Benitez et al v. County of San Diego et al

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UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF CALIFORNIA
MARITZA BENITEZ, individually and as
successor-in-interest to Decedent JOSE
RAMON CERVANTES CONEJO; and
JOSE ALBERTO QUINTERO,
individually and as successor-in-interest to
Decedent JOSE RAMON CERVANTES
CONEJO,
Plaintiff,
v.
COUNTY OF SAN DIEGO; CITY OF
ESCONDIDO; JAMES ALBERGO;
PAUL MATA; DANA CASTLEBERRY;
NHI NGOC DAI; NAPHCARE, INC.;
NAPHCARE OF SAN DIEGO, LLC; and
DOES 1 through 50, inclusive,
Defendants.
AND ALL RELATED CASES
Case Nos.: 25-CV-1143 TWR (DDL),
25-CV-1823 TWR (DDL)
ORDER GRANTING IN PART AND
DENYING IN PART
(1) CITY DEFENDANTS’ MOTION
TO DISMISS,
(2) COUNTY DEFENDANTS’
MOTION TO DISMISS, AND
(3) NAPHCARE DEFENDANTS’
MOTION TO DISMISS
(25-CV-1143 ECF Nos. 29, 32, 38)
Presently before the Court are three Motions to Dismiss: (1) Defendants County of
San Diego, Paul Mata, and Dana Castleberry’s Motion to Dismiss (“County MTD,” ECF
No. 32), (2) Defendants City of Escondido and Officer James Albergo’s Motion to Dismiss
(“City MTD,” ECF No. 29), and (3) Defendants Nhi Ngoc Dai, Naphcare, Inc., and
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Naphcare San Diego, LLC’s Motion to Dismiss (“Naphcare MTD,” ECF No. 38). All three
Motions are fully briefed. 	(See ECF Nos. 45 (“B/Q Opp’n”), 43 (“R/G Opp’n”), 49
(“County Reply”), 48 (“City Reply”), and 54 (“Naphcare Reply”).) 	The Court held oral
argument on the Motions to Dismiss on December 18, 2025. 	(ECF No. 57). 	Having
carefully considered the Parties’ arguments and the relevant law, the Court (1) GRANTS
IN PART AND DENIES IN PART City Defendants’ Motion to Dismiss, (2) GRANTS
IN PART AND DENIES IN PART County Defendants’ Motion to Dismiss, and
(3) GRANTS IN PART AND DENIES IN PART Naphcare Defendants’ Motion to
Dismiss.
BACKGROUND
I. 	Factual Background 1
The two consolidated cases arise out of the arrest, detention, and subsequent death
of Jose Ramon Cervantes Conejo (“Decedent”). 	The vast majority of the allegations
concern Decedent’s treatment at Vista Detention Facility (“VDF”), where he was brought
after being arrested. (See ECF No. 1 in No. 25-CV-1143 (“B/Q Compl.”) ¶ 36.) 2 Plaintiffs
Benitez and Quintero allege wrongdoing by three groups: (1) City Defendants—the City
of Escondido, Officer James Albergo, and Does 21 through 40, (2) County Defendants—
the County of San Diego, Paul Mata, Dana Castleberry, and Does 1 through 20, and
(3) Naphcare Defendants—Nhi Ngoc Dai, Naphcare, Inc., Naphcare San Diego, LLC, and
Does 41 through 50. 	(See generally id.) 	Plaintiffs Garcia and Ramirez only allege
wrongdoing by County Defendants and Naphcare Defendants. (See generally ECF No. 15
in No. 25-CV-1823 (“R/G SAC”).)
/ / /
1 	For purposes of Defendants’ Motions, the facts alleged in Plaintiffs’ complaints are accepted as
true. See Vasquez v. L.A. Cnty., 487 F.3d 1246, 1249 (9th Cir. 2007) (holding that, in ruling on a motion
to dismiss, the Court must “accept all material allegations of fact as true”).
2 	The Factual Background primarily cites to the Benitez/Quintero Complaint (ECF No. 1 in 25-CV-
1143) because it is the lead case, but the Court notes the relevant differences between the two complaints.
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A. 	Plaintiffs Benitez and Quintero’s Allegations Against City Defendants
On March 28, 2024, Defendant Albergo, an Escondido Police Department officer,
arrested Decedent for being drunk in public. 	(See B/Q Compl. ¶ 33.) 	Plaintiffs Benitez
and Quintero allege Defendant Albergo used “excessive force” and “brutalized” Decedent
while arresting him. (Id. ¶ 34.) Plaintiffs Benitez and Quintero further allege Defendant
Albergo was required to take Decedent to a “facility for a 72-hour treatment and evaluation
of inebriates” under Cal. Penal Code § 647(f). (Id. ¶ 35.) Instead, Defendant Albergo took
Decedent to VDF. (Id. ¶ 36.)
B. 	Decedent’s Condition When Arriving at VDF
When Decedent arrived at VDF, “he was not identified by medical staff as having
any head injuries.” (Id. ¶ 38.) Decedent was “acutely intoxicated, disoriented, having hand
and body tremors at rest, slurred speech, poor balance, nausea and vomiting.” (Id. ¶ 39.)
Decedent was “willing but unable to sign a general informed consent” form. (Id.)
C. 	Defendant Mata’s Actions
Upon arrival, Defendant Paul Mata, a registered nurse, gave Decedent an initial
medical assessment. 	(Id. ¶ 40.) 	Defendant Mata did not mark the following items on
Decedent’s Medical Clearance Assessment: that he was confused, had an altered mental
status, was in withdrawal, had slurred speech, had unsteady gait, had a stupor, was
tremulous, or was disoriented. 	(See id.) 	He also did not mark that Decedent was
experiencing tremors, shakes, nausea, or vomiting due to withdrawal on a Comprehensive
Detox Screen Form. (See id.) But Defendant Mata was aware Decedent “was experiencing
tremors, nausea, vomiting, slurred speech and was disoriented because he had noted those
symptoms on a CIWA form.” (Id.)
Further, Defendant Mata marked on the Medical Clearance Assessment that
Decedent did not have a disability requiring accommodation. 	(Id.) 	Defendant Mata
marked “no” on the Receiving Screening Form as the response to whether Decedent had a
history or risk of alcohol withdrawal, despite noting that Decedent drank 12 beers two
times per week and his most recent alcohol use was in the preceding five days. (See id.)
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Defendant Mata also did not list Decedent’s “prior history of seizures under neurological
‘Chronic Conditions.’” (Id.) Finally, Defendant Mata marked on the Medical Clearance
Assessment that Decedent was “fit to continue” the booking process and did not mark that
Decedent should be sent to a sobering cell or any other safety housing. (Id.)
D. 	Defendant Dai’s Actions
Next, Defendant Dai, a Physician Assistant, assessed Decedent, and found that
Decedent had recent or significant alcohol use, and that Decedent was experiencing
withdrawal. (Id. ¶ 44.) Defendant Dai’s treatment plan included starting Diazepam on a
taper for withdrawal, Keppra for seizure prevention, and recommending a low-bunk
assignment. (See id.) Defendant Dai did not order that Decedent be sent to the ER, that
the medications should be administered immediately even if involuntary, nor that Decedent
should be placed in special housing. (See id.)
Defendant Dai is employed by Naphcare. 	(See id.) 	Naphcare is a “third-party
contractor who employed, supervised, and trained medical staff at VDF.” 	(Id. ¶ 15.)
Naphcare requires its employees to be “trained in and follow National Commission of
Correctional Healthcare (‘NCCHC’) Standards in providing medical care to inmates
housed at VDF.” (Id. ¶ 14.) “The NCCHC Standards require that individuals experiencing
severe, life threatening intoxication or withdrawal must be transferred immediately to a
licensed acute care facility and that individuals at risk for progression to more severe levels
of intoxication or withdrawal are to be kept under constant observation by qualified health
professionals or health-trained correctional staff.” (Id.)
E. 	Defendant Castleberry’s Actions
Plaintiffs allege Defendant Castleberry “knew or should have known that [Decedent]
needed to take alcohol withdrawal medications immediately” and when Decedent refused
Defendant Castleberry was “required to complete a medication refusal form” in its entirety
and disclose what medications and why Decedent refused to take them. (Id. ¶ 45.) Instead,
Defendant Castleberry only completed “Refusal to Accept Medical Care/Treatment” forms
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for Decedent’s “refusal of a urine drug screen, covid test, covid vaccine and flu vaccine.”
(Id.)
F. 	Decedent’s Head Trauma and Resulting Death
Sometime after Decedent was placed into housing at VDF, Plaintiff incurred severe
head injuries, but it is unclear how they occurred. 	(See id. ¶ 47.) 	On March 29, 2024,
Decedent was found on the floor of his cell with blood in his nostrils, his right eye swollen
shut, and facial swelling. 	(See id. ¶ 48.) 	Decedent was transported to Palomar Medical
Center in Escondido and admitted to the hospital. (See id.) At the hospital, Decedent “was
diagnosed with severe head injuries, including a left frontal skull fracture, fracture of
medial 	wall 	of 	right 	orbit, 	bifrontal 	subarachnoid 	hemorrhage, 	bilateral 	subdural
hemorrhages involving frontal and parietal areas with bilateral hemorrhagic cerebral
contusions, bilateral periorbital contusions, acute alcohol intoxication, alcohol withdrawal,
and abnormal blood results.” 	(Id. ¶ 49.) 	The Palomar Medical Center’s trauma and
neurosurgery team did not believe Decedent’s injuries were compatible with a simple fall
off a bed. (See id. ¶ 50.) 	Plaintiffs allege Decedent’s head injuries could have occurred
from “falling from a top bunk” or “interactions with other inmates.” (Id. ¶ 47.) Decedent
ultimately fell into a coma and passed away. (See id. ¶ 51.)
II. 	Procedural History
On May 5, 2025, Plaintiffs Maritza Benitez, individually and as successor in interest
to Decedent Jose Ramon Cervantes Conejo; Jose Cervantes Conejo; and Jose Alberto
Quintero, individually and as successor in interest to Decedent Jose Ramon Cervantes
Conejo, filed a Complaint in this Court concerning the death of Jose Ramon Cervantes
Conejo. 	(See generally ECF No. 1 in 25-CV-1143.) 	On March 28, 2025, Plaintiffs The
Estate of Jose Ramon Cervantes Conejo by and through its successor in interest Guadalupe
Conejo Ramirez and Guadalupe Conejo Ramirez filed a Complaint in San Diego Superior
Court, also concerning the death of Jose Ramon Cervantes Conejo. 	(See generally ECF
No. 1 in 25-CV-1823). 	The state action was then removed to the United States District
Court for the Southern District of California on July 17, 2025, and designated as Case No.
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25-CV-1823. 	(See id.) 	On September 2, 2025, the Court consolidated the two actions.
(See ECF No. 27.) Then, on September 16, 2025, in 25-CV-1823, Plaintiffs filed a Second
Amended Complaint substituting Fabian Cervantes Garcia as the successor in interest for
the Estate of Jose Ramon Cervantes Conejo. 	(See 	ECF No. 15 in 25-CV-1823.)
Defendants filed three separate Motions to Dismiss. (See ECF Nos. 29, 32, 38 in No. 25-
CV-1143.)
LEGAL STANDARD
Rule 12(b)(6) allows a court to dismiss a complaint for “failure to state a claim upon
which relief can be granted.” Fed. R. Civ. P. 12(b)(6). To survive a motion to dismiss, the
complaint must contain a “short and plain statement showing that the pleader is entitled to
relief,” backed by sufficient facts that make the claim “plausible on its face.” Fed. R. Civ.
P. 8(a)(2); Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly,
550 U.S. 544, 547 (2007)). 	Plausibility requires “more than a sheer possibility that a
defendant has acted unlawfully.” 	Iqbal, 566 U.S. at 678. 	Rather, it demands enough
factual content for the court to “draw the reasonable inference that the defendant is liable
for the misconduct alleged.” Id. (citing Twombly, 550 U.S. at 556). In ruling on a 12(b)(6)
motion, the court must accept as true “all factual allegations in the complaint” and
“construe the pleadings in the light most favorable to the nonmoving party.” Manzarek v.
St. Paul Fire & Marine Ins. Co., 519 F.3d 1025, 1031 (9th Cir. 2008). This presumption
does not extend to conclusory allegations, unwarranted deductions of fact, or unreasonable
inferences. See In re Gilead Scis. Sec. Litig., 536 F.3d 1049, 1055 (9th Cir. 2008).
If the court dismisses a complaint for failure to state a claim, the “court should grant
leave to amend even if no request to amend the pleading was made, unless it determines
that the pleading could not possibly be cured by the allegation of other facts.” 	Lopez v.
Smith, 203 F.3d 1122, 1127 (9th Cir. 2000) (quoting Doe v. United States, 58 F.3d 494,
497 (9th Cir. 1995)).
/ / /
/ / /
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ANALYSIS
I. 	Standing
Before turning to Defendant-specific arguments, the Court will address the standing
issues brought by all three groups of Defendants.
A. 	California Wrongful Death Standing
Standing to sue for wrongful death is governed by California Code of Civil
Procedure § 377.60. 	Under Section 377.60, a cause of action for the death of a person
caused by the wrongful act or neglect of another may be asserted by any of the following
persons: “decedent’s surviving spouse, domestic partner, children, and issue of deceased
children, or, if there is no surviving issue of the decedent, the persons, including the
surviving spouse or domestic partner, who would be entitled to the property of the decedent
by intestate succession.” 	Id. at 377.60(a). 	Further, “[w]hether or not qualified under
subdivision (a)” the following individuals can bring a cause of action if they were
dependent on the decedent: “the putative spouse, children of the putative spouse,
stepchildren, parents, or the legal guardians of the decedent if the parents are deceased.”
Id. at 377.60(b)(1). A “putative spouse” means “the surviving spouse of a void or voidable
marriage who is found by the court to have believed in good faith that the marriage to the
decedent was valid.” Id. at 377.60(b)(2). 3
1. 	Individuals Without Wrongful Death Standing
County Defendants argue “[n]either the Decedent nor Plaintiff Q[uintero] has
standing as a statutory heir to bring this action under California Code of Civil Procedure
section 377.60.” 	(County MTD at 20.) 	County Defendants are correct. 	Under Section
377.60, neither a “family member” nor the estate itself have standing to bring a wrongful
3 	Naphcare Defendants argue Plaintiff Benitez does not have standing because Decedent’s death
certificate states Decedent was divorced. 	(See Naphcare MTD at 16.) 	Plaintiffs Benitez and Quintero
argue that Section 377.60 applies to putative spouses, (see B/Q Opp’n at 21), which is correct. See Cal.
