC, for failing to immediately summon medical care on his behalf (Gov. Code, § 845.6; first cause of action) and for violating his civil rights by being deliberately indifferent to his medical needs (42 U.S.C. § 1983; second cause of action). His wife, Charlene, asserted a derivative claim for loss of consortium (third cause of action).
The individual public employee defendants include registered nurses Julia Calderon, Barbara Ginn, Deborah Marshall, Andrea Peyer, and Keith Miller, licensed vocational nurses Jodie Calkins and Marcia Carr, and sheriff’s custody specialists and booking officers Rachel Lovato and La Tisha Lofton.
All further statutory references are to the Government Code unless otherwise indicated.
Defendants moved for summary judgment/adjudication and for judgment on the pleadings on each cause of action. Plaintiffs moved for summary judgment. All three motions were heard concurrently. The trial court granted defendants’ motion for judgment on the pleadings on plaintiffs’ first and third causes of action and denied it on plaintiffs’ second cause of action. The court also granted defendants’ motion for summary judgment/adjudication on all three causes of action, and denied plaintiffs’ motion in its entirety. Judgment was entered in favor of defendants and plaintiffs appealed. We affirm on the grounds defendants’ motion for summary judgment/adjudication was properly granted on all three causes of action. It is therefore unnecessary for us to consider whether judgment on the pleadings was properly granted on plaintiffs’ first and third causes of action.
II. BACKGROUND
A. Winfrey’s December 29, 2002, Seizure and Fall
The following facts are undisputed. Winfrey was involved in a motorcycle accident in 1981. He suffered head trauma and “a couple” of seizures shortly thereafter, and at some point voluntarily stopped taking antiseizure medication. He did not have any seizures for approximately 20 years until December 29, 2002, when he was incarcerated at WVDC. He was booked into WVDC on December 28, after being arrested on domestic violence charges. At approximately 7:00 p.m. on December 29, he fell from his top bunk bed and onto the floor of his cell. According to his cell mate, he suffered a seizure before he fell. As a result of his fall, he claims to have suffered severe head trauma and a “re-onset . . . of what was . . . a prior but dormant seizure condition.”
The facts described in this section are taken from plaintiff John Winfrey’s deposition testimony and medical records, and plaintiffs’ admission of facts as set forth in plaintiffs’ motion for summary judgment and opening brief on appeal.
B. Winfrey’s Claims and Theories of Recovery
In his first cause of action, Winfrey claims the County, SBSD, and WVDC (the public entity defendants) and numerous SBSD employees, including nurses and other WVDC staff members (the public employee defendants) are liable for his injuries because they failed to summon immediate medical care for him before he fell. (§ 845.6.) More specifically, he claims defendants knew or should have known of his “prior but dormant” seizure condition based on health screening information he gave at the time of his December 28 booking and two prior bookings in September and October 2002. He also claims defendants should have known that his “prior but dormant” seizure condition required immediate medical care on December 28, including his assignment to a lower bunk and antiseizure medication, because these measures may have prevented his seizure and the injuries he suffered as result of his fall.
In his second cause of action, Winfrey claims that the same defendants violated his federal civil rights by being deliberately indifferent to his right to receive reasonable medical care while in custody. (42 U.S.C. § 1983.) Winfrey’s theory of recovery against the public employee defendants on this claim is similar to his theory of recovery against all defendants on his section 844.6 claim—that is, the public employee defendants were deliberately indifferent to his medical needs because they did not take reasonable measures to prevent his December 29 seizure and resulting fall by assigning him to a lower bunk and prescribing antiseizure medication. In addition, Winfrey claims the public entity defendants were deliberately indifferent to his medical needs based on their booking and health screening policies and procedures. He claims these policies and procedures were deliberately indifferent to his and other inmates’ medical needs because they were not designed to ensure that an inmate’s health screening information given during one booking will be reviewed and considered at the time of a later booking.
In view of Winfrey’s claims and theories of recovery, we first review the undisputed facts concerning the public entity defendants’ policies and procedures for booking arrestees into county jails, including health screening policies and procedures. We then review the evidence concerning the information Winfrey disclosed to health screeners about his seizure disorder, at the time of his three arrests and bookings in September, October, and December 2002, and how that information was handled. Then we address the merits of defendants’ motion for summary judgment/adjudication.
C. SBSD Health Screening Policies and Procedures
The following facts are also undisputed. Throughout the County’s jail system, all arrestees are required to undergo a health screening to determine whether they have any medical issues that require attention. At the time of booking, the arrestee’s health screening information is documented on a single-sided form known as a “Receiving Screening/Health form.” The form is comprised of two distinct portions. The top portion calls for the arrestee’s name, date, time of booking, race, age, and date of birth; the bottom portion calls for the arrestee’s health screening information.
