United States Court of Appeals

FOR THE EIGHTH CIRCUIT

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No. 05-1888

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Allen G. Gibson; David Hall, *

*

Plaintiffs, *

*

Richard St. Cloud, Sr., *

*

Plaintiff - Appellant, *

 *

Michael Langley, *

 * Appeal from the United States

Plaintiff, * District Court for the 

 * District of South Dakota. 

v. *

 * 

Doug Weber; Darrell Slykhuis; *

Jeff Bloomberg; Kay Paa; John *

Degreef: Eugene Regier; Herbert *

Saloum; James H. Shaeffer; Mike Rost; *

Healthcare Medical Technology; *

Doneen Hollingsworth, *

 *

Defendants - Appellees. *

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Submitted: November 18, 2005

Filed: January 10, 2006

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Before MURPHY, BOWMAN, and GRUENDER, Circuit Judges.

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MURPHY, Circuit Judge.
1

Allen G. Gibson, David Hall, and Michael Langley, listed as plaintiffs in the

case caption, filed a separate appeal (docketed as file 04-3932) and their issues were

resolved in an opinion filed on December 15, 2005.

2

The Honorable John A. Simko, United States Magistrate Judge for the District

of South Dakota, presiding with consent of the parties. 

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Richard St. Cloud, Sr.,1

 a diabetic inmate in custody of the South Dakota

Department of Corrections ("DOC"), brought this action against state correctional

officials and outside medical personnel, alleging deliberate indifference to his medical

needs and inadequate medical facilities in violation of the Eighth and Fourteenth

Amendments and state law. The district court2

 granted summary judgment in favor

of all of the defendants on St. Cloud's federal claims and declined to exercise

supplemental jurisdiction over the state law claim for medical malpractice. St. Cloud

appeals, arguing that he has presented sufficient evidence to present his claims to a

jury and that the court erred by dismissing the state claim. We affirm.

St. Cloud suffers from peripheral diabetic neuropathy, a disease which causes

numbness in the feet and makes any injury to his feet a serious health risk. While

incarcerated, he suffered burns to his feet during a Native American sweat lodge

purification ceremony on February 22, 2001. Medical personnel wrote an order two

days later requiring a daily medical shower followed by a change of dressings and the

application of burn ointment. The order restricted St. Cloud from further participation

in sweat lodge ceremonies until his feet healed. 

St. Cloud considered the medical personnel to have "poor attitudes". After being

frustrated by a twenty five minute delay waiting to have his dressings changed, he

decided that he would change the dressings himself and would assume responsibility

for his own care. He signed a Release of Responsibility on March 13 which stated

that he was knowingly acting in noncompliance with the recommendations of medical

personnel. 
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A physician's assistant reported on the status of St. Cloud's injury on March 22.

He noted that the treatment had not yet been effective and recommended skin grafting

because the wounds on St. Cloud's right foot did not appear to be closing. His report

noted minor areas of inflammation but did not mention the possibility of infection.

Medical personnel next entered an order on April 6, ordering St. Cloud to return to

health services for daily dressing changes. Doctors planned on performing a skin graft

on April 10, but they noticed signs of an infection in St. Cloud's right foot during an

April 9 physical. St. Cloud complained of a fever and pain on April 10, and doctors

transferred him to Sioux Valley Hospital. Doctors at the hospital determined that an

infection made it necessary to amputate portions of St. Cloud's right foot; they

performed the amputations on April 11 and 21. He was discharged on April 24 with

an order mandating daily dressing changes. St. Cloud complied with this order.

St. Cloud made numerous complaints to prison administrators relating to the

sweat lodge incident on February 22. He filed grievances on February 24, and March

6, 19, and 21, seeking to have the medical restriction on his participation in sweat

lodge activities lifted. He also filed a lawsuit on May 2 alleging that the restriction

unconstitutionally infringed upon his religious freedom; that action was voluntarily

dismissed in July. On May 9, June 4, and September 2 and 6, he filed resolution

requests complaining about the quality of medical care he had received in relation to

the sweat lodge injury. He filed requests for administrative remedies relating to the

incident on May 13 and September 9. 

 St. Cloud filed the present lawsuit against medical providers and prison

personnel on February 12, 2002. He alleged that Dr. Eugene Regier and Dr. James

Shaeffer, employees of the South Dakota Department of Health who provided medical

care to inmates, and nurse Kay Paa, an employee at the South Dakota State

Penitentiary, had provided medical services that were in deliberate indifference to his
3

St. Cloud conceded in his brief in the district court that summary judgment was

appropriate in favor of the named defendants Mike Rost and Healthcare Medical

Technology. St. Cloud does not assert in his complaint or in his brief that he ever

received treatment from defendants Herbert Saloum and John Degreef, and he does

not argue in his brief that summary judgment was improper in favor of defendant

Doneen Hollingsworth. St. Cloud has thus waived his claims against these parties. 

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medical needs in violation of the Eighth Amendment.3

 He also alleged that Jeff

Bloomberg, then secretary of the South Dakota Department of Corrections, Darrell

Slykhuis, the deputy warden, Doug Weber, the warden, and Deoneen Hollingsworth,

secretary of the South Dakota Department of Health, infringed on his Eighth and

Fourteenth Amendment rights by failing to provide adequate facilities, failing to train

medical personnel, and failing to provide a written treatment plan. He also alleged a

medical malpractice claim based on state law. 

The district court granted summary judgment in favor of the defendants, finding

that there was no genuine issue of material fact supporting St. Cloud's claim that the

medical providers had acted with deliberate indifference toward his condition or that

the prison's administration caused his injuries. It also found that the defendants were

entitled to qualified immunity. Having disposed of the constitutional claims, the court

declined to exercise supplemental jurisdiction over the state malpractice claim and

dismissed it. 