Civ. Proc. Code § 377.60. At the motion to dismiss stage, this is not a basis for dismissing Plaintiff Benitez
from the wrongful death claim.
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death claim. 	The Court therefore DISMISSES the Decedent’s Estate and Plaintiff
Quintero from the wrongful death claim.
2. 	California’s One Action Rule
All Defendants argue that Plaintiffs violate the “one action” rule for California
wrongful death lawsuits. 4 Plaintiffs argue the Court’s consolidation order cured any
potential defect. (See B/Q Opp’n at 22; R/G Opp’n at 20.) “California law permits only
one action for wrongful death.” 	Cotta v. Robinson, No. 1:13-CV-00359-LJO-SM, 2014
WL 4249144, at *4 (E.D. Cal. Aug. 27, 2014) (citing Cross v. Pacific Gas & Elec. Co., 60
Cal.2d 690, 694 (1964)). 	The purpose of the “one action” rule is to ensure there is only
one verdict for one sum. 	See King v. Pac. Gas & Elec. Co., 82 Cal. App. 5th 440, 449–
450 (2022). The Court’s Order Granting the Motion to Consolidate stated the cases would
be consolidated “for all purposes”; thus, there would only be one trial and one verdict for
one sum. 	(ECF No. 27 at 2.) 	Further, in the interest of judicial economy, the Court
ORDERS Plaintiffs to file a consolidated complaint moving forward, see infra Section VI,
therefore disposing of any “one action” rule concerns. As a result, the Motions to Dismiss
are DENIED to the extent they are based on the “one action” rule.
B. 	California Survival Claims Standing
Under California law, if an injury giving rise to liability occurs before a decedent’s
death, then the claim survives to the decedent’s estate. See Cal. Civ. P. Code § 377.20. In
California, a cause of action that survives the decedent “may be commenced by the
decedent’s personal representative or, if none, by the decedent’s successor in interest.” Id.
4 	County Defendants argue “[a]lthough the cases have now been consolidated, the consolidation
order does not merge the pleadings or resolve the defects in Plaintiffs’ wrongful death claims.” (County
MTD at 20.) City Defendants make a similar argument that Plaintiffs “must join together in one action
and name all other known heirs as nominal defendants.” (City MTD at 17 (citing Smith v. Premier All.
Ins. Co., 41 Cal. App. 4th 691, 697 (1995).) Specifically, City Defendants argue that the wrongful death
cause of action should be dismissed under 12(b)(7) for failure to join a party because California only
permits a “single action” for wrongful death. (Id. at 12.) And Naphcare Defendants argue that “all heirs
must join or be joined in a single § 377.60 wrongful death lawsuit, and there cannot be a series of separate
wrongful death suits.” (Naphcare MTD at 6 (citing Estate of Elkins v. Pelayo, 2020 WL 2571387, at *5
(E.D. Cal. May 21, 2020).)
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at 377.30. Decedent’s successor in interest is the “beneficiary of the decedent’s estate or
other successor in interest who succeeds to a cause of action or to a particular item of the
property that is the subject of a cause of action.” Id. at 377.11.
If a decedent dies intestate in California, as is the case here, (see B/Q Compl. ¶ 7),
the beneficiaries are determined by Sections 6401 and 6402 of the California Probate Code.
See id. at 377.10. 	Where a decedent dies intestate and leaves a surviving spouse, the
surviving spouse will receive the decedent’s share of the community property. 	See Cal.
Prob. Code § 6401(a). The surviving spouse will also receive all the decedent’s separate
property unless the decedent left issue, or is survived by a parent, a sibling, or a niece or
nephew. 	See id. at 6401(c). 	If the decedent is survived by any of the above family
members, the family member or members will receive a share of the decedent’s separate
property. See id. at 6401(c)(1)–(3), 6402.
1. 	Plaintiffs Benitez and Garcia
County Defendants argue Plaintiffs Benitez and Garcia share succession rights and
thus must proceed jointly, but because Plaintiff Benitez asserts she is the sole successor in
interest, the claim fails because “the statute presupposes that the proper successor(s) have
been identified.” 	(County MTD at 6 (citing Cal. Code Civ. Proc. §§ 377.30, 377.32).)
Plaintiffs Benitez and Quintero argue this is merely a “matter for the successors in interest
to resolve,” not a basis for dismissal. (B/Q Opp’n at 22.)
At the hearing, Plaintiff Benitez retracted her statement that she is Decedent’s sole
successor in interest and conceded that if she and Decedent were separated at the time the
claim arose, then the claim may not be characterized as community property and both she
and Garcia could be proper successors in interest. (See ECF No. 57.) 5 See Saldivar, 2022
5 	There is some uncertainty as to Plaintiff Benitez and Decedent’s marital status at the time of
Decedent’s death. The Ramirez/Garcia SAC alleges that Plaintiff Benitez and Decedent “were separated
since at least October 2022 and were living separately at the time Decedent sustained the injuries and
damages alleged herein.” (R/G SAC ¶ 4.) Further, Decedent’s death certificate states he was “divorced.”
(See R/G SAC at Exhibit A.) 	The Benitez/Quintero Complaint is silent as to Decedent and Benitez’s
marriage status and Plaintiffs Benitez and Quintero’s Opposition merely states “Plaintiffs’ Complaint does
not anywhere suggest they were ‘estranged’ or ‘living separately.’” 	(B/Q Opp’n at 10.) 	Given this
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WL 19236738 at *4. 	Because both Plaintiffs Benitez and Garcia could be successors in
interest under the California Probate Code and this case will move forward with a
consolidated complaint, this is not a basis for dismissal at the motion to dismiss stage. See
Campos v. Cnty. of Los Angles, No. CV 11-09613 DDP PJWX, 2012 WL 3656518, at *3
(C.D. Cal. Aug. 23, 2012) (finding that when the plaintiffs argued they were both
successors in interest and there was uncertainty on the state of decedent’s marriage at the
time of death, the issue of standing is “more appropriately addressed on summary
judgment”). Thus, to the extent County Defendants’ Motion to Dismiss seeks to dismiss
Plaintiffs Benitez and Quintero’s survival claims for lack of standing, it is DENIED.
2. 	Plaintiff Quintero
County Defendants argue “California law does not recognize a financially dependent
relative as a statutory heir entitled to succeed to a decedent’s claims where the decedent is
survived by a spouse and child.” 	(County MTD at 6 (citing Cal. Prob. Code §§ 6401–
6402).) Plaintiff Quintero argues he was a family member who lived with Decedent which
is sufficient to be a successor in interest. 	(See B/Q Opp’n at 9–10.) 	Not so. 	Under
California Probate Code § 6401, if an individual dies intestate with a surviving spouse and
only one child, the decedent’s community property and one half of the separate property
goes to the surviving spouse and the remaining one half of the separate property goes to
the child. Or under California Probate Code § 6402(a), if an individual dies intestate with
no surviving spouse but with issue, the decedent’s estate will go to their issue/child.
Because Plaintiff Quintero would not be entitled to any of Decedent’s property under the
California Probate Code, Plaintiff Quintero is not a proper successor in interest. 	See Cal.
Civ. P. Code § 377.11. 	To the extent the Benetiz/Quintero Complaint alleges survivor
claims on behalf of Plaintiff Quintero, those claims are DISMISSED. 6
uncertainty, there is the possibility that the cause of action is separate property. See Saldivar v. Wright,
No. 2:20-CV-02081-CAS-PD, 2022 WL 19236738, at *4 (C.D. Cal. Dec. 8, 2022).
6 	Naphcare Defendants argue that neither Plaintiff Benitez nor Quintero “filed or attached a
declaration satisfying Section 377.32’s mandatory requirement” and thus their survival claims are subject
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C. 	Monell Standing
County Defendants argue Plaintiffs Benitez, Quintero, and Ramirez “cannot assert
this violation in their individual capacities because they do[] not allege that any municipal
policy, custom, or failure to train violated their own constitutional rights.” (County MTD
at 14.) 	Plaintiff Ramirez argues because the SAC alleges Defendants’ policies and
practices 	were 	the 	moving 	force 	causing 	“Plaintiffs’ 	economic 	and 	non-economic
damages,” she has standing. (R/G Opp’n at 16) (citing SAC ¶ 119).)
County Defendants are incorrect. 	A decedent’s survivors have standing to assert
Monell claims based on a violation of their substantive constitutional rights or those of the
decedent. See McGinnis v. Cnty. of Sonoma, No. 22-CV-06632-SI, 2023 WL 3874023, at
*3 (N.D. Cal. June 6, 2023) (collecting cases); see also Schwartz v. Lassen Cnty. ex rel.
Lassen Cnty. Jail (Det. Facility), 838 F. Supp. 2d 1045, 1058 (E.D. Cal. 2012) (denying
motion to dismiss Monell claim brought by decedent’s mother where the court inferred that
improper medical care resulted in the decedent’s death and consequently the plaintiff’s loss
of her son’s companionship). 	The County Defendants’ Motion to Dismiss is therefore
DENIED with respect to Monell standing.
D. 	Loss of Familial Association Standing
County Defendants argue Plaintiffs have not alleged the type of highly personal
relationship necessary for standing to pursue loss of familial association claims. 	(See
County MTD at 11.) 	“[T]he relationships protected by the fourteenth amendment ‘are
those that attend the creation and sustenance of a family’ and similar ‘highly personal
relationships.’” 	IDK, Inc. v. Clark Cnty., 836 F.2d 1185, 1193 (9th Cir. 1988) (citing
Roberts v. United States Jaycees, 468 U.S. 609, 618–19 (1984)).
/ / /
to dismissal. (Naphcare MTD at 5.) Naphcare Defendants are incorrect as to Plaintiff Benitez. (See ECF
No. 5 (“Benitez Decl.”).) As to Plaintiff Quintero, he does not contest that he did not file a declaration or
argue why that should not be a basis for dismissal. (See generally B/Q Opp’n.) However, because Plaintiff
Quintero is not a proper successor in interest, the Court does not need to consider whether the lack of a
deceleration is a basis for dismissal.
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1. 	Decedent’s Estate
County Defendants argue “Decedent’s estate lacks standing to bring this claim,
which is a personal substantive due process right belonging only to surviving family
members.” 	(County MTD at 11.) 	Plaintiffs do not respond to this argument and thus
concede its validity. See Duenez v. City of Manteca, No. CIV. S-11-1820 LKK, 2012 WL
4359229, at *11 (E.D. Cal. Feb. 23, 2012) (finding that the decedent’s estate could not be
included in the cause of action for loss of familial relationship). 	The Court therefore
DISMISSES Decedent’s estate from the familial association claim.
2. 	Plaintiff Benitez
County Defendants argue Plaintiff Benitez “alleges no facts showing an ongoing
bond deprived by the Decedent’s death; instead, the pleadings indicate they were estranged
and living separately.” 	(County MTD at 11.) 	The Benitez/Quintero Complaint is silent
regarding Decedent and Benitez’s marriage status. (See generally B/Q Compl.) Further,
Plaintiffs Benitez and Quintero’s Opposition states “Plaintiffs’ Complaint does not
anywhere suggest they were ‘estranged’ or ‘living separately.’” 	(B/Q Opp’n at 10.)
Plaintiff Benitez argues that she is Decedent’s surviving spouse and “district courts within
this Circuit have found that the right to familial association extends to surviving spouses.”
(Id. at 8 (citing Morales v. City of Delano, 852 F.Supp.2d 1253, 1274 (E.D. Cal. 2012)).)
While Plaintiff Benitez is correct that some district courts in this Circuit have found
the right to familial association extends to surviving spouses, other district courts within
this Circuit have declined to do so because the “Ninth Circuit has refrained from creating
a substantive due process right to familial association with one’s spouse.” 	Est. of Arroyo
v. Cnty. of San Diego, No. 3:21-CV-01956-RBM-SBC, 2024 WL 4668146, at *16 (S.D.
Cal. Nov. 4, 2024) (dismissing a loss of familial association claim brought by a widow).
But the Court need not decide whether there is a substantive due process right to familial
association with one’s spouse because Plaintiff Benitez fails to allege a judicially
enforceable Fourteenth Amendment interest. Plaintiff Benitez and Quintero’s Complaint
does little more than allege Benitez is Decedent’s surviving spouse, (see B/Q Compl. ¶ 5),
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and conclusory allegations of intimate relationships are not sufficient. See Est. of Chivrell
v. City of Arcata, 623 F. Supp. 3d 1032, 1044 (N.D. Cal. 2022) (“[T]he mere label of
‘spouse’ . . . alone is insufficient to plead a right of familial association.”). Thus, without
considering County Defendants’ argument that Benitez and Decedent were estranged, the
Court DISMISSES Plaintiff Benitez’s loss of familial association claim.
3. 	Plaintiff Quintero
Plaintiff Quintero does not allege his specific familial relationship with Decedent
and the lack of information on his familial status was not resolved at the hearing. (See ECF
No. 57.) Even assuming Plaintiff Quintero was a close family member to Decedent, such
as a sibling, this would not be sufficient to create standing to assert a loss of familial
association claim. 	See Ward v. City of San Jose, 967 F.2d 280, 284 (9th Cir. 1991), as
amended on denial of reh’g (June 16, 1992) (finding that siblings do not possess a
cognizable liberty interest in their sibling’s companionship and therefore siblings are not
proper plaintiffs for loss of familial association claims). 	Further, Plaintiff Quintero’s
citation to Lee v. City of Los Angeles, 250 F.3d 668 (9th Cir. 2001), (see B/Q Opp’n at 8),
does not provide any basis for the assertion that a “family member” that is “financially
dependent” on a decedent has a substantive due process right to familial association.
Because 	Plaintiff 	Quintero 	lacks 	loss 	of 	familial 	association 	standing, 	the 	Court
DISMISSES Plaintiff Quintero’s loss of familial association claim.