The facts described in this section are set forth in defendants’ separate statement of disputed and undisputed material facts filed in support of defendants’ motion for summary judgment/adjudication, the supporting declarations of nondefendants Kathy Wild, the Health Services Administrator for the SBSD, County employee Jenny Anderson, the “person most knowledgeable” regarding the County’s Jail Information Management System (JIMS), and Captain Robert J. Fonzi, an SBSD employee who is familiar with the SBSD’s booking procedures and training requirements.
The arresting officer completes the top portion of the form, and also documents his or her observations concerning the arrestee’s health, such as whether the arrestee appears to be mentally retarded, is exhibiting hearing or speech problems, is under the influence of drugs or alcohol, is disoriented, confused, has any impaired level of consciousness, or is injured in any way. The arresting officer also documents whether it has been necessary to apply or attempt to apply any type of restraint to the arrestee. The arresting officer then gives the Receiving Screening/Health form to the intake nurse, who completes the health screening portion of the form. The arrestee cannot be booked into the jail and a booking number cannot be obtained for the arrestee until the entire Receiving Screening/Health form is completed and entered into the jail’s computer system or JIMS. The JIMS then issues a booking number for the arrestee.
During the health screening process, the arrestee is required to give information about his or her health to a screener. The purpose of the health screening process is to ascertain the arrestee’s general health and whether he or she has any health condition that requires medication, close observation, special accommodation, medical evaluation, or hospitalization, and whether the arrestee is a danger to himself or others. The screener is usually a licensed health care professional, namely, a registered nurse, licensed vocational nurse, or psychiatric technician, who sits with the arrestee and verbally asks him questions about his mental and physical health.
A nonhealth professional may initiate the health screening process, but if the arrestee discloses a health issue a nurse takes over to complete the screening process.
The screener asks the arrestee whether he or she has any heart problems, diabetes, seizures, hepatitis, or other health issues, and whether the arrestee is taking or needs to take any prescription medications. When the screener has completed the health screen, the arrestee is asked to review the health screen form for accuracy and sign it if all the information on it is correct. The screener also visually observes the arrestee and documents whether he or she has any patent signs or symptoms of illness, such as being under the influence of alcohol or drugs, or respiratory problems.
If the arrestee has a health issue that can be treated or accommodated at the jail, that is, the arrestee is suitable to be booked into the jail, a medical chart is generated using the original Receiving Screening/Health form, and the original of the form becomes part of the arrestee’s medical chart. The booking officer is given the carbon copy of the Receiving Screening/Health form to use in booking the arrestee and obtaining a booking number for the arrestee through the JIMS. The booking officer enters the health screen information into the JIMS, together with the identifying information from the top portion of the Receiving Screening/Health form. The JIMS then assigns a booking number to the arrestee. The copy of the Receiving Screening/Health form is then placed in the arrestee’s booking jacket.
If, on the other hand, the arrestee does not have any medical conditions that require addressing, then no medical chart is made for the arrestee and both the original and carbon copy of the Receiving Screening/Health form are given to the booking officer. The arrestee is then booked into the jail, and both the original and copy of the Receiving Screening/Health form are placed in the arrestee’s booking jacket. Finally, if the arrestee has a serious medical issue that renders him or her unsuitable for incarceration, the arrestee is not booked and must first be cleared for his or her medical condition.
The JIMS allows booking officers and medical staff to access an arrestee’s prior health screen information, if any. The JIMS has a central name index (CNI) feature that allows a booking officer to ascertain whether an arrestee has any prior bookings and thus has any prior health screen information. At the time an arrestee is booked into WVDC, a booking officer conducts a CNI check to ascertain whether the arrestee has any prior bookings. This is done to avoid generating multiple CNI screens for the same individual. If the arrestee already has a CNI screen, then all subsequent arrest, booking, and incarceration information is added to the JIMS under the same CNI screen.
The booking officer may use several different means to determine whether the arrestee has any prior bookings. For instance, the booking officer may conduct a CNI check using the arrestee’s given name, date of birth, social security number, or similar-sounding names.
If the booking officer determines, through using the CNI system, that the arrestee has a prior booking, the booking officer displays the arrestee’s “Person Summary” screen and presses “F10” to bring up a blank health screening form. The booking officer must input the data from the arrestee’s current Receiving Screening/Health form onto the blank health screening form in order to generate a new booking number for the arrestee. The JIMS will not issue a new booking number unless the arrestee’s current health screen information is input into the system using the blank health screen.
In addition, arrestee’s prior health screen and prior booking information may be accessed for review. But the prior health screen information does not have to be reviewed in order to obtain a current booking number for the arrestee.
If the booking officer determines that the arrestee has no prior bookings and is not in the CNI system, the booking procedure is the same. The booking officer must still press “F10” to generate a blank health screening form, and must enter the arrestee’s current health screening data and other information onto the blank health screening form in order to obtain a booking number.
