YOUNG v. NAPHCARE INC (2026)

ORDER GRANTING DEFENDANT'S MOTION TO DISMISS WITH LEAVE TO AMEND

Re: Dkt. No. 20

Pro se plaintiff Joseph Dale Young sues defendant NaphCare, Inc. for providing inadequate medical care in violation of his Eighth and Fourteenth Amendment rights while Mr. Young was incarcerated at Santa Cruz County jail. Mr. Young alleges that NaphCare failed to provide him with the medication he requested fourteen times. NaphCare moves to dismiss for failure to state a claim under Federal Rule of Civil Procedure 12(b)(6), arguing that Mr. Young cannot sue NaphCare under 42 U.S.C. § 1983. Dkt. No. 20. For the reasons stated below, NaphCare's motion to dismiss is granted with leave to amend.

BACKGROUND

Mr. Young was previously incarcerated at Santa Cruz County Jail.¹ Mr. Young suffers from HSV-2, herpes simplex virus type two, which he explains is “a chronic medical condition known to cause painful outbreaks.” Dkt. No. 1, Complaint at 4. NaphCare is a private corporation with which the County of Santa Cruz has contracted to provide medical services at the Santa Cruz jail.

Between June 2024 and October 2024, Mr. Young says that he “suffered an outbreak ․, causing severe pain, inflammation, and chafing in the affected area.” Complaint at 4. Mr. Young “repeatedly requested L-lysine, an over-the-counter amino acid supplement known to suppress HSV outbreaks” as well as “chafing cream to prevent irritation.” Complaint at 4. Mr. Young says that between June 22, 2024, and August 22, 2024, he requested L-lysine and chafing cream at least fourteen times and that “NaphCare staff ignored Plaintiff's requests at least seven times between June 22 and July 17, 2024.” Complaint at 4.

When NaphCare staff “finally acknowledged” Mr. Young, “they still failed to provide the requested L-lysine supplement or any effective alternative treatment that wouldn't cause [him] nausea and abdominal pain.” Complaint at 5. “NaphCare staff also refused to provide chafing cream for the entire duration of Plaintiff's incarceration, leaving Plaintiff to suffer open sores and prolonged pain for the remainder of plaintiff[']s time incarcerated.” Complaint at 5.

Mr. Young sues NaphCare under 42 U.S.C. § 1983, alleging violations of the Eighth and Fourteenth Amendments to the U.S. Constitution. Mr. Young alleges that NaphCare “caused [him] unnecessary pain, prolonged suffering, emotional distress, and risk of further medical complications.” Complaint at 5. Mr. Young requests compensatory damages, punitive damages, fees and costs, injunctive relief, and any other just and proper relief.

LEGAL STANDARD

Federal Rule of Civil Procedure 8(a)(2) requires a complaint to include a “short and plain statement of the claim showing that the pleader is entitled to relief.” If the complaint does not, the defendant may move to dismiss the complaint under Federal Rule of Civil Procedure 12(b)(6). Dismissal is required if the plaintiff fails to allege facts allowing the court to “draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009). “Dismissal under Rule 12(b)(6) is appropriate only where the complaint lacks a cognizable legal theory or sufficient facts to support a cognizable legal theory.” Mendiondo v. Centinela Hosp. Med. Ctr., 521 F.3d 1097, 1104 (9th Cir. 2008). To survive a Rule 12(b)(6) motion, a plaintiff need only plead “enough facts to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007). In considering a Rule 12(b)(6) motion, the Court must “accept all factual allegations in the complaint as true and construe the pleadings in the light most favorable” to the non-moving party. Rowe v. Educ. Credit Mgmt. Corp., 559 F.3d 1028, 1029–30 (9th Cir. 2009). While legal conclusions “can provide the [complaint's] framework,” the Court will not assume they are correct unless adequately “supported by factual allegations.” Iqbal, 556 U.S. at 679, 129 S.Ct. 1937. Courts do not “accept as true allegations that are merely conclusory, unwarranted deductions of fact, or unreasonable inferences.” In re Gilead Scis. Secs. Litig., 536 F.3d 1049, 1055 (9th Cir. 2008) (quoting Sprewell v. Golden State Warriors, 266 F.3d 979, 988 (9th Cir. 2001)). Where a plaintiff proceeds pro se, the Court “must construe the pleadings liberally and must afford the plaintiff the benefit of any doubt.” Karim-Panahi v. Los Angeles Police Dep't, 839 F.2d 621, 623 (9th Cir. 1988).