E. 	Deliberate Indifference Standing
The Benitez-Quintero Complaint asserts a deliberate indifference claim by the
Decedent’s estate and Plaintiffs Benitez and Quintero in their individual capacities. (See
B/Q Compl. ¶¶ 63–76.) 	County Defendants argue “the Benitez-Quintero Plaintiffs lack
standing to pursue this claim in their individual capacities” because survival claims for
deliberate indifference “belong exclusively to the Decedent’s estate via successor(s) in
interest.” (County MTD at 7.) Plaintiffs respond that they are successors in interest, (see
B/Q Opp’n at 9–10), and therefore concede that the proper plaintiff for the deliberate
indifference claim is a successor in interest. Thus, to the extent the deliberate indifference
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claim is brought by Decedent’s estate and Plaintiffs Benitez and Quintero in their
individual capacities, the claims are DISMISSED.
II. 	Statutory Immunity
The Court now turns to the City of Escondido and County of San Diego’s statutory
immunity arguments. 	(See City MTD at 14; County MTD at 19.) 	Under California
Government Code § 815(a), “[e]xcept as otherwise provided by statute . . . [a] public entity
is not liable for an injury, whether such injury arises out of an act or omission of the public
entity or a public employee or any other person.” Plaintiffs, therefore, can only sufficiently
allege state law claims if they can point to a statute that provides for liability.
Plaintiffs rely on California Government Code §§ 815.2(a), 820(a), and 845.6. (See
B/Q Opp’n at 17; R/G Opp’n at 20.) Under Section 815.2, “[a] public entity is liable for
injury proximately caused by an act or omission of an employee of the public entity within
the scope of his employment if the act or omission would, apart from this section, have
given rise to a cause of action against that employee or his personal representative.” And
under Section 820, “[e]xcept as otherwise provided by statute (including Section 820.2), a
public employee is liable for injury caused by his act or omission to the same extent as a
private person.” However, under Section 844.6, “except as provided in this section and in
Sections 814, 814.2, 845.4, and 845.6 . . . a public entity is not liable for . . . [a]n injury to
any prisoner.” As a result, Sections 815.2(a) and 820 do not apply to injuries to prisoners.
See Lawson v. Superior Court, 180 Cal. App. 4th 1372, 1383 (2010) (reasoning that
“[a]lthough a public entity may be vicariously liable for the acts and omissions of its
employees ([Cal.] Gov. Code § 815.2), that rule does not apply in the case of injuries to
prisoners”) (citing Cal. Gov. Code § 844.6); see also Neuroth v. Mendocino County, No.
15-CV-03226-NJV, 2016 WL 379806, at *5 (N.D. Cal. Jan. 29, 2016) (dismissing a Bane
Act claim as to Mendocino County because the plaintiff’s “reliance on a theory of vicarious
liability through an employee through § 815.2 in order to avoid the immunity provisions
of § 844.6 fails”) (citation omitted). Defendants’ statutory immunity arguments, therefore,
turn on whether Decedent was a “prisoner.”
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Under Section 844, “prisoner” includes “a lawfully arrested person who is brought
into a law enforcement facility for the purpose of being booked.” Cal. Gov. Code § 844.
Individuals become a prisoner “as a matter of law, upon his or her initial entry into a prison,
jail, or penal or correctional facility, pursuant to penal processes.” 	Id. 	Here, because
Decedent was lawfully arrested and brought to VDF pursuant to the penal process, he was
a “prisoner” under Section 844 upon his entry into VDF. Because Plaintiff qualified as a
prisoner once he entered VDF, Plaintiffs’ state law claims against the County of San Diego
are barred except for Plaintiffs Benitez and Quintero’s Section 845.6 claim which is
exempted in Section 844.6. Plaintiffs conceded at the hearing that Section 844.6 statutory
immunity bars claims against the County of San Diego except for the Section 845.6 claim.
(See ECF No. 57.) 	Thus, the Court DISMISSES Plaintiffs’ state law claims, except for
the Section 845.6 claim, against the County of San Diego. 	As to the City of Escondido,
because Decedent was not a “prisoner” before he entered VDF, the Court DENIES the
City Defendants’ Motion to Dismiss to the extent it is based on statutory immunity.
III. 	City Defendants’ Motion to Dismiss 7
City Defendants argue “Plaintiffs fail to plausibly allege that any force was used by
any Escondido Defendants, let alone unreasonable force; Plaintiffs cannot, as a matter of
law, identify a legal duty owed by Officer Albergo to [Decedent] pursuant to PC § 647(g);
Plaintiffs fail to plausibly allege or show any responsibility by the Escondido Defendants
for any alleged actions or omissions while [Decedent] was at VDF, i.e., in San Diego
County custody, and Plaintiffs failed to set forth allegations sufficient to demonstrate
compliance with California Government Claims Act claim filing requirements.” 	(City
MTD at 2.)
A. 	Government Claims Act Compliance
City Defendants argue “Plaintiffs failed to set forth plausible allegations of
compliance with the GCA claim filing requirements.” (Id. at 16.) Plaintiffs Benitez and
7 	City Defendants are named as Defendants only in the Benitez/Quintero Complaint. (See generally
B/Q Compl.; R/G SAC.)
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Quintero allege they “timely filed their Government Claims for Damages with . . .
Defendant City of Escondido and filed this lawsuit within six months of the rejection of
their claims.” (B/Q Compl. ¶ 4.) City Defendants argue this is insufficient and Plaintiffs
“must at least allege when claims were presented to the City of Escondido.” (City MTD
at 16.) 	Plaintiffs disagree and argue “[n]othing more is required of Plaintiffs, and
Defendants have offered no authority or evidence to the contrary.” (B/Q Opp’n at 18.)
California Government Code § 905 requires “all claims for money or damages
against local public entities” be presented to the public entity before a lawsuit is filed. And
under California Government Code § 945.4, failure to present a timely claim bars suit
against the entity. The Government Claims Act applies to state law claims in federal court.
See Butler v. Los Angeles Cnty., 617 F. Supp. 2d 994, 1001 (C.D. Cal. 2008). In California
state court, a general statement of compliance with the GCA is sufficient. 	See Perez v.
Golden Empire Transit Dist., 209 Cal. App. 4th 1228, 1237 (2012). 	In contrast, under
federal pleading standards, “bare allegations that a plaintiff has complied with the GCA
are insufficient.” Shannon v. Cnty. of Sacramento, No. 215CV00967KJMCKD, 2016 WL
1138190, at *4 (E.D. Cal. Mar. 23, 2016) (finding a complaint stating that prior to bringing
suit, the plaintiff complied with the Government Claims Act by filing a claim with
Sacramento County and the date of rejection was insufficient because it amounted to no
more than a “legal conclusion”); see also Cardenas v. Cnty. of Tehama, 476 F. Supp. 3d
1055, 1070 (E.D. Cal. 2020) (finding the allegation that the plaintiffs filed timely
administrative tort claims and timely filed the lawsuit within six months of defendants’
rejections of those claims was a mere legal conclusion). 	Plaintiffs Benitez and Quintero
only allege they filed a claim with the City of Escondido, and that they filed this lawsuit
within six months of the rejection of their claims. 	(See B/Q Compl. ¶ 4.) 	Because the
Complaint contains no more than a bare legal conclusion of GCA compliance, the Court
DISMISSES Plaintiffs Benitez and Quintero’s state law claims against the City of
Escondido.
/ / /
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B. 	Excessive Force
City Defendants argue Plaintiffs’ excessive force allegations are “completely
conclusory” and thus do not satisfy the Rule 8 pleading standard. (City MTD at 2.) The
Benitez/Quintero Complaint alleges that while arresting Decedent, Defendants Albergo
and Does 21 through 30 “brutalized [Decedent], subjecting [Decedent] to unreasonable and
excessive force, [when Decedent] did not resist arrest, nor was he a threat to” Defendants.
(B/Q Compl. ¶ 34.) 	Plaintiffs also allege that “the severe head injuries [Decedent]
sustained occurred while he was at VDF or [were] caused by A[lbergo] and D[oes] 21
through 30, inclusive, during his arrest.” 	(Id. ¶ 38) (emphasis added). 	Because the
allegations of how Decedent’s head injury occurred are “internally inconsistent, the Court
need not accept them as true.” 	Wuxi Multimedia, Ltd. v. Koninklijke Philips Elecs., N.V.,
No. 04CV1136 DMS BLM, 2006 WL 6667002, at *9 (S.D. Cal. Jan. 5, 2006), aff’d sub
nom. Wuxi Multimedia Ltd. v. Koninklijke Philips Elecs., N.A., 280 F. App’x 968 (Fed. Cir.
2008).
To state an excessive force claim, a plaintiff must allege facts showing that the
defendant’s conduct was “objectively unreasonable in light of the facts and circumstances
confronting them.” 	See Graham v. Connor, 490 U.S. 386, 397 (1989). 	Here, Plaintiffs
have failed to allege what force was used by Defendant Albergo and Plaintiffs’ own
allegations illustrate the only reasonable inference is that Decedent’s head injury occurred
at VDF. (See B/Q Compl. ¶¶ 38 (“At the time of his VDF booking, [Decedent] was not
identified by medical staff as having any head injuries.”), 47 (“[D]ue to the severity of the
head injuries [Decedent] sustained at VDF. . .”.) Because Plaintiffs fail to plausibly allege
excessive force by Defendant Albergo or Does 21 through 30, the Court DISMISSES
Plaintiffs’ excessive force claim. See Moss v. United States Secret Service, 572 F.3d 962,
969 (9th Cir. 2009) (“[F]or a complaint to survive a motion to dismiss, the non-conclusory
‘factual content,’ and reasonable inferences from that content, must be plausibly suggestive
of a claim entitling the plaintiff to relief”) (citation omitted).
/ / /
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C. 	1983 Claims
City Defendants argue for the third and fourth causes of action, all the “allegations
relate to a period of time in which [Decedent] was in VDF custody” and thus there was no
involvement by the City Defendants. (City MTD at 9.) Plaintiffs argue that “to the extent
Plaintiffs’ injuries were caused by C[ity] Defendants’ actions while he was in their custody,
C[ity] Defendants are liable.” (B/Q Opp’n at 14.)
“To state a claim under § 1983, a plaintiff [1] must allege the violation of a right
secured by the Constitution and laws of the United States, and [2] must show that the
alleged deprivation was committed by a person acting under color of state law.” Naffe v.
Frey, 789 F.3d 1030, 1035–36 (9th Cir. 2015) (quoting West v. Atkins, 487 U.S. 42, 48
(1988)). “[F]or persons who are detained by police in the course of an arrest, the Fourth
Amendment’s prohibition on the use of excessive force protects against the deprivation of
necessary medical care.” 	D’Braunstein v. Cal. Highway Patrol, 131 F.4th 764, 769 (9th
Cir. 2025) (citing Tatum v. City & Cnty. of S.F., 441 F.3d 1090, 1098–99 (9th Cir. 2006)).
“To establish deliberate indifference to medical needs, a pretrial detainee must show (1) a
serious medical need and (2) a deliberately indifferent response, such as defendants’
den[ial], delay or intentional interference with medical treatment.” 	Young v. City of
Menifee, No. ED-CV-17-1630-JGBSPX, 2019 WL 4238880, at *7 (C.D. Cal. Aug. 2,
2019) (second alteration in original and internal quotation marks omitted) (quoting Est. of
Prasad ex rel. Prasad v. Cnty. of Sutter, 958 F. Supp. 2d 1101, 1112 (E.D. Cal. 2013)
(quoting Jett v. Penner, 439 F.3d 1091, 1096 (9th Cir. 2006))). “[W]hat is required under
the Fourth Amendment is ‘objectively reasonable post-arrest care,’ which means that
police officers must ‘seek the necessary medical attention for a detainee when he or she
has been injured while being apprehended by either promptly summoning the necessary
medical help or by taking the injured detainee to a hospital.’” D’Braunstein, 131 F.4th at
769 (quoting Tatum, 441 F.3d at 1099). “But this does not ‘require an officer to provide
what hindsight reveals to be the most effective medical care for an arrested suspect.’” Id.
(quoting Tatum, 441 F.3d at 1098).
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Because Plaintiffs only allege “[a]t the time of [Decedent’s] booking, [he] was
suffering from acute alcohol intoxication which was known to Defendants,” (B/Q Compl.
¶ 37), Plaintiffs do not plausibly allege Decedent was suffering from a serious medical need
when Defendant Albergo arrested him. See Border v. Trumbull Cnty. Bd. Of Com’rs., 414
F.App’x 831, 837 (6th Cir. 2011) (“[A] pretrial detainee’s generalized state of intoxication,
without more, is insufficient to establish a serious medical need or an officer’s deliberate
indifference to a substantial risk of serious harm to a detainee.”). 	As a result, the Court
DISMISSES the Section 1983 claims against City Defendants.
C. 	Loss of Familial Association
Because Plaintiffs fail to state a claim against City Defendants for excessive force
or deliberate indifference, the loss of familial association claim also fails. See infra Section
IV.C.1 (explaining the standard for loss of familial association is deliberate indifference
when, as occurred here, there is time to deliberate). 	The Court therefore DISMISSES
Plaintiffs’ loss of familial association claim against City Defendants.
D. 	Monell Claims
Under Monell v. Department of Social Services of the City of New York, a plaintiff
cannot sue a municipality under a theory of respondeat superior for the constitutional
violations of its employees or agents. 436 U.S. 658, 691 (1978). Instead, municipalities
are liable only when an “action pursuant to official municipal policy of some nature caused
a constitutional tort.” 	Id. 	To state a claim under Monell, the plaintiff must allege (1) a
deprivation of a constitutional right, (2) a policy, (3) which amounted to a deliberate
indifference to the plaintiff’s constitutional right, and (4) that the policy was the “moving
force behind the constitutional violation.” 	Mabe v. San Bernardino Cnty., Dep’t of Pub.
Soc. Servs., 237 F.3d 1101, 1110–11 (9th Cir. 2001).
At the motion to dismiss stage, the Ninth Circuit has made it clear that claims of
Monell liability must comply with the basic principles set forth in Twombly and Iqbal. See
A.E. v. Cnty. of Tulare, 666 F.3d 631, 637 (9th Cir. 2012). Thus, the following two rules
govern the Court’s evaluation of Plaintiffs’ Monell allegations: (1) the complaint “may not
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simply recite the elements of a cause of action, but must contain sufficient allegations of
underlying facts to give fair notice and to enable the opposing party to defend itself
effectively;” and (2) the “factual allegations that are taken as true must plausibly suggest
an entitlement to relief, such that it is not unfair to require the opposing party to be
subjected to the expense of discovery and continued litigation.” Id. at 636–37.