Furthermore, and according to Kathy Wild, the Health Services Administrator for the SBSD, health screeners are not trained to locate, and generally do not locate, access, or use an arrestee’s prior health screening information, either from the JIMS or the arrestee’s prior booking jacket. This is because the purpose of the health screen is to ascertain the arrestee’s current health condition and suitability for current incarceration at the jail.
Wild also explained that the Receiving Screening/Health form has “obviated the need for the JIMS health information screen,” or access to the arrestee’s prior health screening information. According to Wild, “many years” before Winfrey was first booked into WVDC in September 2002, the SBSD used the JIMS “medical information” screen to collect and store the arrestee’s current health screening information. But since that time, the Receiving Screening/Health form was created “to replace the JIMS screen as it concerns the medical staff.” Also according to Wild, the Receiving Screening/Health form “was determined to be a more efficient, thorough, trustworthy and accurate method of collecting and using the health screening information of arrestees.”
Nevertheless, an arrestee’s prior health screen information may be accessed when necessary to treat the arrestee’s current health conditions. If, for example, an arrestee discloses that he or she has had a prior booking and was taking medication at the time but cannot recall the name of the medication, the screener may look up the arrestee’s prior health screening information in order to obtain the name of the medication.
Finally, if an arrestee becomes uncooperative during the health screening portion of the booking process, the arrestee is placed on “delayed booking status.” In these situations, the health screening process is paused. The arrestee is placed in a holding cell and is periodically approached by a deputy who tries to gain the arrestee’s compliance. Although the arrestee’s booking process is delayed for the purpose of completing his or her health screening, the Receiving Screening/Health form may still be given to the booking officer in order to generate a booking number. If this occurs, the original of the Receiving Screening/Health form is either retained by the screener, or given back to the screener by the booking officer after the booking officer obtains a booking number. In either case, the screener attempts to complete the health screening portion of the booking process when and if the arrestee decides to cooperate.
D. Winfrey’s Three Health Screenings (September, October, and December 2002)
The following facts are also undisputed. Winfrey was booked into WVDC on September 7, 2002, following his arrest on domestic violence charges. He was later arrested and booked into the Victorville jail on October 8, 2002. On December 28, 2002, he was arrested and booked into WVDC a second time.
On September 7, 2002, registered nurse Julia Calderon was working as a health screener at WVDC when Winfrey was brought in for booking at approximately 3:00 p.m. Winfrey was uncooperative and would not answer Calderon’s questions concerning whether he had any health issues. Winfrey said, “I have nothing to say,” and “I don’t want to discuss it.” Calderon wrote these statements on Winfrey’s Receiving Screening/Health form. Winfrey was placed on delayed booking status, and Calderon gave the arresting officer the carbon copy of Winfrey’s uncompleted Receiving Screening/Health form to give to the booking officer to obtain a booking number for Winfrey. The original of the form was set aside and was to be completed in the event Winfrey decided to cooperate with the health screening portion of the booking process.
Registered nurse Barbara Ginn came on duty after Winfrey was placed on delayed booking status, and conducted his health screening at approximately 6:25 p.m. Winfrey told Ginn he had a “seizure disorder,” or a past history of a seizure disorder, and was taking Dilantin for seizures and Xanax and Ativan for an “anxiety issue.” He also said he had a heart condition and allergies to antihistamines, Cortisone, and Erythromycin. Ginn documented this information on Winfrey’s Receiving Screening/Health form and generated a medical chart for Winfrey.
When an arrestee discloses a seizure disorder, the policy of WVDC is to house the arrestee on a lower level cell with a bottom bunk. The arrestee is evaluated by a physician and may be prescribed medication. A yellow medical alert wristband is placed on the arrestee’s left wrist with the word “seizures” written in black ink to alert all jail staff that the arrestee has a seizure condition. Ginn followed these procedures. She gave Winfrey a yellow “seizure alert” wristband, assigned him to a lower bunk, scheduled a medical evaluation, and referred him for a mental health evaluation based upon his disclosure of “anxiety issues.”
Later during the evening of September 7, licensed vocational nurse Marcia Carr tried to deliver aspirin to Winfrey pursuant to doctor’s orders, but Winfrey refused to take the aspirin and signed a medical refusal form acknowledging his refusal. On September 9 and 12, registered nurse Keith Miller took Winfrey’s blood pressure according to protocol for inmates taking medication.
On September 13, licensed vocational nurse Jodie Calkins tried to dispense and administer Dilantin to Winfrey for his seizures and pursuant to doctor’s orders. Winfrey refused to take the Dilantin, saying he did not want it and that he was “letting [his] lawyer handle it.” Winfrey also said he would not take the Dilantin until he was put on “the rest of his medications,“ and indicated he wanted Alprazolam and Lorazepam, which were not ordered. Winfrey signed a medication refusal form acknowledging his refusal to take the Dilantin.