St. Cloud appeals, arguing that there is a genuine issue of material fact as to

whether the treatment plan designed for his injuries and the actual treatment he

received was in deliberate indifference to his medical needs. He also argues that the

district court should have retained his state claim even if the federal claims were

properly dismissed. Appellees respond that St. Cloud presented no evidence

establishing that their treatment was in deliberate indifference to his needs or that their

treatment caused the infection which necessitated the amputations. They also argue

that they are entitled to qualified immunity and that the decision to dismiss the state
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law claim is vested solely in the district court's discretion. We review the district

court's grant of summary judgment de novo. Lund v. Hennepin Cty, 427 F.3d 1123,

1125 (8th Cir. 2005). 

To make out an Eighth Amendment violation arising from inadequate medical

attention in a state penitentiary, inmates must show "deliberate indifference" to their

"serious illness[es] or injur[ies]." Estelle v. Gamble, 429 U.S. 97, 105 (1976). A

showing of deliberate indifference is greater than gross negligence and requires more

than mere disagreement with treatment decisions. Estate of Rosenberg v. Crandell, 56

F.3d 35, 37 (8th Cir. 1995). An inmate must prove that officials knew about excessive

risks to his health but disregarded them, Logan v. Clarke, 119 F.3d 647, 649 (8th Cir.

1997), and that their unconstitutional actions in fact caused his injuries. Calloway v.

Miller, 147 F.3d 778, 781 (8th Cir. 1998). 

St. Cloud argues that the treatment plan designed for his right foot created an

excessive risk to his health amounting to a deprivation of his constitutional rights. His

left foot healed within a few days of being admitted into the hospital, and he argues

that this is sufficient evidence to show that the prison's treatment plan for his right foot

was so deficient as to be deliberately indifferent to his condition. Proof of causation

by expert testimony is required when a plaintiff is complaining about treatment of a

sophisticated injury, however. Robinson v. Hager, 292 F.3d 560, 564 (8th Cir. 2002).

St. Cloud's argument that expert testimony is not necessary because an infection is

within the realm of common knowledge overlooks the undisputed facts in this case.

He recognizes that his medical condition of peripheral diabetic neuropathy

predisposed him to injuries of this nature, and the record reflects that his condition

worsened after he refused treatment and that the amputations only became necessary

two months after the accident. Expert medical testimony was necessary to establish

that the allegedly deficient treatment plan resulted in his amputations. Id.
4

Because we conclude that St. Cloud did not submit sufficient evidence to

establish his constitutional claims, it is unnecessary to discuss other defenses raised

in the summary judgment motions. 

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St. Cloud also asserts that the delayed reactions to his burns and ensuing

infection by prison officials evidenced deliberate indifference to his medical needs

sufficient to avoid summary judgment. He argues that medical personnel should have

diagnosed his injury and formulated a written treatment plan more quickly after the

accident and responded sooner after his self treatment of the wounds failed to aid in

his recovery. He also argues that he should not have been required to wait twenty five

minutes after showering for bandages and that he was not immediately provided

sufficient bandages to treat his wounds after deciding to treat the wounds himself. 

To avoid summary judgment an inmate alleging that a delay in treatment

constitutes a constitutional deprivation must produce medical evidence to establish

that the delay had a detrimental effect. Crowley v. Hedgepeth, 109 F.3d 500, 502 (8th

Cir. 1997). Given all the different factors that could have resulted in St. Cloud's

amputations, including his decision to decline medical treatment, see Beck v. Skon,

253 F.3d 330, 333 (8th Cir. 2001), medical evidence was needed. Otherwise a

reasonable juror could not determine whether delays in treatment or other factors

caused the need for the amputations. Robinson, 292 F.3d 560, 564 (8th Cir. 2002).

The district court did not err by granting summary judgment in favor of the

defendants.4

St. Cloud also maintains that summary judgment was improperly entered in

favor of the prison administrators. He argues that they should be held liable for the

institution's failure to provide written treatment plans for all inmate injuries, for failing

to provide minutes from quarterly meetings, and for failing to adequately train the

prison's staff. Since St. Cloud has not shown that his care was constitutionally

deficient, he is unable to prevail on this argument. See Veneklase v. City of Fargo,
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248 F.3d 738, 749 (8th Cir. 2001); Andrews v. Fowler, 98 F.3d 1069, 1076 (8th Cir.

1996). 

Finally, St. Cloud argues that the district court erred by declining to exercise

jurisdiction over the remaining state malpractice claim after dismissing his federal

claims. He argues that we should reverse because the court failed to enumerate any

reason for declining jurisdiction and because the interests of judicial economy,

convenience, and fairness weigh in favor of maintaining supplemental jurisdiction

over his state law claim. He argues that dismissal of his malpractice claim was

exceptionally unfair because the statute of limitations bars him from refiling it in state

court. 

Under 28 U.S.C. § 1367(c)(3), a court may "decline to exercise supplemental

jurisdiction over a claim . . . [if] the district court has dismissed all claims over which

it has original jurisdiction." Congress unambiguously gave district courts discretion

in 28 U.S.C. § 1367(c) to dismiss supplemental state law claims when all federal

claims have been dismissed, and there is no basis to find an abuse of discretion here.

See Labickas v. Arkansas State University, 78 F.3d 333, 334 (8th Cir. 1996);

McLaurin v. F.C. Prater, Co-1, 30 F.3d 982, 985 (8th Cir. 1994). 

For these reasons the judgment of the district court is affirmed. 

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