City Defendants argue Plaintiffs’ Monell claim does not establish the alleged policy
or custom was the “moving force” behind the injury and that Plaintiffs “fail to identify a
City of Escondido policy, custom, or practice, or failure to train.” (City MTD at 10–11.)
Plaintiff Benitez and Quintero respond with a conclusory argument that “the facts alleged
in the Complaint are clearly sufficient for purposes of alleging Monell claims against
municipal / institutional defendants.” (B/Q Opp’n at 16–17.) Examining Plaintiffs Benitez
and Quintero’s Complaint, Plaintiffs allege the County of San Diego, City of Escondido,
Naphcare, 	Inc., 	and 	Naphcare 	San 	Diego, 	LLC 	“maintained 	a 	long-standing
unconstitutional policy, custom, and/or practice which allowed its officers, deputies and
medical staff to delay and/or deny medical care to inmates” and cite to statistics and cases
related to deaths in San Diego jails. 	(B/Q Compl. ¶¶ 33–35, 96.) 	Because Plaintiffs’
allegations only relate to conduct in San Diego County jails, Plaintiffs have failed to
provide factual allegations illustrating that the City of Escondido had any relevant policy
or custom. 	Thus, the Court DISMISSES Plaintiffs’ Monell claims against the City of
Escondido.
D. 	State Law Causes of Action
1. 	Battery
To state a claim for battery under California law, a plaintiff must allege that “the
defendant intentionally did an act that resulted in harmful or offensive contact with the
plaintiff’s person.” See Tekle v. United States, 511 F.3d 839, 855 (9th Cir. 2007). Plaintiffs
argue they have “sufficiently alleged that Defendants caused [Decedent’s] severe head
injuries[] and have thus sufficiently alleged claims for battery under California law.” (B/Q
Opp’n at 24.)
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Plaintiffs are incorrect. Plaintiffs’ Complaint alleges Decedent’s severe head injury
was “sustained at VDF” and that the injury was a “result of either falling from a top bunk
or alternatively, physical injuries from interactions with other inmates due to jail staff
failing to provide for [Decedent’s] physical safety or alternatively, by A[lbergo] and
D[oes] 21 through 30 inclusive, all of which would not have occurred if [Decedent] was
referred to the emergency room for appropriate treatment or properly housed in housing
which afforded close monitoring of his medical condition . . .” (B/Q Compl. ¶ 47 (emphasis
added).) 	Like Plaintiffs’ excessive force claim, conclusory and internally inconsistent
allegations are not sufficient to state a plausible battery claim. 	Thus, the Court
DISMISSES the battery cause of action against City Defendants.
2. 	The Bane Act
City Defendants also argue Plaintiffs’ Bane Act claim fails for the same reasons
Plaintiffs’ other state law claims fail. (See City MTD at 11.) California Civil Code § 52.1
provides a cause of action for violations of plaintiffs’ state or federal civil rights committed
using “threats, intimidation, or coercion.” Plaintiffs rely on the fact that “a successful claim
for excessive force under the Fourth Amendment provides the basis for a successful claim
under § 52.1.” (B/Q Opp’n at 24 (citing Chaudhry v. City of Los Angeles, 751 F.3d 1096,
1105–1106 (9th Cir. 2014).) Because Plaintiffs have failed to state a claim for excessive
force, 	see supra 	Section III.B, and Plaintiffs do not separately allege any threats,
intimidation, or coercion by the City Defendants, the Court DISMISSES the Bane Act
cause of action against City Defendants.
3. 	Negligence
“A plaintiff in a negligence suit must demonstrate a legal duty to use due care, a
breach of such legal duty, and the breach as the proximate or legal cause of the resulting
injury.” Frausto v. Dep’t of California Highway Patrol, 53 Cal. App. 5th 973, 988 (2020).
City Defendants argue the only allegations set forth relating to the City Defendants are
failure to comply with California Penal Code § 647(g), which does not give rise to civil
liability. (See City MTD at 12.) Plaintiffs Benitez and Quintero argue that “[o]fficers may
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breach their duty to seek medical care for arrestees who are in serious needs of medical
care, where they ignored signs, symptoms, and ‘strange behavior which a reasonable
officer in Defendants’ position should have attributed to something other than alcohol
intoxication.’” (B/Q Opp’n at 20 (citing Lum v. Cty. of San Joaquin, 756 F.Supp.2d 1243,
1254 (E.D. Cal. 2010)).)
While City Defendants are correct that California Penal Code § 647(g) does not
create an affirmative duty, see Stout v. City of Porterville, 148 Cal. App. 3d 937, 947 (Ct.
App. 1983), this is not the only basis for finding Defendant Albergo had a duty towards
Decedent. 	Arresting officers have a duty to use reasonable care when responding to an
arrestee’s medical needs. See Frausto, 53 Cal. App. 5th at 993; see also Winger v. City of
Garden Grove, 806 F. App’x 544, 546 (9th Cir. 2020) (“[W]e conclude that the California
Supreme Court would conclude that a law enforcement officer owes a duty of reasonable
care to an arrestee in his custody who needs immediate medical attention.”).
However, City Defendants are also correct that Plaintiffs have failed to allege that
Decedent needed immediate medical attention when he was arrested by Defendant
Albergo. (See City Reply at 4.) Plaintiffs allege “[a]t the time of [Decedent’s] booking,
[he] was suffering from acute alcohol intoxication which was known to Defendants. (B/Q
Compl. ¶ 37.) But Plaintiffs fail to allege Decedent’s intoxication was a serious medical
need at the time Defendant Albergo arrested Decedent. 	See Border, 414 F.App’x at 837.
Because Plaintiffs fail to allege that Decedent was suffering an immediate medical need
when he was arrested by Defendant Albergo, they fail to plausibly allege Defendant
Albergo (or any Doe Defendants) had or breached a duty of care. 	Thus, the Court
DISMISSES the negligence claim against City Defendants.
4. 	Section 845.6
California Government Code § 845.6 creates an affirmative duty for jail officials “to
furnish or obtain medical care for a prisoner in his custody.” Decedent was not a “prisoner”
when he was held by Defendant Albergo because he had not yet entered a prison, jail, or
penal or correctional facility, pursuant to penal processes. 	See Cal. Gov. Code § 844.
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Accordingly, California Government Code § 845.6 does not apply, and the Court
DISMISSES the Section 845.6 claim against City Defendants.
5. 	Medical Negligence
To state a claim for medical negligence, a plaintiff must plead: “(1) the duty of the
professional to use such skill, prudence and diligence as other members of his profession
commonly possess and exercise; (2) a breach of that duty; (3) a proximate causal
connection between the negligent conduct and the resulting injury; and (4) actual loss or
damage resulting from the professional’s negligence.” Doe v. United States, 704 F. Supp.
3d 1049, 1055 (C.D. Cal. 2023) (citation omitted). 	City Defendants argue “there is no
allegation in the Complaint that EPD Officer Albergo or any other Escondido Defendants
are health care providers or trained medical professionals.” (City MTD at 13.) Plaintiffs
Benitez and Quintero do not respond to this argument in their Opposition and thus waive
it. See Moore v. Apple, Inc., 73 F. Supp. 3d 1191, 1205 (N.D. Cal. 2014) (collecting cases);
see also Stichting Pensioenfonds ABP v. Countrywide Fin. Corp., 802 F. Supp. 2d 1125,
1132 (C.D. Cal. 2011). The Court therefore DISMISSES the claim of medical negligence
against City Defendants.
6. 	Wrongful Death
“The elements of the cause of action for wrongful death are the tort (negligence or
other wrongful act), the resulting death, and the damages, consisting of the pecuniary loss
suffered by the heirs.” Lattimore v. Dickey, 239 Cal. App. 4th 959, 968 (2015). Because
Plaintiffs’ fail to allege negligence or some other wrongful act, see supra Sections III.D.1–
5, the Court DISMISSES the wrongful death claim against City Defendants.
IV. 	County Defendants’ Motion to Dismiss
County Defendants argue Plaintiffs fail to state a claim for the following causes of
action: (1) deliberate indifference, (2) loss of familial association, (3) Monell, (4) the Bane
Act, and (5) Government Code Section 845.6. 	(See generally County MTD.) 	County
Defendants also argue the following issues: (1) lack of casual connection for supervisory
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defendants, (2) failure to comply with the Government Claims Act, (3) Plaintiffs Benitez
and Quintero’s medical negligence claim is time-barred, and (4) Plaintiffs Benitez and
Quintero’s due process claim is duplicative. (See id.)
A. 	Government Claims Act Compliance
The Court concluded that statutory immunity bars all state law claims against the
County of San Diego except for Plaintiffs Benitez and Quintero’s Section 845.6 claim. See
supra Section II. County Defendants also argue Plaintiffs Benitez and Quintero’s state law
claims fail because their claims submitted to the County of San Diego do not comply with
the Government Claims Act requirements. (See County MTD at 18.)
1. 	County Defendants’ Request for Judicial Notice
County Defendants’ Request for Judicial Notice (“RJN,” ECF No. 32-3), asks the
Court to take judicial notice of (1) a “true and correct copy of the Government Claim
submitted to the County of San Diego by Plaintiff Maritza Benitez, dated September 26,
2024, received by the County of San Diego on September 30, 2024” and (2) a “true and
correct copy of the Government Claim submitted to the County of San Diego by Plaintiff
Jose Alberto Quintero, dated October 9, 2024, received by the County of San Diego on
October 14, 2024.” 	(Id. at 2.) 	County Defendants argue because “Plaintiffs’ Complaint
expressly alleges compliance with the Government Claims Act . . . the existence and
contents of the government claim are therefore necessarily relied upon.” 	(Id. at 2–3.)
County Defendants, therefore, argue that the Court may properly consider them under the
incorporation-by-reference doctrine. (See id.)
“Judicial notice under Rule 201 permits a court to notice an adjudicative fact if it is
‘not subject to reasonable dispute.’” Khoja v. Orexigen Therapeutics, Inc., 899 F.3d 988,
999 (9th Cir. 2018) (quoting Fed. R. Evid. 201(b)). The court may take judicial notice of
matters of public record, but it “cannot take judicial notice of disputed facts contained in
such public records.” 	Id. 	Unlike rule-established judicial notice, under the incorporation
by reference doctrine, “courts may take into account ‘documents whose contents are
alleged in a complaint and whose authenticity no party questions, but which are not
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physically attached to the [plaintiff’s] pleading.’” 	Davis v. HSBC Bank Nev., N.A., 691
F.3d 1152, 1160 (9th Cir. 2012). A defendant may seek to incorporate a document “if the
plaintiff refers extensively to the document or the document forms the basis of the
plaintiff’s claim.” United States v. Ritchie, 342 F.3d 903, 907 (9th Cir. 2003). “However,
if the document merely creates a defense to the well-pled allegations in the complaint, then
that document did not necessarily form the basis of the complaint.” Id.
To the extent County Defendants request the Court incorporate by reference the
contents of the Plaintiffs’ government tort claims, the request is GRANTED because
Plaintiffs Benitez and Quintero’s Complaint explicitly refers to the documents in question
(see B/Q Compl. ¶ 4), such documents are central to Plaintiffs’ claims as timely filing and
rejection is a prerequisite to filing a civil complaint, see City of Stockton v. Superior Ct.,
42 Cal. 4th 730, 738 (2007), and no party has contested the authenticity of such documents.
2. 	Analysis
County Defendants argue Plaintiffs Benitez and Quintero did not comply with the
Government Claims Act requirements. 	(See County MTD at 18.) 	Further, County
Defendants argue Plaintiffs Benitez and Quintero have “effectively conceded the issue” by
not responding to this argument in their Opposition. 	(County Reply at 7.) 	Because
Plaintiffs Benitez and Quintero’s Opposition does not respond to the County Defendants’
Government Claims Act argument, (see B/Q Opp’n at 18), they have waived this issue.
See Stichting Pensioenfonds ABP, 802 F. Supp. 2d at 1132. 8 Thus, the Court DISMISSES
8 	County Defendants’ argument also prevails on the merits. Before bringing a suit against a public
entity, the Government Tort Claims Act requires the timely presentation of a written claim and a rejection
in whole or part. Cal. Gov. Code § 905; State of California v. Superior Court (Bodde), 90 P.3d 116, 119
(Cal. 2004) (“Under [the Government Claims Act], failure to timely present a claim for money or damages
to a public entity bars a plaintiff from filing a lawsuit against that entity.”). A “claim need not contain the
detail and specificity required of a pleading, but need only fairly describe what the entity is alleged to have
done.” 	Stockett v. Ass’n of Cal. Water Agencies Joint Powers Ins. Auth., 34 Cal. 4th 441, 446 (2004)
(cleaned up) (citation omitted). Therefore, “where there has been a ‘complete shift in allegations, usually
involving an effort to premise civil liability on acts or omissions committed at different times or by
different persons than those described in the claim,’ . . . courts generally found the complaint barred.” Id.
at 447 (quoting Blair v. Superior Court, 218 Cal. App. 3d 221, 226 (1990)).
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the state law claims asserted by Plaintiffs Benitez and Quintero against the County of San
Diego. 9
B. 	Deliberate Indifference
County Defendants argue Plaintiffs fail to allege conduct that rises to the level of
deliberate indifference. 	(See County MTD at 7–10.) 	“[T]he elements of a pretrial
detainee’s medical care claim against an individual defendant under the due process clause
of the Fourteenth Amendment 10 are: “(i) the defendant made an intentional decision with
respect to the conditions under which the plaintiff was confined; (ii) those conditions put
the plaintiff at substantial risk of suffering serious harm; (iii) the defendant did not take
Examining both claims filed with the County of San Diego, Plaintiffs Benitez and Quintero only
alleged excessive force. (See generally RJN.) In Plaintiff Quintero’s claim he states, “various San Diego
County Sheriff’s Department deputies arrested and used excessive force.” 	(Id. at Exh. B.) 	Plaintiff
Benitez’s claim makes the same allegation. (Id. at Exh. A.) Accordingly, the question before the Court
is whether Plaintiffs allegations of “excessive force” are broad enough to encompass the allegations in the
Complaint of medical misconduct by the County at VDF. See Stockett, 34 Cal. 4th at 447 (“A complaint’s
fuller exposition of the factual basis beyond that given in the claim is not fatal, so long as the complaint
is not based on an entirely different set of facts.”). Plaintiffs Benitez and Quintero’s Complaint does not
make any excessive force claims against the County. 	Instead, the Complaint argues that Decedent’s
medical care at VDF resulted in unsafe housing and his ultimate death. 	(See generally B/Q Compl.)