Winfrey’s September 7 health screening information was not input into the JIMS, apparently because Winfrey was placed on delayed booking and the information was not available to the booking officer at the time he or she obtained a booking number for Winfrey. On October 8, Winfrey was arrested a second time, booked into the Victorville jail, and released shortly thereafter. During his October 8 health screening, he provided essentially the same information he disclosed to Ginn on September 7—that he had a heart condition, a history of seizures, and that he was allergic to antihistamines, steroids, and Erythromycin. This information was input into the JIMS.
On December 28, Winfrey was arrested a third time and booked into WVDC a second time. Registered nurse Deborah Marshall conducted Winfrey’s health screening, and he was cooperative. According to Marshall, Winfrey did not tell her he had a seizure disorder, a heart condition, or any other condition that warranted his assignment to a lower bunk bed. He only disclosed that he had allergies to antihistamines, steroids, and Erythromycin, and that he had a cyst on his left index finger. He signed his health screening form, indicating that the information on it was correct. Accordingly, Winfrey was not assigned to a lower bunk, was not given a yellow “seizure alert” wristband, and was not prescribed any medication for seizures.
In his deposition, Winfrey testified that he recalled Marshall asking him whether he had any “serious . . . medical disorders . . . past or current,” and that Marshall also asked him whether he was having any seizures. He told Marshall, “Yes, I’ve had seizures in the past, but I don’t have them now,” and added that he had not had any seizures in “a long time.” Marshall also asked whether he was taking Tegretol for seizures, and Winfrey responded that he should not be taking Tegretol because he was not having any seizures. Booking officer La Tisha Lofton entered Winfrey’s health screening information into the JIMS database on December 28.
At approximately 7:00 p.m. on December 29, Marshall was summoned to Winfrey’s cell pursuant to a “man down” call. Winfrey was lying on the floor of his cell. He had a two-inch long laceration on his scalp, but his vital signs were within normal range. According to Marshall, Winfrey told him at that time that he had a history of seizures but had not had one in approximately one year. Winfrey was treated at a local hospital and released to WVDC at approximately 11:00 p.m.
Registered nurse Andrea Peyer interviewed Winfrey after he was returned to WVDC. According to Peyer, Winfrey said that before that evening he had not had a seizure in 22 years. He also admitted that he did not tell the intake nurse, Marshall, that he had a seizure disorder. He explained he did not tell Marshall he had a history of seizures because he was not given Tegretol or Xanax the last time he was incarcerated.
Peyer gave Winfrey a yellow wristband for seizures, assigned him to a lower level cell and lower bunk, and scheduled a doctor’s appointment for him. She also scheduled “neuro checks” for him every 24 hours. Following Winfrey’s doctor’s appointment, he was prescribed Tegretol for seizures. On December 31, sheriff’s custody specialist Rachel Lovato processed Winfrey’s release from WVDC.
III. DISCUSSION
A. Standard of Review on Summary Judgment
Summary judgment is properly granted when there are no triable issues of material fact and the moving party is entitled to judgment as a matter of law. (Code Civ. Proc., § 437c, subd. (c).) A moving party defendant is entitled to summary judgment if he or she establishes a complete defense to the plaintiff’s causes of action, or shows that one or more elements of each cause of action cannot be established. (Aguilar v. Atlantic Richfield Co. (2001) 25 Cal.4th 826, 850-851.)
On appeal we independently assess the correctness of the trial court’s ruling on the motion for summary judgment. “‘[W]e construe the moving party’s affidavits strictly, construe the opponent’s affidavits liberally, and resolve doubts about the propriety of granting the motion in favor of the party opposing it.’” (Seo v. All-Makes Overhead Doors (2002) 97 Cal.App.4th 1193, 1201-1202.)
B. First Cause of Action/Section 845.6
In his first cause of action, Winfrey alleges that all of the defendants are liable to him for the injuries he suffered as a result of his fall from the upper bunk bed at WVDC, under section 845.6. The trial court ruled that, based on the undisputed facts, none of the defendants were liable to Winfrey under section 845.6 as a matter of law. The trial court was correct.
1. Applicable Law
Section 845.6 provides: “Neither a public entity nor a public employee is liable for injury proximately caused by the failure of the employee to furnish or obtain medical care for a prisoner in his custody; but . . . a public employee, and the public entity where the employee is acting within the scope of his employment, is liable if the employee knows or has reason to know that the prisoner is in need of immediate medical care and he fails to take reasonable action to summon such medical care. . . .”
