IN THE UNITED STATES COURT OF APPEALS

FOR THE FIFTH CIRCUIT

No. 18-20485

MATTHEW JAMES LEACHMAN,

Plaintiff-Appellant,

v.

HARRIS COUNTY, TEXAS, County Judge’s Office; SHERIFF ED 

GONZALES; DOCTOR MARCUS GUICE; DOCTOR DAVID SMITH; 

DOCTOR ALAN HARPER,

Defendants-Appellees.

Appeal from the United States District Court

for the Southern District of Texas

USDC No. 4:18-CV-457

Before WIENER, GRAVES, and OLDHAM, Circuit Judges.

PER CURIAM:*

Matthew James Leachman alleges the Harris County Jail is violating 

his Eighth Amendment rights. He sued the County, the Sheriff, and several 

dentists who care for prisoners at the jail, under 42 U.S.C. § 1983. The district 

court denied his motion for a preliminary injunction, denied his request for 

appointment of counsel, and directed him to file a more definite statement. He 

 

* Pursuant to 5TH CIR. R. 47.5, the court has determined that this opinion should not 

be published and is not precedent except under the limited circumstances set forth in 5TH 

CIR. R. 47.5.4.

United States Court of Appeals

Fifth Circuit

FILED

August 13, 2019

Lyle W. Cayce

Clerk

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appeals from these three orders. We have interlocutory appellate jurisdiction 

over the first two, and we affirm the district court as to both. We lack 

jurisdiction, however, to review the third. 

I.

In 1998, a Texas jury convicted Matthew James Leachman of aggravated 

sexual assault of a child. See Leachman v. State, No. 01-98-01255-CR, 2006 

WL 2381441, at *1 (Tex. App.—Houston [1st Dist.] Aug. 17, 2006, pet. ref’d)

(unpublished). He was sentenced to 40 years in prison. Id. 

In 2015, the Southern District of Texas found Leachman had been denied 

his right to self-representation at trial and granted a writ of habeas corpus 

pursuant to 28 U.S.C. § 2241. See Leachman v. Stephens, No. 4:11-CV-212, 

2015 WL 5730378, at *1 (S.D. Tex. Sept. 30, 2015). After the writ was granted, 

Leachman was transferred from the custody of the Texas Department of 

Criminal Justice (“TDCJ”) to the Harris County Jail while awaiting a new trial. 

See Ex parte Leachman, 554 S.W.3d 730, 734 (Tex. App.—Houston [1st Dist.] 

2018, pet. denied). His Eighth Amendment claim arises from his dental care 

while incarcerated at the Harris County Jail. 

Leachman filed a complaint under 42 U.S.C. § 1983 against the County, 

various jail officials, and dentists working in the jail. Leachman alleged they

were deliberately indifferent to his serious medical needs by refusing to fill his 

cavities and instead offering only to extract his decaying teeth. In particular, 

Leachman asserted that in September 2016, a piece of his back molar broke off 

while he was chewing. In October 2016, he was seen by a jail dentist. The 

dentist informed Leachman that it would be preferable to save the tooth rather 

than extract it but that the County jail had an “extractions only” policy. 

Accordingly, if Leachman wished to try to save the tooth, he would have to wait 

until he was released, wait until he returned to TDCJ’s custody, or arrange for 

a private dentist to fill his teeth at the jail. Leachman refused extraction at 

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the time. Leachman could not locate a private dentist to perform the work 

necessary to save his tooth. The pain worsened, and in February 2017, 

Leachman again visited the dentist, who opined that extraction of the decaying 

tooth was necessary. Leachman agreed to the surgery. 

On January 5, 2018, Leachman went to his annual dental checkup and 

was informed by a different dentist that he had three cavities. The dentist 

explained that the jail dental facility did not perform fillings and did not have 

the proper equipment to do so. Instead, the jail dentist could extract the 

decaying teeth. According to Leachman, within a week of the visit, two of the 

decayed areas “chipped and broke off from those teeth.” He experienced “minor 

discomfort” and feared losing more teeth. 

Leachman filed a motion for a preliminary injunction requiring the 

defendants “to preserve the status quo by filling [his] cavities before decay 

progresses beyond salvageability.” In the motion, Leachman stated that 

although no new pieces of his teeth had broken off, he was experiencing 

discomfort and some pain. Leachman stated that he was unable to submit 

medical evidence on tooth decay but noted that the district court could take 

judicial notice of the effects of tooth decay, emphasizing that it is common 

knowledge that if tooth decay is not treated, it will eventually lead to loss of 

the tooth. He cited Baughman v. Garcia, 254 F. Supp. 3d 848 (S.D. Tex. 2017), 

which states it is “undisputed that tooth decay, if left untreated, is progressive 

and can result in extreme pain, loss of tooth structure, and ultimately loss of 

the affected tooth.” Id. at 874.

II.

We have jurisdiction over the denial of a preliminary injunction under 

28 U.S.C. § 1292(a)(1). See Byrum v. Landreth, 566 F.3d 442, 444 (5th Cir. 

2009). Our review is for abuse of discretion, and we will reverse “only under 

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extraordinary circumstances.” White v. Carlucci, 862 F.2d 1209, 1211 (5th Cir. 