Because liability in the Complaint is premised on an entirely different factual basis which would implicate
different parties than stated in the government claim, Plaintiff Benitez and Quintero’s claims fail to put
the County on notice of their claims based on medical misconduct within VDF. As a result, the California
state law claims against County Defendants are barred by the Government Claims Act. 	See, e.g.,
Hernandez v. City of Stockton, 90 Cal. App. 5th 1222, 1234 (2023) (finding that the plaintiff’s complaint
was barred because the factual basis for recovery asserted in their complaint was not fairly reflected in the
government claim).
9 	The Court notes that the filing of a consolidated amended complaint will not cure this defect.
“Where two or more persons suffer separate and distinct injuries from the same act or omission, each
person must submit a claim, and one cannot rely on a claim presented by another.” Nelson v. County of
Los Angeles, 113 Cal. App. 4th 783, 796 (2003). “This rule applies where different claimants are alleging
survivor theories and wrongful death theories of liability arising from the same transaction.” Castaneda
v. Dep’t of Corr. & Rehab., 212 Cal. App. 4th 1051, 1062 (2013).
10 	The Benitez/Quintero Complaint asserts both the Eight Amendment and Fourteenth Amendment
as bases for the deliberate indifference claim. (See B/Q Compl. ¶ 88.) “Claims of failure to provide care
for serious medical needs, when brought by a detainee who has been neither charged nor convicted of a
crime, are analyzed under the substantive due process clause of the Fourteenth Amendment.” Frary v.
Cnty. of Marin, No. C 12-3928 MEJ, 2012 WL 6218196, *6 (N.D. Cal. Dec. 13, 2012) (citing Lolli v.
County of Orange, 351 F.3d 410, 418–89 (9th Cir. 2003)).
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reasonable available measures to abate that risk, even though a reasonable official in the
circumstances would have appreciated the high degree of risk involved—making the
consequences of the defendant’s conduct obvious; and (iv) by not taking such measures,
the defendant caused the plaintiff’s injuries.” Gordon v. Cnty. of Orange, 888 F.3d 1118,
1125 (9th Cir. 2018). For the third element, the defendant’s conduct “must be objectively
unreasonable” which is “more than negligence but less than subjective intent—something
akin to reckless disregard.” Id. “Neither mere lack of due care, nor an inadvertent failure
to provide adequate medical care, nor even medical malpractice, without more, is sufficient
to meet this standard.” 	Fraihat v. U.S. Immigr. & Customs Enf’t, 16 F.4th 613, 636 (9th
Cir. 2021) (cleaned up). “Instead, a plaintiff must show that the defendant disregarded an
excessive risk to the plaintiff’s health and safety by failing to take reasonable and available
measures that could have eliminated that risk.” Id.
1. 	Defendant Mata11
Defendant Mata, a registered nurse employed by San Diego County, marked on the
Medical Clearance Assessment that Decedent was “fit to continue” the booking process
without selecting that Decedent should be assigned to a sobering cell or other safety
housing and failed to mark the following items on Decedent’s Medical Clearance
assessment: that he was confused, had an altered mental status, was in withdrawal, had
slurred speech, had unsteady gait, had a stupor, was tremulous, or was disoriented. (B/Q
Compl ¶ 40.)
County Defendants do not dispute that alcohol withdrawal is a serious medical
condition, nor that Defendant Mata incorrectly filled out the intake form. (See generally
County MTD.) Rather, County Defendants argue “[w]hile Plaintiffs claim that Defendant
11 	The Ramirez-Garcia Plaintiffs’ request judicial notice of a separate lawsuit in which Defendant
Mata is also named as a defendant. (See R/G Opp’n at n.1.) County Defendants argue the lawsuit “has
no bearing on the allegations here, even more so considering that dismissal motions are pending.” (County
Reply at 3 n.1.) 	Under Federal Rules of Evidence Rule 201, the Court cannot take judicial notice of
disputed facts contained in public records; therefore, the Court finds no basis to take judicial notice of the
separate lawsuit where Defendant Mata is named as a defendant.
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M[ata] observed that the Decedent ‘was experiencing tremors, nausea, vomiting, slurred
speech, and was disoriented,’ they plead no facts suggesting that it was objectively
unreasonable for Defendant M[ata] to conclude that the Decedent could be appropriately
assessed and treated at VDF.” (Id. at 8.) Further, County Defendants argue Plaintiffs fail
“to allege the defendant-specific conduct, knowledge, or causation required for deliberate
indifference” and “[a]bsent any theory connecting the paperwork to harm, dismissal is
required as to Defendant Mata.” (County Reply at 3.) County Defendants are incorrect;
at the motion to dismiss stage, Plaintiffs need only plausibly allege Defendant Mata was
deliberately indifferent to Decedent’s serious medical needs.
a. 	Knowledge
Plaintiffs allege Defendant Mata was aware of Decedent’s alcohol withdrawal
symptoms. 	(See B/Q Compl. ¶ 40 (stating Defendant Mata was aware Decedent “was
experiencing tremors, nausea, vomiting, slurred speech and was disoriented because he had
noted those symptoms on a CIWA form”).) Further, Plaintiffs allege Decedent’s symptoms
of alcohol withdrawal were “obvious.” (Id.) Taking the facts in the light most favorable
to Plaintiffs, the Court finds Plaintiffs plausibly allege Defendant Mata had knowledge
Decedent was suffering from alcohol withdrawal, a severe medical condition.
b. 	Intentional Objectively Unreasonable Conduct
Since a reasonable jury could find that Defendant Mata had knowledge that
Decedent was going through alcohol withdrawal, they could find Defendant Mata’s
intentional choice to fill out the intake form incorrectly and determination that Decedent
was “fit to continue” was objectively unreasonable. 	See M.H. v. Cnty. of Alameda, 62 F.
Supp. 3d 1049, 1078 (N.D. Cal. 2014) (finding that a reasonable jury could find a nurse
was deliberately indifferent when she was “aware of the risk of alcohol withdrawal, but
failed nevertheless to fill out a CIWA form, initiate the CIWA protocol, or otherwise ensure
[the decedent] would receive medical help”); see also Gordon v. Cnty. of Orange, 6 F.4th
961, 971 n.5 (9th Cir. 2021) (citing Thornhill for Estate of Berry v. Aylor, No. 15-CV-24
(GEC), 2017 WL 4685986, at *10–11 (W.D. Va. Oct. 18, 2017) (denying summary
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judgment for screening nurse who “knew that [inmate] had a history of alcohol abuse and
that the signs of alcohol withdrawal would develop later” but failed to initiate CIWA
protocol because she believed he “was at a risk for only heroin, and not alcohol,
withdrawal”)); see also Hanington v. Multnomah Cnty., 593 F. Supp. 3d 1022, 1040 (D.
Or. 2022) (concluding, at the summary judgment stage, that the plaintiffs provided
sufficient evidence that the nurse defendant violated the decedent’s right to receive
adequate medical care when she deliberately ignored the decedent’s criminal history which
increased the likelihood that the decedent’s suicidal tendencies would go undetected and
failed to take reasonable measures to mitigate the risk). 	Accordingly, the Court finds
Plaintiffs properly allege Defendant Mata engaged in intentional objectively unreasonable
conduct.
c. 	Causation
Plaintiffs plausibly allege causation by stating if Defendant Mata had accurately
documented 	Decedent’s 	symptoms, he would have been 	given 	immediate 	medical
treatment or been placed into specialized housing for his safety. (See B/Q Compl. ¶ 40.)
The Ninth Circuit has found similar allegations of causation from a chain of events
sufficient. 	See, e.g., Castro v. Cnty. of Los Angeles, 833 F.3d 1060, 1075–76 (9th Cir.
2016) (finding that a lack of consistent monitoring and housing policy caused the
decedent’s injury from an attack by another inmate). 	Thus, the Court concludes a
reasonable jury could find Defendant Mata’s actions were deliberately indifferent to a
serious medical risk and caused Decedent’s death. 	Accordingly, the Court DENIES the
County Defendants’ Motion to Dismiss with respect to the deliberate indifference claim
against Defendant Mata.
2. 	Defendant Castleberry
Plaintiffs allege Defendant Castleberry, a registered nurse employed by San Diego
County, “knew or should have known” Decedent “required emergency room treatment for
his life-threatening alcohol withdrawal symptoms but did not refer him for such immediate
treatment.” 	(B/Q Compl. ¶ 45.) 	Plaintiffs also allege Defendant Castleberry failed to
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ensure Decedent took prescribed alcohol withdrawal medications and did not fully
complete a medication-refusal form. 	(See id.) 	County Defendants argue “[a]t most,
Plaintiffs allege that she failed to confirm medication compliance or fully complete a
refusal form—facts that do not plausibly suggest that she recognized and consciously
disregarded a serious risk of harm.” (County MTD at 10.)
a. 	Plaintiffs Benitez and Quintero’s Complaint
Plaintiffs Benitez and Quintero do not sufficiently allege Defendant Castleberry
“made an intentional decision with respect to the conditions under which the plaintiff was
confined.” Gordon, 888 F.3d at 1125. Unlike Plaintiffs’ allegations relating to Defendant
Mata—which 	detailed 	how 	he 	was 	aware 	of 	Decedent’s 	symptoms 	of 	alcohol
withdrawal—Plaintiffs’ allegations relating to Defendant Castleberry are limited to the
statement that she “knew or should have known” that Decedent “required emergency room
treatment for his life-threatening alcohol withdrawal symptoms.” (B/Q Compl. ¶ 45.) This
assertion amounts to no more than a legal conclusion. 	See Iqbal, 556 U.S. at 679. Thus,
the Court DISMISSES Plaintiffs Benitez and Quintero’s deliberate indifference claim
against Defendant Castleberry.
b. 	Plaintiffs Ramirez and Garcia’s SAC
In contrast, Plaintiffs Ramirez and Garcia’s SAC alleges that Defendant Castleberry
“knew that [Decedent] had been vomiting, was disoriented, had tremors, was intoxicated,
in withdrawal, had slurred speech, an unsteady gait, and suffered from seizures.” 	(SAC
¶ 47.) Taking the facts in the light most favorable to Plaintiffs, the Court finds Plaintiffs
plausibly allege Defendant Castleberry had knowledge Decedent was suffering from
alcohol withdrawal, a severe medical condition.
Thus, the Court must consider whether Defendant Castleberry made an intentional
choice that was objectively unreasonable. Plaintiffs Ramirez and Garcia allege Defendant
Castleberry chose to not immediately refer Decedent to the emergency room and/or
appropriate specialized housing that would provide adequate medical monitoring, despite
knowing Decedent “had not taken necessary medications to treat his obvious symptoms.”
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(R/G SAC ¶ 49.) At this stage, the Court concludes a reasonable jury could find Defendant
Castleberry’s intentional choice not to refer Decedent to the emergency room or specialized
housing was objectively unreasonable based on Decedent’s refusal to take his medication
and obvious signs of alcohol withdrawal. 	See Castro, 833 F.3d at 1070–72 (explaining
that a defendant’s “lack of response” can be an intentional act sufficient for a deliberate
indifference claim); see also Sandoval v. Cnty. of San Diego, 985 F.3d 657, 670 (9th Cir.
2021) (finding a jury could conclude that a nurse’s actions of administering a quick test
and then ignoring the decedent were “akin to reckless disregard” when a reasonable nurse
would have known the decedent faced a substantial risk of suffering serious harm).
Accordingly, the Court DENIES the County Defendants’ Motion to Dismiss Plaintiffs
Ramirez and Garcia’s deliberate indifference claim against Defendant Castleberry.
C. 	Loss of Familial Association
To show a violation of the right to familial association under the Fourteenth
Amendment, a plaintiff must establish that a state actor’s conduct shocks the conscience.
See Scott v. Smith, 109 F.4th 1215, 1227–28 (9th Cir. 2024)
1. 	The Applicable Standard
“First, [the Court] must decide the appropriate standard of culpability to apply to
[Defendants’] 	conduct 	to 	determine 	whether 	it 	‘shocks 	the 	conscience’ 	under 	the
Fourteenth Amendment’s Due Process Clause.” 	Porter v. Osborn, 546 F.3d 1131, 1137
(9th Cir. 2008). The “deliberate-indifference test” applies when a situation “evolve[s] in a
time frame that permits the officer to deliberate before acting.” 	Id. And the more
demanding “purpose-to-harm test” applies when a situation “escalate[s] so quickly that the
officer must make a snap judgment.” Id.
The Parties disagree on which standard applies here. 	County Defendants argue
“where the alleged deprivation results from unintentional government conduct, liability
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only arises if the conduct was so egregious as to meet this heightened standard.” 12 (County
MTD at 12.) Plaintiffs Benitez and Quintero argue “defendants had time to deliberate so
the ‘deliberate indifference’ standard applies, not purpose to harm.” 	(B/Q Opp’n at 12.)
Here, Defendants had plenty of time to deliberate while they interacted with Decedent and
the situation was not escalating until Decedent suffered his head injury; therefore, the
deliberate indifference standard applies. See Lemire v. California Dep’t of Corr. & Rehab.,
726 F.3d 1062, 1075 (9th Cir. 2013) (“A prison official’s deliberately indifferent conduct
will generally ‘shock the conscience’ so as long as the prison official had time to deliberate
before acting or failing to act in a deliberately indifferent manner.”).
2. 	Violation of the Fourteenth Amendment
Because the deliberate indifference standard applies and the Court determined
Plaintiffs plausibly allege deliberate indifference, see supra Section IV.B, Plaintiffs also
plausibly state a claim for loss of familial association. Thus, the Court DENIES the County
Defendants’ Motion to Dismiss the loss of familial association claim.