The first clause of section 845.6 “confers a broad general immunity” on public entities and public employees for the employee’s failure to furnish or obtain reasonable medical care for a prisoner in the employee’s custody. (Watson v. State of California (1993) 21 Cal.App.4th 836, 841 (Watson).) But the second clause provides for a limited exception to this grant of general immunity. Liability under the second clause of the statute lies when a public employee “intentionally or unjustifiably” fails to “summon” medical care for a prisoner who has a “serious and obvious medical condition[]” requiring “immediate medical care.” (Id. at pp. 841-842, citing Hart v. County of Orange (1967) 254 Cal.App.2d 302, 306.)
Liability under the second clause does not lie when the employee merely fails to provide reasonable medical care to a prisoner. (Watson, supra, 21 Cal.App.4th at p. 841, citing Kinney v. Contra Costa County (1970) 8 Cal.App.3d 761, 770 [no liability for failure to provide medical care when prisoner complained of a bad headache and requested medication] & Lucas v. City of Long Beach (1976) 60 Cal.App.3d 341, 350 [no liability for failure to summon immediate medical care for prisoner’s drug and alcohol intoxication].) Indeed, the second clause of section 845.6 cannot reasonably be construed to impose liability for failing to provide reasonable medical care, because that would conflict with the broad grant of immunity conferred under the first clause of the statute. (Sanders v. County of Yuba (1967) 247 Cal.App.2d 748, 753 (Sanders) [“When the provisions of a statute are subject to two reasonable interpretations, the interpretation that will harmonize rather than that which will bring the two provisions in conflict should be adopted”].)
In Watson, the public employee defendants—several doctors and a senior medical technical assistant—failed to properly diagnose and treat the plaintiff-prisoner’s ruptured Achilles tendon, causing him permanent loss of ankle flexion. (Watson, supra, 21 Cal.App.4th at pp. 839-840.) The prisoner alleged that the defendants were liable for his injuries under the limited liability provision of section 845.6. The court held that summary judgment had properly been granted in favor of the employees and their public entity employer, the state. The court reasoned that the employees’ failure to properly diagnose and treat the plaintiff’s medical condition was not tantamount to a failure to summon medical care for a “serious and obvious” medical condition requiring “immediate medical care” under section 845.6. (Watson, supra, at pp. 841-843.)
Liability under the second clause of section 845.6 is thus limited to cases in which a public employee negligently fails to summon medical care for a prisoner who is suffering a medical emergency or, as the Watson court put it, “serious and obvious medical conditions requiring immediate medical care.” (Watson, supra, 21 Cal.App.4th at p. 841.)
A 1963 Law Revision Commission comment also emphasizes the limited scope of liability under section 845.6: “This section limits the duty to provide medical care for prisoners to cases where there is actual or constructive knowledge that the prisoner is in need of immediate medical care.” (Cal. Law Revision Com. com., 32 West’s Ann. Gov. Code (1995 ed.) foll. § 845.6, p. 447, italics added.) And, as the court in Sanders observed, liability under section 845.6 “is narrowly limited to the particular instances: (1) where the employee knows or has reason to know of the need (2) of immediate medical care and (3) fails to summon such care.” (Sanders, supra, 247 Cal.App.2d at pp. 753-754, first italics added [reconciling §§ 844.6 & 845.6].)
Liability under the second clause of section 845.6 is to be distinguished from a public employee’s potential liability for medical malpractice. Section 845.6 further provides that, “Nothing in this section exonerates a public employee who is lawfully engaged in the practice of one of the healing arts under any law of this state from liability for injury proximately caused by malpractice or exonerates the public entity from its obligation to pay any judgment, compromise, or settlement that it is required to pay under subdivision (d) of section 844.6.” Here, however, Winfrey did not allege and does not argue that any of the individual public employee defendants, including the nurses and other WVDC staff, are liable to him for medical malpractice.
2. Analysis
Here, the undisputed evidence shows that none of the individual public employee defendants knew or had any reason to know that Winfrey was suffering from a “serious and obvious medical condition” or a medical emergency that required immediate medical care at any time before he fell from his top bunk at WVDC on December 29, 2002. When Winfrey was booked into WVDC on December 28 he was not in any distress or in need of any immediate medical attention. He was not suffering from a medical emergency, nor was he claiming to be. Furthermore, the undisputed evidence shows he was provided with appropriate and reasonable medical care after he fell.
Indeed, in his deposition, Winfrey admitted that, during his December 28 health screening, he told Marshall that he had had seizures in the past but did not have them currently and had not had them for a “long time.” He also told Marshall that he should not be taking Tegretol or any other antiseizure medication because he was no longer having seizures. And, in September 2002, Winfrey refused to take Dilantin, even though a doctor had prescribed the medication for his seizure condition.
Thus, by Winfrey’s own admission, he was not in need of immediate medical care on December 28 and 29. Stated another way, Winfrey’s own evidence, construed in the light most favorable to him, shows he is unable to establish that any of the defendants failed to summon immediate medical care on his behalf, an essential element of his first cause of action.