1989).

A movant is entitled to the “extraordinary remedy” of a preliminary 

injunction only if he establishes:

(1) a substantial likelihood of success on the merits, (2) a 

substantial threat of irreparable injury if the injunction is not 

issued, (3) that the threatened injury if the injunction is denied 

outweighs any harm that will result if the injunction is granted, 

and (4) that the grant of an injunction will not disserve the public 

interest.

Byrum, 566 F.3d at 445 (quoting Speaks v. Kruse, 445 F.3d 396, 399–400 (5th 

Cir. 2006)). He must carry “a heavy burden of persuading the district court 

that all four elements are satisfied,” and failure to carry the burden on any one 

of the four elements will result in the denial of the preliminary injunction. 

Enter. Int’l, Inc. v. Corporacion Estatal Petrolera Ecuatoriana, 762 F.2d 464, 

472 (5th Cir. 1985) (quoting Hardin v. Houston Chronicle Publ’g Co., 572 F.2d 

1106, 1107 (5th Cir. 1978) (per curiam)).

The district court determined Leachman had not shown a substantial 

likelihood of success because the “difficult questions of law” at issue “create 

sufficient doubt regarding the probability of his success on the merits.” It also 

determined Leachman had not established a substantial threat of irreparable 

injury.1 So it concluded Leachman had not carried his burden of persuasion. 

We need not reach the second conclusion because we agree with the first.

 

1 Leachman complains that the district court’s order does not include factual findings 

or discuss his evidence in connection with the denial of the motion for preliminary injunction. 

True, a district court’s ruling on a motion for a preliminary injunction must comply with 

Federal Rule of Civil Procedure 52(a) by stating reasons for the ruling. See Davis v. United 

States, 422 F.2d 1139, 1141 (5th Cir. 1970). Compliance with Rule 52(a) is not a jurisdictional 

requirement, however, id. at 1142, and it is enough if the district court’s order gives the 

reviewing court “a clear understanding of the factual basis for the decision,” Burma 

Navigation Corp. v. Reliant Seahorse MV, 99 F.3d 652, 657 (5th Cir. 1996). The district 

court’s order did so here. 

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The Supreme Court has said prison officials violate the Eighth 

Amendment’s prohibition against cruel and unusual punishment when they 

demonstrate deliberate indifference to a prisoner’s serious medical needs, 

amounting to an “unnecessary and wanton infliction of pain.” Estelle v. 

Gamble, 429 U.S. 97, 104 (1976) (quoting Gregg v. Georgia, 428 U.S. 153, 173 

(1976) (plurality opinion)). “A serious medical need is one for which treatment 

has been recommended or for which the need is so apparent that even laymen 

would recognize that care is required.” Gobert v. Caldwell, 463 F.3d 339, 345 

n.12 (5th Cir. 2006). To prevail on a claim of deliberate indifference to medical 

needs, the plaintiff must show the defendant denied him treatment, 

purposefully gave him improper treatment, or ignored his medical complaints. 

Domino v. Tex. Dep’t of Criminal Justice, 239 F.3d 752, 756 (5th Cir. 2001). 

A prisoner’s disagreement or dissatisfaction with his medical treatment 

generally will not suffice to show deliberate indifference. Gobert, 463 F.3d at 

346. “Because society does not expect that prisoners will have unqualified 

access to health care, deliberate indifference to medical needs amounts to an 

Eighth Amendment violation only if those needs are ‘serious.’” Hudson v. 

McMillian, 503 U.S. 1, 9 (1992) (quoting Gamble, 429 U.S. at 103–04). “[W]hen 

‘balancing the needs of the prisoner against the burden on the penal system, 

. . . the essential test is one of medical necessity and not one simply of 

desirability.’” Carlucci v. Chapa, 884 F.3d 534, 538 (5th Cir. 2018) (quoting 

Woodall v. Foti, 648 F.2d 268, 272 (5th Cir. Unit A June 1981)). 

Leachman has not shown he is significantly likely to succeed on the 

merits. We have concluded a prisoner failed to state a claim under the Eighth 

Amendment based on the jail’s provision of “extraction of his injured teeth” 

rather than “more expensive restorative treatment.” McQueen v. Karr, 54 F. 

App’x 406 (5th Cir. 2002) (per curiam). Indeed, we even affirmed dismissal of 

that complaint as frivolous. Id. And our sister circuits have found that similar 

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disputes about a course of dental treatment do not state an Eighth Amendment 

violation. See Mathews v. Raemisch, 513 F. App’x 605, 607 (7th Cir. 2013) 

(extraction instead of a root canal does not amount to deliberate indifference 

to a serious medical need); James v. Penn. Dep’t of Corr., 230 F. App’x 195, 197 

(3d Cir. 2007) (per curiam) (extraction of an abscessed tooth was not an Eighth 

Amendment violation even where another possible treatment, a root canal, was 

not available pursuant to prison policy); Willis v. Washington, 172 F.3d 54 (7th 

Cir. 1999) (unpublished table decision) (no Eighth Amendment violation where 

prisoner alleged “he was told he either could live with the pain or have his 

teeth pulled” and argued “he should have been offered alternatives to 

extraction”). 