D. 	Plaintiffs Ramirez and Garcia’s Failure to Train and Supervise Claims
The Ramirez-Garcia SAC asserts a failure to train and supervise claim on behalf of
the Decedent’s estate against Supervisory Doe Defendants 1–9. (See R/G SAC ¶¶ 68–98.)
County Defendants argue the “Ramirez-Garcia SAC does not allege that any Supervisory
Doe Defendant personally committed a constitutional violation, nor does it allege that any
exercised authority over a subordinate who did so.” (County MTD at 13.)
“A defendant may be held liable as a supervisor under § 1983 ‘if there exists either
(1) his or her personal involvement in the constitutional deprivation, or (2) a sufficient
causal connection between the supervisor’s wrongful conduct and the constitutional
violation.’” Starr v. Baca, 652 F.3d 1202, 1207 (9th Cir. 2011) (quoting Hansen v. Black,
885 F.2d 642, 646 (9th Cir. 1989)). 	For example, “[a] supervisor can be liable in his
12 	County Defendants do not cite any authority for this proposition. 	(See County MTD at 12.)
Further, the Court has already concluded the individually named County Defendants made intentional
choices. See supra Section IV.B.
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individual capacity for his own culpable action or inaction in the training, supervision, or
control of his subordinates; for his acquiescence in the constitutional deprivation; or for
conduct that showed a reckless or callous indifference to the rights of others.” Id. (quoting
Watkins v. City of Oakland, 145 F.3d 1087, 1093 (9th Cir. 1998)).
For Does 1–4, Plaintiffs Ramirez and Garcia argue they “failed to properly train their
subordinates on: dealing with inmates in medical distress; communicating critical medical
information; treatment of withdrawals/seizures; NCCHC Standards; and supervisors’ duty
to ensure all employees were properly trained to meet the needs of their patients.” 	(R/G
Opp’n at 14 (citing SAC ¶¶ 69–73).) For Does 5–9, Plaintiffs Ramirez and Garcia allege
they “failed to properly train and supervise defendants Mata, Castleberry, Dai and Does
10–30 in the performance of their duties in evaluating ill patients; assigning appropriate
housing for individuals in withdrawal; and/or performing required cell safety checks.” (Id.
at 15 (citing SAC ¶ 87).) For all Doe Defendants, Plaintiffs Ramirez and Garcia argue the
failures to train caused, denied, or delayed care for Decedent, which resulted in his death.
(See id.)
Plaintiffs’ general allegations are not sufficient to plausibly allege supervisor
liability. 	Plaintiffs “must at least attempt to ‘refer to unknown defendants as Defendant
John Doe 1, John Doe 2, John Doe 3, and so on . . . [and] allege specific facts showing how
each particular doe defendant violated his rights.’” 	Hernandez v. San Bernardino Cnty.,
No. ED-CV-2:21-101-JGBSPX, 2023 WL 3432206, at *4 (C.D. Cal. Jan. 26, 2023)
(alterations in original & emphasis added) (quoting Keavney v. Cnty. of S.D., No. 3:19-cv-
01947-AJB-BGS, 2020 WL 4192286, at *4 (S.D. Cal. July 21, 2020)). Accordingly, the
Court DISMISSES Plaintiffs Ramirez and Garcia’s third and fourth causes of action for
failure to train and supervise.
E. 	Monell Claims
To state a claim under Monell, the plaintiff must allege (1) a deprivation of a
constitutional right, (2) a policy, (3) which amounted to a deliberate indifference to the
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plaintiff’s constitutional right, and (4) that the policy was the “moving force behind the
constitutional violation.” Mabe, 237 F.3d at 1110–11; see also supra Section III.D.
1. 	Deprivation of a Constitutional Right
Monell claims are “contingent on a violation of constitutional rights.” 	Lockett v.
Cty. of L.A., 977 F.3d 737, 741 (9th Cir. 2020) (internal quotation marks omitted). 	As
previously explained, see supra Section IV.3.1, the Court finds Plaintiffs have plausibly
plead a constitutional violation.
2. 	Legal Theories
“A local government is liable for an injury under § 1983 under three possible
theories.” Rodriguez v. Cnty. of L.A., 891 F.3d 776, 802 (9th Cir. 2018) (citing Clouthier
v. Cnty. of Contra Costa, 591 F.3d 1232, 1249 (9th Cir. 2010), overruled on other grounds
by Castro, 833 F.3d 1060. 	“First, a local government may be liable if ‘execution of a
government’s policy or custom, whether made by its lawmakers or by those whose edicts
or acts may fairly be said to represent official policy, inflict[ed] the injury.’” Id. (alteration
in original) (quoting Monell, 436 U.S. at 694). 	“Second, a local government can fail to
train employees in a manner that amounts to ‘deliberate indifference’ to a constitutional
right, such that ‘the need for more or different training is so obvious, and the inadequacy
so likely to result in the violation of constitutional rights, that the policymakers of the city
can reasonably be said to have been deliberately indifferent to the need.’” Id. (quoting City
of Canton v. Harris, 489 U.S. 378, 390 (1989)). “Third, a local government may be held
liable if ‘the individual who committed the constitutional tort was an official with final
policy-making authority or such an official ratified a subordinate’s unconstitutional
decision or action and the basis for it.’” Id. at 802–03 (quoting Gravelet-Blondin v. Shelton,
728 F.3d 1086, 1097 (9th Cir. 2013)).
a. 	Longstanding Policy, Custom, or Practice
The Parties agree there is no formal policy at issue and Plaintiffs are alleging an
informal custom or practice. 	When examining allegations of an informal custom or
practice, liability can “not be predicated on isolated or sporadic incidents; it must be
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founded upon practices of sufficient duration, frequency and consistency that the conduct
has become a traditional method of carrying out that policy.” 	Trevino v. Gates, 99 F.3d
911, 918 (9th Cir. 1996). 	But “the line between adequate and inadequate evidence of
repeated constitutional violations does not involve a specific quantum or number of
allegations.” Est. of Mendez v. City of Ceres, 390 F. Supp. 3d 1189, 1209 (E.D. Cal. 2019).
Further, “[c]ourts are ‘somewhat split’ on the level of detail and the number of similar
unconstitutional incidents a plaintiff must show to establish a longstanding practice or
custom.” 	Est. of Kong by & through Kong v. City of San Diego, No. 22-CV-1858-BAS-
DDL, 2023 WL 4939370, at *6 (S.D. Cal. Aug. 2, 2023). While plaintiffs necessarily have
“limited access to details of governmental policies and training procedures prior to
discovery,” plaintiffs relying on prior incidents must still allege incidents that are
“substantially similar in character.” Seever v. City of Modesto, No. 121CV01373JLTEPG,
2022 WL 17418355, at *3 (E.D. Cal. Dec. 5, 2022). “[T]he correct analysis focuses on the
similarity between the ‘factually pertinent’ aspects of the prior incidents.” 	Id. (quoting
McCoy v. City of Vallejo, 2020 WL 374356, at * 4 (E.D. Cal. Jan. 23, 2020)).
While Plaintiffs list numerous “systematic deficiencies,” 13 the thrust of Plaintiffs’
Monell claim is that the County of San Diego has a custom or practice of improperly
screening detainees and putting them into inappropriate and unsafe housing assignments.
(See B/Q Compl. ¶ 53; R/G SAC ¶ 104; ECF No. 57.) To illustrate this informal practice,
Plaintiffs cite to seven cases, the fact that from 2006 through 2020, a total of 185 people
13 	Specifically, Plaintiffs Benitez and Quintero allege the following systematic deficiencies:
“inadequate medical intake, lack of required training or screening, inadequate diagnosis and treatment of
medical conditions, improper housing for inmates with serious medical needs, inadequate safety checks
for inmates with serious medical needs and non-compliant policies and procedures.” (B/Q Compl. ¶ 96.)
Plaintiffs Ramirez and Garcia specifically allege Defendants have a widespread practice of “deny[ing]
treatment to inmates in serious medical distress and to place inmates in inappropriate housing not suited
to their medical need” (R/G SAC ¶ 104), “not properly screening inmates for medical care or treatment”
(id. ¶ 105), “failing to communicate the medical needs of inmates between the medical staff and deputies”
(id. ¶ 106), and not properly checking on the welfare of inmates (id. ¶ 106). Plaintiffs Ramirez and Garcia
also allege a practice of not properly investigating misconduct and interfering with investigations. (Id.
¶¶ 109–110.)
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died in San Diego County’s jails—a rate higher than any other large county across the
State, and a State Auditor’s Review of 30 individuals’ deaths from 2006 through 2020,
which found that some of the individuals had serious medical or mental health needs that
the Sheriff’s Department’s health staff did not identify during the intake process. (See B/Q
Compl. ¶ 95; R/G SAC ¶ 43.)
The Parties disagree on which of the cases cited are relevant to illustrating a custom
or practice. 	County Defendants argue that of the seven cases Plaintiffs cite, only one—
Estate of Elisa Serna et al v. County of San Diego, et al.—is relevant because it is the only
case concerning alcohol withdrawal. 	(See County MTD at 16.) 	Plaintiffs argue “[i]t is
inconsequential whether such inadequate medical care stemmed from medical emergencies
caused by alcohol withdrawal or some other precipitating factor.” 	(B/Q Opp’n at 18.) 14
Neither party has applied the standard correctly. 	Prior instances must be “substantially
similar in character”; this is not so rigid of a standard to only include alcohol withdrawal,
as the County Defendants suggest, but also not broad enough of a standard to encompass
any medical condition, as Plaintiffs suggest. 	An incident is not substantially similar to
Decedent’s medical screening and housing if the severe injury has nothing to do with an
intoxicating substance. 	The Court therefore discounts Plaintiffs’ allegations of prior
incidents that do not involve a medical issue related to substance abuse. This includes the
incidents involving a head injury (see B/Q Compl. ¶ 95(g); R/G SAC ¶ 43(g)), seizure
condition (see B/Q Compl. ¶ 95(b); R/G SAC ¶ 43(b)), and water intoxication (see B/Q
Compl. ¶ 95(d); R/G SAC ¶ 43(d)). 	See Pauu v. Cnty. of San Diego, No. 23-CV-2162
TWR (SBC), 2024 WL 2980793, at *12 (S.D. Cal. June 13, 2024) (discounting allegations
of prior conduct involving off-duty officers or uses of force other than a firearm when the
plaintiff was shot by an on-duty officer’s firearm and alleged a custom of permitting or
condoning the use of excessive force).
14 	At the hearing, Plaintiffs Benitez and Quintero argued that the level of specificity should be at the
deprivation of right level and Plaintiffs Garcia and Ramirez argued any form of withdrawal should be
sufficient. (See ECF No. 57.)
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This leaves three cases as relevant examples of prior conduct: (1) Estate of Elisa
Serna et al v. County of San Diego, et al. (see B/Q Compl. ¶ 95(a); R/G SAC ¶ 43(a)) ($15
million dollar settlement regarding a 2019 death when the decedent was in medical
observation from alcohol withdrawal); (2) Estate of Daniel Sisson, et al. v. County of San
Diego, et al. (see B/Q Compl. ¶ 95(c); R/G SAC ¶ 43(c)) ($3 million dollar jury award
from a 2011 death at VDF when the decedent suffered an asthma attack while suffering
from drug withdrawal); and (3) Victorianne v. County of San Diego (see B/Q Compl.
¶ 95(f); R/G SAC ¶ 43(f)) ($2.3 million dollar settlement from a 2012 death when the
decedent suffered a drug overdose after San Diego County jail staff did not put the decedent
in medical housing). In addition, the State Auditor’s Report from 2022 provides examples
of a pattern of improper screening at intake leading to in-custody deaths. (See B/Q Compl.
¶ 95(i); R/G SAC ¶ 43(i).) While the entire State Auditor’s Report is not included in either
complaint, it is properly incorporated by reference into the Ramirez Garcia SAC by
hyperlink. 15 The State Auditor’s Report explains that “accidental deaths” in San Diego
County “mainly included drug overdoses.” 	(R/G SAC at n.2 (“Auditor Report”) at 17.)
Further, “more individuals died of accidental causes in custody of the San Diego Sheriff’s
Department than in the custody of each of the comparable counties.” (Id. at 15; see also
B/Q Compl. ¶ 95(h); R/G SAC ¶ 43(h) (stating “[f]rom 2006 through 2020, a total of 185
people died in San Diego County’s jails—a rate higher than any other large county across
the State”).) 	Putting these facts together, drug overdose deaths occurred in San Diego
County facilities at a higher rate than in comparable counties. Further, the Auditor Report
15 	“When a plaintiff includes a hyperlink in their complaint, courts have found that the linked item is
incorporated by reference therein.” Over Active Imaginations Inc. v. Amazon.com Inc., 737 F. Supp. 3d
1094, 1101 n.2 (W.D. Wash. 2024) (quoting EEOC v. 98 Starr Rd. Operating Co., 682 F. Supp. 3d 414,
420 (D. Vt. 2023)). Further, the Court “sua sponte may find that a document is incorporated by reference
into a complaint.” 	Sloatman v. Housewright, No. 221CV08235WLHMAA, 2023 WL 8852375, at *4
(C.D. Cal. Nov. 17, 2023), report and recommendation adopted, No. 221CV08235WLHMAA, 2023 WL
8850724 (C.D. Cal. Dec. 18, 2023). While the Benitez/Quintero Complaint did not hyperlink the State
Auditor Report, because it is referenced in their Complaint and the Court is ordering all Plaintiffs to file
one consolidated complaint, the Court does not need to reach whether the allegations would be sufficient
without the details from within the State Auditor’s Report.
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identifies screening in the intake process as a contributor to these deaths. 	(See Auditor
Report at 1, 18–19.) 	For example, the Auditor Report highlights an instance where an
intake nurse “determined that an individual needed to have a secondary nurse evaluation
because the individual exhibited possible symptoms of drug withdrawal” but never
communicated that need and the individual “died 24 hours after completing booking” from
a drug overdose. (Id. at 20.)