Winfrey argues, however, that Marshall had constructive knowledge of his seizure history on December 28, because it was entered into the JIMS system on October 2, and, in September 2002, he was issued a wristband for seizures and assigned to a lower bunk after he disclosed that he had a history of seizures. Winfrey maintains that this evidence creates a triable issue of fact concerning whether he had a serious and obvious medical condition and was in need of immediate medical care on December 28 and 29. We disagree.
Indeed, even if Marshall or any of the other public employee defendants knew or should have known, on December 28 and 29, that Winfrey had a history of seizures, and even if Marshall or another WVDC staff member should have therefore continued his seizure medication or placed him on a lower bunk, this does not mean that Winfrey had a “serious and obvious medical condition[]” requiring “immediate medical care.” (Watson, supra, 21 Cal.App.4th at p. 841.) Nor does it mean that Marshall or any of the other public employee defendants failed to summon immediately-needed medical care for Winfrey in violation of section 845.6.
In sum, the public employee defendants’ failure to continue Winfrey’s seizure medication and place him on a lower bunk was not tantamount to the failure to summon immediately-needed medical care on Winfrey’s behalf, even if these measures may have prevented Winfrey’s fall and resulting injuries. Nor are any of the public entity defendants liable to Winfrey under section 845.6, because none of their employees are liable under the statute. (§ 845.6 [public entity defendant not liable unless employee is acting within scope of employment when employee fails to summon immediately-needed medical care for prisoner in employee’s custody].)
The trial court also granted defendants’ motion for judgment on the pleadings on plaintiffs’ first and third causes of action on the grounds the factual theory of recovery alleged in plaintiffs’ complaint was not presented in plaintiffs’ government claim. (§ 950.2; Watson, supra, 21 Cal.App.4th at pp. 839, 843-844; Nelson v. State of California (1982) 139 Cal.App.3d 72, 79; Fall River Joint Unified School Dist. v. Superior Court (1988) 206 Cal.App.3d 431, 434.) In light of our conclusion that summary adjudication was properly granted in favor of defendants on plaintiffs’ first and third causes of action, it is unnecessary for us to review this ruling.
C. Second Cause of Action/Title 42 United States Code Section 1983 Liability
In his second cause of action, Winfrey claims that each of the public employee defendants violated his due process rights under the Eighth and Fourteenth Amendments by being deliberately indifferent to his serious medical needs and are therefore liable for his resulting damages pursuant to title 42 United States Code section 1983 (42 U.S.C. 1983). He also alleges that the public employee defendants’ deliberate indifference was the result of a long-standing policy, practice, or custom on the part of the public entity defendants—the County, the SBSD, and WVDC—of failing to adequately train and supervise their employees to properly evaluate the medical needs of pretrial detainees at county jail facilities. And, he alleges the public entity defendants are liable based on their constitutionally defective policies and procedures.
The trial court granted summary adjudication on this cause of action in favor of the public entity defendants on the ground that “no triable issue has been raised that [Winfrey] was deprived of a constitutional right under these facts.” The court also ruled that none of the public employee defendants were “deliberately indifferent” to Winfrey’s medical needs, and even if they were, they were entitled to qualified immunity because none of them violated any of Winfrey’s clearly established constitutional rights. As we explain, summary adjudication was properly granted on this cause of action in favor of each of the defendants.
1. Applicable Law/Overview
Pretrial detainees or jail inmates have an established, substantive due process right under the Fifth and Fourteenth Amendments “‘to not have officials remain deliberately indifferent to their serious medical needs.’” (Gibson v. County of Washoe, Nev. (9th Cir. 2002) 290 F.3d 1175, 1187 (Gibson).) A sentenced prisoner has a comparable right under the Eighth Amendment’s ban on cruel and unusual punishment, and the two rights are analyzed under the same standards. (Ibid.; Frost v. Agnos (9th Cir. 1988) 152 F.3d 1124, 1128.) “Persons” who violate these rights are civilly liable to the injured party under 42 U.S.C. 1983. (Gibson, supra, at p. 1187.)
42 U.S.C. 1983 provides, in part: “Every person who, under color of any statute, ordinance, regulation, custom, or usage, of any State . . . subjects, or causes to be subjected, any citizen of the United States or other person within the jurisdiction thereof to the deprivation of any rights, privileges, or immunities secured by the Constitution and laws, shall be liable to the party injured in an action at law, suit in equity, or other proper proceeding for redress . . . .”