There is some precedent supporting the theory that a prison’s refusal to 

provide medical treatment that is ordered by a doctor or dentist can constitute 

deliberate indifference. See, e.g., Jones v. Tex. Dep’t of Criminal Justice, 880 

F.3d 756, 758, 760 (5th Cir. 2018) (per curiam) (prisoner stated a viable claim 

where he was denied a diabetic diet ordered by his doctor, which allegedly

resulted in a heart attack and other life-threatening complications); Carlucci, 

884 F.3d at 538–41 (prisoner stated a viable claim Eighth Amendment claim 

under Bivens where dentist advised he needed bridges and dental surgery but 

prison failed to provide the recommended dental procedure). 

In light of this conflicting case law, Leachman has not shown a 

substantial likelihood of success on the merits. He is not entitled to the 

extraordinary remedy of a preliminary injunction.

III.

Leachman also sought appointment of counsel to represent him in his 

§ 1983 lawsuit. He contends he requires the assistance of counsel based on the 

complexity of his case and because proving his case would require expert 

medical testimony, subpoenaing documents not in his possession, and 

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discovery from nonparties. The district court denied his motion. We have 

previously said this decision is immediately appealable. See Robbins v. 

Maggio, 750 F.2d 405, 409, 413 (5th Cir. 1985).2

Leachman has no automatic right to appointed counsel in this civil rights 

matter. See Ulmer v. Chancellor, 691 F.2d 209, 212 (5th Cir. 1982). A district 

court is not required to appoint counsel for an indigent § 1983 plaintiff “unless 

the case presents exceptional circumstances.” Id. To determine whether 

exceptional circumstances exist, courts consider (1) “the type and complexity 

of the case”; (2) the indigent’s ability to adequately present the case; (3) the 

indigent’s ability to investigate the case adequately; and (4) “whether the 

evidence will consist in large part of conflicting testimony so as to require skill 

in the presentation of evidence and in cross examination.” Id. at 213. We will 

not overturn a district court’s decision regarding appointment of counsel unless 

the appellant shows a “clear abuse of discretion.” Cupit v. Jones, 835 F.2d 82, 

86 (5th Cir. 1987). 

The district court determined that Leachman failed to present 

exceptional circumstances because the case was not complex and because he 

was in a position to adequately communicate and present his case. We agree. 

In light of the clear, concise, and well-researched pleadings Leachman has filed 

and the lack of complexity of his claims, Leachman has not shown exceptional 

circumstances demonstrating an abuse of discretion. See Ulmer, 691 F.2d at 

212. 

IV.

Finally, Leachman challenges the district court’s order requiring him to 

provide a more definite statement. We lack interlocutory appellate jurisdiction 

 

2 Although the Court will soon consider this issue en banc, see Williams v. Catoe, No. 

18-40825 (5th Cir. June 18, 2019) (order granting initial hearing en banc), we apply Robbins

as the current law of the circuit. 

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over this order. It is not a final judgment, see 28 U.S.C. § 1291, an interlocutory 

order subject to immediate appeal, id. § 1292(a), or certified for immediate 

appeal by the district court, id. § 1292(b). See Martin v. Halliburton, 618 F.3d 

476, 481 (5th Cir. 2010). Though the collateral order doctrine allows some 

additional interlocutory appeals, the doctrine extends only to “decisions that 

are conclusive, that resolve important questions separate from the merits, and 

that are effectively unreviewable on appeal from the final judgment in the 

underlying action.” Mohawk Indus., Inc. v. Carpenter, 558 U.S. 100, 106 (2009)

(quoting Swint v. Chambers Cty. Comm’n, 514 U.S. 35, 42 (1995)). That is not 

the case with an order requiring a more definite statement of the plaintiff’s 

claims for relief. 

Leachman asks us to exercise pendant jurisdiction based on the other 

interlocutory orders that are properly before us. To be sure, exercising pendant 

jurisdiction may be “proper in rare and unique circumstances where a final 

appealable order is ‘inextricably intertwined’ with an unappealable order or 

where review of the unappealable order is necessary to ensure meaningful 

review of the appealable order.” Thornton v. Gen. Motors Corp., 136 F.3d 450, 

453 (5th Cir. 1998) (per curiam) (quoting Woods v. Smith, 60 F.3d 1161, 1166 

n. 29 (5th Cir. 1995)). But that is not the case here. A routine order requiring 

a plaintiff to provide additional factual detail is not inextricably intertwined 

with the interlocutory orders before us. 

* * *

The district court’s orders denying Plaintiff-Appellant’s motion for a 

preliminary injunction and motion for appointment of counsel are AFFIRMED. 

Plaintiff-Appellant’s appeal from the district court’s order requiring a more 

definite statement is DISMISSED for want of jurisdiction. 

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