Considering the three specific cases of substance abuse deaths—with one instance
occurring at VDF—and the larger trend of accidental deaths in San Diego County custody,
which are mainly drug overdose deaths, Plaintiffs have provided enough “factually
pertinent” evidence of a pattern or custom by San Diego County of improperly screening
and housing individuals going through substance-related severe medical events. 	See
Seever, 2022 WL 17418355, at *6 (concluding that five prior instances of similar pertinent
factual details, additional incidents showing the alleged pattern at a broader level, and two
instances involving a defendant was sufficient to support a custom or practice Monell
claim). 	Thus, the Court DENIES the County Defendants’ Motion to Dismiss Plaintiffs’
Monell claim based on an informal custom or practice.
b. 	Inadequate Training
Plaintiffs allege County Defendants failed to train employees on “how to recognize
when jail inmates are suffering from severe medical distress that requires immediate
medical attention and care,” when to “immediately summon medical care for inmates who
are suffering from severe medical distress,” and “how to properly house such inmates.”
(B/Q Compl. ¶ 110; R/G SAC ¶ 103.) 	County Defendants argue Plaintiffs’ “allegations
merely assume that inadequate medical care implies a failure to properly train, which is
insufficient to establish a causal link to the Decedent’s harm.” (County MTD at 18.)
“Failure to train may constitute a basis for Monell liability where the failure amounts
to deliberate indifference to the rights of those who deal with municipal employees.”
Benavidez v. Cty. of San Diego, 993 F.3d 1134, 1153 (9th Cir. 2021). “To allege a failure
to train, a plaintiff must include sufficient facts to support a reasonable inference (1) of a
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constitutional violation; (2) of a municipal training policy that amounts to a deliberate
indifference to constitutional rights; and (3) that the constitutional injury would not have
resulted if the municipality properly trained their employees.” 	Id. 	“A pattern of similar
constitutional violations by untrained employees is ‘ordinarily necessary’ to demonstrate
deliberate indifference for purposes of failure to train.” 	Connick v. Thompson, 563 U.S.
51, 61 (2011). But the Supreme Court has not “foreclose[d] the possibility that evidence
of a single violation of federal rights, accompanied by a showing that a municipality has
failed to train its employees to handle recurring situations presenting an obvious potential
for such a violation, could trigger municipal liability.” 	Bd. of Cnty. Comm’rs of Bryan
Cnty., Okl. v. Brown, 520 U.S. 397, 409 (1997).
Because Plaintiffs have adequately alleged a practice of inadequate screening and
improper housing that the County was on notice of, they have plausibly alleged deliberate
indifference by the County in continuing to inadequately train staff on how to identify,
screen, and house individuals suffering from severe substance abuse medical events. 	See
Greer v. Cnty. of San Diego, 726 F. Supp. 3d 1058, 1079 (S.D. Cal. 2023) (denying a
motion for summary judgment on the plaintiff’s Monell failure to train claim when
evidence of past similar conduct that had “already harmed numerous prior inmates”
provided evidence “that the County knew its continued failure to train, supervise, or
discipline was substantially likely to result in other inmates suffering injury”); see also
Connick, 563 U.S. at 62 (explaining that a policymaker’s “continued adherence to an
approach that they know or should know has failed to prevent tortious conduct by
employees may establish the conscious disregard for the consequences of their action—the
‘deliberate indifference’—necessary to trigger municipal liability.”). This is also sufficient
to allege that the failure to adequately train plausibly led to Decedent’s inadequate medical
treatment and resulting death. 	See Est. of Wilson by & through Jackson v. Cnty. of San
Diego, No. 20-CV-457-BAS-DEB, 2020 WL 3893046, at *4 (S.D. Cal. July 10, 2020).
The Court therefore DENIES the County of San Diego’s Motion to Dismiss Plaintiffs’
Monell claim based on failure to train.
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E. 	Plaintiffs Benitez and Quintero’s Due Process Claim
County Defendants argue that Plaintiffs Benitez and Quintero’s fourth cause of
Action for Deprivation of Life Without Due Process is entirely duplicative of the
allegations in their third cause of action for Deliberate Indifference. (See County MTD at
25.) 	Plaintiffs 	Benitez 	and 	Quintero 	argue 	“[w]here 	both 	Fourth 	and 	Fourteenth
Amendment rights are violated, the fact that a cause of action lies under one Amendment
‘cannot extinguish’ an otherwise viable cause of action under the other.” (B/Q Opp’n at
14 (citing Manuel v. City of Joliet, Ill., 137 S. Ct. 911, 918–19 (2017).) Plaintiffs’ argument
is unpersuasive since both the third and fourth causes of action rely on the Fourteenth
Amendment. (See B/Q Compl. at 26, 29.)
“Courts may dismiss claims that essentially repeat another claim in the same
complaint.” Segura v. City of La Mesa, 647 F. Supp. 3d 926, 940 (S.D. Cal. 2022). When
a specific constitutional Amendment “provides an explicit textual source of constitutional
protection against a particular sort of government behavior, that Amendment, not the more
generalized notion of ‘substantive due process,’ must be the guide for analyzing these
claims.” 	Albright v. Oliver, 510 U.S. 266, 273 (1994) (plurality) (quotation marks
omitted); accord 	Graham v. Connor, 490 U.S. 386, 395 (1989). 	Here, both Plaintiffs
Benitez and Quintero’s fourth and third causes of action are based on the Fourteenth
Amendment. (See B/Q Compl. at 26, 29.) Because Plaintiffs’ Deprivation of Life Without
Due Process claim is duplicative of their Deliberate Indifference claim the Court
DISMISSES Plaintiff Benitez and Quintero’s fourth cause of action for Deprivation of
Life Without Due Process.
F. 	State Law Claims
The state law claims—other than Plaintiffs Benitez and Quintero’s Section 845.6
claim—against the County of San Diego are subject to dismissal based on statutory
immunity. See supra Section II. Further, Plaintiffs Benitez and Quintero’s Section 845.6
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claim is subject to dismissal for failure to comply with the Government Claims Act. 16 See
supra Section IV.A. 	Therefore, the Court considers the merits of the state law claims
alleged against the individual County Defendants only.
1. 	Plaintiffs Benitez and Quintero’s Medical Negligence Claim
County Defendants argue Plaintiffs Benitez and Quintero filed their Complaint after
the one-year statute of limitations period elapsed because Decedent died on April 12, 2024,
and Plaintiffs filed their Complaint on May 5, 2025. (See County MTD at 22–23.) Further,
County Defendants argue because Plaintiffs’ Opposition provides “no authority, no
analysis, and no effort to explain how the claim could be timely under the applicable
limitations period” they have conceded the claim is time barred. 	(County Reply at 10.)
Plaintiffs Benitez and Quintero’s Opposition argues they sufficiently alleged claims for
medical negligence but does not specifically respond to the statute of limitations argument.
(See B/Q Opp’n at 25.) Finding Plaintiffs waived this claim, the Court DISMISSES the
Plaintiffs Benitez and Quintero’s medical negligence claim. 	See Stichting Pensioenfonds
ABP, 802 F. Supp. 2d at 1132 (“[I]n most circumstances, failure to respond in an opposition
brief to an argument put forward in an opening brief constitutes waiver or abandonment in
regard to the uncontested issue.”).
2. 	The Bane Act
County Defendants argue Plaintiffs’ Bane Act claim fails because “Plaintiffs identify
no conduct resembling threat, intimidation, or coercion.” (County Reply at 9.) 17 The Bane
16 	Even if the Court considered the merits of Plaintiffs Benitez and Quintero’s Section 845.6 claim,
the Court would find the Section 845.6 claim fails because Plaintiffs only allege that Defendants’ medical
response was inadequate not that medical treatment was never summoned. 	See Lapachet v. California
Forensic Med. Grp., Inc., 313 F. Supp. 3d 1183, 1198 (E.D. Cal. 2018) (“[R]eliance on § 845.6 is
unavailing because, on the facts alleged, medical care was in fact summoned.”); see also Scalia v. Cnty.
of Kern, 308 F. Supp. 3d 1064, 1087 (E.D. Cal. 2018) (dismissing the Section 845.6 claim when medical
care was provided but the plaintiffs disagreed with the treatment).
17 	County Defendants argue Plaintiffs Benitez and Quintero “offer no other response to the County
Defendants’ arguments and thus concede dismissal of this claim as to them.” (Id. at 8.) While Plaintiffs
Benitez and Quintero’s response in their Opposition is fairly conclusory, (see B/Q Opp’n at 24), it appears
to generally respond to all Defendants’ arguments and thus the Court declines to find waiver.
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Act 	protects 	against 	all 	conduct 	aimed 	at 	interfering 	with 	rights 	secured 	by 	the
constitutional or statutory law of the United States, or of California, “where the interference
is carried out ‘by threats, intimidation or coercion,’ whether or not the offending conduct
is motivated by discriminatory animus.” 	Cornell v. City & County of San Francisco, 17
Cal. App. 5th 766, 791 (2017).
County 	Defendants 	argue 	“California 	district 	courts 	are 	divided 	on 	whether
deliberate indifference alone can satisfy the coercion requirement.” (County Reply at 9.)
But the Ninth Circuit has found “the Bane Act does not require the ‘threat, intimidation or
coercion’ element of the claim to be transactionally independent from the constitutional
violation alleged.” 	Reese v. County of Sacramento, 888 F.3d 1030, 1043 (9th Cir. 2018)
(citing Cornell, 17 Cal. App. 5th at 798–802 (2017)). 	Applying Reese, Plaintiffs’
allegations of deliberate indifference can satisfy the “threat, intimidation, and coercion”
element of the Bane Act. 	Because Plaintiffs plausibly allege a deliberate indifference
claim, Plaintiffs also plausibly allege a Bane Act claim. 	The Court therefore DENIES
County Defendants’ Motion to Dismiss Plaintiffs’ Bane Act claim.
V. 	Naphcare Defendants’ Motion to Dismiss
Naphcare Defendants argue “neither pleading alleges facts establishing deliberate
indifference, negligence, causation, or any Naphcare policy giving rise to Monell liability”
and thus all claims against Naphcare Defendants should be dismissed. (Naphcare MTD at
1.)
A. 	Sufficient Notice
As a preliminary matter, Naphcare Defendants argue both complaints “are due to be
dismissed as each complaint fails to satisfy the notice-pleading standards of Federal Rules
of Civil Procedure 8(a) and 10(b) because they are vague, conclusory, and indiscriminately
attribute acts and omissions to ‘Defendants’ as a collective.” (Id. at 8.) This argument is
without 	merit. 	Both 	complaints 	make specific 	allegations 	about 	Defendant 	Dai’s
interactions with Decedent. 	(See B/Q Compl. ¶ 44; R/G SAC ¶ 36.) 	Further, group
pleadings are not barred if the allegations provide fair notice to defendants of claims against
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them. See Roberts v. Cty. of Riverside, No. EDCV191877JGBSHKX, 2020 WL 3965027,
at *3 (C.D. Cal. June 5, 2020).
Next, Naphcare Defendants argue Plaintiffs have failed to plead causation for all
causes of action because none of Plaintiffs’ theories on how Decedent suffered his head
injury implicate Naphcare. (See Naphcare MTD at 1.) This argument mischaracterizes the
level of causation needed. Plaintiffs allege that Defendant Dai failed to send Decedent for
72-hour 	treatment, 	failed 	to 	order 	immediate 	medication 	administration 	even 	if
involuntary, and failed to require that Decedent received specialized housing with close
observation. (See B/Q Compl. ¶ 44.) Plaintiffs allege because of Defendant Dai’s lack of
proper treatment, Decedent was placed into improper housing at VDF, which resulted in
him sustaining his ultimately fatal head injury. (Id. ¶ 47.) This allegation is sufficient for
causation.
B. 	Section 1983 Claims
1. 	Plaintiffs Benitez and Quintero’s Claims against Does 41-50
Naphcare Defendants argue that Defendants Does 41–50 should be dismissed
because the Benitez/Quintero Complaint does not explain how Does 41–50 violated the
claimant’s constitutional rights. 	(See Naphcare MTD at 10.) 	Plaintiffs Benitez and
Quintero assert “Defendants D[oes] 41-50 were employees or agents of N[aphcare Inc.]
. . . who at all times complained of were acting within the course and scope of their
employment.” (B/Q Compl. ¶ 26.) Plaintiffs “must at least attempt to ‘refer to unknown
defendants as Defendant John Doe 1, John Doe 2, John Doe 3, and so on . . . [and] allege
specific facts showing how each particular doe defendant violated his rights.’” Hernandez
v. San Bernardino Cnty., No. ED-CV-2:21-101-JGBSPX, 2023 WL 3432206, at *4 (C.D.
Cal. Jan. 26, 2023) (alterations in original & emphasis added) (quoting Keavney v. Cnty.
of S.D., No. 3:19-cv-01947-AJB-BGS, 2020 WL 4192286, at *4 (S.D. Cal. July 21, 2020)).
Because Plaintiffs fail to do so, the Court DISMISSES Plaintiffs Benitez and Quintero’s
claims against Does 41–50.
/ / /
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2. 	Deliberate Indifference
Defendant Dai, a Physician Assistant employed by Naphcare, is alleged to have
assessed Decedent and found that he was experiencing alcohol withdrawal. 	(See B/Q
Compl. ¶ 44.) Defendant Dai’s treatment plan included starting Diazepam on a taper for
withdrawal, Keppra for seizure prevention, and recommending a low-bunk assignment.
(Id.) 	But Defendant Dai did not order that the medications should be administered
immediately even if involuntary, send Decedent to the ER, nor order specialized housing.
(Id.)
First, Naphcare Defendants argue that Plaintiffs have failed to specifically allege a
severe medical need. 	(See Naphcare MTD at 13; Naphcare Reply at 11.) 	The Court
disagrees. Plaintiffs allege Decedent was suffering alcohol withdrawal, which is a severe
medical need. 	See Hernandez v. Cnty. of Monterey, 110 F. Supp. 3d 929, 948 (N.D. Cal.
2015). 	Further, at the hearing, Naphcare conceded that severe alcohol withdrawal is a
serious medical need. (See ECF No. 57.)
Next, Naphcare Defendants argue Plaintiffs do not allege intentional conduct. (See
Naphcare MTD at 14.) 	But as Naphcare Defendants recognize, Defendant Dai made the
intentional choice to recommend a treatment plan included starting Diazepam on a taper
for withdrawal, Keppra for seizure prevention, and recommending a low-bunk assignment.