“Persons” who may be held liable under 42 U.S.C. 1983 include individual public employees and local governmental bodies (e.g., counties and cities), but do not include states or state officials acting in their official capacities. (Pitts v. County of Kern (1998) 17 Cal.4th 340, 348-349, and cases cited.) Furthermore, a public employee is liable for denying needed medical care to a detainee only if the employee is subjectively aware that his or her failure to provide such medical care is likely to cause the detainee serious harm, and the employee nevertheless disregards that risk by failing to take reasonable measures to prevent or abate that risk. (Farmer v. Brennan (1994) 511 U.S. 825, 837, 847 [114 S.Ct. 1970, 128 L.Ed.2d 811] (Farmer).) In other words, the public employee must be subjectively aware of a substantial risk of serious harm to the detainee, and consciously disregard that risk. (Id. at p. 842; see also Toguchi v. Chung (9th Cir. 2004) 391 F.3d. 1051, 1058.)
A similar “deliberate indifference” standard applies in determining whether a municipality or local governmental body is liable under 42 U.S.C. 1983. (Gibson, supra, 290 F.3d at pp. 1185-1196.) It is well settled that a municipality cannot be held vicariously liable under 42 U.S.C. 1983 for the acts of its employees under the doctrine of respondeat superior. (Monell v. Dept. of Soc. Serv. of City of N.Y. (1978) 436 U.S. 658, 694-695 [98 S.Ct. 2018, 56 L.Ed.2d 611] (Monell).) Rather, the municipality must itself cause the constitutional tort. (City of Canton, Ohio v. Harris (1989) 489 U.S. 378, 387-389 [109 S.Ct. 1197, 103 L.Ed.2d 412] (Canton).) “‘It is only when the “execution of the government’s policy or custom . . . inflicts the injury” that the municipality may be held liable under [42 U.S.C.] 1983.’” (Id. at p. 385, quoting Monell, supra, at p. 694.) In other words, the municipal policy or custom must be the “‘moving force [behind] the constitutional violation.’” (Canton, supra, at p. 389, quoting Monell, supra, at p. 694.)
2. Analysis/The Public Entity Defendants
Winfrey agrees that, in order to prevail against any of the public entity defendants on his 42 U.S.C. 1983 claim, he must establish that he had a constitutional right of which he was deprived and the public entity defendants “had a policy which was the moving force behind the constitutional violation.” (Italics added.) (Monell, supra, 436 U.S. at p. 694, italics added.) And, for the public entity defendants’ policy to be the moving force behind the alleged constitutional violation, there must be a direct causal link between that policy and Winfrey’s injuries. (Bd. of County Com’rs of Bryan County v. Brown (1997) 520 U.S. 397, 404-406, 415 [117 S.Ct. 1382, 137 L.Ed.2d 626] (Brown) [finding insufficient evidence of direct causal link between employee’s violation of plaintiff’s constitutional right and public employer’s decision to hire employee].) Here, however, and based on the undisputed evidence, Winfrey cannot establish this direct causal link.
For purposes of our discussion, we assume, without deciding, that the health screening policies and procedures in place at WVDC at the time of Winfrey’s 2002 bookings and health screenings were attributable to each and all of the public entity defendants, namely, the County, the SBSD, and WVDC.
Winfrey faults the public entity defendants’ health screening policies and procedures—specifically, the practice of not accessing inmates’ prior health screening information at the time of a current booking—for the public employee defendants’ alleged failure to undertake measures to prevent his December 29 seizure and resulting fall. These measures would have included assigning Winfrey to a lower bunk and prescribing antiseizure medication for him on December 28 and 29—the same measures that were undertaken on Winfrey’s behalf at the time of his September 7 booking.
But Winfrey cannot establish that his December 29 fall and resulting injuries would have been prevented—even if nurse Marshall or any of the other public employee defendants who were working on December 28 and 29 had accessed Winfrey’s October 8 health screening information through the JIMS database, or even if Winfrey’s September 7 health screening information had been input into the JIMS database and accessed on December 28 and 29. This is because Winfrey admitted in his deposition that, on December 28 and in response to Marshall’s health screening questions, he said he had not had any seizures for a “long time,” and should therefore not be taking Tegretol or any other antiseizure medication.
Assuming the truth of Winfrey’s deposition testimony, or reading the evidence in the light most favorable to Winfrey, Winfrey’s December 28 representations to Marshall would have reasonably indicated to Marshall that there was no need to prescribe antiseizure mediation for Winfrey, assign him to a lower bunk, or take other steps to prevent him from having another seizure or fall. It is also undisputed that Winfrey refused to take Dilantin while he was in custody at WVDC in September 2002, contrary to doctor’s orders. This evidence, in combination with Winfrey’s December 28 representations to Marshall, shows that Winfrey would not have taken antiseizure medication on December 28 and 29 even if it had been prescribed for him.