DISCUSSION

Private entities such as NaphCare can be subject to suit under § 1983 if they (1) acted under color of state law and (2) the alleged constitutional violation “was caused by an official policy or custom of” the private entity. See Tsao v. Desert Palace, Inc., 698 F.3d 1128, 1139 (9th Cir. 2012). Only the second requirement is at issue here.

To allege that an injury was “caused by an official policy or custom,” a plaintiff must show that the defendant had an official policy in place, meaning “a deliberate choice to follow a course of action ․ made from among various alternatives by the officials or officials responsible for establishing final policy with respect to the subject matter in question.” See id. at 1143 (quoting Long v. County of Los Angeles, 442 F.3d 1178, 1185 (9th Cir. 2006)). If the policy alleged is one of “inaction or omission,” as Mr. Young alleges here, Mr. Young must show that the policy “amounts to deliberate indifference to the plaintiff's constitutional right” and that the defendant “could have prevented the violation with an appropriate policy.” See id. (quoting first Oviatt v. Pearce, 954 F.2d 1470, 1474 (9th Cir. 1992), then Gibson v. County of Washoe, 290 F.3d 1175, 1194 (9th Cir. 2002), overruled on other grounds by Castro v. County of Los Angeles, 833 F.3d 1060 (9th Cir. 2016) (en banc)).

Here, Mr. Young has alleged only that he could not receive “L-lysine, an over-the-counter amino acid supplement known to suppress HSV outbreaks․ and chafing cream to prevent irritation.” Complaint at 4. Mr. Young does not allege that NaphCare had a policy, that is to say a general course of action decided upon by NaphCare leaders, to prevent Mr. Young from obtaining this medically necessary treatment. See Tsao, 698 F.3d at 1143–46; AE ex rel. Hernandez v. County of Tulare, 666 F.3d 631, 637 (9th Cir. 2012). Mr. Young's allegations include that he “submitted at least fourteen (14) medical requests to NaphCare staff between June 22, 2024 and August 22, 2024” and that he apparently never received “the requested L-lysine supplement or any effective alternative treatment that wouldn't cause me nausea and abdominal pain.” Complaint at 4. Young alleges that “NaphCare staff ignored [his] requests at least seven times” out of those fourteen requests. Complaint at 4. But that inconsistency, absent more factual allegations, does not allow the Court to infer that NaphCare had a general policy of ignoring his requests because, by Mr. Young's own allegations, NaphCare did respond to some requests.

To be sure, the strongest allegation in Mr. Young's favor is that he made fourteen requests. If he chooses to amend his complaint, he should allege additional facts that make plausible the inference that he was ignored because NaphCare had a policy of ignoring requests to such an extent that NaphCare was deliberately indifferent to his right to adequate care. For example, Mr. Young's current complaint alleges that his fourteen requests took place over two months and that he did not receive his requested treatment in that time. Complaint at 4. But that fact is consistent with a local NaphCare employee merely failing to respond to Mr. Young's requests competently, as opposed to NaphCare having a policy or custom of denying such requests. Additional facts in a future, amended complaint should establish that NaphCare's denials of Mr. Young's requests were pursuant to a policy of deliberate indifference and not equally consistent with a policy of neglect or incompetence. The Court cautions that even with such allegations, any future amended complaint against NaphCare may still fail to state a claim under Rule 12(b)(6).

Mr. Young could also consider amending his complaint to include more facts that would support a ratification theory of liability as to NaphCare. A state actor can be liable for an individual's actions when an official “ratified a subordinate's unconstitutional decision or action and the basis for it.” Gordon v. County of Orange, 6 F.4th 961, 974 (9th Cir. 2021). To allege liability based on NaphCare ratifying its staff members' actions, however, Mr. Young's claim would be stronger if he could allege that NaphCare or a NaphCare leader did not “[s]imply go[ ] along with discretionary decisions made by ․ subordinates” but instead made a “policy statement ․ [which was] expressly approved by the supervising policymaker.” See City of St. Louis v. Praprotnik, 485 U.S. 112, 130, 108 S.Ct. 915, 99 L.Ed.2d 107 (1988).

The Court also notes that the requirement that his denial of care have been the result of a NaphCare policy or practice would not apply to any claim Mr. Young might assert against a named individual who denied him care. To state a claim against such an individual, Mr. Young would need to plead facts establishing that that individual knew of a substantial risk of serious harm and disregarded that risk by failing to take reasonable steps to abate it. “ ‘The treatment a prisoner receives in prison and the conditions under which he is confined are subject to scrutiny under the Eighth Amendment.’ ” Farmer v. Brennan, 511 U.S. 825, 832, 114 S.Ct. 1970, 128 L.Ed.2d 811 (1994) (citation omitted). The Eighth Amendment requires prison officials to “ensure that inmates receive adequate food, clothing, shelter, and medical care,” and to “ ‘take reasonable measures to guarantee the safety of the inmates.’ ” Id. A prison official violates the Eighth Amendment when two requirements are met: (1) the deprivation alleged must be, objectively, sufficiently serious, id. at 834, 114 S.Ct. 1970 (citing Wilson v. Seiter, 501 U.S. 294, 298, 111 S.Ct. 2321, 115 L.Ed.2d 271 (1991)), and (2) the prison official possesses a sufficiently culpable state of mind, i.e., the offending conduct was wanton, id. (citing Wilson, 501 U.S. at 297, 111 S.Ct. 2321).