(See B/Q Compl. ¶ 44.) Plaintiffs also allege Defendant Dai made the intentional choice
not to send Decedent to the ER, order the medications be administered immediately, even
if involuntarily, nor to order specialized housing. (See id.) These intentional choices are
enough for a reasonable jury to conclude that Defendant Dai put Decedent at a substantial
risk. 	See Castro, 833 F.3d at 1070–72 (explaining that a defendant’s “lack of response”
can be an intentional act sufficient for a deliberate indifference claim). Whether Defendant
Dai had the authority to make those choices and whether her treatment plan was a
reasonable measure to abate the risk to Decedent are questions of fact not appropriately
decided at the motion to dismiss stage. 	See Rainey v. Garcia, No. 1:08CV01731-
AWIYNPPC, 	2010 	WL 	308280, 	at 	*4 	(E.D. 	Cal. 	Jan. 	19, 	2010), 	report 	and
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recommendation adopted, No. 108CV01731AWIYNPGSA, 2010 WL 1033430 (E.D. Cal.
Mar. 19, 2010) (reasoning that “whether or not [the d]efendant actually could have
provided effective treatment for [the p]laintiff’s condition—whether [the defendant] had
the resources, authority, or responsibility to provide the necessary treatment—is a question
of disputed fact” not appropriate for resolution at the motion to dismiss stage). Thus, the
Court DENIES Naphcare Defendants’ Motion to Dismiss with respect to the deliberate
indifference claim against Defendant Dai.
3. 	Loss of Familial Association
Because Plaintiffs’ deliberate indifference claim survives, see supra Section V.B.2,
the loss of familial association claim also survives. The Court therefore DENIES Naphcare
Defendants’ Motion to Dismiss with respect to the loss of familial association claim.
C. 	Monell Claims
A plaintiff may assert Monell claims against a private entity contracting with a
municipality if the private entity (1) acted under color of state law, (2) a constitutional
violation occurred, and (3) the violation was caused by an official policy or custom. 	See
Tsao v. Desert Palace, Inc., 698 F.3d 1128, 1139 (9th Cir. 2012).
1. 	Color of State Law
Naphcare Defendants do not dispute they were acting under the color of state law.
(See generally Naphcare MTD.) 	Even if they did, numerous courts in this Circuit have
concluded that medical providers with a contractual relationship with a state entity are
acting under the color of state law. 	See, e.g., George v. Sonoma Cty. Sheriff’s Dep’t, 732
F. Supp. 2d 922, 935 (N.D. Cal. 2010) (concluding that a private hospital and physician
providing medical services to a county jail inmate pursuant to a contract with the county
were state actors). 	Plaintiffs allege that Naphcare “was the third-party contractor who
employed, supervised, and trained medical staff at VDF.” (B/Q Compl. ¶ 14.) The Court
therefore finds Plaintiffs plausibly allege Naphcare was acting under the color of state law.
/ / /
/ / /
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2. 	Constitutional Violation
Naphcare Defendants argue for the Benitez/Quintero Complaint, the Monell claims
fail “substantively because no constitutional deprivation is linked to any NaphCare policy”
and the Ramirez/Garcia SAC is also deficient because it “relies on conclusory assertions.”
(Naphcare MTD at 17–18.) As previously discussed, see supra Section V.B.2, Plaintiffs
plausibly allege Defendant Dai committed a constitutional violation. 	Accordingly, the
Court finds Plaintiffs plausibly allege Naphcare committed a constitutional violation.
3. 	Official Policy or Custom
Naphcare Defendants argue Plaintiffs fail to identify any Naphcare policy, custom,
or training deficiency that caused a constitutional violation. 	(Naphcare MTD at 17.)
Plaintiffs Garcia and Ramirez argue they allege “the County’s contract with the Naphcare
entities required their employees to be trained in NCCHC standards” and prior to
Decedent’s “incident, the Naphcare entities were aware of other failures to render emergent
medical care to seriously ill inmates in San Diego County jails.” (R/G Opp’n at 17 (citing
R/G SAC ¶¶ 11–12, 43).) 18 And Plaintiffs Benitez and Quintero rely on their argument
that the County, City, and Naphcare allowed “officers, deputies and medical staff to delay
and/or deny medical care to inmates.” (B/Q Opp’n at 16.) Further, Plaintiffs rely on the
same evidence as proffered for San Diego County’s custom or policy. (Id.; R/G Opp’n at
17.)
The mere contractual relationship between the County of San Diego and Naphcare
does not mean both entities have the same policies. See Est. of Schuck by & through Schuck
v. Cnty. of San Diego, No. 23-CV-785-DMS-AHG, 2025 WL 2625254, at *22 (S.D. Cal.
Sept. 11, 2025) (finding the sharing of a common aim and contract does not impute a policy
from the county to the other party). 	Further, Plaintiffs do not allege that Naphcare was
involved in the cases they rely on. Because Plaintiffs cannot rely on the evidence of deaths
18 	Plaintiffs Garcia and Ramirez attempt to introduce new evidence of Naphcare’s unconstitutional
customs or practices in their Opposition, (see R/G Opp’n at 18), but these instances cannot be considered
in determining whether their SAC plausibly alleges a Monell claim against Naphcare.
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in San Diego County jails without tying them to Naphcare, they are left with the singular
instance of Naphcare’s misconduct in this case, which does not rise to the level of an
overarching policy. Moreover, Plaintiffs cannot rely on the NCCHC standards as a policy
for Monell liability because the NCCHC standards would have required Decedent to be
transferred to a hospital. See Valerie Arismendez v. Deputy Velasquez, No. Cv 19-08767-
Cjc (Skx), 2020 WL 6162819 at *9 (C.D. Cal Aug. 28, 2020) (“Monell liability applies
where action pursuant to an official municipal policy causes a constitutional tort, not where
action contrary to policy causes one”) (emphasis in original). Similarly, while Plaintiffs
allege that Naphcare required its employees/agents to be trained in NCCHC standards, (see
B/Q Compl. ¶ 14; R/G SAC ¶ 11), Plaintiffs do not make any specific allegations that
Naphcare failed to provide said training. 	(See generally B/Q Compl.; R/G SAC.) 	And
Plaintiffs cannot rely on the past instances of substance related deaths to illustrate a failure
to train because they have not alleged Naphcare was involved in the prior instances. 	See
Cabanillas v. City of S. Gate, No. 2:24-CV-08027-ODW (BFMX), 2025 WL 2294327, at
*7 (C.D. Cal. Aug. 8, 2025) (finding the plaintiff failed to plausibly allege a failure to train
Monell claim when they did not establish a pattern of similar misconduct and did not
identify any specific inadequacy in the training). Because Plaintiffs fail to plausibly allege
a persistent and widespread policy by Naphcare or a failure to train, the Court DISMISSES
the Monell claims against Naphcare Defendants.
D. 	Qualified Immunity
Next, Naphcare Defendants argue, assuming they were acting under the color of law
as a state actor, they are entitled to qualified immunity. (See Naphcare MTD at 18 (citing
Estate of Keith Bach v. County of San Diego, et. al, Case No. 3:24-cv-01687, ECF No.
26).) But, as Naphcare Defendants conceded at the hearing, (see ECF No. 57), the Ninth
Circuit’s decision in Jensen v. Lane Cnty., 222 F.3d 570 (9th Cir. 2000) is controlling. In
Jensen, the Ninth Circuit held that a private medical provider contracted with a county was
not entitled to qualified immunity. 	Id. at 	577–79. 	Therefore, because Naphcare
Defendants “are privately employed medical providers, the defense of qualified immunity
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is categorically unavailable”; thus, the Court DENIES Naphcare Defendants’ Motion to
Dismiss to the extent it is based on qualified immunity. 	Spillard v. Ivers, No. 21-16772,
2023 WL 4992827, at *1 (9th Cir. Aug. 4, 2023) (citing Jensen, 222 F.3d at 577–79).
E. 	State Law Claims
1. 	Plaintiffs Benitez and Quintero’s Section 845.6 Claim
Because Naphcare Defendants are not public entities nor public employees and
Section 845.6 only provides liability for “a public employee” or a “public entity,” the
Section 845.6 claim necessarily fails in regard to Naphcare. Thus, the Court DISMISSES
Plaintiffs Benitez and Quintero’s Section 845.6 claim against Naphcare Defendants.
2. 	Negligence and Medical Negligence
Naphcare Defendants argue both complaints “improperly conflate[] the actions and
duties of the County and NaphCare, fail[] to allege any specific acts or omissions by
NaphCare personnel that breached a duty of care, and fail[] to allege a causal connection
between any such conduct and Decedent’s injuries or death.” (Naphcare MTD at 21.)
As to the Ramierz-Garcia SAC, Plaintiffs allege that Defendant Dai did not act with
the “skill and care ordinarily used by healthcare professionals engaged in the practice of
their 	profession 	in 	the 	same 	or 	similar 	locality 	and 	under 	the 	same 	or 	similar
circumstances.” (R/G SAC ¶ 137.) Further, Plaintiffs allege Defendant Dai did not comply
with the NCCHC standards when providing care to Decedent. (Id. ¶ 35.) This is enough
to plausibly state a claim for medical negligence; therefore, the Court DENIES Naphcare
Defendants’ Motion to Dismiss with regard to medical negligence in the Ramierz-Garcia
SAC.
As to the Benitez-Quintero Complaint, Plaintiffs assert both negligence and medical
negligence causes of action. 	(See generally B/Q Compl.) 	Naphcare Defendants argue
Plaintiffs only identify the standard of “ordinary care.” (Naphcare MTD at 21.) But this
argument misstates the Complaint. (See B/Q Compl. ¶ 160 (stating “[t]he negligence and
carelessness of Defendants consisted of their failure to use that degree of skill and care
ordinarily used by healthcare professionals engaged in the practice of their profession in
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the same or similar locality and under the same or similar circumstances.”).) 	Thus, the
Court DENIES Naphcare Defendants’ Motion to Dismiss Plaintiffs Benitez and Quintero’s
medical negligence and negligence claims.
3. 	Wrongful Death
Naphcare Defendants argue the Ramierz-Garcia SAC’s wrongful death claim is
“predicated on § 845.6.” (Naphcare MTD at 19.) This is incorrect. Plaintiffs Ramierz and
Garcia asserted “all California state law claims as a basis for state law wrongful death cause
of action.” 	(R/G Opp’n at 21 (citing R/G SAC ¶ 125).) Because Plaintiffs Ramierz and
Garcia plausibly assert a claim for medical negligence and similarly, the Benitez-Quintero
Complaint plausibly asserts claims for negligence and medical negligence, the Court
DENIES Naphcare Defendants’ Motion to Dismiss Plaintiffs’ wrongful death claim.
4. 	The Bane Act
Naphcare Defendants argue “Plaintiffs have not adequately pleaded a deliberate
indifference claim against any NaphCare Defendant let alone the requisite intentional
threats, intimidation or coercion required” for a Bane Act violation. 	(Naphcare MTD at
23.) The Bane Act protects against all conduct aimed at interfering with rights secured by
the constitutional or statutory law of the United States, or of California, where the
interference is carried out “by threats, intimidation or coercion,” whether or not the
offending conduct is motivated by discriminatory animus. 	Cornell, 17 Cal. App. 5th at
791. As previously explained, see supra Section IV.F.2, the threat or coercion required for
a Bane Act violation does not need to be separate from the constitutional or statutory
violation alleged. 	See Reese, 888 F.3d at 1043. 	Because Plaintiffs plausibly allege a
deliberate indifference claim against Defendant Dai, Plaintiffs also plausibly allege a Bane
Act claim against Naphcare Defendants. Thus, the Court DENIES Naphcare Defendants’
Motion to Dismiss Plaintiffs’ Bane Act claim.
VI. 	Consolidation of the Complaints and Leave to Amend
As discussed with the Parties at the hearing, (see ECF No. 57), the existence of two
complaints has posed difficulties in briefing and the effective resolution of this action.
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Therefore, in the interest of judicial economy, the Court ORDERS the Parties to file one
amended consolidated complaint. Because the Court is ordering one amended complaint,
some claims will be dismissed with prejudice only as to some of the Plaintiffs. See DeSoto
v. Yellow Freight Sys., Inc., 957 F.2d 655, 658 (9th Cir. 1992) (“If a complaint is dismissed
for failure to state a claim, leave to amend should be granted ‘unless the court determines
that the allegation of other facts consistent with the challenged pleading could not possibly
cure the deficiency.’”) (quoting Schreiber Distrib. Co. v. Serv-Well Furniture Co., 806
F.2d 1393, 1401 (9th Cir. 1986)); see also Moore, 73 F. Supp. 3d at 1205 (explaining that
when a plaintiff fails to address a particular claim in its opposition to a motion to dismiss
that claim, “courts generally dismiss it with prejudice”) (citation omitted).
Thus, the following claims are dismissed WITH PREJUDICE because amendment
would be futile: (1) state law claims brought against the County of San Diego, (2) Plaintiff
Quintero’s survivor and loss of familial association claims, (3) the Section 845.6 claim
brought against Naphcare Defendants by Plaintiffs Benitez and Quintero, (4) the Section
845.6 claim brought against County Defendants by Plaintiffs Benitez and Quintero, (5) the
loss of familial association and deliberate indifference claims brought by Decedent’s
Estate, (6) the deliberate indifference claim brought by Plaintiffs Benitez and Quintero in
their individual capacities, and (7) the medical negligence claim brought against County
Defendants by Plaintiffs Benitez and Quintero. 	All other claims are dismissed WITH
LEAVE TO AMEND.
CONCLUSION
For the foregoing reasons, the Court (1) GRANTS IN PART AND DENIES IN
PART City Defendants’ Motion to Dismiss, (2) GRANTS IN PART AND DENIES IN
PART County Defendants’ Motion to Dismiss, and (3) GRANTS IN PART AND
DENIES IN PART Naphcare Defendants’ Motion to Dismiss. 	Within twenty-one (21)
days of the date on which this Order is electronically docketed, Plaintiffs SHALL FILE
an amended consolidated complaint. Defendants SHALL ANSWER Plaintiffs’ amended
consolidated complaint or 	SHALL RESPOND 	to Plaintiffs’ amended consolidated
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complaint within forty-two (42) days of the date on which this Order is electronically
docketed.
IT IS SO ORDERED.
Dated: January 29, 2026
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