Accordingly, Winfrey cannot establish that the public entity defendants’ policies and procedures were the “moving force” behind the alleged constitutional violation, or the public employee defendants’ deliberate indifference to his reasonable medical needs. (Monell, supra, 436 U.S. at p. 694.) In other words, Winfrey cannot establish a direct causal link between the public entity defendants’ practice of not accessing an arrestee’s prior health screening information at a current booking, and the public employee defendants’ alleged deliberate indifference to Winfrey’s serious medical needs—that is, the employees’ failure to take measures to prevent his December 29 seizure and fall. (Brown, supra, 520 U.S. at pp. 404-406, 415.)
3. Analysis/The Public Employee Defendants’ Liability
The undisputed evidence also shows that none of the public employee defendants, including registered nurses Calderon, Ginn, Marshall, Peyer, and Miller, licensed vocational nurses Calkins and Carr, and sheriff’s custody specialists and booking officers Lovato and Lofton, were deliberately indifferent to Winfrey’s serious medical needs. (Farmer, supra, 511 U.S. at p. 837.) Stated another way, Winfrey cannot establish that any of the public employee defendants were subjectively aware that his or her failure to take steps to prevent Winfrey’s December 29 seizure and resulting fall, such as assigning him to a lower bunk or ensuring that he was prescribed antiseizure medication, was likely to result in serious harm to Winfrey.
As discussed, Winfrey admitted in his deposition that, at the time of his December 28 health screening, he told Marshall he had not had any seizures in a “long time” and should therefore not be taking any antiseizure medication. This reasonably indicated to Marshall that Winfrey did not need to be assigned to a lower bunk or prescribed antiseizure medication. As also discussed, it was unreasonable to expect Marshall to access Winfrey’s prior health screening information, compare that to his current representations about his health status, and argue with him about whether he should be taking antiseizure medication or be assigned to a lower bunk. It is also undisputed that Winfrey was alert and oriented at the time of his December 28 health screening, and did not present the appearance of having a serious medical issue.
Nor were any of the other public employee defendants deliberately indifferent to Winfrey’s reasonable medical needs. For instance, Calderon’s sole contact with Winfrey was in attempting to obtain his health screening information at the time of his booking on September 7, 2002. She was unable to complete the health screening because Winfrey was uncooperative. This does not amount to deliberate indifference to Winfrey’s serious medical needs on the part of Calderon.
After Calderon left her shift, Ginn completed Winfrey’s health screening. Winfrey faults Calderon and Ginn for failing to ensure that his September 7 health screening information was recorded in the JIMS database. But as discussed, that failure cannot be causally linked to Winfrey’s December 29 seizure and fall, in light of Winfrey’s September 13 refusal to take his Dilantin, and his December 28 admission that his seizure condition was dormant and that he had no need to take antiseizure medication. Moreover, the undisputed evidence shows that Calderon and Ginn were by no means deliberately indifferent to Winfrey’s serious medical needs.
Winfrey advances no reason why the other public employee defendants, including registered nurses Peyer and Miller, licensed vocational nurses Calkins and Carr, and sheriff’s custody specialists and booking officers Lovato and Lofton were deliberately indifferent to his medical needs. Nor do we discern any, based on the following undisputed facts: Peyer’s only interaction with Winfrey occurred on December 29 when he was returned to WVDC following his seizure and fall; Miller’s sole contacts with Winfrey occurred on September 9 and 12, when Miller took Winfrey’s blood pressure; Calkins’s only interaction with Winfrey was to attempt to give him Dilantin on September 13, which Winfrey refused; Carr’s sole contact with Winfrey was on September 7, when she attempted to give Winfrey aspirin, which he refused; Lovato’s only interaction with Winfrey was to sign him out of WVDC when he was released on December 31; and Lofton’s only interaction with Winfrey was to enter his December 28 health screening information into the JIMS database and obtain a booking number for him.
In light of our conclusion that none of the public employee defendants were deliberately indifferent to Winfrey’s serious medical needs as a matter of law, the public employee defendants were entitled to qualified immunity from suit on Winfrey’s civil rights claim. (Saucier v. Katz (2001) 533 U.S. 194, 201-202 [121 S.Ct. 2151, 150 L.Ed.2d 272] [official entitled to qualified immunity from suit for civil rights violation when facts alleged show official did not violate plaintiff’s constitutional rights].)
D. Third Cause of Action/Loss of Consortium
Because defendants are entitled to summary adjudication on Winfrey’s first and second causes of action, they are entitled to summary adjudication on Charlene’s derivative claim for loss of consortium, plaintiffs’ third cause of action. (Snyder v. Michael’s Stores, Inc. (1997) 16 Cal.4th 991, 998-999, 1001 [loss of consortium claim dependent, legally and causally, on spouse’s cause of action for personal injuries].)
IV. DISPOSITION
The judgment is affirmed. Respondents shall recover their costs on appeal.
We concur: Hollenhorst Acting P.J., Gaut J.