Deliberate indifference to a prisoner's serious medical needs violates the Eighth Amendment's proscription against cruel and unusual punishment. See Estelle v. Gamble, 429 U.S. 97, 104, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976). A determination of “deliberate indifference” involves an examination of two elements: the seriousness of the prisoner's medical need and the nature of the defendant's response to that need. McGuckin v. Smith, 974 F.2d 1050, 1059 (9th Cir. 1992), overruled on other grounds, WMX Technologies, Inc. v. Miller, 104 F.3d 1133, 1136 (9th Cir. 1997) (en banc). A “serious” medical need exists if the failure to treat a prisoner's condition could result in further significant injury or the “unnecessary and wanton infliction of pain.” Id. (citing Estelle, 429 U.S. at 104, 97 S.Ct. 285).

A prison official is deliberately indifferent if he knows a prisoner faces a substantial risk of serious harm and disregards that risk by failing to take reasonable steps to abate it. Farmer, 511 U.S. at 837, 114 S.Ct. 1970. The prison official must not only “be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists,” but “must also draw the inference.” Id. If a prison official should have been aware of the risk, but was not, then the official has not violated the Eighth Amendment, no matter how severe the risk. Gibson v. County of Washoe, 290 F.3d 1175, 1188 (9th Cir. 2002). Consequently, for deliberate indifference to be established, there must exist both a purposeful act or failure to act on the part of the defendant and harm resulting therefrom. See McGuckin, 974 F.2d at 1060. The deliberate indifference standard does not require a showing that the prison official acted with an improper motive, such as an intent to harm; it is enough that the official acted or failed to act despite knowledge of a substantial risk of serious harm. Edmo v. Corizon, Inc., 935 F.3d 757, 793 (9th Cir. 2019).

If he chooses to file an amended complaint, Mr. Young should also allege additional facts establishing that his level of medical care met the deliberate indifference standard. See Farmer, 511 U.S. at 832, 834, 114 S.Ct. 1970. Mr. Young must show that NaphCare or individual NaphCare workers knew of and disregarded an excessive risk to Mr. Young's health or safety by failing to take reasonable steps to abate that risk. Id. at 837, 114 S.Ct. 1970. Because Mr. Young appears to have received some timely treatment—NaphCare staff allegedly responded to plaintiff's requests at least some times in June and July 2024, Complaint at 4—Mr. Young must show that NaphCare's “chosen course of treatment ‘was medically unacceptable under the circumstances,’ and was chosen ‘in conscious disregard of an excessive risk to [the prisoner's] health,’ ” rather than representing a mere difference of acceptable medical opinion. Toguchi v. Chung, 391 F.3d 1051, 1058 (9th Cir. 2004). Additional helpful facts Mr. Young might allege in an amended complaint could include that course of medical treatment, if any, NaphCare staff did provide as well as any verbal or written exchanges or any other context surrounding Mr. Young's requests for L-lysine and chafing cream.

CONCLUSION

Because Mr. Young has failed to allege that NaphCare had an official policy, custom, or pattern and practice that caused the alleged violation of his Eighth and Fourteenth Amendment rights, NaphCare's motion to dismiss is granted without prejudice and with leave to amend. Mr. Young has 56 days from receipt of this order to file an amended complaint, if he so chooses. If he declines to file an amended complaint, his claims in this action will be dismissed with prejudice.

Mr. Young has indicated that he is currently an inmate at Santa Cruz County Jail. See Dkt. Nos. 30, 31. The Clerk of the Court is directed to mail a copy of this order to the address provided in his letters to the Court: Joseph D. Young, Inmate #S-271199, Santa Cruz County Jail, 259 Water Street, Santa Cruz, CA 95060. The Court denies Young's request that this matter be stayed indefinitely for so long as he remains incarcerated.

IT IS SO ORDERED.

FOOTNOTES

1.   The Court assumes the truth of the allegations in the complaint for the purposes of defendant's Rule 12(b)(6) motion.

P. Casey Pitts, United States District Judge